The Interpersonal Adaptiveness of Dispositional Guilt and Shame: A Meta-Analytic Investigation.

Despite decades of empirical research, conclusions regarding the adaptiveness of dispositional guilt and shame are mixed. We use meta-analysis to summarize the empirical literature and clarify these ambiguities. Specifically, we evaluate how guilt and shame are uniquely related to pro-social orientation and, in doing so, highlight the substantial yet under-acknowledged impact of researchers' methodological choices. A series of meta-analyses was conducted investigating the relationship between dispositional guilt (or shame) and pro-social orientation. Two main methodological moderators of interest were tested: test format (scenario vs. checklist) and statistical analysis (semi-partial vs. zero-order correlations). Among studies employing zero-order correlations, dispositional guilt was positively correlated with pro-social orientation (k = 63, Mr = .13, p < .001), whereas dispositional shame was negatively correlated, (k = 47, Mr = -.05, p = .07). Test format was a significant moderator for guilt studies only, with scenario measures producing significantly stronger effects. Semi-partial correlations resulted in significantly stronger effects among guilt and shame studies. Although dispositional guilt and shame are differentially related to pro-social orientation, such relationships depend largely on the methodological choices of the researcher, particularly in the case of guilt. Implications for the study of these traits are discussed.

Accuracy of Judging Affect and Accuracy of Judging Personality: How and When Are They Related?

OBJECTIVES: The present research is concerned with the relation between accuracy in judging targets' affective states and accuracy in judging the same targets' personality traits. In two studies, we test the link between these two types of accuracy with the prediction that accuracy of judging traits and of judging states will be associated when fundamental affective qualities are shared. METHOD: In Study 1, affective states and personality traits of 29 targets were rated by 124 judges whose individual accuracy was scored as the correlation between their ratings and target criterion scores (across targets). In Study 2, a comparable analysis was done using 30 different targets and 330 different judges. RESULTS: Accuracy in judging distressed affect was significantly positively correlated with accuracy in judging Neuroticism in both studies, as well as in a meta-analysis across the two studies. Accuracy in judging positive affect was significantly positively correlated with accuracy in judging Extraversion in one of the two studies, with the meta-analysis across the two studies being significant. CONCLUSIONS: These findings provide preliminary evidence for a new model (State and Trait Accuracy Model) that outlines when concordance in accuracy across traits and states should be expected.

Narcissism and other-derogation in the absence of ego threat.

The relation between narcissism and other-derogation has been examined primarily in the context of ego threat. In three studies, we investigated whether narcissistic individuals derogate others in the absence of ego threat. In Study 1, 79 judges watched four videotaped dyadic interactions and rated the personality of the same four people. In Study 2, 66 judges rated the personality of a friend. In Study 3, 72 judges considered the average Northeastern University student and rated the personality of this hypothetical person. Across the three studies, targets' personality characteristics were described on the 100-item California Adult Q-Sort (CAQ; Block, 2008). Judges' ratings of targets were compared to a CAQ prototype of the optimally adjusted person to assess target-derogation. Judges' narcissism and other-derogation were positively related in Studies 1 and 2. Narcissism positively predicted and self-esteem negatively predicted target-derogation after controlling for each other in Study 3. Narcissistic individuals derogate others more than non-narcissistic individuals regardless of whether ego threat is present or absent.

Narcissism and discrepancy between self and friends' perceptions of personality.

Most research on narcissism and person perception has used strangers as perceivers. However, research has demonstrated that strangers' ratings are influenced by narcissists' stylish appearance (Back, Schmukle, & Egloff, 2010). In the present study, we recruited participants and their close friends, individuals whose close relationship should immunize them to participants' superficial appearance cues. We investigated the relation between narcissism and personality ratings by self and friends. Participants (N = 66; 38 women; Mage = 20.83 years) completed the Narcissistic Personality Inventory (Raskin & Terry, 1988) and described their personality on the 100-item California Adult Q-Sort (CAQ; Block, 2008). Participants' personality was also described on the CAQ by close friends. The "optimally adjusted individual" prototype was used to summarize participant and friend personality ratings (Block, 2008). Participants with high narcissism scores were ascribed higher optimal adjustment by self than by friends. Narcissistic individuals' self-ratings were extremely positive and more favorable than friends' ratings of them.

Hydrocortisone versus vasopressin for the management of adult patients with septic shock refractory to norepinephrine: A multicenter retrospective study.

STUDY OBJECTIVE: Significant practice variation exists when selecting between hydrocortisone and vasopressin as second line agents in patients with septic shock in need of escalating doses of norepinephrine. The goal of this study was to assess differences in clinical outcomes between these two agents. DESIGN: Multicenter, retrospective, observational study. SETTING: Ten Ascension Health hospitals. PATIENTS: Adult patients with presumed septic shock receiving norepinephrine prior to study drug initiation between December 2015 and August 2021. INTERVENTION: Vasopressin (0.03-0.04 units/min) or hydrocortisone (200-300 mg/day). MEASUREMENTS AND MAIN RESULTS: A total of 768 patients were included with a median (interquartile range) SOFA score of 10 (8-13), norepinephrine dose of 0.3 mcg/kg/min (0.1-0.5 mcg/kg/min), and lactate of 3.8 mmol/L (2.4-7.0 mmol/L) at initiation of the study drug. A significant difference in 28-day mortality was noted favoring hydrocortisone as an adjunct to norepinephrine after controlling for potential confounding factors (OR 0.46 [95% CI, 0.32-0.66]); similar results were seen following propensity score matching. Compared to vasopressin, hydrocortisone initiation was also associated with a higher rate of hemodynamic responsiveness (91.9% vs. 68.2%, p < 0.01), improved resolution of shock (68.8% vs. 31.5%, p < 0.01), and reduced recurrence of shock within 72 h (8.7% vs. 20.7%, p < 0.01). CONCLUSIONS: Addition of hydrocortisone to norepinephrine was associated with a lower 28-day mortality in patients with septic shock, compared to the addition of vasopressin.

Factors that influence parental and caregiver acceptance of routine childhood vaccination: Summary of a qualitative evidence synthesis.

We summarise a Cochrane review of qualitative evidence that explored parents' views and practices around routine childhood vaccination, and provide implications for research and practice that are relevant to the South African (SA) context. Many public health interventions to encourage vaccination are informed by an assumption that vaccine hesitancy is due to a lack of knowledge or irrational forms of thinking. The findings from this review suggest that childhood vaccination views and practices are complex social processes that are shaped by multiple factors and carry a variety of meanings. As such, we suggest that biomedical approaches must be supplemented by more nuanced and sociopolitically informed strategies for enhancing and sustaining childhood vaccination practices in SA.

'If you are found taking medicine, you will be called names and considered less of a man': young men's engagement with HIV treatment and care during ulwaluko (traditional initiation and circumcision) in the Eastern Cape Province of South Africa.

This paper explores how HIV-positive abakhwetha (young male initiates) undergoing ulwaluko (traditional Xhosa initiation and circumcision) engage with HIV-related biomedical care and treatment. Health-focused life history narratives (n = 36), semi-structured interviews (n = 32) and analysis of health facility files (n = 41) with adolescent boys and young men (ages 13-24) living with HIV, and semi-structured interviews with traditional and biomedical health practitioners (n = 14) were conducted in 2017 and 2018. This research was part of the Mzantsi Wakho study, a longitudinal, mixed methods study of adolescents living with HIV (n = 1060). Findings demonstrate that ulwaluko rules of not engaging with biomedical care and treatment pose a challenge for initiates who are taking chronic medicine. Fears of inadvertent disclosure of their HIV-positive status collide with the pressure to successfully complete ulwaluko in order to be legitimised as men. In response to this dilemma, they engage a variety of strategies - including taking medicine in secret by hiding them, having a trusted person deliver them discretely, and stopping medicine-taking altogether. The three months following ulwaluko also pose a challenge in accessing biomedical treatment and care. In this time of high surveillance, amakrwala (new men) do not present at health facilities for fear of being thought to have had a botched circumcision or to have contravened 'manhood rules' and left ulwaluko before having healed properly. To get around this, those who continued taking medicine engaged caregiver pick-ups. Beyond suggesting that ulwaluko is a high-risk time for disengagement from biomedical treatment and care, this paper builds on a robust scholarship on the importance of locality and context in gender and health research. It documents the creativity, agency and resilience of initiates and their families as they subvert and re-signify health-related masculine norms.

The meaning of guilt: Reconciling the past to inform the future.

Despite decades of empirical research, a deceptively simple question remains unanswered: Is guilt good? Whereas some researchers assert that routine experiences of guilt (i.e., "trait guilt") are maladaptive and indicative of poor psychological adjustment, others assert trait guilt to be adaptive and indicative of a prosocial disposition. In the current research we outline the theoretical underpinnings of 2 of the most commonly employed measures of trait guilt: unsituated measures (e.g., the Personal Feelings Questionnaire (PFQ; Harder & Lewis, 1987) and situated scenario-based measures (e.g., the Test of Self-Conscious Affect [TOSCA]; Tangney, Wagner, & Gramzow, 1989). We examine the construct validity of both measure types across 3 studies using a variety of traits (self- and informant-reported), states, and behaviors. Results provide overwhelming support for a "2-construct" argument, with PFQ guilt (our unsituated measure of choice) and TOSCA guilt (our situated measure of choice) displaying divergent results across nearly all traits, states, and behaviors measured. While the correlates of PFQ guilt were consistently maladaptive, the correlates of TOSCA guilt were consistently adaptive. Furthermore, only the PFQ predicted daily experiences of negative affect and state guilt. TOSCA guilt was unrelated to negative affective experience in daily life, thereby calling into question its conceptualization as an affective trait. Findings using the TOSCA and PFQ shame scales are also presented. We conclude by presenting a preliminary process model of guilt that may have utility for designing future research studies and developing new guilt questionnaires. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Defining the research agenda to measure and reduce tuberculosis stigmas.

Crucial to finding and treating the 4 million tuberculosis (TB) patients currently missed by national TB programmes, TB stigma is receiving well-deserved and long-delayed attention at the global level. However, the ability to measure and evaluate the success of TB stigma-reduction efforts is limited by the need for additional tools. At a 2016 TB stigma-measurement meeting held in The Hague, The Netherlands, stigma experts discussed and proposed a research agenda around four themes: 1) drivers: what are the main drivers and domains of TB stigma(s)?; 2) consequences: how consequential are TB stigmas and how are negative impacts most felt?; 3) burden: what is the global prevalence and distribution of TB stigma(s) and what explains any variation? 4): intervention: what can be done to reduce the extent and impact of TB stigma(s)? Each theme was further subdivided into research topics to be addressed to move the agenda forward. These include greater clarity on what causes TB stigmas to emerge and thrive, the difficulty of measuring the complexity of stigma, and the improbability of a universal stigma 'cure'. Nevertheless, these challenges should not hinder investments in the measurement and reduction of TB stigma. We believe it is time to focus on how, and not whether, the global community should measure and reduce TB stigma.

Global-to-local policy transfer in the introduction of new molecular tuberculosis diagnostics in South Africa.

SETTING: Lack of innovation in diagnostics has contributed to tuberculosis (TB) remaining a global health challenge. It is critical to understand how new diagnostic technologies are translated into policies and how these are implemented. OBJECTIVE: To examine policy transfer for two rapid molecular diagnostic tests, GenoType(®) MDRTBplus and Xpert(®) MTB/RIF, to understand policy development, uptake and implementation in South Africa. METHODS: A policy transfer analysis framework integrating the key dimensions of policy transfer into one coherent model was used. Two phases of key informant interviews were undertaken with a wide range of stakeholders. RESULTS: Both tests were developed through innovative partnerships and responded to urgent public health needs. GenoType was introduced through a process that was more inclusive than that for Xpert. National policy and planning processes were opaque for both tests. Their implementation, maintenance and expansion suffered from poor communication and coordination, insufficient attention to resource implications, technical challenges and a lack of broader health systems thinking. CONCLUSION: Our analysis identified the risks and benefits of partnerships for technological innovation, the complex intersections between global and national actors and the impact of health systems on policy transfer, and the risks of rescue- and technology-focused thinking in addressing public health challenges.

Do positive illusions foster mental health? An examination of the Taylor and Brown formulation.

The proposition recently offered by S. E. Taylor and J. D. Brown (1988) that positive illusions foster mental health has garnered considerable attention and acceptance. However, the significant theoretical and applied implications of their view for mental health require a critical evaluation of their argument. An examination of the logic and empirical evidence used to relate mental health to three key positive illusions--unrealistically positive views of the self, illusions of control, and unrealistic optimism--failed to substantiate Taylor and Brown's thesis. Further survey of more recent studies on positive illusions and mental health also failed to lend support to the Taylor and Brown generalization. Close consideration of several assumptions underlying the formulation raises further questions regarding their thesis. The present article concludes that it remains unproven that positive illusions foster mental health.

"Judgable" people: personality, behavior, and competing explanations.

"Judgability" discriminates people who are open and knowable from those who are closed and enigmatic. The current study investigated this individual difference characteristic and its personality and behavioral correlates. Subjects (N = 164) were videotaped interacting with a partner of the opposite sex. They completed several personality measures, and each subject was described by 2 friends. Three indices--subject-peer agreement, peer-peer agreement, and peer-behavior agreement--formed a reliable composite index of judgability. The correlates of judgability included extraversion, agreeableness, conscientiousness, emotional stability, and, more generally, psychological adjustment.

Explorations in behavioral consistency: properties of persons, situations, and behaviors.

In a study exploring the cross-situational consistency of behavior, 140 undergraduate Ss were video-taped in each of 3 laboratory settings, and personality descriptions of these Ss were obtained from friends and acquaintances. Analyses focused on the degree to which Ss maintained consistent patterns of behavior across laboratory settings and between these settings and daily life. The following conclusions were reached: (a) Behavior can exhibit impressive consistency at the level of psychological meaning, (b) psychological properties of situations can be detected from their behavioral effects, (c) cross-situational consistency and discriminativeness are independent, and (d) some behaviors are more consistent than others.

Predicting personality and behavior: a boundary on the acquaintanceship effect.

Recent research has shown that interjudge agreement in personality ratings increases with acquaintanceship. The present study sought to replicate and extend this finding by investigating the relation between acquaintanceship and behavioral prediction. A total of 138 undergraduate targets were videotaped while interacting with an opposite-sex partner in 3 situations. The targets also completed 5 personality measures. Results indicated that acquaintances' judgments predicted personality scores much better than did strangers' judgments, but acquaintances' and strangers' judgments did equally well at predicting behavior. Implications for research on the accuracy of personality judgments are discussed.

Friends and strangers: acquaintanceship, agreement, and the accuracy of personality judgment.

We examined the effect of acquaintanceship on interjudge agreement in personality ratings. Approximately 150 undergraduates described their own personalities using the Q-sort. They were also described by two close acquaintances and by two "strangers" who knew them only via a single, spontaneous interaction viewed on videotape. The effect of acquaintanceship was powerful: Judgments by close acquaintances agreed with each other and with subjects' self-judgments much better than did judgments by strangers, even though strangers' judgments agreed with each other and with subjects' self-judgments beyond a chance level. This result implies that agreement among acquaintances' judgments must derive at least partly from experience with and observation of the person who is judged. The same traits that yielded better agreement among acquaintances also yielded better agreement among strangers and tended to be rated higher in subjective visibility, suggesting that people are intuitively knowledgeable about the traits they can judge with more and less agreement.

Overly positive self-evaluations and personality: negative implications for mental health.

The relation between overly positive self-evaluations and psychological adjustment was examined. Three studies, two based on longitudinal data and another on laboratory data, contrasted self-descriptions of personality with observer ratings (trained examiners or friends) to index self-enhancement. In the longitudinal studies, self-enhancement was associated with poor social skills and psychological maladjustment 5 years before and 5 years after the assessment of self-enhancement. In the laboratory study, individuals who exhibited a tendency to self-enhance displayed behaviors, independently judged, that seemed detrimental to positive social interaction. These results indicate there are negative short-term and long-term consequences for individuals who self-enhance and, contrary to some prior formulations, imply that accurate appraisals of self and of the social environment may be essential elements of mental health.

The psychic costs of intense positive affect.

Recent research indicates that happiness, or affective well-being, is related primarily to the frequency, not to the intensity, of positive affect (PA). The question arises as to why intense positive affect (PI) is not a larger contributor to subjective well-being. Whether processes that yield PI also produce intense negative affect was examined. Studies 1 and 2 suggested that cognitive mechanisms that amplify or dampen affect can carry over from positive to negative events. Study 3 demonstrated that, because of judgment mechanisms, an extremely positive event can make other events less positive. Study 4 revealed that naturally occurring intensely positive experiences are often preceded by negative ones. Study 5 suggested that the more persons valence success at a task, the happier they will be if they succeed, but unhappier if they fail. The 5 studies reveal that intense positive experiences may sometimes have costs that counterbalance their desirable nature.

Transforming growth factor beta 1 improves wound healing and random flap survival in normal and irradiated rats.

OBJECTIVES: To evaluate the effect of chronic irradiation on wound healing and random flap survival (FV), and the effect of transforming growth factor beta 1 (TGF-beta 1) in this setting using an animal model. DESIGN: A randomized, controlled study with four groups of rats to study the effect of irradiation 4 months before surgical intervention. The effect of TGF-beta 1 on FV and wound healing also was evaluated in the irradiated and nonirradiated groups. SUBJECTS: Ninety-five rats were available for evaluation. Group 1 (n = 10) was the control; group 2 (n = 28) received TGF-beta 1; group 3 (n = 28) received radiation therapy; and group 4 (n = 29) received radiation therapy and TGF-beta 1. INTERVENTION: The irradiated groups received 15 Gy to their dorsal skin. Four months later all received McFarlane skin flaps. Groups 2 and 4 received topical TGF-beta 1, 4 micrograms, to the bed of the flap; groups 1 and 3 received saline. On postoperative day 7 all rats were evaluated for tensile strength and FV, and histologic staining with hematoxylin-eosin for collagen and TGF-beta 1 was done. The slides were evaluated in a "blinded" fashion. RESULTS: Irradiation decreased tensile strength and FV, but not to a notable degree. Transforming growth factor beta 1 improved tensile strength in the irradiated (P = .04, Student's t test) and nonirradiated groups (P = .05, Student's t test). Transforming growth factor beta 1 also improved FV in all groups, but significantly in the irradiation plus TGF-beta 1 group (P = .001, Student's t test). The TGF-beta 1 group had the most mature collagen present at the wound edge. No qualitative difference was seen in the immunohistochemical staining for the four groups. CONCLUSIONS: Transforming growth factor beta 1 improves wound healing and random FV in radiated and nonirradiated rat skin. Further study is needed to determine the radiation dose necessary to create an "impaired wound-healing model" in rats, and the optimum dose of TGF-beta 1 in this setting.

Time urgency: the construct and its measurement.

Time urgency may be an important construct in industrial and organizational psychology. Preliminary analyses have indicated that time urgency may be multidimensional, and available self-report measures have been criticized on psychometric grounds. The present research addressed the dimensionality of time urgency. Behaviorally anchored rating scales (BARS), in which behavioral statements are substituted for qualitative anchors, were used to construct time urgency measures. The BARS technique produced multidimensional measures of time urgency that possessed adequate reliability and construct validity. The scales were tested on a wide variety of subjects. It is concluded that time urgency is a multidimensional construct. Relationships between the time urgency measures, job satisfaction, and work stress are discussed in light of previous research findings.