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Item A new look at the attribution model: Considerations for the measurement of public mental illness stigma.(APA, 2021) Johnson-Kwochka, Annalee; Minor, Kyle S.; Ashburn-Nardo, Leslie; Wu, Wei; Stull, Laura G.; Salyers, Michelle P.; Psychology, School of ScienceMultiple versions of the Attribution Model and the corresponding Attribution Questionnaire have been used to assess public mental illness stigma. The objective of the current study was to examine (a) the factor structure of the Attribution Questionnaire and (b) relationships between constructs in the Attribution Model. Analyzing a sample of 334 U.S. adults recruited from Amazon Mechanical Turk, the authors employ confirmatory factor analyses to test three proposed factor structures of the Attribution Questionnaire and latent variable path analyses to reexamine relationships between variables in the stigmatization of people who experience mental illness. Confirmatory factor analyses of three previously examined versions of the Attribution Model revealed that the model proposed by the initial version of the Attribution Questionnaire had the best fit with the data comparative fit index (CFI = 0.92, root-mean-square error of approximation [RMSEA] = 0.07, standardized root-mean-square residual [SRMR] = 0.05). Subsequent path analyses among contructs in the model revealed acceptable model fit (CFI = 0.92, RMSEA = 0.07, SRMR = 0.06) and individual paths largely supported the hypotheses suggested by the Attribution Model. Analyses supported the original version of the Attribution Model and questionnaire with slight modifications, demonstrating that attributions of dangerousness and personal responsibility are associated with the endorsement of coercive treatment, and that attributions about dangerousness are associated with a lower desire to help. These findings suggest modifications in the current measurement of public mental illness stigma.Item Self-efficacy and HPV Vaccine Attitudes Mediate the Relationship Between Social Norms and Intentions to Receive the HPV Vaccine Among College Students(SpringerLink, 2020-12) Stout, Madison E.; Christy, Sharon M.; Winger, Joseph G.; Vadaparampil, Susan T.; Mosher, Catherine E.; Psychology, School of ScienceHuman papillomavirus (HPV) has been linked to genital warts and multiple cancers affecting both men and women. Despite college students’ high risk for HPV, their vaccination rates remain suboptimal. The current observational study examined the relationship between social norms and human papillomavirus (HPV) vaccine intentions and potential mechanisms underlying this relationship among undergraduates. Participants (N=190; 66.8% female) completed a survey assessing HPV vaccine social norms, attitudes, self-efficacy, and intentions. Three mediation analyses were conducted to examine whether self-efficacy and attitudes mediated the relationship between social norms (i.e., parents, friends, doctor) and intentions, controlling for demographic and health care covariates. Social norms were indirectly related to intentions through self-efficacy and attitudes in multiple models (ps<.05). Specifically, perceiving greater support for HPV vaccination from one’s friends, parents, and doctor was related to greater HPV vaccine self-efficacy, which, in turn, was related to increased vaccine intentions. In addition, perceiving greater parental and doctor support for HPV vaccination was related to more favorable attitudes towards the vaccine, which, in turn, were related to increased vaccine intentions. Findings suggest potential targets for future interventions to promote HPV vaccination among young adults.Item Relations of Mindfulness and Illness Acceptance With Psychosocial Functioning in Patients With Metastatic Breast Cancer and Caregivers(Oncology Nursing Society, 2020-11-01) Chinh, Kelly; Secinti, Ekin; Johns, Shelly A.; Hirsh, Adam T.; Miller, Kathy D.; Schneider, Bryan; Storniolo, Anna Maria; Mina, Lida; Newton, Erin V.; Champion, Victoria L.; Mosher, Catherine E.; Psychology, School of ScienceObjectives: To examine relationships in mindfulness and illness acceptance and psychosocial functioning in patients with metastatic breast cancer and their family caregivers. Sample & setting: 33 dyads from an academic cancer center in the United States. Methods & variables: Participants completed questionnaires on mindfulness, illness acceptance, relationship quality, anxiety, and depressive symptoms. Dyadic, cross-sectional data were analyzed using actor-partner interdependence models. Results: Greater nonjudging, acting with awareness, and illness acceptance among caregivers were associated with patients' and caregivers' perceptions of better relationship quality. Higher levels of these processes were associated with reduced anxiety and depressive symptoms in patients and caregivers. Implications for nursing: Aspects of mindfulness and illness acceptance in dyads confer benefits that are primarily intrapersonal in nature. Nurses may consider introducing mindfulness and acceptance-based interventions to patients and caregivers with adjustment difficulties.Item Symptom experiences in post-treatment cancer survivors: Associations with acceptance and commitment therapy constructs(SpringerLink, 2020-11-02) Lewson, Ashley B.; Johns, Shelley A.; Krueger, Ellen; Chinh, Kelly; Kidwell, Kelley M.; Mosher, Catherine E.; Psychology, School of SciencePurpose: Acceptance and commitment therapy (ACT) has improved symptom and quality-of-life outcomes in pilot research with post-treatment cancer survivors. To further test the ACT model, the present study examined relationships between ACT constructs and subgroups of post-treatment survivors based on the severity of common symptoms. Methods: Survivors who had completed primary treatment for stage I or II cancer (N=203) participated in this one-time survey. Latent class analysis (LCA) was used to identify subgroups of survivors based on the severity of fatigue, sleep disturbance, pain, anxiety, and depressive symptoms. Multinomial logistic regressions employing Vermunt’s 3-step approach were used to examine ACT constructs (e.g., mindfulness, acceptance, values progress) as correlates of survivor subgroups based on symptoms. Results: LCA showed three survivor classes: (1) mild to moderate levels of all symptoms except for normal pain intensity, (2) mild anxiety, moderate fatigue, and normal levels of all other symptoms, and (3) normal levels of all symptoms. Lower mindfulness, acceptance, and values progress and higher cognitive fusion, psychological inflexibility, and values obstruction were associated with a greater likelihood of being in class 1 or 2 than class 3. Conclusion: Findings are consistent with the ACT model. Survivors with greater symptom burden reported greater withdrawal from personally meaningful activities and less acceptance of their cancer diagnosis and internal experiences (e.g., thoughts, feelings, symptoms). Findings provide strong justification for further testing of ACT to reduce symptom-related suffering in cancer survivors.Item Effects of Mindfulness-Based Interventions on Fatigue in Cancer Survivors: A Systematic Review and Meta-Analysis of Randomized Controlled Trials(Elsevier, 2021-04) Johns, Shelley A.; Tarver, Will L.; Secinti, Ekin; Mosher, Catherine E.; Stutz, Patrick V.; Carnahan, Jennifer L.; Talib, Tasneem L.; Shanahan, Mackenzie L.; Faidley, Micah T.; Kidwell, Kelley M.; Rand, Kevin L.; Psychology, School of ScienceThis systematic review and meta-analysis was designed to determine the efficacy of mindfulness-based interventions (MBIs) in improving fatigue-related outcomes in adult cancer survivors. Randomized controlled trials (RCTs) were identified from PubMed, MEDLINE, PsycINFO, CINAHL, Web of Science, and EMBASE databases and reference lists of included studies. Separate random-effects meta-analyses were conducted for fatigue and vitality/vigor. Twenty-three studies reporting on 21 RCTs (N=2,239) met inclusion criteria. MBIs significantly reduced fatigue compared to controls at post-intervention (g=0.60, 95% CI [0.36, 0.83]) and first follow-up (g=0.42, 95% CI [0.20, 0.64]). Likewise, MBIs significantly improved vitality/vigor at post-intervention (g=0.39, 95% CI [0.25, 0.52]) and first follow-up (g=0.35, 95% CI [0.03, 0.67]). The evidence grade was low due to risk of bias, substantial heterogeneity, and publication bias among studies. MBIs show promise in improving fatigue and vitality/vigor in cancer survivors. More rigorous trials are needed to address current gaps in the evidence base.Item Comparative responsiveness and minimally important difference of Fatigue Symptom Inventory (FSI) scales and the FSI-3 in trials with cancer survivors(Springer, 2022-07) Mosher, Catherine E.; Secinti, Ekin; Johns, Shelley A.; Kroenke, Kurt; Rogers, Laura O.; Psychology, School of ScienceBackground Fatigue is a highly prevalent and disabling symptom in cancer survivors. Although many measures have been developed to assess survivors’ fatigue, their ability to accurately capture change following intervention has rarely been assessed in post-treatment survivors. Ultra-brief fatigue measures are preferable in clinical practice but have limited evidence supporting their use with cancer survivors. We examined the psychometric properties of four Fatigue Symptom Inventory (FSI) measures, including the new FSI-3, in cancer survivors. Examined properties included responsiveness to change and minimally important differences (MIDs). Methods We analyzed data from three randomized controlled trials with post-treatment cancer survivors (N = 328). Responsiveness to change was evaluated by comparing standardized response means for survivors who reported their fatigue as being better, the same, or worse at 2–3 months. Responsiveness to intervention was assessed via effect sizes, and MIDs were estimated by using several methods. We also computed area under the curve (AUC) values to assess FSI measures’ discriminative accuracy compared to an established cut-point. Results All FSI measures differentiated survivors who reported improvement at 2–3 months from those with stable fatigue, but did not uniformly differentiate worsening fatigue from stable fatigue. Measures showed similar levels of responsiveness to intervention, and MIDs ranged from 0.29 to 2.20 across FSI measures. AUC analyses supported the measures’ ability to detect significant fatigue. Conclusions Four FSI scales show similar responsiveness to change, and estimated MIDs can inform assessment of meaningful change in fatigue. The FSI-3 shows promise as an ultra-brief fatigue measure for survivors.Item A cognitive model of diminished expression in schizophrenia: The interface of metacognition, cognitive symptoms and language disturbances(Elsevier, 2020-12) García-Mieres, Helena; Lundin, Nancy B.; Minor, Kyle S.; Dimaggio, Giancarlo; Popolo, Raffaele; Cheli, Simone; Lysaker, Paul H.; Psychology, School of ScienceThe resistance of negative symptoms to pharmacologic treatment has spurred interest in understanding the psychological factors that contribute to their formation and persistence. However, little is understood about the psychological processes that reinforce and sustain the negative symptoms domain of diminished expression. Prior research has shown that higher levels of diminished expression relate to deficits in metacognitive capacity. We propose a more complex model in which diminished expression occurs when impairments in metacognitive self-reflectivity, alterations in higher-order language structure, and cognitive symptoms interact and thus interfere with persons' ability to understand and express emotions in ways others can recognize. Individuals with schizophrenia-spectrum disorders (N = 201) provided personal narratives detailing their life story and reflections about their mental illness. Self-reflectivity was measured with the Metacognition Assessment Scale-Abbreviated, and situation models were extracted from participants' personal narratives via Coh-Metrix 3.0, an automated program that calculates language indices. Diminished expression and cognitive symptoms were measured with the Positive and Negative Syndrome Scale. Structural equation models (SEM) examined whether self-reflectivity mediated the impact of cognitive symptoms and situation models on diminished expression. Results of the SEM revealed that self-reflectivity partially mediated the impact of situation models on diminished expression (β = -.073, p = .008, ±95% CI [-0.126, -0.019]). and fully mediated the influence of cognitive symptoms in diminished expression (β = 0.099, p = .001, ±95% CI [0.038, 0.160]). In conclusion, results suggest that self-reflectivity, linguistic cohesion, and cognitive symptoms may be useful targets for intervention in efforts to treat diminished expression in psychosis.Item Power and sex-based harassment among LGBQs(2022-01-01) Dinh, Tuyen K.; Stockdale, Margaret S.Abstract Much of the sex-based harassment (SBH) literature to date focuses on the experiences of heterosexual White women (Brassel et al., 2020). Hence, researchers attempting to understand the motivation of perpetrators of such incidences are often from heterosexual samples, where men harass women to maintain or gain power (e.g., Berdahl, 2007). This leads to the absence of perspectives from historically oppressed groups, such as lesbian, gay, bisexual, or queer (LGBQ) identifying persons. In this paper, we seek to further understand whether power, which is often conceptualized as a key antecedent to sex-based harassment, is also a motivating factor among LGBQ persons. The purpose of this study was to examine two forms of power (egocentric vs responsibility) on increasing sex-based harassment tendencies through feeling states evoked by their respective power types. Results indicate that power effects sex-based harassment tendencies in similar ways as found in heterosexual samples. Specifically, egocentric and responsibility focused power increased SBH through sexy-powerful feelings, moderated by trait dominance, and responsibility-focused power increased SBH through communal feelings. These data provide support for generalizing a theory of SBH intentions to LGBQ populations and we provide recommendations for HR managers.Item Psychogenic Nonepileptic Seizures in Children and Adolescents(Springer, 2021-03) Patel, Hema; Blake, Hilary; Dunn, David; Psychology, School of ScienceThough psychogenic non-epileptic seizures (PNES) are seen commonly during evaluation of children and adolescents with epilepsy, the literature regarding developmental changes in PNES is limited. Evidence Acquisition: Literature search was conducted in PubMed. Key search terms included: Pseudoseizure* OR PNES OR [(non-epileptic or nonepileptic or psychogenic or non-epileptic attack disorder) AND (seizure*)], resulting in 3,236 articles. Filters included human, ages 1-18 years, English language and last 15 years (2004-2019), resulting in 533 articles. We reviewed 33 articles, which included 19 articles that involved children (1-18 years), with 10 or more children with PNES in their study group. 21 articles obtained in cross references that were outside the filter setting (including time frame and age range) were also reviewed, for a total of 54 articles. Results: Majority of the studies were retrospective. We detail clinical features, predisposing factors and appropriate workup for children and adolescents with possible PNES. There is no consensus regarding frequency of psychiatric comorbidities in children with PNES. No controlled trials of treatment of PNES in children are available, but cognitive behavioral therapy is the consensus for adult PNES. Outcome appears to be better in children with PNES. Conclusions: There is a need for be long-term prospective studies to document various clinical features and outcome of pediatric and adolescent PNES, and also the comorbid conditions.Item Examination of the SUPPS-P Impulsive Behavior Scale among Male and Female Youth: Psychometrics and Invariance(MDPI, 2021-04-07) Pechorro, Pedro; Revilla, Rebecca; Palma, Victor H.; Nunes, Cristina; Martins, Cátia; Cyders, Melissa A.; Psychology, School of ScienceThe UPPS-P Impulsive Behavior Scale is one of the most used and easily administered self-report measures of impulsive traits. The main objective of this study was to examine the psychometric properties of the shorter SUPPS-P scale among a school sample of 470 youth (Mage = 15.89 years, SD = 1.00) from Portugal, subdivided into males (n = 257, Mage = 15.97 years, SD = 0.98) and females (n = 213, Mage = 15.79 years, SD = 1.03). Confirmatory factor analysis results revealed that the latent five-factor structure (i.e., Negative urgency, Lack of perseverance, Lack of premeditation, Sensation seeking, and Positive urgency) obtained adequate fit and strong measurement invariance demonstrated across sex. The SUPPS-P scale also demonstrated satisfactory psychometric properties in terms of internal consistency, discriminant and convergent (e.g., with measures of youth delinquency, aggression) validities, and criterion-related validity (e.g., with crime seriousness). Findings support the use of the SUPPS-P scale in youth. Given the importance of adolescence as a critical period characterized by increases in impulsive behaviors, having a short, valid, reliable, and easily administered assessment of impulsive tendencies is important and clinically impactful.