Confidence in beliefs about pain predicts expectancy effects on pain perception and anticipatory processing in right anterior insula.

Psychological factors play a major role in exacerbating chronic pain. Effective self-management of pain is often hindered by inaccurate beliefs about the nature of pain which lead to a high degree of emotional reactivity. Probabilistic models of perception state that greater confidence (certainty) in beliefs increases their influence on perception and behavior. In this study, we treat confidence as a metacognitive process dissociable from the content of belief. We hypothesized that confidence is associated with anticipatory activation of areas of the pain matrix involved with top-down modulation of pain. Healthy volunteers rated their beliefs about the emotional distress that experimental pain would cause, and separately rated their level of confidence in this belief. Confidence predicted the influence of anticipation cues on experienced pain. We measured brain activity during anticipation of pain using high-density EEG and used electromagnetic tomography to determine neural substrates of this effect. Confidence correlated with activity in right anterior insula, posterior midcingulate and inferior parietal cortices during the anticipation of pain. Activity in the right anterior insula predicted a greater influence of anticipation cues on pain perception, whereas activity in right inferior parietal cortex predicted a decreased influence of anticipatory cues. The results support probabilistic models of pain perception and suggest that confidence in beliefs is an important determinant of expectancy effects on pain perception.

Anxiety reduction through detachment: subjective, physiological, and neural effects.

The ability to volitionally regulate emotions helps to adapt behavior to changing environmental demands and can alleviate subjective distress. We show that a cognitive strategy of detachment attenuates subjective and physiological measures of anticipatory anxiety for pain and reduces reactivity to receipt of pain itself. Using functional magnetic resonance imaging, we locate the potential site and source of this modulation of anticipatory anxiety in the medial prefrontal/anterior cingulate and anterolateral prefrontal cortex, respectively.

共情、共情唤醒机制及共情结果的关系

Empathy was defined as affective experience isomorphic to another person’s affective experience elicited by the person’s affective state in this research. By constructing questionnaires and situational measurement approaches, the relationship among empathy, perspective-taking, imagination, empathic concern, distress, and interconnectedness and helping was analyzed. Perspective-taking and imagination were regarded as arousal mechanisms of empathy. Empathic concern and distress were reactive outcomes of empathy. Interpersonal outcomes of empathy were discussed in this research were empathic interconnectedness and helping. The results showed that perspective-taking had significant positive influence on empathic concern. Empathy partly mediated the effects of perspective-taking on empathic concern. Influence of imagination on empathic distress was partly mediated by empathy also. Perspective-taking had significant negative influence on empathic distress. Empathy had direct effects on its reactive outcomes, and indirect effects on its interpersonal outcomes mediated totally by empathic concern. Classification analysis according to the relationship among empathy, its arousal mechanisms, and reactive outcomes of empathy showed that disposition of empathic reactivity could be divided into 4 styles: general high empathy (22.5%), general low empathy (25.7%), empathic concern (24.4%) and empathic distress (27.3%). 4 styles were different in interpersonal acuity and mental health. It was suggested that adaptive function of 4 styles was different. And the styles of disposition of empathic reactivity significantly predicted situational empathy and its intrapersonal and interpersonal outcomes.

In pursuit of an identity: A qualitative exploration of retirement from women's artistic gymnastics

David Lavallee, Hannah K. Robinson, In pursuit of an identity: A qualitative exploration of retirement from women's artistic gymnastics, Psychology of Sport and ExerciseVolume 8, Issue 1, , January 2007, Pages 119-141. RAE2008

Rambo's Interdisciplinary Approach to Religious Conversion: The Case of St. Augustine

This dissertation illustrates the merits of an interdisciplinary approach to religious conversion by employing Lewis Rambo’s systemic stage model to illumine the process of St. Augustine’s conversion. Previous studies of Augustine’s conversion have commonly explored his narrative of transformation from the perspective of one specific discipline, such as theology, history, or psychology. In doing so, they have necessarily restricted attention to a limited set of questions and problems. By bringing these disciplines into a structured, critical conversation, this study demonstrates how formulating and responding to the interplay among personal, social, cultural, and religious dimensions of Augustine’s conversion process may eventuate in the consideration of issues previously unarticulated and thus unaddressed. Rambo (1993) formulates a model of religious change that consists of what he calls context, crisis, quest, encounter, interaction, commitment, and consequences. Change is explained by drawing upon the research and scholarship of psychologists, sociologists, anthropologists, and religionists, in conjunction with the contributions of theologians. This study unfolds in the following chapters: I. Introduction; II. Literature review of scholarship about conversion, with emphasis on explication of Rambo’s model; III. A description of the case of Augustine, drawn from a close reading of the Confessions; IV. Literature review of scholarship about Augustine’s conversion; V. Interdisciplinary interpretation of Augustine’s conversion; and VI. Implications for scholars of conversion, and for pastoral caregivers, as well as recommendations for future research. This dissertation demonstrates how Augustine’s conversion experience was deeply influenced by 1) psychological distress and crisis; 2) the quest to know himself and the divine; 3) interactions with significant others; 4) participation in Christian communities; 5) philosophical and cultural changes; and 6) the encounter with the divine. As such, this study reveals the value of interpreting Augustine’s conversion as an evolving process constituted in multiple factors that can be differentiated from one another, yet clearly interact with one another. It examines the implications of constructing an interdisciplinary approach to Augustine’s conversion narrative for both the academy and the Christian community, and recommends the use of Rambo’s model in studies of other cases of religious change.

Example-Based Image Restoration via Boosted Classifiers

We propose a novel image registration framework which uses classifiers trained from examples of aligned images to achieve registration. Our approach is designed to register images of medical data where the physical condition of the patient has changed significantly and image intensities are drastically different. We use two boosted classifiers for each degree of freedom of image transformation. These two classifiers can both identify when two images are correctly aligned and provide an efficient means of moving towards correct registration for misaligned images. The classifiers capture local alignment information using multi-pixel comparisons and can therefore achieve correct alignments where approaches like correlation and mutual-information which rely on only pixel-to-pixel comparisons fail. We test our approach using images from CT scans acquired in a study of acute respiratory distress syndrome. We show significant increase in registration accuracy in comparison to an approach using mutual information.

Moral shielding: A grounded theory of integrity maintenance in multidisciplinary teams

Using a classic grounded theory methodology (CGT), this study explores the phenomenon of moral shielding within mental health multidisciplinary teams (MDTS). The study was located within three catchment areas engaged in acute mental health service practice. The main concern identified was the maintenance of a sense of personal integrity during situational binds. Through theoretical sampling thirty two practitioners, including; doctors, nurses, social workers, occupational therapists, counsellors and psychologists, where interviewed face to face. In addition, emergent concepts were identified through observation of MDTs in clinical and research practice. Following a classic grounded theory methodology, data collection and analysis occurred simultaneously. A constant comparative approach was adopted and resulted in the immergence of three sub- core categories; moral abdication, moral hinting and pseudo-compliance. Moral abdication seeks to re-position within an event in order to avoid or deflect the initial obligation to act, it is a strategy used to remove or reduce moral ownership. Moral gauging represents the monitoring of an event with the goal of judging the congruence of personal principles and commitments with that of other practitioners. This strategy is enacted in a bid to seek allies for the support of a given moral position. Pseudo-compliance represents behaviour that hides desired principles and commitments in order to shield them from challenge. This strategy portrays agreement with the dominant position within the MDT, whilst holding a contrary position. It seeks to preserve a reservoir of emotional energy required to maintain a sense of personal integrity. Practitioners who were successful in enacting moral shielding were found to not experience significant emotional distress associated with the phenomenon of moral distress; suggesting that these practitioners had found mechanisms to manage situational binds that threatened their sense of personal integrity.

The effect of positive psychological interventions on psychological and physical well-being during pregnancy

Prenatal well-being can have significant effects on the mother and developing foetus. Positive psychological interventions, including gratitude and mindfulness, consistently demonstrate benefits for well-being in diverse populations. No research has been conducted on gratitude during pregnancy; the few studies of prenatal mindfulness interventions have demonstrated well-being benefits. The current study examined the effects of gratitude and mindfulness interventions on prenatal maternal well-being, cortisol and birth outcomes. Five studies were conducted. Study 1 was a systematic review of mindfulness intervention effects on cortisol; this highlighted potential benefits of mindfulness but the need for rigorous protocols in future research. In Study 2 a gratitude and a mindfulness intervention were developed and evaluated; findings indicate usefulness of two 3 week interventions. Study 3 examined the effects of these interventions in a randomised controlled trial (RCT) of non-pregnant women, before examining a pregnant group. No significant intervention effects were found in this study, potentially due to insufficient power and poor protocol adherence. Changes in expected directions were observed for most outcomes and the potential utility of a combined gratitude and mindfulness intervention was noted. In Study 4 a gratitude during pregnancy (GDP) scale was developed and the reliability of an existing mindfulness measure (MAAS) was examined in a pregnant group. Both scales were found to be suitable and reliable measures in pregnancy. Study 5 incorporated the findings of the previous four studies to examine of the effect of a combined mindfulness and gratitude intervention with a group of pregnant women. Forty-six participants took part in a 5-week RCT that examined intervention effects on prenatal gratitude, mindfulness, happiness, satisfaction with life, social support, prenatal stress, depression and sleep. Findings indicated that the intervention improved sleep quality and that effects for prenatal distress were approaching significance. Issues of attrition and non-compliance to study protocols were problematic and are discussed. In summary, the current thesis highlights the need for robust measurement, and intervention and cortisol sampling protocols in future research, particularly with pregnant groups. Findings also demonstrate tentative benefits of a gratitude and mindfulness intervention during pregnancy.

A qualitative analysis of parental coping with an early diagnosis of hearing loss in Ireland

The recent implementation of Universal Neonatal Hearing Screening (UNHS) in all 19 maternity hospitals across Ireland has precipitated early identification of paediatric hearing loss in an Irish context. This qualitative, grounded theory study centres on the issue of parental coping as families receive and respond to (what is typically) an unexpected diagnosis of hearing loss in their newborn baby. Parental wellbeing is of particular concern as the diagnosis occurs in the context of recovery from birth and at a time when the parent-child relationship is being established. As the vast majority of children with a hearing loss are born into hearing families with no prior history of deafness, parents generally have had little exposure to childhood hearing loss and often experience acute emotional vulnerability as they respond to the diagnosis. The researcher conducted in-depth interviews primarily with parents (and to a lesser extent with professionals), as well as a follow-up postal questionnaire for parents. Through a grounded theory analysis of data, the researcher subsequently fashioned a four-stage model depicting the parental journey of receiving and coping with a diagnosis. The four stages (entitled Anticipating, Confirming, Adjusting and Normalising) are differentiated by the chronology of service intervention and defined by the overarching parental experience. Far from representing a homogenous trajectory, this four-stage model is multifaceted and captures a wide diversity of parental experiences ranging from acute distress to resilient hopefulness

Two versions of life: emotionally negative and positive life events have different roles in the organization of life story and identity.

Over 2,000 adults in their sixties completed the Centrality of Event Scale (CES) for the traumatic or negative event that now troubled them the most and for their most positive life event, as well as measures of current PTSD symptoms, depression, well-being, and personality. Consistent with the notion of a positivity bias in old age, the positive events were judged to be markedly more central to life story and identity than were the negative events. The centrality of positive events was unrelated to measures of PTSD symptoms and emotional distress, whereas the centrality of the negative event showed clear positive correlations with these measures. The centrality of the positive events increased with increasing time since the events, whereas the centrality of the negative events decreased. The life distribution of the positive events showed a marked peak in young adulthood whereas the life distribution for the negative events peaked at the participants' present age. The positive events were mostly events from the cultural life script-that is, culturally shared representations of the timing of major transitional events. Overall, our findings show that positive and negative autobiographical events relate markedly differently to life story and identity. Positive events become central to life story and identity primarily through their correspondence with cultural norms. Negative events become central through mechanisms associated with emotional distress.

Autobiographical Memories for Very Negative Events: The Effects of Thinking about and Rating Memories.

In three related experiments, 250 participants rated properties of their autobiographical memory of a very negative event before and after writing about either their deepest thoughts and emotions of the event or a control topic. Levels of emotional intensity of the event, distress associated with the event, intrusive symptoms, and other phenomenological memory properties decreased over the course of the experiment, but did not differ by writing condition. We argue that the act of answering our extensive questions about a very negative event led to the decrease, thereby masking the effects of expressive writing. To show that the changes could not be explained by the mere passage of time, we replicated our findings in a fourth experiment in which all 208 participants nominated a very negative event, but only half the participants rated properties of their memory in the first session. Implications for reducing the effects of negative autobiographical memories are discussed.

Poverty and Place in the Context of the American South

In the United States, poverty has been historically higher and disproportionately concentrated in the American South. Despite this fact, much of the conventional poverty literature in the United States has focused on urban poverty in cities, particularly in the Northeast and Midwest. Relatively less American poverty research has focused on the enduring economic distress in the South, which Wimberley (2008:899) calls “a neglected regional crisis of historic and contemporary urgency.” Accordingly, this dissertation contributes to the inequality literature by focusing much needed attention on poverty in the South.

Each empirical chapter focuses on a different aspect of poverty in the South. Chapter 2 examines why poverty is higher in the South relative to the Non-South. Chapter 3 focuses on poverty predictors within the South and whether there are differences in the sub-regions of the Deep South and Peripheral South. These two chapters compare the roles of family demography, economic structure, racial/ethnic composition and heterogeneity, and power resources in shaping poverty. Chapter 4 examines whether poverty in the South has been shaped by historical racial regimes.

The Luxembourg Income Study (LIS) United States datasets (2000, 2004, 2007, 2010, and 2013) (derived from the U.S. Census Current Population Survey (CPS) Annual Social and Economic Supplement) provide all the individual-level data for this study. The LIS sample of 745,135 individuals is nested in rich economic, political, and racial state-level data compiled from multiple sources (e.g. U.S. Census Bureau, U.S. Department of Agriculture, University of Kentucky Center for Poverty Research, etc.). Analyses involve a combination of techniques including linear probability regression models to predict poverty and binary decomposition of poverty differences.

Chapter 2 results suggest that power resources, followed by economic structure, are most important in explaining the higher poverty in the South. This underscores the salience of political and economic contexts in shaping poverty across place. Chapter 3 results indicate that individual-level economic factors are the largest predictors of poverty within the South, and even more so in the Deep South. Moreover, divergent results between the South, Deep South, and Peripheral South illustrate how the impact of poverty predictors can vary in different contexts. Chapter 4 results show significant bivariate associations between historical race regimes and poverty among Southern states, although regression models fail to yield significant effects. Conversely, historical race regimes do have a small, but significant effect in explaining the Black-White poverty gap. Results also suggest that employment and education are key to understanding poverty among Blacks and the Black-White poverty gap. Collectively, these chapters underscore why place is so important for understanding poverty and inequality. They also illustrate the salience of micro and macro characteristics of place for helping create, maintain, and reproduce systems of inequality across place.

SCHUBERT’S WINTERREISE AND THE PIANO TRIO IN Eb; TWO REMARKABLE WORKS FROM ONE REMARKABLE YEAR – 1827: A RECORDING PROJECT

During Franz Schubert’s penultimate year of 1827, he produced two profoundly important and mature works that are the focus of this recording project. The works are, in chronological order: • Winterreise (cycle of 24 songs on the poetry of Wilhelm Müller, 1794-1827) • Piano Trio in Eb Major, Op. 100, D. 929 A unique feature of the project is to present Winterreise in two poetic orders: as traditionally performed and published by Schubert, and in the final ordering published by the poet. The program notes accompanying the dissertation’s three compact discs have extensive information as well as comparative tables of Müller’s and Schubert’s final ordering of the cycle. There are significant differences in ordering, and ultimately the listener will determine which is more dramatically satisfying. Dark melancholy is the central emotion in Winterreise, which Schubert composed at various times throughout 1827 in a mood of corresponding gloom and distress. By contrast, the summer and fall of that year produced, in quick succession, the two glowing and remarkable Piano Trios in Bb and Eb, the second of which is included on these compact discs. The contrast between the trios and Winterreise follows the outward circumstances of Schubert’s life and health, a pattern of sorrow and later consolation and elation. The sound recordings for this dissertation recording project are available on three compact discs that can be found in the Digital Repository at the University of Maryland (DRUM). Winterreise was recorded in August 2009, at the University of Baltimore recital hall in Baltimore, Maryland with University of Maryland Professor François Loup. The trio, recorded in live performance in Baltimore in the spring of 2010, features two members of the Baltimore Symphony Orchestra: Qing Li, B.S.O. principal second violin, and Bo Li, B.S.O. section cellist.

Improving mental health among people living with HIV: a review of intervention trials in low- and middle-income countries.

People living with HIV (PLWH) experience greater psychological distress than the general population. Evidence from high-incomes countries suggests that psychological interventions for PLWH can improve mental health symptoms, quality of life, and HIV care engagement. However, little is known about the effectiveness of mental health interventions for PLWH in low and middle-income countries (LMICs), where the large majority of PLWH reside. This systematized review aims to synthesize findings from mental health intervention trials with PLWH in LMICs to inform the delivery of mental health services in these settings. A systematic search strategy was undertaken to identify peer-reviewed published papers of intervention trials addressing negative psychological states or disorders (e.g., depression, anxiety) among PLWH in LMIC settings. Search results were assessed against pre-established inclusion and exclusion criteria. Data from papers meeting criteria were extracted for synthesis. Twenty-six papers, published between 2000 and 2014, describing 22 unique interventions were identified. Trials were implemented in sub-Saharan Africa (n=13), Asia (n=7), and the Middle East (n=2), and addressed mental health using a variety of approaches, including cognitive-behavioral (n=18), family-level (n=2), and pharmacological (n=2) treatments. Four randomized controlled trials reported significant intervention effects in mental health outcomes, and eleven preliminary studies demonstrated promising findings. Among the limited mental health intervention trials with PLWH in LMICs, few demonstrated efficacy. Mental health interventions for PLWH in LMICs must be further developed and adapted for resource-limited settings to improve effectiveness.

Mental Health and Substance Use Among Patients in a North Carolina HIV Clinic.

BACKGROUND: The HIV/AIDS epidemic is a significant public health concern in North Carolina, and previous research has pointed to elevated mental health distress and substance use among HIV-infected populations, which may impact patients' adherence to medications. The aims of this study were to describe the prevalence of mental health and substance use issues among patients of a North Carolina HIV clinic, to examine differences by demographic characteristics, and to examine factors associated with suboptimal adherence to HIV medications. METHODS: This study was a secondary analysis of clinical data routinely collected through a health behavior questionnaire at a large HIV clinic in North Carolina. We analyzed data collected from February 2011 to August 2012. RESULTS: The sample included 1,398 patients. Overall, 12.2% of patients endorsed current symptomology indicative of moderate or severe levels of depression, and 38.6% reported receiving a psychiatric diagnosis at some point in their life. Additionally, 19.1% had indications of current problematic drinking, and 8.2% reported problematic drug use. Nearly one-quarter (22.1%) reported suboptimal adherence to HIV medications. Factors associated with poor adherence included racial/ethnic minority, age less than 35 years, and indications of moderate or severe depression. LIMITATIONS: The questionnaire was not completed systematically in the clinic, which may limit generalizability, and self-reported measures may have introduced social desirability bias. CONCLUSION: Patients were willing to disclose mental health distress, substance use, and suboptimal medication adherence to providers, which highlights the importance of routinely assessing these behaviors during clinic visits. Our findings suggest that treating depression may be an effective strategy to improve adherence to HIV medications.