Mind the Gap? : An Intensive Longitudinal Study of Between-Person and Within-Person Intention-Behavior Relations

Acknowledgments This work was supported by the University of Konstanz, Germany. The first author was supported by a fellowship of the Swiss National Science Foundation (Fellowship P2ZHP1_155103).Peer reviewedPostprin

Understanding Between-Person Interventions With Time-Intensive Longitudinal Outcome Data : Longitudinal Mediation Analyses

Acknowledgments The physical activity trial (Example 2) was funded by the Swiss National Science Foundation awarded to U.S. (PP00P1_133632/1). J.I. (P2ZHP1_155103) and C.B. (P2BEP1_158975) were supported by fellowships of the Swiss National Science Foundation. The authors thank Melanie Amrein, Pamela Rackow, and involved students for their contributions to the data collection in the eating behavior trial (Example 1). We also thank Niall Bolger for valuable discussions on this topic, and the New York University Couples Lab for helpful feedback on an earlier version of this manuscript.Peer reviewedPublisher PD

Risk factors for homelessness among women with schizophrenia

A study of risk factors for homelessness among the severely mentally ill was extended to include women, and a case-control study of 100 indigent women with schizophrenia meeting criteria for literal homelessness and 100 such women with no history of homelessness was conducted. Subjects were recruited from shelters, clinics, and inpatient psychiatric programs in New York City. Clinical interviewers used standardized research instruments to probe three domains of risk factors: severity of mental illness, family background, and prior mental health service use. Findings adjusted for ethnicity revealed that homeless women had higher rates of a concurrent diagnosis of alcohol abuse, drug abuse, and antisocial personality disorder. Homeless women also had less adequate family support

Initial elevation bias in subjective reports

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The role of gender constancy in early gender development.

Kohlberg's (1966) hypothesis that the attainment of gender constancy motivates children to attend to gender norms was reevaluated by examining these links in relation to age. Ninety-four 3-to 7-year-old children were interviewed to assess whether and how constancy mediates age-related changes in gender-related beliefs. As expected, results indicated a general pattern of an increase in stereotype knowledge, the importance and positive evaluation of one's own gender category, and rigidity of beliefs between the ages of 3 and 5. Moreover, the stability phase, rather than full constancy, mediated some of these relations. After age 5, rigidity generally decreased with age, with relations primarily mediated by consistency. One of the most compelling yet controversial ideas in the gender literature is ''gender constancy.'' As proposed by Indeed, as reviewed recently Inconsistencies across studies may occur for various reasons. First, relations in very young children may sometimes be misleading because many young children appear to show a phase of ''pseudoconstancy'' (Emmerich, Goldman, Kirsh, & Sharabany, 1977; A second problem is that it remains unclear which stage of gender constancy drives children's reactions. In a recent review of the literature on relations between stage of gender constancy and responsiveness to gender-related information, gender consistency did not emerge as the crucial component A third problem is that gender development does not change in a linear fashion. For example, children's gender stereotypes appear to be held rigidly at approximately 5 years and then become more flexible Indeed, there has been theoretical debate about whether full constancy understanding should be associated with relatively high or low levels of rigidity. These alternative predictions are interesting in light of the literature on essentialistic thought (e.g., Gelman, 2003). Children's attempts to understand the implications of different essences are particularly important for social categories because individuals can belong to the categories and identify with them, and thus they have implications for ingroup and outgroup attitudes and behaviors. That is, it matters which features of categories are critically linked to such essences. For example, if children think that wearing pink, frilly dresses result from ''girlness,'' boys should avoid them and girls should love them. Once children learn that such features are not fundamental to being a boy or a girl (i.e., the gender consistency stage), however, adherence to these more superficial aspects of the category can be relinquished. Bem (1989) made this argument for why it makes sense to teach young children that genitals, not appearance or activities, are the critical distinctions between males and females. If this is true, higher levels of consistency understanding should be associated with less rigidity, supporting These observations suggest that a closer look at the effects of gender constancy is needed. This is important not only because of inconsistencies in prior research. Recent analyses of gender development have described a close connection between cognitive-developmental theory and other theories that emphasize the importance of children's emerging understanding of gender categories, namely, gender schema theories (e.g., The present study also examined whether different levels of gender constancy understanding might be related to different kinds of beliefs. To this end, multiple measures of stability, consistency, and gender-related beliefs were included. Children as young as 3 years of age were interviewed to provide us with the opportunity to capture the processes that occur at an early stage of gender constancy. Moreover, children representing a full span of 4 years, from early 3-yearolds to early 7-year-olds, were included in the sample so that possible curvilinear patterns of gender-related beliefs, posited earlier, could be examined. This age range was of particular interest because it has been identified as a period of rapid change in gender beliefs. The gender-belief measures used in this study examined knowledge of gender stereotypes and several types of attitudes about norm adherence, specifically, the degree of belief that violations are wrong, feelings about interacting with norm violators, degree of fear of turning into the other sex if one violates gender norms, and expectations about parents' and peers' attitudes toward norm violations. In addition, based on the recent convergence of categorization theories discussed earlier, an additional type of belief was examined. Many studies have documented how identification with a particular social category can promote a sense of belonging, connectedness, and increased positive evaluation of the group (see It was expected that children would show agerelated increases in knowledge of gender stereotypes and gender category identification (centrality and evaluation), as well as increasingly rigid attitudes about adhering to gender norms, at least until 5 years of age. It was further expected that increasing understanding of some aspects of gender constancy would mediate these beliefs (see Method Participants Participants were recruited from public and private schools in a large eastern city, as well as through university faculty and staff willing to have their children participate. More than 90% of the children were White, with a small number of Asian, Latino, and African American children participating as well. Based on the demographic characteristics of the schools from which most of the children in this study were recruited, the majority of children were from middle-to upper-middle-class backgrounds. Ninetyfour children ranging in age from 3.13 to 7.30 years (M 5 5.14) were interviewed (48 girls, 46 boys). For most of the analyses, children were split into a younger (22 boys, 20 girls; M 5 4.08) and older (24 boys, 28 girls; M 5 6.00) cohort. Procedures Children were interviewed in two sessions at the university or in their schools, depending on the arrangements of the individual teachers and parents. Questionnaires were administered to participants in a set order designed to minimize possible effects of reactivity across measures. Interviewers-five female and one male-were all trained in the standardized administration of all measures (see Gender-Constancy Measures An interview derived from previously validated measures was the primary way we assessed level of gender constancy attainment Stability. Children's attainment of the stability stage was evaluated using two methods. The first part of the measure consisted of seven forced-choice questions based on prior gender constancy measures, as described previously. Of the seven forced-choice questions, three referred to the participant (e.g., ''When you grow up, will you be a man or a woman?'') and four referred to a male or female target (e.g., ''When this grown-up was little, was this grown-up really a girl or really a boy?''). The second part of this measure was based on a procedure originally developed by Children's responses to the open-ended consistency probes were recorded verbatim. Correct responses were then scored according to the coding scheme developed by The coding of open-ended rationales was completed by two judges who were blind to the age of the child, and interjudge reliability was high (average kappa 5 .96 for five questions collapsed, omitting the ''no response/unscorable'' code). Items were scored as correct only if the initial forced-choice question was answered correctly and the open-ended response was scored as indicating true constancy. In addition to these five items, a supplementary set of six forced-choice consistency questions was administered to all children. These questions were worded differently from those included in the standard interview measure, focusing explicitly on the act of transformation. Specifically, these questions focused on transformations involving the following: others' and personal appearance (e.g., ''If a boy wore nail polish, would he become a girl?''), and others' and personal activity choice (e.g., ''If you played with baby dolls right now, would you be a boy or girl?''). To score these items, 1 point was awarded for each correct answer. Preliminary analyses indicated that this subscale did not demonstrate the problematic relationship with age found with the standard forced-choice interview method scale, suggesting that an explicit emphasis on gender transformation is another way to avoid the effects of pseudoconstancy. In addition, this scale correlated significantly with the standard interview scale when the open-ended responses were taken into account (r 5 .35. p , .01). Therefore, the 11 total questions were combined into a single scale with a possible range of scores from 0 to 11 (alpha 5 .85, M 5 4.53, SD 5 2.88). Belief Variables Children were asked a series of questions assessing their knowledge and feelings about gender, as well as how important it was that they and others adhere to Gender Constancy 1125 gender norms. Several of these were part of a series of related questions based on the prior literature (e.g., Knowledge: Who usually wears nail polish, boys or girls? Rule-based rigidity: Is it wrong for boys to wear nail polish?; Would it be OK for a boy to wear nail polish if he didn't get into trouble and nobody laughed? Self-rigidity: Would you like to be friends with a boy who wears nail polish?; Would you like to go to a school where boys were allowed to wear nail polish? Fear of changing sex: [lead-in question: Do you wear nail polish?] Are you afraid you would become a girl if you wore nail polish? (for boys only) Knowledge. Children were asked which sex usually participates in each of five highly gender-typed behaviors: wears barrettes, wears nail polish, is strong, plays with dolls, and plays with trucks. Although more items about stereotyped knowledge were originally included in the interview, some had to be dropped because virtually all the children already knew them (e.g., shaves head) or they were not stereotyped as male or female typical (e.g., cooks). Responses to the five items were scored as number correct and converted to proportions. This was done to compare results across dependent variables, which were all transformed to a 0 to 1 scale. Thus, knowledge had a possible range of 0 to 1, indicating the proportion of the five items correct (alpha 5 .53). Centrality/evaluation. A measure of identification with one's gender group was developed based on prior research with adults (e.g., Rule-based rigidity. This scale, adapted from prior research (e.g., Self-rigidity. Children's attitudes about others who participate in or condone gender-atypical behavior were measured by their responses to eight questions. Two questions were asked in reference to the four target behaviors described earlier: Would the child want to be friends with someone who performed the particular cross-sex transgression? Would the child want to go to a school where the particular cross-sex transgression was allowed?'' Each response indicating a rigid approach to gender norms was given 1 point, and each response indicating a flexible approach was given 0 points. Scores across all questions were then averaged and transformed to a scale ranging from 0 to 1 (alpha 5 .89, M 5 .65, SD 5 .36). Fear of changing sex. Fear of physical repercussions for cross-sex transgressions was assessed with two forced-choice questions regarding children's fear of turning into the other sex if they were to engage in a sex-atypical behavior. Children were asked one 1126 Ruble et al. question for each of two other-sex stimuli (wearing nail polish and playing with baby dolls for boys; shaving one's head and playing with trucks for girls). The total score for each child was an average of the scores for their two responses, transformed to a scale from 0 to 1 (M 5 .42, SD 5 .42). As boys and girls were asked about different sets of stimuli, separate alphas were calculated (boys: alpha 5 .61; girls: alpha 5 .59). Peer and parent rigidity. These measures were based on prior research on children's fear of being sanctioned for norm violations (e.g., Children were shown each pair of toys and asked what would happen if they chose one of the crossgender toys placed in front of them and what their parents and friends might say in response. Two forced-choice questions were asked next, and they constitute the measures used in the present study: ''Would your friends (parents) be angry? Would they make fun of you?'' These questions were asked about two toys [dolls and tea sets for boys; trucks and dinosaurs for girls]. Thus, there were four scores for each participant, which were averaged, resulting in a score from 0 to 1 that represented the overall percentage of rigid responses, with a higher score indicating higher rigidity (peer measure: M 5 .35, SD 5 .35; parent measure: M 5 .15, SD 5 .28). Alphas for girls were: peers 5 .82 and parents 5 .73. Alphas for boys were: peers 5 .60 and parents 5 .74. Results The major purpose of this study was to examine agerelated changes in gender-related beliefs and their relations to the stages of gender constancy in children. First, we investigated how each variable related to age, both graphically and in zero-order correlations. Next, we focused on mediation and moderation analyses of the effects of constancy on gender beliefs using regression analyses

Mental health literacy: a cross-cultural approach to knowledge and beliefs about depression, schizophrenia and generalized anxiety disorder

Many families worldwide have at least one member with a behavioral or mental disorder, and yet the majority of the public fails to correctly recognize symptoms of mental illness. Previous research has found that Mental Health Literacy (MHL)—the knowledge and positive beliefs about mental disorders—tends to be higher in European and North American cultures, compared to Asian and African cultures. Nonetheless quantitative research examining the variables that explain this cultural difference remains limited. The purpose of our study was fourfold: (a) to validate measures of MHL cross-culturally, (b) to examine the MHL model quantitatively, (c) to investigate cultural differences in the MHL model, and (d) to examine collectivism as a predictor of MHL. We validated measures of MHL in European American and Indian samples. The results lend strong quantitative support to the MHL model. Recognition of symptoms of mental illness was a central variable: greater recognition predicted greater endorsement of social causes of mental illness and endorsement of professional help-seeking as well as lesser endorsement of lay help-seeking. The MHL model also showed an overwhelming cultural difference; namely, lay help-seeking beliefs played a central role in the Indian sample, and a negligible role in the European American sample. Further, collectivism was positively associated with causal beliefs of mental illness in the European American sample, and with lay help-seeking beliefs in the Indian sample. These findings demonstrate the importance of understanding cultural differences in beliefs about mental illness, particularly in relation to help-seeking beliefs

Evaluation of the integrated intervention for dual problems and early action among latino immigrants with co-occurring mental health and substance misuse symptoms: A randomized clinical trial

Importance: Immigrants are at an increased risk for co-occurring mental health and substance misuse symptoms; however, effective treatments are lacking. Objective: To evaluate the effectiveness of the Integrated Intervention for Dual Problems and Early Action (IIDEA) program compared with enhanced usual care. Design, Setting, and Participants: This effectiveness randomized clinical trial was conducted from September 2, 2014, to February 2, 2017, in 17 clinics or emergency departments and 24 community sites in Boston, Massachusetts, as well as in Madrid and Barcelona, Spain. Equal randomization (1:1) in 2-person blocks was used, assigning participants to either the IIDEA treatment group (n = 172) or the enhanced usual care control group (n = 169). Intent-to-treat analyses assessed effectiveness, and post hoc analyses examined whether results varied by symptom severity or treatment dose. Eligible participants were between 18 and 70 years of age, self-identified as Latino, screened positive for co-occurring symptoms, and were not receiving specialty behavioral health services. Interventions: Participants were randomized to a 10-session IIDEA treatment or to enhanced usual care. Main Outcomes and Measures: Primary outcomes were changes in alcohol and drug misuse and results of a urine test for drug metabolites but not for alcohol misuse. Secondary outcomes were symptoms of depression, generalized anxiety, posttraumatic stress disorder, and overall mental health. Results: In total, 341 participants were randomized to either the IIDEA treatment group (n = 172; 94 [54.7%] female, mean [SD] age, 33.5 [11.6] years) or the enhanced usual care control group (n = 169; 80 [47.3%] female, mean [SD] age, 34.3 [11.8] years). No statistically significant effects of IIDEA were found for primary drug and alcohol outcomes (ASI Lite-drug score: β = -0.02 [SE, 0.69; P = .88; Cohen d, 0.00; 95% CI, -0.17 to 0.17]; ASI Lite-alcohol score: β = -0.01 [SE, 1.19; P = .66; Cohen d, 0.00; 95% CI, -0.12 to 0.12]; urine drug test result: β = -0.36 [SE, 0.43; P = .50; OR, 0.70; 95% CI, 0.30-1.61]), but statistically significant effects were observed for secondary mental health outcomes. The IIDEA treatment was effective in reducing depressive symptoms per the Public Health Questionnaire-9 score (β = -1.14; SE, 0.47; P = .02; Cohen d, 0.20 [95% CI, 0.04-0.36]), posttraumatic stress disorder symptoms per the Posttraumatic Stress Disorder Checklist-5 score (β = -3.23; SE, 1.59; P = .04; Cohen d, 0.25 [95% CI, 0.01-0.37]), and overall mental health symptoms per the Hopkins Symptom Checklist-20 (β = -0.20; SE, 0.07; P = .01; Cohen d, 0.25 [95% CI, 0.08-0.42]) and composite mental health (β = -3.70; SE, 1.75; P = .04; Cohen d, 0.19 [95% CI, 0.01-0.36]) scores at the 6-month follow-up. Exploratory analyses suggested that 6-month treatment effects occurred for patients whose drug misuse was moderate to severe at the baseline assessment. Among patients with moderate to severe substance misuse, IIDEA substantially reduced substance use per the urine test results (odds ratio, 0.25 [95% CI, 0.09-0.67]; P = .01). Treatment dose showed small to large effect sizes by outcome. Conclusions and Relevance: The IIDEA treatment did not change drug misuse but did improve secondary mental health and substance misuse outcomes for a heterogeneous population with moderate to severe symptoms; this finding provides a path for treating Latino immigrants with co-occurring mental health and substance misuse symptoms. Trial Registration: ClinicalTrials.gov Identifier: NCT02038855.This study was funded in part by grant R01DA034952 from NIDA of the National Institutes of Health; grant R01MH100155-01S1 from NIMH; and grants ISCII PI13/02200 and PI16/01852 from Instituto de Salud Carlos III, grant 20151073 from Delegación del Gobierno para el Plan Nacional de Drogas, and grant LSRG-1-005-16 from the American Foundation for Suicide Prevention (Dr Baca-García

Surface Hardness Impairment of Quorum Sensing and Swarming for Pseudomonas aeruginosa

The importance of rhamnolipid to swarming of the bacterium Pseudomonas aeruginosa is well established. It is frequently, but not exclusively, observed that P. aeruginosa swarms in tendril patterns—formation of these tendrils requires rhamnolipid. We were interested to explain the impact of surface changes on P. aeruginosa swarm tendril development. Here we report that P. aeruginosa quorum sensing and rhamnolipid production is impaired when growing on harder semi-solid surfaces. P. aeruginosa wild-type swarms showed huge variation in tendril formation with small deviations to the “standard” swarm agar concentration of 0.5%. These macroscopic differences correlated with microscopic investigation of cells close to the advancing swarm edge using fluorescent gene reporters. Tendril swarms showed significant rhlA-gfp reporter expression right up to the advancing edge of swarming cells while swarms without tendrils (grown on harder agar) showed no rhlA-gfp reporter expression near the advancing edge. This difference in rhamnolipid gene expression can be explained by the necessity of quorum sensing for rhamnolipid production. We provide evidence that harder surfaces seem to limit induction of quorum sensing genes near the advancing swarm edge and these localized effects were sufficient to explain the lack of tendril formation on hard agar. We were unable to artificially stimulate rhamnolipid tendril formation with added acyl-homoserine lactone signals or increasing the carbon nutrients. This suggests that quorum sensing on surfaces is controlled in a manner that is not solely population dependent