Home Blood Pressure Monitoring: New Evidence for an Expanded Role

In a Perspective, Mark Caulfield discusses potential implications of using home blood pressure monitoring for diagnosis and treatment of hypertension. Please see later in the article for the Editors' Summar

Educating through Exemplars: Alternative Paths to Virtue

This paper confronts Zagzebski’s exemplarism with the intertwined debates over the conditions of exemplarity and the unity-disunity of the virtues, to show the advantages of a pluralistic exemplar-based approach to moral education (PEBAME). PEBAME is based on a prima facie disunitarist perspective in moral theory, which amounts to admitting both exemplarity in all respects and single-virtue exemplarity. First, we account for the advantages of PEBAME, and we show how two figures in recent Italian history (Giorgio Perlasca and Gino Bartali) satisfy Blum’s definitions of ‘moral hero’ and ‘moral saint’ (1988). Then, we offer a comparative analysis of the effectiveness of heroes and saints with respect to character education, according to four criteria derived from PEBAME: admirability, virtuousness, transparency, and imitability. Finally, we conclude that both unitarist and disunitarist exemplars are fundamental to character education; this is because of the hero's superiority to the saint with respect to imitability, a fundamental feature of the exemplar for character education

General and specific avoidance: the development and concurrent validation of a new measure of avoidance coping

Research on coping has been hampered by psychometric shortcomings in coping scales, which have typically relied on items based on face-value, extracted too many factors or lacked the evidence for the obtained structure from confirmatory factor analysis. The present paper describes the development and concurrent validation of a new three-factor avoidance coping scale, the General and Specific Avoidance Questionnaire (GSAQ), which comprises General Avoidance, Emotional Avoidance and Conflict Avoidance. In contrast to earlier scales the items were derived from a scenario technique which elicits items from participants’ experience, and the three factor structure was endorsed by two confirmatory factor analyses on independent samples and a further exploratory factor analysis based on the total pooled sample of participants from all three analyses. Factor correlations indicate that the scales measure discrete facets of the avoidance coping domain, and while concurrent validation showed that General and Conflict Avoidance were related in predictable ways to criterion measures, the pattern for Emotional Avoidance was unexpected

Interoception and Respiratory Sinus Arrhythmia in Gambling Disorder

This is the author accepted manuscript. The final version is available from Wiley via the DOI in this recordGambling has long-standing links with excitement and physiological arousal, but prior research has not considered i) gamblers’ ability to detect internal physiological signals, or ii) markers of parasympathetic functioning. The present study measured interoception in individuals with gambling disorder, using selfreport measures and a heart beat counting task administered at rest. Resting state Respiratory Sinus Arrhythmia (RSA), an index of heart rate variability, was measured as a proxy for parasympathetic control and emotional regulation capacity. In a case-control design, 50 individuals with gambling disorder were compared against 35 controls without gambling problems. Participants completed two self-report measures of bodily awareness and a behavioural test of heart beat counting. A resting state electrocardiogram (five minutes) was used to calculate RSA. There were no significant differences on the self-report or behavioral interoception probes. The group with gambling disorder displayed significantly reduced RSA, which at face value is consistent with reduced parasympathetic control. However, the group difference in RSA did not survive controlling for age and smoking status, as established predictors of heart rate variability. Our findings do not support any changes in interoceptive processing in people with gambling disorder, at least under resting conditions. Our observation that group differences in RSA are partly explained by smoking behavior highlights the importance of controlling for nicotine use in future research characterizing physiological functioning and emotional regulation in disordered gambling.Centre for Gambling Research at UBCProvince of British Columbia governmentBritish Columbia Lottery CorporationNatural Sciences and Engineering Research Council (Canada

Negative Impressions of Childbirth in a North-West England Student Population

Background: Socio-cultural childbirth representations can influence perceptions of childbirth negatively. In this paper we report on a survey study to explore factors associated with negative impressions of childbirth in a North-West England University student sample. We also explored whether different sources and perceptions of childbirth information were linked to fear of childbirth. Methods: All students received a survey link via an online messaging board and/or direct email. Female students who were 18-40 years of age and childless (but planned to have children in the future) were invited to participate. Demographics, birth preferences, a fear of birth and general anxiety measures were included as well as questions about what sources of information shaped students’ attitudes towards pregnancy and birth (i.e. visual/written media, experiences of friends/family members, school-based education, and other) and impressions of birth from these sources (i.e. positive, negative, both positive and negative and not applicable). Results: Eligible students (n=276) completed the online questionnaire. The majority were Caucasian (87%) with a mean age of 22.6 years. Ninety-two students (33.3%) reported negative childbirth impressions through direct or vicarious sources. Students with negative impressions were significantly more likely to report higher fear of birth scores. Negatively perceived birth stories of friends/family members, and mixed perceptions of visual media representations of birth were associated with higher fear of birth scores. Having witnessed a birth first-hand and describing the experience as amazing was linked to lower fear scores. Conclusion: First-hand observations of birth, especially positive experiences, had implications for salutary outcomes. Negative or conflicting perceptions of vicarious experiences were associated with increased levels of childbirth fear. While further research is needed, these 3 insights suggest a need for positive birth stories and messages to be disseminated to mitigate negative effects of indirect accounts

The Effect of Counterconditioning on Evaluative Responses and Harm Expectancy in a Fear Conditioning Paradigm

In fear conditioning, extinction targets harm expectancy as well as the fear response, but it often fails to eradicate the negative affective value that is associated with the conditioned stimulus. In the present study, we examined whether counterconditioning can serve to reduce evaluative responses within fear conditioning. The sample consisted of 70 nonselected students, 12 of whom were men. All participants received acquisition with human face stimuli as the conditioned stimuli and an unpleasant white noise as the unconditioned stimulus. After acquisition, one third of the sample was allocated to an extinction procedure. The other participants received counterconditioning with either a neutral stimulus (neutral tone) or a positive stimulus (baby laugh). Results showed that counterconditioning (with both neutral and positive stimuli), in contrast to extinction, successfully reduced evaluative responses. This effect was found on an indirect measure (affective priming task), but not on self-report. Counterconditioning with a positive stimulus also tended to enhance the reduction of conditioned skin conductance reactivity. The present data suggest that counterconditioning procedures might be a promising approach in diminishing evaluative learning and even expectancy learning in the context of fear conditioning

Positive psychology of Malaysian students: impacts of engagement, motivation, self-compassion and wellbeing on mental health

Malaysia plays a key role in education of the Asia Pacific, expanding its scholarly output rapidly. However, mental health of Malaysian students is challenging, and their help-seeking is low because of stigma. This study explored the relationships between mental health and positive psychological constructs (academic engagement, motivation, self-compassion, and wellbeing), and evaluated the relative contribution of each positive psychological construct to mental health in Malaysian students. An opportunity sample of 153 students completed the measures regarding these constructs. Correlation, regression, and mediation analyses were conducted. Engagement, amotivation, self-compassion, and wellbeing were associated with, and predicted large variance in mental health. Self-compassion was the strongest independent predictor of mental health among all the positive psychological constructs. Findings can imply the strong links between mental health and positive psychology, especially selfcompassion. Moreover, intervention studies to examine the effects of self-compassion training on mental health of Malaysian students appear to be warranted.N/

A mixed-methods study using a nonclinical sample to measure feasibility of ostrich community : a web-based cognitive behavioral therapy program for individuals with debt and associated stress

Background: There are increasing concerns about the health and well-being of individuals facing financial troubles. For instance, in the United Kingdom, the relationship between debt and mental health difficulties is becoming more evident due to the economic downturn and welfare reform. Access to debt counseling services is limited and individuals may be reluctant to access services due to stigma. In addition, most of these services may not be appropriately resourced to address the psychological impact of debt. This study describes outcomes from an Internet-based cognitive behavioral therapy (ICBT) program, Ostrich Community (OC), which was developed to provide support to those struggling with debt and associated psychological distress. Objective: The aim of this feasibility study was to assess the suitability and acceptability of the OC program in a nonclinical sample and examine mental health and well-being outcomes from using the program. Methods: A total of 15 participants (who were not suffering from severe financial difficulty) were assisted in working through the 8-week ICBT program. Participants rated usability and satisfaction with the program, and after completion 7 participants took part in a semistructured interview to provide further feedback. Before the first session and after the final session all participants completed questionnaires to measure well-being and levels of depression, stress, and anxiety and pre- and postscores were compared. Results: Satisfaction was high and themes emerging from the interviews indicate that the program has the potential to promote effective financial behaviors and improve financial and global psychosocial well-being. When postcompletion scores were compared with those taken before the program, significant improvements were identified on psychometric measures of well-being, stress, and anxiety. Conclusions: The OC program is the first ICBT program that targets poor mental health associated with financial difficulty. This feasibility study indicates that OC may be an effective intervention for increasing financial resilience, supporting individuals to become financially independent, and promoting positive financial and global well-being. Further work with individuals suffering from debt and associated emotional difficulties will help to examine clinical effectiveness more closely

Central Coherence in Eating Disorders: A Synthesis of Studies Using the Rey Osterrieth Complex Figure Test

Background: Large variability in tests and differences in scoring systems used to study central coherence in eating disorders may lead to different interpretations, inconsistent findings and between study discrepancies. This study aimed to address inconsistencies by collating data from several studies from the same research group that used the Rey Osterrieth Complex Figure Test (Rey Figure) in order to produce norms to provide benchmark data for future studies. Method: Data was collated from 984 participants in total. Anorexia Nervosa, Bulimia Nervosa, recovered Anorexia Nervosa, unaffected family members and healthy controls were compared using the Rey Figure. Results: Poor global processing was observed across all current eating disorder sub-groups and in unaffected relatives. There was no difference in performance between recovered AN and HC groups. Conclusions: This is the largest dataset reported in the literature and supports previous studies implicating poor global processing across eating disorders using the Rey Figure. It provides robust normative data useful for future studies