Background
Lack of agreement about criteria and terminology for children's language problems affects access to services as well as hindering research and practice. We report the second phase of a ...study using an online Delphi method to address these issues. In the first phase, we focused on criteria for language disorder. Here we consider terminology.
Methods
The Delphi method is an iterative process in which an initial set of statements is rated by a panel of experts, who then have the opportunity to view anonymised ratings from other panel members. On this basis they can either revise their views or make a case for their position. The statements are then revised based on panel feedback, and again rated by and commented on by the panel. In this study, feedback from a second round was used to prepare a final set of statements in narrative form. The panel included 57 individuals representing a range of professions and nationalities.
Results
We achieved at least 78% agreement for 19 of 21 statements within two rounds of ratings. These were collapsed into 12 statements for the final consensus reported here. The term ‘Language Disorder’ is recommended to refer to a profile of difficulties that causes functional impairment in everyday life and is associated with poor prognosis. The term, ‘Developmental Language Disorder’ (DLD) was endorsed for use when the language disorder was not associated with a known biomedical aetiology. It was also agreed that (a) presence of risk factors (neurobiological or environmental) does not preclude a diagnosis of DLD, (b) DLD can co‐occur with other neurodevelopmental disorders (e.g. ADHD) and (c) DLD does not require a mismatch between verbal and nonverbal ability.
Conclusions
This Delphi exercise highlights reasons for disagreements about terminology for language disorders and proposes standard definitions and nomenclature.
According to the common-sense model of self-regulation, individuals form lay representations of illnesses that guide coping procedures to manage illness threat. We meta-analyzed studies adopting the ...model to (a) examine the intercorrelations among illness representation dimensions, coping strategies, and illness outcomes; (b) test the sufficiency of a process model in which relations between illness representations and outcomes were mediated by coping strategies; and (c) test effects of moderators on model relations. Studies adopting the common-sense model in chronic illness (k = 254) were subjected to random-effects meta-analysis. The pattern of zero-order corrected correlations among illness representation dimensions (identity, consequences, timeline, perceived control, illness coherence, emotional representations), coping strategies (avoidance, cognitive reappraisal, emotion venting, problem-focused generic, problem-focused specific, seeking social support), and illness outcomes (disease state, distress, well-being, physical, role, and social functioning) was consistent with previous analyses. Meta-analytic path analyses supported a process model that included direct effects of illness representations on outcomes and indirect effects mediated by coping. Emotional representations and perceived control were consistently related to illness-related and functional outcomes via, respectively, lower and greater employment of coping strategies to deal with symptoms or manage treatment. Representations signaling threat (consequences, identity) had specific positive and negative indirect effects on outcomes through problem- and emotion-focused coping strategies. There was little evidence of moderation of model effects by study design, illness type and context, and study quality. A revised process model is proposed to guide future research which includes effects of moderators, individual differences, and beliefs about coping and treatment.
Public Significance Statement
This review indicates that relations between patients' illness beliefs and important illness-related outcomes (reducing disease progression, improving functioning, promoting well-being, allaying distress) across studies are accounted for by sets of coping strategies (avoidance, cognitive reappraisal, emotion venting, problem-focused coping, seeking social support). Behavioral interventions aimed at changing illness outcomes should not only target change in the beliefs linked to adaptive outcomes, but also the coping strategies related to the beliefs.
In this article, I build a new line of health inequality research that parallels the emerging structural racism literature. I develop theory and measurement for the concept of structural sexism and ...examine its relationship to health outcomes. Consistent with contemporary theories of gender as a multilevel social system, I conceptualize and measure structural sexism as systematic gender inequality at the macro level (U.S. state), meso level (marital dyad), and micro level (individual). I use U.S. state-level administrative data linked to geocoded data from the NLSY79, as well as measures of inter-spousal inequality and individual views on women’s roles as predictors of physical health outcomes in random-effects models for men and women. Results show that among women, exposure to more sexism at the macro and meso levels is associated with more chronic conditions, worse self-rated health, and worse physical functioning. Among men, macro-level structural sexism is also associated with worse health. However, greater meso-level structural sexism is associated with better health among men. At the micro level, internalized sexism is not related to physical health among either women or men. I close by outlining how future research on gender inequality and health can be furthered using a structural sexism perspective.
Objective: Loss of pleasure or interest in activities (i.e., anhedonia) is a risk factor for suicidality, treatment nonresponse, and relapse. Extant treatments that focus on reducing negative affect ...have limited effects upon positive affect (a core feature of anhedonia). We investigated whether a novel intervention aimed at increasing reward sensitivity was more efficacious for positive affect than a cognitive-behavior treatment aimed at reducing threat sensitivity, in individuals with clinically severe symptoms of depression or anxiety, and functional impairment. Method: The Treatment for Affective Dimensions trial was offered in a 2-site randomized study at outpatient treatment centers in Los Angeles and Dallas. Ninety-six patients were randomized to 15 weekly, individual sessions of Positive Affect Treatment (PAT) or Negative Affect Treatment (NAT). The primary outcome was improvement in positive affect (Positive and Negative Affect Schedule-Positive) from pretreatment to 6-month follow-up (6MFU). Secondary outcomes were improvements in negative affect (Positive and Negative Affect Schedule-Negative), suicidal ideation, and symptoms (Depression Anxiety Stress Scales). Results: PAT resulted in greater improvements in positive affect, p = .009, d = .52, and higher positive affect at 6MFU, p = .002, d = .67, than NAT. Participants in PAT also reported lower negative affect, p = .033, d = .52, and lower symptoms of depression, p = .035, d = .34, anxiety, p < .018, d = .30, and stress, p = .006, d = .43 at 6MFU. Finally, probability of suicidal ideation at 6MFU was lower in PAT than NAT (1.7% vs. 12.0%), p < .001. Conclusions: Compared to NAT, PAT demonstrated better outcomes (at 6MFU) on positive affect, depression, anxiety, stress, and suicidal ideation, for patients with symptomatic pretreatment levels of these outcomes.
What is the public health significance of this article?
Psychological treatment for individuals with depression or anxiety has typically focused on reducing negative emotions. This study demonstrates the superiority of a novel positive affect treatment designed to increase reward sensitivity over a treatment focused upon reducing threat sensitivity for raising positive affect and reducing depression, anxiety, stress, and suicidal ideation.
Although the experience of negative emotions is generally associated with negative behaviors and outcomes, researchers have largely overlooked the possibility that negative emotions can lead to ...proactive behavior. For instance, emotions such as anger and fear can spark proactive behavior by signaling a need to change the status quo. Whereas theory and research on the topic have produced conflicting arguments and inconsistent results. I integrate a discrete emotions perspective with theories of proactivity to determine the conditions under which anger and fear prompt proactive behavior. In doing so I provide a conceptual framework that enables understanding of specific factors that determine when anger is directed away from fight that harms others and toward fight that benefits others, and when fear is directed away from flight and toward increased protective effort (fight). This article contributes to theory with a contingent model that specifies when and why anger and fear spark proactive behavior and generate functional outcomes. It also offers practical advice for organizations to effectively manage emotional experiences and thereby increase proactive behavior resulting from experienced anger or fear.
Objective
Increasing attention has been paid to the distinction between the dimensions of narcissistic grandiosity and vulnerability. We examine the degree to which basic traits underlie vulnerable ...narcissism, with a particular emphasis on the importance of Neuroticism and Agreeableness.
Method
Across four samples (undergraduate, online community, clinical‐community), we conduct dominance analyses to partition the variance predicted in vulnerable narcissism by the Five‐Factor Model personality domains, as well as compare the empirical profiles generated by vulnerable narcissism and Neuroticism.
Results
These analyses demonstrate that the lion's share of variance is explained by Neuroticism (65%) and Agreeableness (19%). Similarity analyses were also conducted in which the extent to which vulnerable narcissism and Neuroticism share similar empirical networks was tested using an array of criteria, including self‐, informant, and thin slice ratings of personality; interview‐based ratings of personality disorder and pathological traits; and self‐ratings of adverse events and functional outcomes. The empirical correlates of vulnerable narcissism and Neuroticism were nearly identical (MrICC = .94). Partial analyses demonstrated that the variance in vulnerable narcissism not shared with Neuroticism is largely specific to disagreeableness‐related traits such as distrustfulness and grandiosity.
Conclusions
These findings demonstrate the parsimony of using basic personality to study personality pathology and have implications for how vulnerable narcissism might be approached clinically.
The way we respond to life’s daily stressors has strong implications for our physical health. Researchers have documented the detrimental effects of initial emotional reactivity to daily stressors on ...future physical health outcomes but have yet to examine the effects of emotions that linger after a stressor occurs. The current study investigated how negative affect that lingers the day after a minor stressor occurs is associated with health-related outcomes. Participants (N = 1,155) in a community-based, nationwide study answered questions about daily stressors and affect across 8 consecutive days and about their physical health almost 10 years later. Multilevel models indicated that people experience heightened levels of negative affect the day after a stressor occurs. Furthermore, higher levels of lingering negative affect are associated with greater numbers of chronic conditions and worse functional limitations 10 years later. Findings suggest that affective recovery from daily stressors has unique importance for long-term physical health.
•A brief new measure to assess COVID-19 anxiety syndrome features is presented.•The measure has acceptable levels of reliability and concurrent validity.•The measure was found to predict COVID-19 ...anxiety and work and social adjustment controlling for other variables.
The central aim of our study was to widen the mental health response to the COVID-19 pandemic by developing and evaluating a measure that could be used to identify the presence of anxiety syndrome features associated with COVID-19. In Study 1, a community sample of 292 participants completed the newly developed COVID-19 Anxiety Syndrome Scale (C-19ASS) and results were subjected to a Principal Components Analysis. An 11-item two-factor structure was identified. In Study 2, a community sample of 426 participants completed a battery of questionnaires including the C-19ASS. A Confirmatory Factor Analysis was performed on the C-19ASS. A 9-item two-factor structure was confirmed. Results also indicated that the C-19ASS has acceptable levels of reliability and concurrent validity. The C-19ASS perseveration factor was found to explain an additional 9.3% variance in COVID-19 anxiety, and additional 2.2% variance in work and social adjustment (functional impairment), over and above all other variables. The C-19ASS appears to be a reliable and valid measure of the COVID-19 anxiety syndrome. The implications of these findings are discussed.
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