1
|
Chiu HTS, Low DCW, Chan AHT, Meiser-Stedman R. Relationship between anxiety sensitivity and post-traumatic stress symptoms in trauma-exposed adults: A meta-analysis. J Anxiety Disord 2024; 103:102857. [PMID: 38507961 DOI: 10.1016/j.janxdis.2024.102857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 12/21/2023] [Accepted: 03/07/2024] [Indexed: 03/22/2024]
Abstract
Given the high rate of trauma exposure among the general population, it is important to delineate the risk factors for post-traumatic stress disorder (PTSD). While historically implicated in panic disorder, anxiety sensitivity is increasingly found to play a role in PTSD. The present review investigated the size of the relationship between anxiety sensitivity and PTSD symptoms among trauma exposed adults. A systematic search on multiple electronic databases (PTSDpubs, CINAHL, MEDLINE and PsycINFO) generated a total of 1025 records, among which 52 (n = 15173) met study inclusion criteria and were included in our random effects meta-analysis. Our results indicated a medium effect size (r = .46, 95% CI =.41,.50) for the relationship between anxiety sensitivity and PTSD symptoms. There was significant between-study heterogeneity. Furthermore, sub-group analyses revealed that study design (cross-sectional vs. longitudinal) may significantly moderate the association between anxiety sensitivity and PTSD severity. No moderation effect was found for assessment of PTSD through interview versus questionnaire, interpersonal versus non-interpersonal trauma, or low versus high study quality. Such patterns of results are consistent with cognitive models of PTSD. Clinical implications, strengths and limitations of the review were discussed.
Collapse
Affiliation(s)
- Henry Tak Shing Chiu
- Department of Clinical Psychology and Psychological Therapies, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK.
| | - Debbie Chi Wing Low
- School of Psychology and Clinical Language Sciences, University of Reading, UK
| | - Angel Hiu Tung Chan
- Department of Clinical Psychology and Psychological Therapies, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK
| | - Richard Meiser-Stedman
- Department of Clinical Psychology and Psychological Therapies, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK
| |
Collapse
|
2
|
Li Y, Ju R, Hofmann SG, Chiu W, Guan Y, Leng Y, Liu X. Distress tolerance as a mechanism of mindfulness for depression and anxiety: Cross-sectional and diary evidence. Int J Clin Health Psychol 2023; 23:100392. [PMID: 37456917 PMCID: PMC10345371 DOI: 10.1016/j.ijchp.2023.100392] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 06/21/2023] [Indexed: 07/18/2023] Open
Abstract
Background Both trait and state mindfulness are associated with less depression and anxiety, but the mechanisms remain unknown. Distress tolerance, an important transdiagnostic factor of emotional disorders, may mediate the relationship between mindfulness and depression/anxiety. Method Study 1 examined the mediation model at the between-person level in a large cross-sectional sample (n = 905). In Study 2, a daily diary study (n = 110) was conducted to examine within-person changes. Participants were invited to complete daily diaries measuring daily mindfulness, distress tolerance, depression and anxiety for 14 consecutive days. Results In Study 1, results of simple mediation analyses indicated that distress tolerance mediated the relationship between mindfulness and depression/anxiety at the between-person level. In Study 2, results of multilevel mediation analyses indicated that, in both the concurrent model and time-lagged model, daily distress tolerance mediated the effects of daily mindfulness on daily depression/anxiety at both the within- and between-person level. Conclusions Distress tolerance is a mechanism underlying the relationship between mindfulness and depression/anxiety. Individuals with high or fluctuating depression and anxiety may benefit from short-term or long-term mindfulness training to increase distress tolerance.
Collapse
Affiliation(s)
- Yanjuan Li
- Beijing Key Laboratory of Behavior and Mental Health, School of Psychological and Cognitive Sciences, Peking University, Beijing, China
| | - Ruilin Ju
- Beijing Key Laboratory of Behavior and Mental Health, School of Psychological and Cognitive Sciences, Peking University, Beijing, China
| | - Stefan G. Hofmann
- Department of Clinical Psychology, Philipps University Marburg, Germany
| | - Wingsze Chiu
- Beijing Key Laboratory of Behavior and Mental Health, School of Psychological and Cognitive Sciences, Peking University, Beijing, China
| | - Ye Guan
- Beijing Key Laboratory of Behavior and Mental Health, School of Psychological and Cognitive Sciences, Peking University, Beijing, China
| | - Yu Leng
- Beijing Key Laboratory of Behavior and Mental Health, School of Psychological and Cognitive Sciences, Peking University, Beijing, China
| | - Xinghua Liu
- Beijing Key Laboratory of Behavior and Mental Health, School of Psychological and Cognitive Sciences, Peking University, Beijing, China
| |
Collapse
|
3
|
Rudenstine S, Schulder T, Ettman C, Galea S. Perceived coping mitigates anxiety symptoms in the context of COVID-19 stress in an urban university student sample. Psychol Rep 2022:332941221074038. [PMID: 35084273 PMCID: PMC8894909 DOI: 10.1177/00332941221074038] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Perceived coping and its two subprocesses, trauma-focused coping (finding meaning in the details and memory of a potential trauma or stressor) and forward-focused coping (focusing on planning for the future) have been shown to be important in the context of potentially traumatic events. The COVID-19 pandemic and its associated stressors have negatively impacted population mental health, and preliminary investigations have demonstrated the importance of perceived abilities to cope during the pandemic. The current study sought to examine the potentially moderating role of each subprocess on the relationship between stress and anxiety symptoms in a low-income student sample during COVID-19 (N = 2364). We computed two hierarchical multiple linear regressions to assess for significant interactions between stress and perceived coping subprocess scores on anxiety outcomes. Our results demonstrated that both trauma-focused coping and forward-focused coping served as effect modifiers in the relationship between COVID-19related stress and anxiety. Such findings highlight the importance of interventions that incorporate both forms of coping for low-income students during a chronic stressor.
Collapse
|
4
|
Vujanovic AA, Webber HE, McGrew SJ, Green CE, Lane SD, Schmitz JM. Distress tolerance: prospective associations with cognitive-behavioral therapy outcomes in adults with posttraumatic stress and substance use disorders. Cogn Behav Ther 2022; 51:326-342. [PMID: 34994673 DOI: 10.1080/16506073.2021.2007995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
74Distress tolerance (DT; perceived or actual ability to tolerate aversive physical or emotional states) is related to both posttraumatic stress disorder (PTSD) symptoms and substance use disorders (SUD). This investigation evaluates self-report and behavioral measures of DT as potential predictors of PTSD and SUD cognitive-behavioral therapy outcomes. Participants included 41 treatment-seeking adults (53.7% women; 73.2% African American; Mage = 44.90, SD = 9.68) who met at least four symptoms of DSM-5 PTSD and DSM-IV substance dependence, assessed via structured interviews. At baseline (pre-treatment), participants completed the Distress Tolerance Scale (DTS), Mirror-Tracing Persistence Task (MTPT), Breath Holding task, and Paced Auditory Serial Addition Task. The Clinician-Administered PTSD Scale for DSM-5 severity scores and percent days of primary substance use, measured via Timeline Follow-back, were used as indicators of PTSD symptoms and substance use, respectively. Covariates included treatment condition, baseline PTSD symptom severity, and baseline substance use. Lower perceived DT at baseline (DTS total score) was associated with higher PTSD symptom severity at end-of-treatment. Lower behavioral DT at baseline (MTPT duration) was associated with higher substance use at the conclusion of treatment (i.e. proportion of number of use days to total number of days between two final treatment sessions).
Collapse
Affiliation(s)
- Anka A Vujanovic
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Heather E Webber
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Shelby J McGrew
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Charles E Green
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Scott D Lane
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Joy M Schmitz
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, TX, USA
| |
Collapse
|
5
|
The Impact of Wildfires on Mental Health: A Scoping Review. Behav Sci (Basel) 2021; 11:bs11090126. [PMID: 34562964 PMCID: PMC8466569 DOI: 10.3390/bs11090126] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 09/07/2021] [Accepted: 09/16/2021] [Indexed: 01/27/2023] Open
Abstract
One of the many consequences of climate change is an increase in the frequency, severity, and, thus, impact of wildfires across the globe. The destruction and loss of one's home, belongings, and surrounding community, and the threat to personal safety and the safety of loved ones can have significant consequences on survivors' mental health, which persist for years after. The objective of this scoping review was to identify primary studies examining the impact of wildfires on mental health and to summarize findings for PTSD, depression, anxiety, and substance use. Literature searches on Pubmed and Embase were conducted in February and April of 2021, respectively, with no date restrictions. A total of 254 studies were found in the two database searches, with 60 studies meeting the inclusion criteria. Three other studies were identified and included based on relevant in-text citations during data abstraction. The results show an increased rate of PTSD, depression, and generalized anxiety at several times of follow-up post-wildfire, from the subacute phase, to years after. An increased rate of mental health disorders post-wildfire has been found in both the adult and pediatric population, with a number of associated risk factors, the most significant being characteristics of the wildfire trauma itself. Several new terms have arisen in the literature secondary to an increased awareness and understanding of the impact of natural disasters on mental health, including ecological grief, solastalgia, and eco-anxiety. There are a number of patient factors and systemic changes that have been identified post-wildfire that can contribute to resilience and recovery.
Collapse
|
6
|
Akbari M, Hosseini ZS, Seydavi M, Zegel M, Zvolensky MJ, Vujanovic AA. Distress tolerance and posttraumatic stress disorder: a systematic review and meta-analysis. Cogn Behav Ther 2021; 51:42-71. [PMID: 34279189 DOI: 10.1080/16506073.2021.1942541] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The association between distress tolerance (DT) and posttraumatic stress disorder (PTSD) is well established. This study aimed to provide an account of the magnitude of this effect across available studies. From the 2,212 records yielded by the initial search, 56 studies comprised 12,672 participants (Mage = 29.96, SD = 12.05; 44.94% women) were included in the investigation upon a priori criteria. Results demonstrated consistent negative associations between DT and PTSD symptoms, such that lower DT was associated with higher PTSD symptom severity and vice versa; the effect size (ES) was relatively small in magnitude (r = -0.335, 95% CI [-0.379, -0.289]). Moreover, ESs for the DT-PTSD association were significantly greater for studies which examined self-reported DT compared to those that examined behavioral DT. The number of traumatic event types experienced (trauma load) was the most consistent moderator of the DT and PTSD association. The clinical implications of the role of DT in PTSD are discussed.
Collapse
Affiliation(s)
- Mehdi Akbari
- Department of Clinical Psychology, Faculty of Psychology and Education, Kharazmi University, Tehran, Iran
| | | | - Mohammad Seydavi
- Department of Clinical Psychology, Faculty of Psychology and Education, Kharazmi University, Tehran, Iran
| | - Maya Zegel
- Department of Psychology, University of Houston, Houston, Texas, USA
| | - Michael J Zvolensky
- Department of Psychology, University of Houston, Houston, Texas, USA.,Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Texas, USA
| | - Anka A Vujanovic
- Department of Psychology, University of Houston, Houston, Texas, USA
| |
Collapse
|
7
|
Anxiety Sensitivity and Distress Tolerance Predict Changes in Internalizing Symptoms in Individuals Exposed to Interpersonal Trauma. COGNITIVE THERAPY AND RESEARCH 2021. [DOI: 10.1007/s10608-021-10234-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
8
|
Making and Receiving Offers of Help on Social Media Following Disaster Predict Posttraumatic Growth but not Posttraumatic Stress. Disaster Med Public Health Prep 2020; 15:484-490. [PMID: 32349839 PMCID: PMC8532121 DOI: 10.1017/dmp.2020.43] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Objectives: Social media provides an opportunity to engage in social contact and to give and receive help by means of online social networks. Social support following trauma exposure, even in a virtual community, may reduce feelings of helplessness and isolation, and, therefore, reduce posttraumatic stress symptoms (PTS), and increase posttraumatic growth (PTG). The current study aimed to assess whether giving and/or receiving offers of help by means of social media following large community fires predicted PTS and/or PTG. Methods: A convenience sample of 212 adults living in communities that were affected by large-scale community fires in Israel (November 2016) completed questionnaires on giving and receiving offers of help by means of social media within 1 mo of the fire (W1), and the PTSD checklist for DSM-5 (PCL-5) and PTG questionnaire (PTGI-SF), 4 mo after the fire (W2). Results: Regression analyses showed that, after controlling for age, gender, and distance from fire, offering help by means of social media predicted higher PTG (β = 0.22; t = 3.18; P < 0.01), as did receiving offers of help by means of social media (β = 0.18; t = 2.64; P < 0.01). There were no significant associations between giving and/or receiving offers of help and PTS. Conclusions: Connecting people to social media networks may help in promoting posttraumatic growth, although might not impact on posttraumatic symptoms. This is one of the first studies to highlight empirically the advantages of social media in the aftermath of trauma exposure.
Collapse
|
9
|
Lass ANS, Winer ES. Distress tolerance and symptoms of depression: A review and integration of literatures. CLINICAL PSYCHOLOGY-SCIENCE AND PRACTICE 2020. [DOI: 10.1111/cpsp.12336] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Alisson N. S. Lass
- Department of Psychology Mississippi State University Starkville Mississippi
| | - E. Samuel Winer
- Department of Psychology Mississippi State University Starkville Mississippi
| |
Collapse
|
10
|
de Wet A, Dowling T, Swartz L, Lesch A, Kagee A, Kafaar Z, Hassan NR, Newman PA. Complexities in the process of translating research documents in cross-cultural settings. Glob Public Health 2020; 15:818-827. [PMID: 31994442 DOI: 10.1080/17441692.2020.1718736] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
In multilingual societies, where researchers and participants often do not speak the same language, research is a challenge as a mismatch of understanding between researchers, research instruments and participants often occurs. Reporting on the translation process is crucial because of the potential implications for the validity of the data that follow from it. We aimed to report on the complexities of such a translation process and many considerations that came to our attention. Methodologically, we used a detailed case study to demonstrate that the complexity of translation might be underestimated by researchers who may neglect to report on the challenges that they experience to benefit the wider research community. We emphasise that translating documents, particularly between languages that are not cognate, requires time and financial resources that researchers often do not anticipate or plan for. By discussing what happened to texts that were translated, and how we as researchers were challenged by considerations that were primarily linguistic but also straddled cultural and socio-political domains, we hope to encourage a deeper understanding of the translation task. We conclude that consideration of these complexities is necessary if the aim is the development of translated documents which complement the researchers' goals.
Collapse
Affiliation(s)
- Anneliese de Wet
- Department of Psychology, Stellenbosch University, Stellenbosch, South Africa
| | - Tessa Dowling
- African Languages, School of Languages & Literatures, University of Cape Town, Cape Town, South Africa
| | - Leslie Swartz
- Department of Psychology, Stellenbosch University, Stellenbosch, South Africa
| | - Anthea Lesch
- Department of Psychology, Stellenbosch University, Stellenbosch, South Africa
| | - Ashraf Kagee
- Department of Psychology, Stellenbosch University, Stellenbosch, South Africa
| | - Zuhayr Kafaar
- Department of Psychology, Stellenbosch University, Stellenbosch, South Africa
| | - Neil R Hassan
- Department of Psychology, Stellenbosch University, Stellenbosch, South Africa
| | - Peter A Newman
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| |
Collapse
|
11
|
Zegel M, Tran JK, Vujanovic AA. Posttraumatic stress, alcohol use, and alcohol use motives among firefighters: The role of distress tolerance. Psychiatry Res 2019; 282:112633. [PMID: 31708250 DOI: 10.1016/j.psychres.2019.112633] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 10/20/2019] [Accepted: 10/23/2019] [Indexed: 01/10/2023]
Abstract
Firefighters represent a unique, vulnerable population at high risk for alcohol use disorder (AUD) and posttraumatic stress disorder (PTSD) symptomatology due to the high rates of occupational exposure to traumatic events. To inform specialized alcohol use interventions for firefighters, it is important to understand relevant malleable cognitive-affective factors related to PTSD and AUD symptoms. Distress tolerance (DT), defined as the perceived ability to withstand negative emotional states, is one promising factor relevant to this domain. The current study examined the moderating role of DT in the association of PTSD symptom severity with alcohol use severity and alcohol use motives. Participants included 652 trauma-exposed firefighters (93.3% male; Mage = 38.7 years, SD = 8.6) who endorsed lifetime (ever) alcohol use. Results indicated that there was a significant interactive effect of PTSD symptom severity and DT on coping-oriented alcohol use motives but not other alcohol-related outcomes. These findings were evident after adjusting for alcohol consumption, romantic relationship status, number of years in the fire service, occupational stress, and trauma load. This is the first study to concurrently examine these variables among firefighters and this line of inquiry has great potential to inform intervention efforts for this vulnerable, understudied population.
Collapse
Affiliation(s)
- Maya Zegel
- Trauma and Stress Studies Center, Department of Psychology, University of Houston, 3695 Cullen Boulevard, 126 Heyne Building, Houston, TX 77204, USA
| | - Jana K Tran
- Firefighter Support Network, Houston Fire Department, Houston, Texas, USA
| | - Anka A Vujanovic
- Trauma and Stress Studies Center, Department of Psychology, University of Houston, 3695 Cullen Boulevard, 126 Heyne Building, Houston, TX 77204, USA.
| |
Collapse
|
12
|
Fan Y, Lance CE. A Reformulated Correlated Trait-Correlated Method Model for Multitrait-Multimethod Data Effectively Increases Convergence and Admissibility Rates. EDUCATIONAL AND PSYCHOLOGICAL MEASUREMENT 2017; 77:1048-1063. [PMID: 29795944 PMCID: PMC5965652 DOI: 10.1177/0013164416677144] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The correlated trait-correlated method (CTCM) model for the analysis of multitrait-multimethod (MTMM) data is known to suffer convergence and admissibility (C&A) problems. We describe a little known and seldom applied reparameterized version of this model (CTCM-R) based on Rindskopf's reparameterization of the simpler confirmatory factor analysis model. In a Monte Carlo study, we compare the CTCM, CTCM-R, and the correlated trait-correlated uniqueness (CTCU) models in terms of C&A, model fit, and parameter estimation bias. The CTCM-R model largely avoided C&A problems associated with the more traditional CTCM model, producing C&A solutions nearly as often as the CTCU model, but also avoiding parameter estimation biases known to plague the CTCU model. As such, the CTCM-R model is an attractive alternative for the analysis of MTMM data.
Collapse
Affiliation(s)
- Yi Fan
- University of Georgia, Athens, GA, USA
| | - Charles E. Lance
- Organizational Research & Development, LLC, Lawrenceville, GA, USA
- University of the Western Cape, Capetown, South Africa
| |
Collapse
|
13
|
Fredrickson BL, Boulton AJ, Firestine AM, Van Cappellen P, Algoe SB, Brantley MM, Kim SL, Brantley J, Salzberg S. Positive Emotion Correlates of Meditation Practice: A Comparison of Mindfulness Meditation and Loving-kindness Meditation. Mindfulness (N Y) 2017; 8:1623-1633. [PMID: 29201247 PMCID: PMC5704778 DOI: 10.1007/s12671-017-0735-9] [Citation(s) in RCA: 69] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The purpose of this study was to uncover the day-to-day emotional profiles and dose-response relations, both within-persons and between-persons, associated with initiating one of two meditation practices, either mindfulness meditation or loving-kindness meditation. Data were pooled across two studies of midlife adults (N = 339) who were randomized to learn either mindfulness meditation or loving-kindness meditation in a six-week workshop. The duration and frequency of meditation practice was measured daily for nine weeks, commencing with the first workshop session. Likewise, positive and negative emotions were also measured daily, using the modified Differential Emotions Scale (Fredrickson, 2013). Analysis of daily emotion reports over the targeted nine-week period showed significant gains in positive emotions and no change in negative emotions, regardless of meditation type. Multilevel models also revealed significant dose-response relations between duration of meditation practice and positive emotions, both within-persons and between-persons. Moreover, the within-person dose-response relation was stronger for loving-kindness meditation than for mindfulness meditation. Similar dose-response relations were observed for the frequency of meditation practice. In the context of prior research on the mental and physical health benefits produced by subtle increases in day-to-day experiences of positive emotions, the present research points to evidence-based practices - both mindfulness meditation and loving-kindness meditation - that can improve emotional wellbeing.
Collapse
Affiliation(s)
- Barbara L Fredrickson
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill
| | - Aaron J Boulton
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill
| | - Ann M Firestine
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill
| | - Patty Van Cappellen
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill
| | - Sara B Algoe
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill
| | | | | | - Jeffrey Brantley
- Duke Integrative Medicine and Department of Psychiatry and Behavioral Sciences, Duke University
| | | |
Collapse
|