Who am I?: The influence of affect on the working self-concept

Influence of comorbid depression and diagnostic workup on diagnosis of physical illness: a randomized experiment

OBJECTIVES

Patients with mental illness are less likely to receive the same physical healthcare as those without mental illness and are less likely to be treated in accordance with established guidelines. This study employed a randomized experiment to investigate the influence of comorbid depression on diagnostic accuracy.

METHODS

Physicians were presented with an interactive vignette describing a patient with a complex presentation of pernicious anemia. They were randomized to diagnose either a patient with or without (control) comorbid depression and related behaviors. All other clinical information was identical. Physicians recorded a differential diagnosis, ordered tests, and rated patient likeability.

RESULTS

Fifty-nine physicians completed the study. The patient with comorbid depression was less likeable than the control patient (p=0.03, 95 % CI [0.09, 1.53]). Diagnostic accuracy was lower in the depression compared to control condition (59.4 % vs. 40.7 %), however this difference was not statistically significant χ2(1)=2.035, p=0.15. Exploratory analyses revealed that patient condition (depression vs. control) interacted with the number of diagnostic tests ordered to predict diagnostic accuracy (OR=2.401, p=0.038). Accuracy was lower in the depression condition (vs. control) when physicians ordered fewer tests (1 SD below mean; OR=0.103, p=0.028), but there was no difference for physicians who ordered more tests (1 SD above mean; OR=2.042, p=0.396).

CONCLUSIONS

Comorbid depression and related behaviors lowered diagnostic accuracy when physicians ordered fewer tests - a time when more possibilities should have been considered. These findings underscore the critical need to develop interventions to reduce diagnostic error when treating vulnerable populations such as those with depression.

Self-concept Clarity and Subjective Well-Being: Disentangling Within- and Between-Person Associations

Previous research has suggested that, among adolescents, clarity about one's self-concept is closely related to subjective well-being. However, longitudinal studies are scarce, and whether a clear self-concept is the cause or effect of subjective well-being remains unclear. This study examined the dynamic longitudinal associations between self-concept clarity and subjective well-being at the between- and within-person levels over a one-year time span among adolescents (baseline Mage = 16.01 years; 57.0% girls) from China. The data were collected in three waves (each at a six-month interval), in which adolescents reported their self-concept clarity and well-being (i.e., positive and negative affect and personal satisfaction with life). Both Random Intercept Cross-Lagged Panel Models (RI-CLPMs) and Cross-Lagged Panel Models (CLPMs) were applied to examine the stability, cross-sectional relationships, and cross-lagged effects between adolescents' self-concept clarity and subjective well-being over time. The CLPMs provided unique support for a reciprocal relations model of self-concept clarity and subjective well-being (including both cognitive and emotional well-being) across three time points, although the results of traditional CLPM might represent an unknown blend of between- and within-person effects. However, the RI-CLPM analyses provided tentative support only for cross-sectional correlations between self-concept clarity and well-being outcomes. Our findings advance the literature by elucidating longitudinal relationships between self-concept clarity and subjective well-being in collectivist cultural contexts using CLPM and RI-CLPM.

Semantic Self-Images and Well-Being in Young and Older Adults: Does the Accessibility Matter?

In the present study we investigated whether and how age group, dimensions of well-being and their interactions predicted the phenomenological properties of semantic self-images, taking also into account the different levels of accessibility of self-images (i.e., order of generation). Results on the first self-image revealed that, independently of age, higher levels of life satisfaction predicted higher likelihood of positive than negative statement and higher levels of negative affect and life satisfaction predicted higher levels of personal relevance of the self-image. When all self-images were considered, for higher levels of life satisfaction neutral and positive self-images were more likely than negative ones, and for lower levels of positive affect, neutral images were more likely than negative ones. Moreover, young adults were more likely than older adults to report neutral rather than negative self-images and, for higher levels of positive affect, they were more likely to report neutral and positive images instead of negative ones. These results suggest that the accessibility of semantic self-images should be taken into account in the investigation of the complex association between well-being and semantic self-images. Theoretical and practical implications of these results are discussed.

Moving From Me to We: Interpersonal Coordination’s Effects on Self-Construal

We all move in time together throughout our lives, and doing so has been shown to lead to more pro-social attitudes and behaviors towards co-actors. However, little research has investigated how coordinated movement affects how individuals feel about themselves. This mixed-methods study took self-generated qualitative responses of how participants construed their own identities after either coordinated movement or a carefully matched control task. Responses were analysed qualitatively using thematic analyses, and quantitatively using content analysis. Four themes were identified from thematic analysis, and inferential statistical testing showed significant differences in how participants construed their identities post coordination (cf. control). Participants in the coordinated condition generated a higher proportion of interdependent (social) rather than independent (personal) self-construals, driven by differences in broad social structures/constructs rather than close specific social relations. Furthermore, participants in the coordinated condition reported less mental state items, and more sexual/romantic items. These findings may explain how and why coordinated movement leads to prosociality amongst those who take part, by leading individuals to think of themselves and each other in group terms.

Emotionally evocative patients in the emergency department: a mixed methods investigation of providers' reported emotions and implications for patient safety

BACKGROUND

Emergency department (ED) physicians and nurses frequently interact with emotionally evocative patients, which can impact clinical decision-making and behaviour. This study introduces well-established methods from social psychology to investigate ED providers' reported emotional experiences and engagement in their own recent patient encounters, as well as perceived effects of emotion on patient care.

METHODS

Ninety-four experienced ED providers (50 physicians and 44 nurses) vividly recalled and wrote about three recent patient encounters (qualitative data): one that elicited anger/frustration/irritation (angry encounter), one that elicited happiness/satisfaction/appreciation (positive encounter), and one with a patient with a mental health condition (mental health encounter). Providers rated their emotions and engagement in each encounter (quantitative data), and reported their perception of whether and how their emotions impacted their clinical decision-making and behaviour (qualitative data).

RESULTS

Providers generated 282 encounter descriptions. Emotions reported in angry and mental health encounters were remarkably similar, highly negative, and associated with reports of low provider engagement compared with positive encounters. Providers reported their emotions influenced their clinical decision-making and behaviour most frequently in angry encounters, followed by mental health and then positive encounters. Emotions in angry and mental health encounters were associated with increased perceptions of patient safety risks; emotions in positive encounters were associated with perceptions of higher quality care.

CONCLUSIONS

Positive and negative emotions can influence clinical decision-making and impact patient safety. Findings underscore the need for (1) education and training initiatives to promote awareness of emotional influences and to consider strategies for managing these influences, and (2) a comprehensive research agenda to facilitate discovery of evidence-based interventions to mitigate emotion-induced patient safety risks. The current work lays the foundation for testing novel interventions.

Differentiating the effects of anger and sadness: A perspective of spontaneous trait inference

In the present research, three experiments were conducted to examine the effects of anger and sadness on spontaneous trait inferences (STIs). Using a probe recognition paradigm, Experiment 1 revealed that angry participants made more errors in response to probes following trait-implying behaviours than sad participants did. Using a false recognition paradigm, Experiments 2 and 3 revealed that angry participants made more errors in response to systematic pair trials than sad participants did. The three experiments provided convergent evidence that angry individuals were more inclined to form STIs than sad individuals were. The current research first demonstrated the different effects of specific negative mood states (anger vs. sadness) on STIs, providing further insight into the relationship between mood and STIs.

The Impact of Affect on Out-Group Judgments Depends on Dominant Information-Processing Styles: Evidence From Incidental and Integral Affect Paradigms

Two studies tested the affect-as-cognitive-feedback model, in which positive and negative affective states are not uniquely associated with particular processing styles, but rather serve as feedback about currently accessible processing styles. The studies extend existing work by investigating (a) both incidental and integral affect, (b) out-group judgments, and (c) downstream consequences. We manipulated processing styles and either incidental (Study 1) or integral (Study 2) affect and measured perceptions of out-group homogeneity. Positive (relative to negative) affect increased out-group homogeneity judgments when global processing was primed, but under local priming, the effect reversed (Studies 1 and 2). A similar interactive effect emerged on attributions, which had downstream consequences for behavioral intentions (Study 2). These results demonstrate that both incidental and integral affect do not directly produce specific processing styles, but rather influence thinking by providing feedback about currently accessible processing styles.

Sometimes happy people focus on the trees and sad people focus on the forest: context-dependent effects of mood in impression formation

Research indicates that affect influences whether people focus on categorical or behavioral information during impression formation. One explanation is that affect confers its value on whatever cognitive inclinations are most accessible in a given situation. Three studies tested this malleable mood effects hypothesis, predicting that happy moods should maintain and unhappy moods should inhibit situationally dominant thinking styles. Participants completed an impression formation task that included categorical and behavioral information. Consistent with the proposed hypothesis, no fixed relation between mood and processing emerged. Whether happy moods led to judgments reflecting category-level or behavior-level information depended on whether participants were led to focus on the their immediate psychological state (i.e., current affective experience; Studies 1 and 2) or physical environment (i.e., an unexpected odor; Study 3). Consistent with research on socially situated cognition, these results demonstrate that the same affective state can trigger entirely different thinking styles depending on the context.