The feasibility and acceptability of integrating dogs into inpatient rehabilitation therapy with children with acquired brain injury

INTRODUCTION

Children with acquired brain injury (ABI) are at risk for poor therapeutic engagement due to cognitive impairment, affect lability, pain, and fatigue. Animal-assisted therapy (AAT) has the potential to improve patient engagement in rehabilitation therapies; however, the feasibility of integrating AAT into the rigorous therapy schedule of inpatient clinical care or its reception by patients, families, and staff is unknown.

OBJECTIVE

To examine the feasibility and acceptability of incorporating dogs into physical therapy and occupational therapy sessions with pediatric patients being treated on an inpatient rehabilitation unit for acquired brain injury.

DESIGN

A feasibility study of AAT within the context of a within-subjects crossover study.

SETTING

Pediatric inpatient rehabilitation unit.

PARTICIPANTS

Sixteen patients, aged 7-28 years (mean = 13.6 years, standard deviation [SD] = 5.2 years; 50% male), being treated on the inpatient rehabilitation unit following ABI.

INTERVENTION

AAT - the integration of dogs into inpatient physical therapy and occupational therapy sessions.

MAIN OUTCOME MEASURES

Feasibility measures: enrollment rate, the proportion of AAT sessions a dog attended, adverse events, instances where therapist or handler ended session early, patient animal closeness, and utilization of dog in session. Satisfaction measures: parent satisfaction questionnaires and therapist feedback.

RESULTS

Feasibility was supported by high enrollment rate (88.9%) and dog attendance rate of 93%-95%; 84.3% of sessions used the dog in multiple ways and patients reported a high level of closeness with the dog in session, indicating that the dogs were integrated in meaningful ways. No adverse events were noted, therapists reported that intervention was convenient, and clinical care was not negatively impacted. A high level of satisfaction was reported by families and therapists.

CONCLUSIONS

Findings suggest that AAT is feasible and acceptable, and it may be a valuable tool for therapists working with patients with ABI on an inpatient rehabilitation unit.

Blinded by wistfulness: on how nostalgia strengthens attitudes

Across four studies, we explored how feeling nostalgic about an attitude object impacts the metacognitive characteristics of the attitude toward that object and how those metacognitions predict the evaluation's underlying strength. In each study, participants reflected on and evaluated a song or television show that either did or did not elicit nostalgia. Across these studies, we found support for the hypotheses that nostalgic attitude objects are viewed more positively, appraised with greater attitudinal importance, and exhibited less objective ambivalence. In Study 4, we observed that nostalgic attitudes are associated with greater behavioural intentions and that this relationship was mediated both by attitudinal importance and objective ambivalence. These studies contribute to our understanding of how nostalgia affects attitude formation processes.

Denver pain authenticity stimulus set (D-PASS)

We introduce the Denver Pain Authenticity Stimulus Set (D-PASS), a free resource containing 315 videos of 105 unique individuals expressing authentic and posed pain. All expressers were recorded displaying one authentic (105; pain was elicited via a pressure algometer) and two posed (210) expressions of pain (one posed expression recorded before [posed-unrehearsed] and one recorded after [posed-rehearsed] the authentic pain expression). In addition to authentic and posed pain videos, the database includes an accompanying codebook including metrics assessed at the expresser and video levels (e.g., Facial Action Coding System metrics for each video controlling for neutral images of the expresser), expressers' pain threshold and pain tolerance values, averaged pain detection performance by naïve perceivers who viewed the videos (e.g., accuracy, response bias), neutral images of each expresser, and face characteristic rating data for neutral images of each expresser (e.g., attractiveness, trustworthiness). The stimuli and accompanying codebook can be accessed for academic research purposes from https://digitalcommons.du.edu/lsdl_dpass/1/ . The relatively large number of stimuli allow for consideration of expresser-level variability in analyses and enable more advanced statistical approaches (e.g., signal detection analyses). Furthermore, the large number of Black (n = 41) and White (n = 56) expressers permits investigations into the role of race in pain expression, perception, and authenticity detection. Finally, the accompanying codebook may provide pilot data for novel investigations in the intergroup or pain sciences.

Too Tired and in Too Good of a Mood to Worry About Privacy: Explaining the Privacy Paradox Through the Lens of Effort Level in Information Processing

Policy-oriented Abstract

Data privacy is one of the most pressing issues today. The world is thirsty for novel, effective, and efficient policies to strike an appropriate balance between protecting individuals’ privacy and creating economic value from their personal information. Whereas governmental efforts, such as the enaction of General Data Protection Regulation, California Consumer Privacy Act, and other privacy regulations, have been pushing boundaries to strike this balance, the effects of these types of initiatives on individuals’ privacy awareness and behavior are uncertain, likely to be nuanced, and will take time to sort out. In this paper, we explain the privacy paradox, a phenomenon with important implications that apply to policymakers, industry professionals, and individuals. The privacy paradox refers to a mismatch between individuals’ stated privacy concerns and their actual disclosure behaviors. In three behavioral experiments, we show how the paradox is revealed when individuals are cognitively tired especially when they are in a good mood. These findings do not indicate that individuals do not care about privacy because they do when they are not cognitively tired especially when they are in a bad mood. By explaining the privacy paradox, we inform existing and future privacy policies to strike that balance we all strive for.

Race Deficits in Pain Detection: Medical Providers and Laypeople Fail to Accurately Perceive Pain Authenticity Among Black People

Across six studies ( N = 904), we suggest a novel mechanism for race disparities in pain treatment: Perceiver deficits in discriminating real from fake pain for Black (relative to White) individuals. Across Studies 1–4, White participants (Studies 1–4) and Black participants (Study 2) were better at discerning authentic from inauthentic pain expressions for White targets than for Black targets. This effect emerged for both subtle (Studies 1 and 2) and intense (Studies 3 and 4) pain stimuli. Studies 5 and 6 examined consequences for medical care decisions by examining pain treatment recommendations by laypeople (Study 5) and pain authenticity judgments by medical providers (Study 6). This work advances theory in pain perception, emotion judgment, and intergroup relations. It also has practical significance for identifying unexplored mechanisms causing racial disparities in medical care.

Black and White Lies: Race-Based Biases in Deception Judgments

In six studies ( N = 605), participants made deception judgments about videos of Black and White targets who told truths and lies about interpersonal relationships. In Studies 1a, 1b, 1c, and 2, White participants judged that Black targets were telling the truth more often than they judged that White targets were telling the truth. This truth bias was predicted by Whites' motivation to respond without prejudice. For Black participants, however, motives to respond without prejudice did not moderate responses (Study 2). In Study 3, we found similar effects with a manipulation of the targets' apparent race. Finally, in Study 4, we used eye-tracking techniques to demonstrate that Whites' truth bias for Black targets is likely the result of late-stage correction processes: Despite ultimately judging that Black targets were telling the truth more often than White targets, Whites were faster to fixate on the on-screen "lie" response box when targets were Black than when targets were White. These systematic race-based biases have important theoretical implications (e.g., for lie detection and improving intergroup communication and relations) and practical implications (e.g., for reducing racial bias in law enforcement).

Perceptions of Entitativity and Attitude Change

The current work explored the properties of groups that lead them to be persuasive and the processes through which such persuasion occurs. Because more entitative groups induce greater levels of information processing, their arguments should receive greater elaboration, leading to persuasion when members of groups present strong (vs. weak) counter attitudinal arguments. Experiment 1 explored these hypotheses by examining if idiosyncratic perceptions of group entitativity and manipulations of argument strength affect attitude change and argument elaboration. Experiment 2 experimentally manipulated group entitativity and argument strength independently to examine the causal relationship between entitativity, attitude change, and argument elaboration. In both experiments, it was found that groups greater in entitativity were more persuasive when presenting strong (vs. weak) arguments and induced greater argument elaboration. Implications for our understanding of entitativity, persuasion, and information processing about social groups are discussed.

Women as Men and People: Effects of Gender-Marked Language

This study examined the implications of gender-marked language. It was hypothesized that man-suffix occupation titles (e.g., chairman) would lead perceivers to interpret a social target's personality as more masculine than no-suffix occupation titles (e.g., chair) and that person-suffix occupation titles (e.g., chairperson) would lead perceivers to interpret a social target's personality as less masculine than no-suffix occupation titles. Experiment 1 supported these predictions. Moreover, the effect was stronger for participants who reported more traditional gender role beliefs. Experiment 2 replicated this effect and showed that repeated exposure to occupation title suffixes (i.e., priming), coupled with the knowledge that the occupation title was chosen by the target (i.e., implicit personality effects), mediated the findings. In addition to explaining some of the cognitive underpinnings of sexist language, these results speak to conditions when priming will influence social perception.

Implicit and Explicit Measures of Sexual Orientation Attitudes: In Group Preferences and Related Behaviors and Beliefs among Gay and Straight Men

The relations among implicit and explicit measures of sexual orientation attitudes and sexual-orientation-related behavior and beliefs among gay men (Study 1) and straight men (Studies 1 and 2) were explored. Study 1 found relations between implicit and explicit measures of sexual orientation attitudes, large differences between gay and straight men on both implicit and explicit measures, and that these measures predicted sexual-orientation-related behaviors among gay men. Also, only straight men exhibited a negative relation between their attitudes toward homosexuality and heterosexuality. Study 2 found that as straight men held more negative attitudes toward homosexuality, they more strongly endorsed the importance of heterosexual identity and of traditional masculine gender roles. These endorsements mediated the negative relation between their attitudes toward heterosexuality and homosexuality. Implications for assessing attitudes toward sexual orientation and their relations for sexual orientation identity are discussed.

Resistance Can Be Good or Bad: How Theories of Resistance and Dissonance Affect Attitude Certainty

This research investigated how lay theories about resisting persuasion can affect attitude certainty. Specifically, people who believed that resistance was negative (i.e., implies close-mindedness) showed different levels of attitude certainty after resisting persuasive messages than people who believed resistance was positive (i.e., implies intelligence). When people held positive lay theories of resistance and overcame ostensibly strong arguments, they showed increased attitude certainty (compared to those who overcame ostensibly weak arguments). However, individuals who believed that resistance was negative did not show increases in attitude certainty when overcoming strong arguments. Experiment 2 suggests that the effect of lay theories and perceived argument strength on attitude certainty was due to dissonance created by believing that resistance is undesirable but nonetheless resisting persuasion.

Of Two Minds

Because different processes underlie implicit and explicit attitudes, we hypothesized that they are differentially sensitive to different kinds of information. We measured implicit and explicit attitudes over time, as different types of attitude-relevant information about a single attitude object were presented. As expected, explicit attitudes formed and changed in response to the valence of consciously accessible, verbally presented behavioral information about the target. In contrast, implicit attitudes formed and changed in response to the valence of subliminally presented primes, reflecting the progressive accretion of attitude object-evaluation pairings. As a consequence, when subliminal primes and behavioral information were of opposite valence, people formed implicit and explicit attitudes of conflicting valence.

The Multiple Self-Aspects Framework: Self-Concept Representation and Its Implications

The multiple self-aspects framework (MSF) conceives of the self-concept as a collection of multiple, context-dependent selves. From this perspective, five principles are derived, addressing issues such as how context activates particular regions of self-knowledge and how self-relevant feedback affects self-evaluations and affect. Support for these principles is discussed. Furthermore, the MSF advances several novel predictions, including how active self-aspects filter one’s experiences and perceptions, how the impact of chronic accessibility is more circumscribed than previously realized, and how self-concept representation modulates the experience of affect. In addition, the MSF helps integrate isolated lines of research within several diverse literatures, including self-regulation, stability and variability for the self, the integration of others into the self-concept, and several individual difference factors as well. Overall, the current work speaks to issues of relevance to several subdisciplines in psychology (e.g., cultural, developmental, personality, social) interested in the self, providing conceptual and methodological insights.

The simple life: on the benefits of low self-complexity

This article examines the spillover amplification hypothesis, which proposes that because people lower in self-complexity experience stronger responses to life events they will show relatively better well-being in the presence of positive factors (e.g., better social support) and relatively poorer well-being in the presence of negative factors (e.g., a history of negative experiences). Across three studies, support for spillover amplification was found. Specifically, people lower in self-complexity revealed greater self-esteem, less depression, and fewer illnesses when they had greater social support (Study 1) and more desirable personality characteristics (Study 2), yet they had poorer well-being if they had a history of many negative life events (Study 3). Thus, how one's self-concept is represented in memory moderates the relationship between many well-established factors and well-being.

When Chronic Isn't Chronic: The Moderating Role of Active Self-Aspects

The current work considered how self-concept organization moderates the consequences of chronic attributes, which are widely assumed to be always accessible and influential. In Study 1, the accessibility of participants' chronic attributes was assessed before and after activating a self-aspect that was either relevant or irrelevant to participants' chronic attributes. Results showed that chronic attributes were more accessible when they were relevant to a participant's active self-aspect than when they were irrelevant to it. In Study 2, participants read ambiguous behaviors performed by others, some of which could be interpreted in line with their own chronic attribute or an alternative attribute. Participants were more likely to interpret behaviors as consistent with their own chronic attributes, but only when a relevant self-aspect had been previously activated. These studies suggest that chronicity can be moderated by self-aspect activation, consistent with the perspective that the self consists of multiple, context-dependent self-aspects.

Understanding implicit and explicit attitude change: a systems of reasoning analysis

There is considerable controversy about how to conceptualize implicit and explicit attitudes, reflecting substantial speculation about the mechanisms involved in implicit and explicit attitude formation and change. To investigate this issue, the current work examines the processes by which new attitudes are formed and changed and how these attitudes predict behavior. Five experiments support a systems of reasoning approach to implicit and explicit attitude change. Specifically, explicit attitudes were shaped in a manner consistent with fast-changing processes, were affected by explicit processing goals, and uniquely predicted more deliberate behavioral intentions. Conversely, implicit attitudes reflected an associative system characterized by a slower process of repeated pairings between an attitude object and related evaluations, were unaffected by explicit processing goals, uniquely predicted spontaneous behaviors, and were exclusively affected by associative information about the attitude object that was not available for higher order cognition.

Stereotype threat and working memory: Mechanisms, alleviation, and spillover

Stereotype threat (ST) occurs when the awareness of a negative stereotype about a social group in a particular domain produces suboptimal performance by members of that group. Although ST has been repeatedly demonstrated, far less is known about how its effects are realized. Using mathematical problem solving as a test bed, the authors demonstrate in 5 experiments that ST harms math problems that rely heavily on working memory resources--especially phonological aspects of this system. Moreover, by capitalizing on an understanding of the cognitive mechanisms by which ST exerts its impact, the authors show (a) how ST can be alleviated (e.g., by heavily practicing once-susceptible math problems such that they are retrieved directly from long-term memory rather than computed via a working-memory-intensive algorithm) and (b) when it will spill over onto subsequent tasks unrelated to the stereotype in question but dependent on the same cognitive resources that stereotype threat also uses. The current work extends the knowledge of the causal mechanisms of stereotype threat and demonstrates how its effects can be attenuated and propagated.

On the causal mechanisms of stereotype threat: can skills that don't rely heavily on working memory still be threatened?

Recent work suggests that stereotype threat (ST) harms performance by reducing available working memory capacity. Is this the only mechanism by which ST can occur? Three experiments examined ST's impact on expert golf putting, which is not harmed when working memory is reduced but is hurt when attention is allocated to proceduralized processes that normally run outside working memory. Experiment 1 showed that well learned golf putting is susceptible to ST. Experiments 2 and 3 demonstrated that giving expert golfers a secondary task eliminates ST-induced impairment. Distracting attention away from the stereotype-related behavior eliminates the harmful impact of negative stereotype activation. These results are consistent with explicit monitoring theories of choking under pressure, which suggest that performance degradation can occur when too much attention is allocated to processes that usually run more automatically. Thus, ST alters information processing in multiple ways, inducing performance decrements for different reasons in different tasks.

The mediating effects of attitudes toward homosexuality between secure attachment and disclosure outcomes among gay men

Past research has found that a stronger secure attachment style, developed in childhood, enhances one's ability to acknowledge negative feelings, cope with negative life events, and develop satisfying social relationships. Because an integral part of the "coming out" process for gay men is the ability to seek support from the gay community in order to reevaluate negative beliefs toward homosexuality, a gay man's attachment style may strongly impact this critical stage of his life. Results demonstrated that men who more strongly endorsed a secure attachment style reported more positive attitudes toward their own homosexuality, and that these more positive attitudes could mediate the relation between more secure attachment style, greater levels of self-disclosure regarding their homosexuality, and greater self-esteem. Implications of these data for internalized homophobia, the coming-out process, and effective social functioning are discussed.

Within-target illusory correlations and the formation of context-dependent attitudes

Two experiments explored the formation of context-dependent attitudes about a single social target. One such mechanism for the development of differential attitudes toward a target in different contexts is illusory correlation formation. It was proposed that within-target illusory correlations (i.e., perceiving unwarranted associations between salient target behaviors and distinctive domains in which the target is observed) can result in biased evaluations of a social target in different domains (e.g., home vs. work). When memory-based (vs. on-line) judgments were induced, perceivers formed context-dependent attitudes for both group (Experiment 1) and individual (Experiment 2) targets. These findings are consistent with theories regarding multiply categorizable attitude objects. Further, they suggest that some apparent discrepancies between attitudes and behavior may reflect holding multiple context-dependent attitudes about social targets.

Target entitativity: implications for information processing about individual and group targets

It is hypothesized that perceptions of entitativity (i.e., seeing social targets as possessing unity and coherence) have important implications for how one organizes information about, and forms impressions of, individual and group targets. When perceivers expect entitativity, they should form an integrated impression of the target, resulting in on-line judgments. However, when perceivers expect little entitativity, they should not process target-relevant information in an integrative fashion, resulting in memory-based judgments. Although many factors affect perceptions of entitativity, the current study focused on expectations of similarity and behavioral consistency. It was predicted that in general, perceivers expect greater entitativity for individual than group targets. However, when explicitly provided with similar expectancies of entitativity, information processing would be similar for both individual and group targets. Two experiments supported these predictions, using recall, memory-judgment correlation, and illusory correlation measures.