The nonverbal expression of guilt in healthy adults

Guilt is a negative emotion elicited by realizing one has caused actual or perceived harm to another person. One of guilt's primary functions is to signal that one is aware of the harm that was caused and regrets it, an indication that the harm will not be repeated. Verbal expressions of guilt are often deemed insufficient by observers when not accompanied by nonverbal signals such as facial expression, gesture, posture, or gaze. Some research has investigated isolated nonverbal expressions in guilt, however none to date has explored multiple nonverbal channels simultaneously. This study explored facial expression, gesture, posture, and gaze during the real-time experience of guilt when response demands are minimal. Healthy adults completed a novel task involving watching videos designed to elicit guilt, as well as comparison emotions. During the video task, participants were continuously recorded to capture nonverbal behaviour, which was then analyzed via automated facial expression software. We found that while feeling guilt, individuals engaged less in several nonverbal behaviours than they did while experiencing the comparison emotions. This may reflect the highly social aspect of guilt, suggesting that an audience is required to prompt a guilt display, or may suggest that guilt does not have clear nonverbal correlates.

Early nap cessation in young children as a correlate of language and psychosocial outcomes: Evidence from a large Canadian sample

OBJECTIVES

Most children stop napping between 2 and 5years old. We tested the association of early nap cessation (ie, children who stopped before their third birthday) and language, cognition functioning and psychosocial outcomes.

METHODS

Data were from a national, longitudinal sample of Canadian children, with three timepoints. Children were 0-to-1 year old at T1, 2-to-3 years old at T2, and 4-to-5 years old at T3. Early nap cessation was tested as a correlate of children's psychosocial functioning (cross-sectionally and longitudinally), cognitive function (longitudinally), and language skills (longitudinally). There were 4923 children (50.9% male; 90.0% White) and their parents in this study who were included in the main analyses. Parents reported on demographics, perinatal and developmental variables, child functioning, and child sleep. Children completed direct assessments of receptive language and cognitive ability. Nap cessation, demographic, and developmental-control variables were tested as correlates of cross-sectional and longitudinal outcomes using linear regression (with a model-building approach).

RESULTS

Early nap cessation correlated with higher receptive language ability (β = 0.059 ± 0.028) and lower anxiety (β = -0.039 ± 0.028) at T3, after controlling for known correlates of nap cessation, nighttime sleep, and other sociodemographic correlates of the outcomes. Cognitive ability, hyperactivity-inattention, and aggression were not correlated with nap cessation.

CONCLUSIONS

Early nap cessation is related to specific benefits (ie, better receptive language and lower anxiety symptoms). These findings align with previous research. Future research should investigate differences associated with late nap cessation and in nap-encouraging cultures, and by ethnicity.

A bifactor model supports unidimensionality of the International Knee Documentation Committee Subjective Knee Form in young active patients with anterior cruciate ligament tears: a retrospective analysis of a randomized controlled trial

BACKGROUND

The International Knee Documentation Committee Subjective Knee Form (IKDC) is the most highly recommended patient reported outcome measure for assessing patients with anterior cruciate ligament (ACL) injuries and those undergoing ACL reconstruction (ACLR) surgery. The IKDC was developed as a unidimensional instrument for a variety of knee conditions. Structural validity, which determines how an instrument is scored, has not been definitively confirmed for the IKDC in respondents with ACL injuries, and in fact an alternative two-factor/subscale structure has been proposed in this population. The purpose of this study was to determine the most appropriate structure and scoring system for the IKDC in young active patients following ACL injury.

METHODS

In total, 618 young patients deemed at high risk of graft rupture were randomized into the Stability 1 trial. Of the trial participants, 606 patients (98%) completed a baseline IKDC questionnaire used for this analysis. A cross sectional retrospective secondary data analysis of the Stability 1 baseline IKDC data was completed to assess the structural validity of the IKDC using exploratory and confirmatory factor analyses. Factor analyses were used to test model fit of the intended one-factor structure, a two-factor structure, and alternative four-factor and bifactor structures (i.e., a combination of a unidimensional factor with additional specific factors) of the IKDC, in a dataset of young active ACL patients.

RESULTS

The simple one-factor and two-factor structures of the IKDC displayed inadequate fit in our dataset of young ACL patients. A bifactor model provided the best fit. This model contains one general factor that is substantially associated with all items, plus four secondary, more specific content factors (symptoms, activity level, activities of daily living, and sport) with generally weaker associations to subsets of items. Although the single-factor model did not provide unambiguous support to unidimensionality of the IKDC based on fit indices, the bifactor model supports unidimensionality of the IKDC when covariance between items with similar linguistic structure, response options, or content are acknowledged.

CONCLUSIONS

Overall, findings of a bifactor model with evidence of a reliable general factor well defined by all items lends support to continue interpreting and scoring this instrument as unidimensional. This should be confirmed in other samples. Clinically, based on these findings, the IKDC can be represented by a single score for young active patients with ACL tears. A more nuanced interpretation would also consider secondary factors such as sport and activity level.

TRIAL REGISTRATION

The Stability 1 trial for which these data were collected was registered on ClinicalTrial.gov (NCT02018354).

Effects of online self-compassionate writing on stigmatizing and affirming self-perceptions: Potential boundary conditions in undergraduate women

This study investigated the effects of an online self-compassionate writing intervention on stigmatizing and affirming self-views toward the body in a sample of college women (N = 254). Participants were randomly assigned to a self-compassionate writing, attentional-control writing, or wait-list control condition for one week, and completed measures of self-compassion, affirming self-perceptions, and stigmatizing self-perceptions at baseline, one-week post intervention, and one-month post intervention. A series of mixed AN(C)OVAs revealed no significant effects by condition or time on stigmatizing or affirming self-views toward the body when controlling for self-esteem, internalized weight stigma, and eating disorder symptomatology. Follow-up exploratory analyses demonstrated no significant effects by condition on the six facets of self-compassion. Notably, participants were significantly more likely to drop out from the study over time if they were lower in self-compassion and self-esteem, and higher in internalized weight stigma at baseline. These results suggest that online self-compassion writing interventions may need to be longer and more potent, especially for women with more entrenched and stigmatized views about their bodies, as well as potential boundary conditions of cultivating self-compassion in a short-term online intervention.

Development and Preliminary Validation of the KOOS-ACL: A Short Form Version of the KOOS for Young Active Patients With ACL Tears

BACKGROUND

The Knee injury and Osteoarthritis Outcomes Score (KOOS) is a widely used region-specific outcome measure for assessing patients of all ages with a variety of knee conditions. Use of the KOOS for young active patients with anterior cruciate ligament (ACL) tear has been called into question regarding its relevance and interpretability for this specific population. Furthermore, the KOOS does not have adequate structural validity for use in high-functioning patients with ACL deficiency.

PURPOSE

To develop a condition-specific short form version of the KOOS that is appropriate for the young active population with ACL deficiency: the KOOS-ACL.

STUDY DESIGN

Cohort study (diagnosis); Level of evidence, 2.

METHODS

A baseline data set of 618 young patients (≤25 years old) with ACL tears was divided into development and validation samples. Exploratory factor analyses were conducted in the development sample to identify the underlying factor structure and to reduce the number of items based on statistical and conceptual indicators. Confirmatory factor analyses were conducted to check fit indices of the proposed KOOS-ACL model in both samples. Psychometric properties of the KOOS-ACL were assessed using the same data set, expanded to include patient data from 5 time points (baseline and postoperative 3, 6, 12, and 24 months). Internal consistency reliability, structural validity, convergent validity, responsiveness to change, floor/ceiling effects, and detection of treatment effects between surgical interventions (ACL reconstruction alone vs ACL reconstruction + lateral extra-articular tenodesis) were assessed.

RESULTS

A 2-factor structure was deemed most appropriate for the KOOS-ACL. Of 42 items, 30 were removed from the full-length KOOS. The final KOOS-ACL model showed acceptable internal consistency reliability (α = .79-.90), structural validity (comparative fit index and Tucker-Lewis index = 0.98-0.99; root mean square error of approximation and standardized root mean square residual = 0.04-0.07), convergent validity (Spearman correlation with International Knee Documentation Committee subjective knee form = 0.61-0.83), and responsiveness across time (significant small to large effects; P < .05).

CONCLUSION

The new KOOS-ACL questionnaire contains 12 items and 2 subscales-Function (8 items) and Sport (4 items)-relevant to young active patients with an ACL tear. Use of this short form would reduce patient burden by more than two-thirds; it provides improved structural validity as compared with the full-length KOOS for our population of interest; and it demonstrates adequate psychometric properties in our sample of young active patients undergoing ACL reconstruction.

External Validation of the KOOS-ACL in the MOON Group Cohort of Young Athletes Followed for 10 Postoperative Years

BACKGROUND

The Knee injury and Osteoarthritis Outcome Score-Anterior Cruciate Ligament (KOOS-ACL) is a short form version of the KOOS, developed to target populations of young active patients with ACL tears. The KOOS-ACL consists of 2 subscales: Function (8 items) and Sport (4 items). The KOOS-ACL was developed and validated using data from the Stability 1 study from baseline to postoperative 2 years.

PURPOSE

To validate the KOOS-ACL in an external sample of patients matching the outcome's target population.

STUDY DESIGN

Cohort study (diagnosis); Level of evidence, 1.

METHODS

The Multicenter Orthopaedic Outcomes Network group cohort of 839 patients aged 14 to 22 years who tore their ACLs while playing sports was used to assess internal consistency reliability, structural validity, convergent validity, responsiveness to change, and floor/ceiling effects of the KOOS-ACL at 4 time points: baseline and postoperative 2, 6, and 10 years. Detection of treatment effects between graft type (hamstring tendon vs bone-patellar tendon-bone) were also compared between the full-length KOOS and KOOS-ACL.

RESULTS

The KOOS-ACL demonstrated acceptable internal consistency reliability (α = .82-.89), structural validity (Tucker-Lewis index and comparative fit index = 0.98-0.99; standardized root mean square residual and root mean square error of approximation = 0.04-0.07), convergent validity (Spearman correlation with International Knee Documentation Committee subjective knee form = 0.66-0.85; Western Ontario and McMaster Universities Osteoarthritis Index function = 0.84-0.95), and responsiveness to change across time (large effect sizes from baseline to postoperative 2 years; d = 0.94 [Function] and d = 1.54 [Sport]). Stable scores and significant ceiling effects were seen from 2 to 10 years. No significant differences in KOOS or KOOS-ACL scores were detected between patients with different graft types.

CONCLUSION

The KOOS-ACL shows improved structural validity when compared with the full-length KOOS and adequate psychometric properties in a large external sample of high school and college athletes. This strengthens the argument to use the KOOS-ACL to assess young active patients with ACL tears in clinical research and practice.

The psychophysiology of guilt in healthy adults

Guilt is a negative emotion, elicited by realizing one has caused actual or perceived harm to another person. Anecdotally, guilt often is described as a visceral and physical experience. However, while the way that the body responds to and contributes to emotions is well known in basic emotions, little is known about the characteristics of guilt as generated by the autonomic nervous system. This study investigated the physiologic signature associated with guilt in adults with no history of psychological or autonomic disorder. Healthy adults completed a novel task, including an initial questionnaire about their habits and attitudes, followed by videos designed to elicit guilt, as well as the comparison emotions of amusement, disgust, sadness, pride, and neutral. During the video task, participants' swallowing rate, electrodermal activity, heart rate, respiration rate, and gastric activity rate were continuously recorded. Guilt was associated with alterations in gastric rhythms, electrodermal activity, and swallowing rate relative to some or all the comparison emotions. These findings suggest that there is a mixed pattern of sympathetic and parasympathetic activation during the experience of guilt. These results highlight potential therapeutic targets for modulation of guilt in neurologic and psychiatric disorders with deficient or elevated levels of guilt, such as frontotemporal dementia, posttraumatic stress disorder, and Obsessive-compulsive disorder.

Investigating the relationships between temporal and spatial ratio estimation and magnitude discrimination using structural equation modeling: Evidence for a common ratio processing system

Humans perceive ratios of spatial and temporal magnitudes, such as length and duration. Previous studies have shown that spatial ratios may be processed by a common ratio processing system. The aim of the current study was to determine whether ratio processing is a domain-general ability and consequently involves common processing of temporal and spatial magnitudes. Two hundred seventy-five participants completed a battery of spatial and temporal ratio estimation and magnitude discrimination tasks online. Structural equation modeling was used to analyze the relationship between ratio processing across domains while controlling for absolute magnitude discrimination ability. The four-factor higher order model, consisting of spatial and temporal magnitude and ratio processing latent variables, showed adequate local and global fit, χ²(44) = 41.41, p = .626, root mean square error of approximation = .000. We found a significant relationship (r = .63) between spatial and temporal ratio processing, suggesting that ratio processing may be a domain-general ability. Additionally, absolute magnitude processing explained a large part (60-66%) of the variance in both spatial and temporal ratio processing factors. Overall, findings suggest that representation of spatial and temporal ratios is highly related and points toward a common ratio processing mechanism across different types of magnitudes. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The Knee Injury and Osteoarthritis Outcome Score Does Not Have Adequate Structural Validity for Use With Young, Active Patients With ACL Tears

BACKGROUND

The Knee Injury and Osteoarthritis Outcome Score (KOOS) is well known and commonly used to assess young, active patients with ACL injuries. However, this application of the outcome measure has been called into question. There is currently no evidence supporting the structural validity of the KOOS for this patient population. Structural validity refers to whether a questionnaire meant to provide scores on different subscales behaves as intended in the populations of interest. Structural validity should be assessed for all questionnaire measures with multiple items or subscales.

QUESTIONS/PURPOSES

Does the KOOS demonstrate adequate structural validity in young, active patients with ACL tears, when evaluated using (1) exploratory and (2) confirmatory factor analyses?

METHODS

Between January 2014 and March 2017, 1033 patients were screened for eligibility in the Stability 1 randomized controlled trial from nine centers in Canada and Europe. Patients were eligible if they had an ACL deficient knee, were between 14 and 25 years old, and were thought to be at higher risk of reinjury based on the presence of two or more of the following factors: participation in pivoting sports, presence of a Grade 2 pivot shift or greater, generalized ligamentous laxity (Beighton score of 4 or greater), or genu recurvatum greater than 10°. Based on this criteria, 367 patients were ineligible and another 48 declined to participate. In total, 618 patients were randomized into the trial. Of the trial participants, 98% (605 of 618) of patients had complete baseline KOOS questionnaire data available for this analysis. Based on study inclusion criteria, the baseline KOOS data from the Stability 1 trial represents an appropriate sample to investigate the structural validity of the KOOS, specifically for the young, active ACL deficient population.A cross sectional retrospective secondary data analysis of the Stability 1 baseline KOOS data was completed to assess the structural validity of the KOOS using exploratory and confirmatory factor analyses. Exploratory factor analysis investigates how all questionnaire items group together based on their conceptual similarity in a specific sample. Confirmatory factor analysis is similar but used often in a second stage to test and confirm a proposed structure of the subscales. These methods were used to assess the established five-factor structure of the KOOS (symptoms [seven items], pain [nine items], activities of daily living [17 items], sport and recreation [five items], and quality of life [four items]) in young active patients with ACL tears. Incremental posthoc modifications, such as correlating questionnaire items or moving items to different subscales, were made to the model structure until adequate fit was achieved. Model fit was assessed using chi-square, root mean square error of approximation (RMSEA) and an associated 90% confidence interval, comparative fit index (CFI), Tucker-Lewis index (TLI), as well as standardized root mean square residual (SRMR). Adequate fit was defined as a CFI and TLI > 0.9, and RMSEA and SRMR < 0.08.

RESULTS

Structural validity of the KOOS was not confirmed when evaluated using (1) exploratory or (2) confirmatory factor analyses. The exploratory factor analysis, where the 42 KOOS items were allowed to group naturally, did not reflect adequate fit for a five-factor model (TLI = 0.828). Similarly, the confirmatory factor analysis used to investigate the KOOS structure as it was originally developed, revealed inadequate fit in our sample (RMSEA = 0.088 [90% CI 0.086 to 0.091]). Our analysis suggested a modified four-factor structure may be more appropriate in young, active ACL deficient patients; however, the final version presented here is not appropriate for clinical use because of the number and nature of post-hoc modifications required to reach adequate fit indices.

CONCLUSION

The established five-factor structure of the KOOS did not hold true in our sample of young, active patients undergoing ACL reconstruction, indicating poor structural validity.

CLINICAL RELEVANCE

We question the utility and interpretability of KOOS subscale scores for young, active patients with ACL tears with the current form of the KOOS. A modified version of the KOOS, adjusted for this patient population, is needed to better reflect and interpret the outcomes and recovery trajectory in this high-functioning group. A separate analysis with a defined a priori development plan would be needed to create a valid alternative.

Family Physician Clinical Inertia in Managing Hypoglycemia

AIMS

Clinical inertia behaviour affects family physicians managing chronic disease such as diabetes. Literature addressing clinical inertia in the management of hypoglycemia is scarce. The objectives of this study were to create a measurement for physician clinical inertia in managing hypoglycemia (ClinInert_InHypoDM), and to determine physicians' characteristics associated with clinical inertia.

METHODS

The study was a secondary analysis of data provided by family physicians from the InHypo-DM Study, applying exploratory factor analysis. Principal axis factoring with an Oblimin rotation was employed to detect underlying factors associated with physician behaviors. Multiple linear regression was used to determine association between the ClinInert_InHypoDM scores and physician characteristics.

RESULTS

Factor analysis identified a statistically sound 12-item one-factor scale for clinical inertia behavior. No statistically significant differences in clinical inertia score for the studied independent variables were found.

CONCLUSIONS

This study provides a scale for assessing clinical inertia in the management of hypoglycemia. Further testing this scale in other family physician populations will provide deeper understanding about the characteristics and factors that influence clinical inertia. The knowledge derived from better understanding clinical inertia in primary care has potential to improve outcomes for patients with diabetes.

Gender Differences or Gender Bias?

Abstract. Sadism, defined by the infliction of pain and suffering on others for pleasure or subjugation, has recently garnered substantial attention in the psychological research literature. The Assessment of Sadistic Personality (ASP) was developed to measure levels of everyday sadism and has been shown to possess excellent reliability and validity using classical test theory methods. However, it is not known how well ASP items discriminate between respondents of different trait levels, or which Likert categories are endorsed by persons of various trait levels. Additionally, individual items should be evaluated to ensure that men and women of similar levels of sadism have an equal probability of response endorsement. The purpose of this research was to apply item response theory (IRT) and differential item functioning (DIF) to investigate item properties of the ASP across its three translations: English, Polish, and Italian. Overall, the results of the IRT analysis showed that with the exception of Item 9, the ASP demonstrated sound item properties. The DIF rate analyses identified two items from each questionnaire that were of practical significance across gender. Implications of these results are discussed.

Personality Measurement and Profile in a European Sample of Civil Airline Pilots

Abstract. The study examined the psychometric properties of the Revised NEO Personality Inventory (NEO PI-R, UK edition) in a large European sample of civil airline pilots. The NEO PI-R is a comprehensive and robust measure of personality that has been validated across cultures and contexts. Furthermore, the personality profile of the pilot sample was examined and compared to a normative sample representing the UK working population. Data from 591 pilots (95.1% male) were collected. Analyses include the internal reliability and factorial validity (precisely, Exploratory Structural Equation Modeling) to examine the measurement equivalence of the NEO PI-R with reference to UK norms ( N = 1,301). Internal reliability estimates of the NEO PI-R scores were good at the domain level, but generally weak at the facet level. The structural model in the pilot sample was congruent with the general working population sample. Furthermore, there was convincing evidence for a distinct personality profile of civil pilots, although the stability of this profile will require further validation. The NEO PI-R’s validity in the assessment of general personality in civil airline pilots is discussed, along with implications of the results for the utility of personality assessment in civil aviation contexts.

Measuring Patients' Perceptions of Health Care Encounters: Examining the Factor Structure of the Revised Patient Perception of Patient-Centeredness (PPPC-R) Questionnaire

PURPOSE

Given the ongoing desire to make health care more patient-centered and growing evidence supporting the provision of patient-centered care, it is important to have valid tools for measuring patient-centered care. The patient-centered clinical method (PCCM) is a conceptual framework for providing patient-centered care. A revision to the PCCM framework led to a corresponding need to enhance the Patient Perception of Patient-Centeredness (PPPC) questionnaire. The original PPPC was aligned with the components of the PCCM conceptual framework and developed to measure patient-centeredness from the patient's perspective. The purpose of this study was to examine the factor structure of a revised version of the PPPC (ie, PPPC-R).

METHODS

Eleven new items were added to the original 14 items. The modified questionnaire was administered to patients in primary health care teams in Ontario, Canada. The confirmatory factor analysis was conducted on a subset of 381 patients who had seen a family physician.

RESULTS

The initial proposed 4-factor model first tested with a confirmatory factor analysis (CFA) did not fit adequately. Exploratory factor analysis was therefore used as a second step to modify the model and to identify weak items. A 3-factor exploratory model with 18 of the original 25 items was converted into a final hypothetical CFA model that had a good fit (χ² ₍₁₃₂₎=176.795, P<0.01; CFI=0.991; RMSEA=0.030). The third factor contained only 2 items and so is interpreted with caution.

CONCLUSIONS

The validity of the PPPC-R is supported by some congruence between the conceptual framework (the PCCM) and the statistical analysis (CFA), but there is not a 1:1 correspondence. The components of the PCCM represent conceptually what is important when teaching, researching, and providing patient-centered care, whereas the PPPC-R represents patient-centered care as it is experienced by the patient.

Cultural Connectedness and Its Relation to Mental Wellness for First Nations Youth

We explored the interrelationships among components of cultural connectedness (i.e., identity, traditions, and spirituality) and First Nations youth mental health using a brief version of the original Cultural Connectedness Scale. Participants included 290 First Nations youth (M age = 14.4) who were recruited from both urban and rural school settings in Saskatchewan and Southwestern Ontario. We performed a confirmatory factor analysis of the Cultural Connectedness Scale-Short Version (CCS-S) items to investigate the factor stability of the construct in our sample. We examined the relationships between the CCS-S subscales and self-efficacy, sense of self (present and future), school connectedness, and life satisfaction using hierarchical multiple linear regression analyses to establish the validity of the abbreviated measure. The results revealed that cultural connectedness, as measured by the 10-item CCS-S, had strong associations with the mental health indicators assessed and, in some cases, was associated with First Nations youth mental health above and beyond other social determinants of health. Our results extend findings from previous research on cultural connectedness by elucidating the meaning of its components and demonstrate the importance of culture for positive youth development.

Dimensionality of the PTSD Checklist in a Canadian Aboriginal Sample

Background and Purpose: The PTSD Checklist–Civilian Version (PCL-C) is a widely used screening instrument measuring posttraumatic stress disorder (PTSD). However, to our knowledge, the factor structure of the PCL-C has not been examined in an Aboriginal population. Considerable research indicates that PTSD symptoms are characterized by 4 factors, with both the “King model” and the “Simms model” supported by the literature. Methods: Using confirmatory factor analysis on the PCL-C, we examined whether these models and the overall scale were supported in an Aboriginal community sample (N = 273). Results: The data supported both models. However, the 4 factors were highly correlated, providing some support for a 1-factor model as well. Conclusions: Our data support use of the PCL-C in Aboriginal health research.

Psychometric properties and a latent class analysis of the 12-item World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) in a pooled dataset of community samples

The 12-item World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) is a brief measurement tool used cross-culturally to capture the multi-dimensional nature of disablement through six domains, including: understanding and interacting with the world; moving and getting around; self-care; getting on with people; life activities; and participation in society. Previous psychometric research supports that the WHODAS 2.0 functions as a general factor of disablement. In a pooled dataset from community samples of adults (N = 447) we used confirmatory factor analysis to confirm a one-factor structure. Latent class analysis was used to identify subgroups of individuals based on their patterns of responses. We identified four distinct classes, or patterns of disablement: (1) pervasive disability; (2) physical disability; (3) emotional, cognitive, or interpersonal disability; (4) no/low disability. Convergent validity of the latent class subgroups was found with respect to socio-demographic characteristics, number of days affected by disabilities, stress, mental health, and substance use. These classes offer a simple and meaningful way to classify people with disabilities based on the 12-item WHODAS 2.0. Focusing on individuals with a high probability of being in the first three classes may help guide interventions.

Harm, Intent, and the Nature of Aggressive Behavior

The research goals were to use the constructs of harm and intent to quantify the severity of aggression in the real-world setting of the bar/club, to describe the range of aggressive behaviors and their relationship to harm and intent, and to examine gender differences in the form and severity of aggression. Systematic observations were conducted by trained observers on 1,334 nights in 118 bars/clubs. Observers documented a range of aggressive acts by 1,754 patrons in 1,052 incidents, with many forms of aggression occurring at more than one harm and intent level. Women used different forms of aggression, inflicted less harm, and were more likely to have defensive intent compared with men. Implications of the findings for research and measurement of aggression and applications to preventing aggression and violence are discussed.

Coping Strategies and Psychological Outcomes: The Moderating Effects of Personal Resiliency

Certain coping strategies alleviate stress and promote positive psychological outcomes, whereas others exacerbate stress and promote negative psychological outcomes. However, the efficacy of any given coping strategy may also depend on personal resiliency. This study examined whether personal resiliency moderated the effects of task-oriented, avoidance-oriented, and emotion-oriented coping strategies on measures of depression, anxiety, stress, positive affect, negative affect, and satisfaction with life. Results (N = 424 undergraduates) showed higher personal resiliency was associated with greater use of task-oriented coping strategies, which were in turn associated with more adaptive outcomes, and less reliance on nonconstructive emotion-oriented strategies, which in turn were associated with poorer psychological outcomes. In addition, individual differences in personal resiliency moderated the effects of task-oriented coping on negative affect and of emotion-oriented coping on negative affect and depression. Specifically, proactive task-oriented coping was associated with greater negative affect for people lower in personal resiliency. Moreover, high personal resiliency attenuated the negative effects of emotion-oriented coping on depression and negative affect. The effects of avoidance-oriented coping were mixed and were not associated with or dependent on levels of personal resiliency.

Development of a Cultural Connectedness Scale for First Nations youth

Despite a growing recognition of cultural connectedness as an important protective factor for First Nations (FN) peoples' health, there remains a clear need for a conceptual model that organizes, explains, and leads to an understanding of the resiliency mechanisms underlying this concept for FN youth. The current study involved the development of the Cultural Connectedness Scale (CCS) to identify a new scale of cultural connectedness. A sample of 319 FN, Métis, and Inuit youths enrolled in Grades 8-12 from reserve and urban areas in Saskatchewan and Southwestern Ontario, Canada, participated in the current study. A combination of rational expert judgments and empirical data were used to refine the pool of items to a set that is a representative sample of the indicators of the cultural connectedness construct. Exploratory factor analysis (EFA) was used to examine the latent structure of the cultural connectedness items, and a confirmatory factor analysis was used to test the fit of a more parsimonious version of the final EFA model. The resulting 29-item inventory consisted of 3 dimensions: identity, traditions, and spirituality. Criterion validity was demonstrated with cultural connectedness dimensions correlating well with other youth well-being indicators. The conceptualization and operationalization of the cultural connectedness has a number of potential applications both for research and prevention. This study provides an orienting framework that guides measurement of cultural connectedness that researchers need to further explore the role of culture in enhancing resiliency and well-being among FN youth in Canada.

Associations of hair cortisol concentration with self-reported measures of stress and mental health-related factors in a pooled database of diverse community samples

A pooled database from diverse community samples was used to examine the associations of hair cortisol concentration (HCC) with self-reported stress and stress-linked mental health measures, including depression, anxiety, alcohol and drug use, disability and experiences with aggression. As part of innovative research using a mobile laboratory to study community mental health, data were pooled from five sub-studies: a random sample of the general population (n = 70), people who had received treatment for a mental health and/or substance use problem (n = 78), family members of people treated for mental health and/or substance use problems (n = 49), community volunteers who sometimes felt sad or blue or thought they drank too much (n = 83) and young adults in intimate partner relationships (n = 44). All participants completed a computerized questionnaire including standard measures of perceived stress, chronic stress, depression, anxiety, hazardous drinking, tobacco use, prescription drug use, illicit drug use, disability and intimate partner aggression. HCC was significantly associated with use of antidepressants, hazardous drinking, smoking and disability after adjusting for sub-study and potential confounders (sex, body-mass index, use of glucocorticoids and hair dyed). In addition, preliminary analyses suggest a significant curvilinear relationship between HCC and perceived stress; specifically, HCC increased with higher perceived stress but decreased at the highest level of stress. Overall, HCC was associated with mental health-related variables mainly reflecting substance use or experiencing a disability. The relationship between HCC and self-reported stress is unclear and needs further research.

Teasing Apart the Roles of Gender and Alcohol in Drinking Consequences Using an Event-Level Analysis

The objective was: to assess gender differences in university students' likelihood of experiencing negative drinking consequences across the first academic year, controlling for amount of alcohol consumed on each occasion; also to assess whether the relation between amount consumed and experiencing the consequence is moderated by gender. On weekly assessments over 26 weeks, first-year university students (N = 265; 177 women; Mage = 18.48) recorded number of drinks consumed and negative drinking consequences experienced each day. A greater percentage of men experienced at least one drinking consequence. However, when analyses focused on drinking occasions controlling for consumption, women were at greater risk for experiencing many drinking consequences including unplanned sex, injury, and memory lapses. Further, the likelihood of experiencing unprotected sex increased with greater alcohol consumption for women but not for men. A greater focus on risks for women is needed in understanding and preventing negative drinking consequences.

A modified random walk door-to-door recruitment strategy for collecting social and biological data relating to mental health, substance use, addiction, and violence problems in a Canadian community

AIMS

To describe a modified "random walk" door-to-door recruitment strategy used to obtain a random community sample for participation in a study relating to mental health, substance use, addiction, and violence (MSAV) problems and involving the collection of both self-report and biological (hair and saliva) data. This paper describes study protocols, response rates for the study and for the provision of biological data, and possible further applications for this data collection method.

DESIGN

A two-stage cluster sample was derived from the 2006 Canadian census sampling frame for a small Ontario community, based on the random selection of city blocks as the primary sampling units and households as the secondary sampling units.

SETTING

A small city in Ontario, Canada.

PARTICIPANTS

A general population sample of 92 participants selected randomly from households using Kish tables.

MEASURES

A computerized questionnaire was administered to obtain self-report data on MSAV problems. Saliva was collected to study genetic vulnerabilities to MSAV problems, and hair was collected to examine stress levels (via the hormone cortisol) as they relate to MSAV problems.

FINDINGS

The study showed a response rate of 50% and a high rate of provision of biological samples (over 95%).

CONCLUSIONS

Modified random walk methodologies involving face-to-face recruitment may represent a useful approach for obtaining general population samples for studies of MSAV problems, particularly those involving the collection of biological samples. Further studies are needed to assess whether this approach leads to better response rates and improved estimates compared to other survey methods used in research on substance use.

Understanding men's aggression in bars: development of the Beliefs and Attitudes toward Male Alcohol-Related Aggression (BAMARA) inventory

BACKGROUND

While several qualitative studies suggest that beliefs and attitudes are important in explaining men's alcohol-related aggression, no quantitative instrument measuring men's beliefs and attitudes about male alcohol-related aggression has been developed. The purpose of this study was to develop and test a theoretically based multidimensional inventory measuring Beliefs and Attitudes toward Male Alcohol-Related Aggression (BAMARA) consisting of 9 dimensions: (i) expected negative consequences; (ii) expected positive consequences; (iii) personal approval; (iv) perceived male peer approval; (v) perceived female peer approval; (vi) perceived normality; (vii) relaxed norms when drinking; (viii) alcohol as an excuse; and (ix) male honor/protection of masculinity.

METHODS

A random sample of 1,343 young adult male college and university students participated in an online survey. Item analyses using confirmatory factor analytic (CFA) and item-response theory (IRT) procedures were conducted to select a refined pool of items promoting high internal consistency and discriminant validity of the 9 scales. We evaluated the criterion validity of the 9 scales, the BAMARA total score (BAMARA-Total), and a short form of the inventory (BAMARA-SF) in terms of their association with experiences of barroom aggression and other theoretically linked constructs.

RESULTS

CFA and IRT analyses resulted in a 53-item inventory consisting of the 9 scales with adequate model fit and good internal consistency indices. Criterion validity was demonstrated, with the BAMARA scales correlating well with reports of actual experiences of aggression in bars. BAMARA-Total and BAMARA-SF were found to be significantly associated with barroom aggression controlling for a number of important control variables.

CONCLUSIONS

This new instrument is expected to have many important applications in the male aggression literature, with the full BAMARA being employed for the assessment of specific beliefs and attitudes and the BAMARA-SF used as a general attitudinal measure.

Does the relationship between depression and intimate partner aggression vary by gender, victim-perpetrator role, and aggression severity?

Research has shown a consistent link between intimate partner violence (IPV) and depression, although this association may vary by gender, role in IPV (victim, perpetrator, or bidirectional), and aggression severity. We evaluated these factors in a telephone survey of 14,063 Canadians. All three factors were found to affect the association of depression with IPV. Specifically, depression was more strongly associated with IPV by a partner (i.e., victimization) for women but with aggression toward a partner (i.e., perpetration) for men. Severity of aggression was associated with increased risk of depression for both one-sided and bidirectional aggression by a partner but more strongly for one-sided aggression toward a partner. These findings suggest that research, prevention, and treatment should focus on all roles in IPV, not just male-to-female aggression.

Defending girlfriends, buddies and oneself: injunctive norms and male barroom aggression

OBJECTIVE

Research has demonstrated that young adults tend to overestimate their peers' approval of risky behaviors (i.e., injunctive norms) and that perceived peer approval is associated with actual behavior; however, no empirical studies have assessed injunctive norms in relation to male barroom aggression. The objectives of the present study were to compare young men's own approval of male barroom aggression with their perceptions of approval by male and female peers and to determine the extent that perceived peer approval of male barroom aggression was associated with self-reported physical aggression at a bar, controlling for own approval and heavy episodic drinking.

METHOD

525 young adult male university and community college students who reported drinking and going to a bar, club or pub rated their own approval and perceptions of peers' approval of bar aggression on items reflecting four domains of approval: (1) general approval, (2) defend self, (3) defend friend and (4) protect girlfriend.

RESULTS

For all four domains, participants attributed greater approval to male peers than to themselves. Aggression was positively associated with own approval for all domains and with perceived male peer approval for general approval, defend self and defend friend, controlling for heavy episodic drinking and own approval of aggression. Perceived approval by female peers was not associated with increased likelihood of aggression.

CONCLUSION

The findings suggest that both perceived male peer approval and personal approval are factors associated with male barroom aggression and that addressing approval of barroom aggression is a critical direction for prevention programming.

Not just the booze talking: trait aggression and hypermasculinity distinguish perpetrators from victims of male barroom aggression

BACKGROUND

To our knowledge, no research has assessed whether young male victims and perpetrators of barroom aggression differ in terms of their drinking patterns and predisposing characteristics. This study assessed the extent that frequent heavy episodic drinking (HED) and bar-going, trait aggression, and hypermasculinity were differentially associated with victimization versus perpetration for aggression occurring among young adult men in the setting of the public drinking establishment.

METHODS

A random sample of 2,500 male students attending a local university and a local community college was invited to participate in an online survey. Participants were asked the number of times in the past 12 months they had experienced an incident of aggression at a bar in which (a) someone was physically aggressive toward them and (b) they were physically aggressive toward another person. Responses were coded as (i) any perpetration of aggression, (ii) victim only, (iii) no aggression. A composite variable of HED (5 or more drinks per occasion) and bar-going frequency was computed: (i) both HED and bar ≥ twice a month, (ii) only HED ≥ twice a month, (iii) only bar ≥ twice a month, and (iv) both < twice a month. Standard measures of trait aggression and hypermasculinity were used.

RESULTS

Multivariate multinomial logistic regression analyses revealed that a combination of both frequent HED and frequent bar-going was associated with both perpetration and victimization at a bar (compared to no aggression). Trait aggression and hypermasculinity were associated with perpetration but not with victimization. Logistic regression analyses directly comparing perpetrators with victims indicated that perpetrators were more likely to both drink heavily and go to bars frequently and were more likely to have high levels of trait aggression and hypermasculinity.

CONCLUSIONS

While HED is an important target for prevention programming, additional efforts should be directed toward addressing the combination of frequent HED and frequent bar-going as well as underlying aggressive personalities and masculinity concerns among young men.

When do first-year college students drink most during the academic year? An internet-based study of daily and weekly drinking

OBJECTIVE

The authors investigated the alcohol consumption trajectories among first-year university students.

PARTICIPANTS

A sample of 415 students attending a large university in Southwestern Ontario, Canada, was recruited.

METHODS

Students completed a baseline questionnaire and 26 weekly brief Internet surveys assessing alcohol consumption from September 2006 to April 2007.

RESULTS

Findings indicated that alcohol consumption varies considerably as a function of time of the academic year. Overall trends indicate that students drink more heavily at the beginning of each semester and less during exam periods. Daily patterns indicate that most drinking occurs on weekends. The highest drinking days in the first academic year included Halloween, New Year's Eve, and St. Patrick's Day.

CONCLUSIONS

The present study provides evidence that periods of high and low alcohol consumption are contingent upon specific events and the time of the year.

Situational and respondent-level motives for drinking and alcohol-related aggression: a multilevel analysis of drinking events in a sample of Canadian university students

Situational drinking motives (i.e., motives specific to the drinking situation) as well as respondent-level drinking motives (i.e., usual drinking motives across drinking situations) were examined in terms of their relations with aggression experienced by university students. Secondary, multi-level analyses were conducted on the Canadian Campus Survey (CCS), a national survey of 40 Canadian universities conducted between March 1 and April 30, 2004 (N=6,282). For their three most recent drinking events, students reported their motive for drinking (i.e., situational motive) and whether they had an argument/fight. Respondent-level drinking motives were computed by averaging motives across drinking events. Drinking to cope at the situational-level increased the likelihood of aggression. Respondent-level enhancement motives also increased the risk of aggression. Aesthetic motives were important at both situational and respondent levels decreasing the risk for alcohol-related aggression. Gender did not moderate these relations. These results suggest that prevention programming might benefit from a focus on altering drinking motives, or their underlying causes, in order to reduce alcohol-related aggression among young adults.

"Every male in there is your competition": young men's perceptions regarding the role of the drinking setting in male-to-male barroom aggression

The present paper explores young men's perceptions regarding the influence of the bar setting on male-to-male barroom aggression. Focus group interviews were conducted with 27 young men aged 18-25 in London, Ontario, Canada. Participants were given a description of a typical incident of aggression between men in bars and asked to discuss why the incident happened. The following themes pertaining to the role of the setting were identified: (1) sexual competition and male rivalry; (2) heightened concerns with image and social pressure to fight; (3) anonymity and taking on a different identity; (4) provocation and negative stimuli; (5) bar staff behavior; (6) acceptance and expectation of aggression; (7) high level of drunkenness; and (8) thrill, excitement, high energy level, and uncertainty of what might happen. These findings are discussed within a situational/crime prevention framework and prevention implications are highlighted.

Where, with whom, and how much alcohol is consumed on drinking events involving aggression? Event-level associations in a Canadian national survey of university students

BACKGROUND

Epidemiological research using event-level data can provide a better understanding of the association between alcohol consumption, characteristics of drinking contexts, and the likelihood of aggressive behavior. The present research assessed whether alcohol intake and characteristics of the drinking context were associated with the likelihood of aggression within individuals across 3 drinking events based on a national sample of university students, taking into account individual characteristics and university level variables. Additionally, we determined whether individual characteristics, particularly drinking pattern, were associated with alcohol-related aggression controlling for drinking event characteristics, and whether relations of aggression to alcohol and drinking contexts differed by gender.

METHODS

Secondary analyses of the 2004 Canadian Campus Survey (CCS), a national survey of 6,282 university students (41% response rate) at 40 Canadian universities, were conducted. Respondents were asked about their three most recent drinking events, including whether they were in an argument or fight with someone, number of drinks consumed, and characteristics of the drinking context as well as their usual drinking frequency and heavy episodic drinking. We used multi-level analyses to account for the nested structure of the data (i.e., drinking events nested within individuals who were nested within universities).

RESULTS

The number of drinks consumed was positively associated with aggression. Drinking contexts found to be positively associated with aggression included being at a party, at a fraternity/sorority and/or residence, at three or more drinking places (versus 1 or 2), and having a partner present whereas having a meal reduced the likelihood of aggression. A significant interaction was found between gender and being at a party, with a significant effect found for women but not for men.

CONCLUSIONS

These results support experimental evidence indicating a direct role of alcohol in aggression and point to characteristics of the drinking context that might be targeted in future prevention initiatives.

Role of motivation to respond to provocation, the social environment, and trait aggression in alcohol-related aggression

Little attention has been paid to the motivation to respond to provocation and to the interaction between this motivation, alcohol, the drinking environment, and individual characteristics. Undergraduates at six Canadian universities (N = 1,232) read three vignettes describing conflict situations with social environmental manipulations while imagining themselves as either sober or intoxicated. Self-ratings assessed likelihood of assertive and aggressive responses and motivational indices of anger, offensiveness of the instigator's actions, and importance to respond to the provocation. Respondents also completed a measure of trait aggression. Multi-group structural equation models supported the hypothesis that perceived likelihood of reactive aggression is influenced by perceived alcohol intoxication, gender, trait aggression, social environmental factors, and motivation to respond to the provocation. In addition, a number of interactions were found among the predictors. These results provide insight into the types of factors that may influence aggression in drinking situations.

Clinical and demographic characteristics of voluntary and involuntary psychiatric inpatients

Voluntary and involuntary psychiatric inpatients were compared on demographic, social and clinical characteristics. Chi-squared tests of independence revealed significant differences in age and financial support based on status at admission. No significant differences were found with respect to diagnostic category. It was concluded that demographic, social and clinical characteristics do not clearly discriminate between voluntary and involuntary inpatients.