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Peer support is increasingly recognized as consistent with the goals of integrated primary care and is being implemented in primary care settings as a patient-centered approach that increases patient activation and access to care. Within the Veterans Health Administration (VHA), peer support specialists (PSSs) have traditionally worked in specialty mental health settings and only recently started working in Primary Care-Mental Health Integration (PC-MHI) settings. Prior research has identified implementation challenges, such as role confusion, when integrating peer support into new settings. In this qualitative descriptive study, we conducted semistructured interviews on perceived barriers and facilitators to implementing peer support in PC-MHI with 25 key stakeholders (7 PSSs, 6 PSS supervisors, 6 PC-MHI providers, and 6 primary care providers). We used conventional content analysis to code responses within four a priori implementation categories: barriers, initial facilitators, long-term facilitators, and leadership support. Perceived barriers included poor program functioning, inadequate administrative support, role confusion, and negative stakeholder attitudes. Key perceived facilitators of initializing and maintaining peer support were similar; administrative support was emphasized followed by program functioning and team cohesion. Stakeholder buy-in and access/visibility were perceived to facilitate initial implementation, whereas evidence of success was believed to facilitate maintenance. Stakeholder buy-in and administrative support were considered key elements of leadership support. Results were consistent with prior research from specialty mental health settings, but identified unique considerations for PC-MHI settings, particularly clarifying the PSS role based on local PC-MHI needs, obtaining buy-in, and facilitating integration of PSSs into the primary care team. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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PMID:Perceived barriers and facilitators to implementation of peer support in Veterans Health Administration Primary Care-Mental Health Integration settings. 3040 53

Responding prosocially to the emotion of others may become increasingly important in late life, especially as partners and friends encounter a growing number of losses, challenges, and declines. Facial expressions are important avenues for communicating empathy and concern, and for signaling that help is forthcoming when needed. In a study of young, middle-aged, and older adults, we measured emotional responses (facial expressions, subjective experience, and physiological activation) to a sad, distressing film clip and a happy, uplifting film clip. Results revealed that, relative to younger adults, older adults showed more sadness and confusion/concern facial expressions during the distressing film clip. Moreover, for older adults only, more sadness and fewer disgust facial expressions during the distressing film clip were associated with higher levels of relational connectedness. These findings remained stable when accounting for subjective emotional experience, physiological activation, and trait empathy in response to the film clip. When examining the uplifting film clip, older adults showed more happiness facial expressions relative to younger adults at trend levels. More facial expressions of happiness were associated with higher levels of relational connectedness, but unlike the effect of sadness expressions, this was not moderated by age. These findings underscore an important adaptive social function of facial expressions-particularly in response to the distress of others-in late life. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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PMID:Responding to the emotions of others: Age differences in facial expressions and age-specific associations with relational connectedness. 3073 Jan 67

During the later Middle Ages, a number of religiously oriented people behaved in ways that we would consider unusual, yet it was unusual for them to be regarded as mentally disordered. This article reviews late medieval thinking and practice with regard to mental disorder and also with regard to the discernment of spirits, that is, how it could be decided whether an experience or impulse to do something was the consequence of God or a good spirit, an evil spirit, or some purely human cause. Many of the criteria for discerning a good spirit were behavioral, for example, consistently showing humility and discretion, and were clearly distinct from those displayed in mental disorder. A comparison of the criteria for mental disorder with those used to discern spirits shows how the distinction between mental disorder and religious experience could have been made and why confusion of the two seems to have been rare. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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PMID:Mental disorder and mysticism in the late medieval world. 3073 Jan 70

Some epistemic emotions, such as surprise and curiosity, have attracted increasing scientific attention, whereas others, such as confusion, have yet to receive the attention they deserve. In addition, little is known about the relations between these emotions, their joint antecedents and outcomes, and how they differ from other emotions prompted during learning and knowledge generation (e.g., achievement emotions). In 3 studies (Ns = 102, 373, 125) using a trivia task with immediate feedback, we examined within-person interrelations, antecedents, and effects of 3 epistemic emotions (surprise, curiosity, and confusion). Studies 2 and 3 additionally included 2 achievement emotions (pride and shame). Using multilevel modeling to disentangle within- and between-person variance, we found that achievement emotions were associated with accuracy (i.e., correctness of the answer), whereas epistemic emotions were related to high-confidence errors (i.e., incorrect answers a person was confident in) generating cognitive incongruity. Furthermore, as compared with achievement emotions, epistemic emotions were more strongly and positively related to subsequent knowledge exploration. Specifically, surprise and curiosity were positive predictors of exploration. Confusion had positive predictive effects on exploration which were significant in Studies 1 and 3 but not in Study 2, suggesting that the effects of confusion are less stable and need to be investigated further. Apart from the findings for confusion, the results were fully robust across all 3 studies. They shed light on the distinct origins and outcomes of epistemic emotions. Directions for future research and practical implications are discussed. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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PMID:Surprised-curious-confused: Epistemic emotions and knowledge exploration. 3088 47

Replication research holds an increasingly important place in modern psychological science. If such work is to improve the state of knowledge rather than add confusion, however, replication attempts must be held to high standards of rigor. As an example of how replication attempts can add confusion rather than clarity, we consider an article by Shanks and colleagues (2015). They conducted a meta-analysis of studies examining romantic motivation, using problematic criteria for the inclusion of effects and reached conclusions of a null effect that were unwarranted. A more rigorous and defensible approach, relying on a representative analysis of effects and p-curves, suggests a different, more positive conclusion with no evidence of p-hacking. Shanks et al. also conducted several experiments that suffered from numerous issues, such as relying on inappropriate subject samples (e.g., older adults likely to be less sensitive to mating manipulations than college students used in previous research), altered research methods, and demonstrably weak manipulations, among other problems. We discuss the broader implications of this case, to illustrate both the opportunities and the pitfalls inherent in attempts to replicate contextually sensitive research. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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PMID:Moving beyond unwise replication practices: The case of romantic motivation. 3097 67

Shanks et al. (2015) challenged the evidence that various forms of decision making can be influenced by romantic/mating primes. In their comment, Sundie, Beal, Neuberg, and Kenrick (2019) question both the meta-analysis and the 8 studies Shanks et al. reported, and describe an alternative p-curve analysis that they interpret as showing that romantic priming is a genuine phenomenon. In this reply, we comment on several contradictions in Sundie et al.'s article. First, they suggest that Shanks et al.'s replication experiments yielded different results from the original studies because we failed to appreciate the contextual sensitivity of romantic priming effects, but this argument rests largely on evidence from the very studies we were unable to replicate, and a wealth of other evidence suggests that social priming effects are largely invariant across samples and settings. Second, Sundie et al. criticize the selection rule by which Shanks et al. identified relevant priming studies, but then go on to include exactly the same set of studies in their p-curve analysis. Third, they criticize Shanks et al.'s selection of statistical results from these studies and propose a much wider selection, but then acknowledge that their selection process is poorly suited to assessing publication bias and p-hacking. Fourth, we show that their p-curve analysis, far from demonstrating that this literature is unaffected by p-hacking, in fact shows the exact opposite. Sundie et al. claim that Shanks et al.'s priming manipulation was demonstrably weak, but their argument is based on a confusion between different dependent measures. We conclude that romantic priming remains unproven, and urge researchers in this field to undertake high-powered preregistered replication studies. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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PMID:Still no evidence that risk-taking and consumer choices can be primed by mating motives: Reply to Sundie, Beal, Neuberg, and Kenrick (2019). 3097 58

Searching for two targets produces a dual-target cost compared with single-target search, with reduced attentional guidance toward targets (Stroud, Menneer, Cave, & Donnelly, 2012). We explore the effect of holding a color in working memory (WM) on guidance in single-target search. In Experiments 1 and 2, participants searched for a T of a specific color while holding one of the following in WM: a color patch, a letter, a dot pattern, or an oriented bar. Only when holding a color in WM was guidance in single-target search affected as strongly as it is in dual-target search. In Experiment 3, the target changed color from trial to trial. A color in WM reduced guidance, but not to the extent of dual-target search. However, search and WM error rates were high, suggesting interference and incomplete engagement with the combined task. We conclude that the guidance cost in dual-target search is not solely due to attentional capture by the WM-color, because the WM-color can be effectively separated from search color, with little confusion between the two. However, WM load does cause substantial interference in guidance when both tasks involve color. These results illustrate the complex interactions between WM and attentional guidance. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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PMID:The relationship between working memory and the dual-target cost in visual search guidance. 3098 78

Open people show greater interest in situations that are complex, novel, and difficult to understand-situations that may also be experienced as confusing. Here we investigate the possibility that openness/intellect is centrally characterized by more positive relations between interest and confusion. Interest and confusion are key states experienced during engagement with information and learning. However, little is known about the within-person relation between them, let alone individual differences in this relation. We tested our hypotheses by making use of different paradigms, stimuli, and participants. Across five studies (N = 640) we tested the relation between openness/intellect and within-person interest-confusion relations in response to art (Study 1); science, philosophy, and art (Study 2); psychology lectures (Study 3); a poem (Study 4); and a complex problem solving task (Study 5). Average interest-confusion relations varied between different studies, but for all studies the distributions of the relations went from highly negative to highly positive-individual differences in direction rather than just degree. In all but 1 study we found consistent support for our hypotheses-openness/intellect is associated with more positive relations between interest and confusion. No other personality domain or intelligence was consistently related to interest-confusion relations. Together, these findings suggest a new phenomenological aspect of being open-curiosity toward confusing situations. Our findings support the link between openness/intellect and sensitivity to the value of complex information, and are discussed with regards to their relevance for engagement with information and learning. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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PMID:Confused or curious? Openness/intellect predicts more positive interest-confusion relations. 3125 77

There is considerable confusion in the visual attention literature as to whether shifts of attention are biased against or in favor of previously attended regions. Studies requiring target localization have shown a performance cost when the target location randomly repeats instead of changes, whereas studies requiring arbitrary keypress responses to target identities have shown a benefit. These studies differ in the amount of attention required to the target and in the stimulus-response translation rules. To evaluate the contribution of each of these factors in accounting for the mixed results, we had participants indicate whether color singletons appeared in the left versus right visual field, or in the upper versus lower visual field, by making spatially compatible keypress responses (a between-experiment manipulation of the stimulus-response translation rules). Within each experiment, we manipulated whether a subtle discrimination of shape was necessary before localizing the target (a manipulation of focal attention). The findings revealed that the costs and benefits for repeating the target location are determined by stimulus-response translation rules, with no effect of or on attention independent of these rules. The results are accounted for by the theory of event coding, and further challenge the notion that location repetition effects reliably reflect attentional bias. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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PMID:Is attention really biased toward the last target location in visual search? The role of focal attention and stimulus-response translation rules. 3134 42

Alexithymia-a trait associated with difficulties understanding one's own emotions-is theorized to stem from deficits in interoceptive awareness, or the ability to detect, accurately monitor, and regulate internal bodily processes. The present meta-analysis analyzed all studies that empirically examined the relationship between alexithymia and interoceptive awareness. Across 66 independent samples (N = 7,146), alexithymia had a small, negative correlation with interoceptive awareness (r = -.162, p = .001, 95% CI [-.252, -.068]), but additional analyses revealed that the strength and directionality of this association was heavily influenced by the specific interoceptive awareness components measured (e.g., interoceptive accuracy vs. sensibility) and the methods used to measure interoceptive awareness (e.g., objective vs. self-report measures). The strength of this relationship was also moderated by diagnosis of participants such that alexithymia was moderately associated with interoceptive awareness in samples with psychiatric and developmental disorders, but the relationship was nonsignificant in healthy, typically developing samples. Results suggest interoception may represent a shared transdiagnostic vulnerability that underlies atypical emotional processing in a variety of disparate clinical populations but that current operationalization and measurement of interoceptive awareness continues to create confusion and inconsistency in the literature. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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PMID:A meta-analysis on the relationship between interoceptive awareness and alexithymia: Distinguishing interoceptive accuracy and sensibility. 3138 Jun 55


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