Assessing personality traits associated with depression: the utility of a tiered model

BACKGROUND: We sought to develop a refined measure of eight personality traits or constructs observed in those who develop depression. We report the psychometric properties of the derived Temperament and Personality (T and P) questionnaire, as well as a pilot study examining its capacity to differentiate over-represented personality traits in those with depression. METHOD: The factor structure of the T&P measure was examined in a general practice sample of 529 subjects. We imposed a range of factorial solutions to determine how higher-order molar constructs arborized to eight lower-order constructs. Scale scores generated at each derived tier were contrasted for 52 out-patients with major depression and control subjects from the general practice sample to pursue over-represented personality constructs, and to clarify if an optimal number of constructs could be identified. RESULTS: In the factor analysis, some 90% of the items loaded on their a priori construct. The questionnaire showed high internal consistency, test-retest reliability and minimal sensitivity to mood state effects. Analyses rejected the hypothesis that risk to depression might be generally affected by individuals merely scoring high on all 'normal' personality styles, whether higher-order or lower-order traits. CONCLUSIONS: Findings suggest that, while identified constructs linked well with the widely accepted theoretical model of personality (the Five Factor Model) at one tier, such a fixed model may be too inflexible. We therefore detail potential advantages to using a multi-tiered model of personality traits in application studies.     

Depression and help-seeking in a western sample of 'highly acculturated' Chinese and controls

BACKGROUND: It is commonly reported that "the Chinese" have low rates of depression, partially reflecting a greater tendency to somatize and to be less likely to seek help. OBJECTIVE: To examine the impact of acculturation on depression reporting and help-seeking patterns. METHOD: We compared 50 highly acculturated Chinese with age and gender-matched non-Chinese control subjects in a western region on measures of state and lifetime depression, attributional interpretation of somatic cues and help-seeking. RESULTS: The highly acculturated Chinese did not differ in state depression rates or tendency to 'somatize'. There were trends for the Chinese to be less likely to view any depressive episode as a 'disorder' and to seek help for a psychological problem. CONCLUSION: Differences held to exist in the Chinese in acknowledging, reporting and seeking help for depression appear strongly culturally determined.     

Elevating mothers’ voices: recommendations for improved patient-centered postpartum

The weeks and months after birth are vital not only for infant health but also for the health and well-being of women and families as a whole. The first 12 weeks postpartum, also known as the 4th trimester, is part of a continuum of pregnancy to recovery and family adjustment. In the United States, this transitional period has been a neglected area for women’s health, especially considering the inherent biological, physical, and social changes experienced by millions of women each year. The Patient-Centered Outcomes Research Institute supported the 4th Trimester Project to partner with new mothers, health care providers, and health advocates to better describe and understand unmet maternal postpartum health needs. Through woman-centered engagement, the patient–researcher–clinician–advocate team co-developed priority areas for research, policy, communication, and health care service delivery.     

Definition of the HLA-A2 restricted peptides recognized by human CD8+ effector T cells by flow-assisted sorting of the CD8+ CD45RA+ CD28- T cell subpopulation

In response to antigenic stimulation, naive MHC-class I restricted and antigen-specific CD8+ CD45RA+ CD28+ T cells undergo clonal expansion, differentiate into CD8+ CD45RO+ memory T cells and convert to CD8+ CD45RA+ CD28- T cells displaying potent immune effector functions upon re-encounter with the nominal antigen. We show that the effector CD8+ CD45RA+ CD28- T cell subset is expanded in peripheral blood lymphocytes (PBL) from patients with human papilloma virus (HPV)+ cervical lesions as well as in PBL from patients with pulmonary tuberculosis. Flow-cytometric cell sorted CD8+ CD45RA+ CD28- and CD8+ CD45RA+ CD28- T cells were tested for recognition of HLA-A2 restricted peptides derived either from the human papillomavirus (HPV)16-E7 gene product, or from M. tuberculosis antigens. Mostly CD8+ CD45+ CD28- T cells define antigen/peptide-specific and MHC-restricted responses. These data were confirmed in PBL from patients with tuberculosis using HLA-A2 tetramer-complexes loaded with a peptide from the M. tuberculosis Ag85b antigen by flow cytometry. The sorting of this T cell subset enables to determine the fine specificity of CD8+ effector T cells without the need for in vitro manipulation.     

Identifying key areas for active interprofessional learning partnerships: A facilitated dialogue

Student and service user involvement is recognised as an important factor in creating interprofessional education (IPE) opportunities. We used a team-based learning approach to bring together undergraduate health professional students, early career professionals (ECPs), public partners, volunteers, and carers to explore learning partnerships. Influenced by evaluative inquiry, this qualitative study used a free text response to allow participants to give their own opinion. A total of 153 participants (50 public partners and 103 students and professionals representing 11 healthcare professions) took part. Participants were divided into mixed groups of six (n = 25) and asked to identify areas where students, professionals, and public could work together to improve health professional education. Each group documented their discussions by summarising agreed areas and next steps. Responses were collected and transcribed for inductive content analysis. Seven key themes (areas for joint working) were identified: communication, public as partners, standards of conduct, IPE, quality improvement, education, and learning environments. The team-based learning format enabled undergraduate and postgraduate health professionals to achieve consensus with public partners on areas for IPE and collaboration. Some of our results may be context-specific but the approach is generalisable to other areas.     

Psychological ownership interventions increase interest in claiming government benefits

Each year, eligible individuals forgo billions of dollars in financial assistance in the form of government benefits. To address this participation gap, we identify psychological ownership of government benefits as a factor that significantly influences individuals’ interest in applying for government benefits. Psychological ownership refers to how much an individual feels that a target is their own. We propose that the more individuals feel that government benefits are their own, the less likely they are to perceive applying for them as an aversive ask for help, and thus, the more likely they are to pursue them. Three large-scale field experiments among low-income individuals demonstrate that higher psychological ownership framing of government benefits significantly increases participants’ pursuit of benefits and outperforms other common psychological interventions. An additional experiment shows that this effect occurs because greater psychological ownership reduces people’s general aversion to asking for assistance. Relative to control messages, these psychological ownership interventions increased interest in claiming government benefits by 20% to 128%. These results suggest that psychological ownership framing is an effective tool in the portfolio of potential behavioral science interventions and a simple way to stimulate interest in claiming benefits.

Each year, eligible individuals forgo billions of dollars in financial assistance in the form of government benefits. This is the case for two of the largest US benefits programs in 2020: the Economic Impact Payment (the “stimulus check”) and the Earned Income Tax Credit (EITC). About nine million individuals did not claim the first wave of stimulus checks (1), sacrificing roughly $10.4 billion. Further, ∼20% of eligible individuals do not claim the EITC, forgoing an estimated $7.3 billion annually (2). This difference between eligibility and uptake in government benefits is commonly referred to as the “benefits participation gap.” Many policymakers are focused on closing this participation gap, as receiving government benefits has been shown to reduce poverty, childhood hunger, and educational gaps, as well as physical and mental illness (3–5).Existing efforts to close the participation gap have largely focused on addressing individuals’ ability to claim government benefits. As such, this work has focused on interventions that increase awareness and knowledge of benefits, reduce the complexity of the process, or minimize logistical barriers (6–8). However, for such efforts to be fruitful, individuals must have a fundamental desire to claim their benefits.The current work introduces psychological ownership as a factor that significantly influences people’s desire to claim government benefits. Psychological ownership is a fundamental human perception (9, 10) and refers to the perception that a target is “mine” (11). Although psychological ownership has primarily been studied with respect to people’s feelings toward organizations and products, recent research has demonstrated that people can experience psychological ownership toward monetary resources and that these perceptions can influence financial decisions (12, 13). However, there have been seemingly no large-scale field investigations designed to directly examine whether psychological ownership impacts societal welfare, and the potential magnitude of its effects. In the present work, we propose that psychological ownership of government benefits is a simple and powerful perception that can enhance individuals’ desire to pursue these benefits.We suggest that applying for government benefits feels like requesting assistance, which can feel aversive and decrease individuals’ desire to apply for benefits. Because individuals prefer to feel autonomous and efficacious (14, 15), they tend to avoid opportunities that threaten these self-beliefs, such as asking for help (16). Such assistance resistance has been observed among people in a range of contexts, including those needing mental health services, aging individuals needing support, and even individuals requiring assistance from a help manual (17–19). We propose that increasing psychological ownership of government benefits increases interest in claiming these benefits by reducing individuals’ discomfort toward asking for help. Specifically, we suggest that psychological ownership interventions encourage individuals to conceptualize government benefits as their own money, resulting in the perception that applying for benefits is akin to claiming money that belongs to them. Thus, applying for government benefits should seem less like an uncomfortable “ask for help” and more like a rightful “ask for what is mine.” Indeed, a pilot study (n = 505) found that individuals with higher psychological ownership of a government benefit were less likely to perceive the application for that benefit as an uncomfortable ask for help [B = −0.12, SE = 0.039, t(332) = 6.72, P = 0.010]. As such, we expect communications that increase psychological ownership of government benefits to heighten individuals’ interest in claiming those benefits.We test these propositions across four preregistered experiments measuring real behavior. We first report three large-scale field experiments (n = 60,729) that test the effectiveness of psychological ownership interventions in increasing the pursuit of the EITC and stimulus checks among low-income individuals deemed eligible for these benefits. In these experiments, we encourage participants to visit websites created to help them access their benefits online, which was the most viable way to access benefits during the global pandemic. Experiment 1 demonstrates that higher psychological ownership framing increases interest in claiming EITC benefits. Experiment 2 demonstrates the generalizability of psychological ownership interventions by showing the effectiveness of higher psychological ownership framing for a different government benefit: the stimulus check. Experiment 3 shows that psychological ownership interventions can be more powerful than other popular interventions that incorporate social norms or a deadline. Finally, Experiment 4 (n = 810) provides a full test of the proposed conceptual model utilizing another type of financial assistance (i.e., COVID-19 funds). It demonstrates that increasing psychological ownership of available COVID-19 funds decreases individuals’ discomfort around asking for help, increasing their probability of pursuing those funds. Taken together, we find that psychological ownership interventions encourage individuals to seek government benefits, and to a greater degree than other common psychological interventions.