Guilt, Shame and Academic Misconduct.

Moral and self-conscious emotions like guilt and shame can function as internal negative experiences that punish or deter bad behaviour. Individual differences exist in people's tendency to experience guilt and shame. Being disposed to experience guilt and/or shame may predict students' expectations of their emotional reactions to engaging in immoral behaviour in the form of academic misconduct, and thus dissuade students from intending to engage in this behaviour. In this study, students' (n = 459) guilt and shame proneness, their expectations of feeling guilt and shame if they engaged in academic misconduct, and their intentions to engage in academic misconduct were measured. Three of the four facets of the guilt and shame proneness scale [GASP: Guilt-Negative-Behavior-Evaluation (NBE), Guilt-Repair, Shame-Negative-Self-Evaluation (NSE)] had significant negative correlations with academic misconduct intentions, and these relationships were mediated by anticipating shame and guilt related to engaging in academic misconduct. These results suggest that for some students expecting to experience negative moral emotions when engaging in academic misconduct may protect them from breaching ethical assessment rules.

'Is hearing believing?': A study of voices and beliefs in psychosis and trauma.

OBJECTIVE: This study compared voice characteristics and beliefs in participants diagnosed with post-traumatic stress disorder (PTSD) with dissociation, schizophrenia (SCZ) and both diagnoses of SCZ and PTSD. The relationship between dissociation and voice beliefs was also assessed. METHOD: We identified 56 participants meeting the diagnostic criteria for PTSD with dissociation, SCZ or both diagnoses (PTSD + SCZ) who also experienced auditory hallucinations. Measures included PTSD Symptoms Scales Interview (PSSI-5), Psychotic Symptoms Rating Scale (PSYRAT), Clinician Administered Dissociative States Scale (CADSS), Beliefs about Voices Questionnaire (BAVQ) and Positive and Negative Syndrome Scale (PANSS). RESULTS: Beliefs about voices were similar across diagnostic groups. Participants with SCZ were more likely to attribute their voices to an external origin, and participants with dual diagnosis were less able to control their voices. The PTSD-only group scored higher in dissociation scores than either the SCZ-only or dual diagnosis group. Malevolent voice appraisals correlated with dissociation scores only in the dual diagnosis group. CONCLUSIONS: This research supports the hypothesis that voice beliefs are similar across diagnoses of PTSD and SCZ. However, differences in voice characteristics, emotional responses and relationship to dissociation may need to be considered in the psychological management of voices.

Visual phenomenology in schizophrenia and post-traumatic stress disorder: an exploratory study.

BACKGROUND: Visual experiences such as hallucinations are commonly reported by people with psychosis, psychological trauma and dissociative states, although questions remain about their similarities and differences. For diagnostic and therapeutic purposes, clinical research must better delineate and compare the characteristics of these experiences in post-traumatic stress disorder (PTSD) and in schizophrenia. AIMS: To compare visual phenomena and dissociation in participants with a primary psychotic illness and those with a trauma diagnosis. METHOD: A quantitative group design study comparing visual phenomena in three participant groups who also have a history of hearing voices: schizophrenia and no trauma history (n = 19), PTSD with dissociation (n = 17) and comorbid schizophrenia and PTSD (n = 20). Validated clinical measures included the North-East Visual Hallucination Interview, PTSD Symptoms Scale Interview, Clinician Administered Dissociative States Scale, Psychotic Symptoms Rating Scales and Positive and Negative Syndrome Scale. RESULTS: There was a remarkable similarity in visual experiences, including rates of complex visual hallucinations, between the three diagnostic groups. There were no significant differences in the severity or components of distress surrounding the visual experiences. Dissociation predicted visual hallucination severity for the comorbid schizophrenia and PTSD group, but not for PTSD or schizophrenia alone. CONCLUSIONS: Visual experiences in PTSD can include visual hallucinations that are indistinguishable from those experienced in schizophrenia. Multimodal hallucinations are frequently observed in both schizophrenia and PTSD. A model for visual hallucinations in PTSD is suggested, following two separate neurobiological pathways based on distinct responses to trauma.

Can anxiety and race interact to influence face-recognition accuracy? A systematic literature review.

Wrongful convictions continue to occur through eyewitness misidentification. Recognising what factors, or interaction between factors, affect face-recognition is therefore imperative. Extensive research indicates that face-recognition accuracy is impacted by anxiety and by race. Limited research, however, has examined how these factors interact to potentially exacerbate face-recognition deficits. Brigham (2008) suggests that anxiety exacerbates other-race face-recognition deficits. Conversely, Attentional Control Theory predicts that anxiety exacerbates deficits for all faces. This systematic review examined existing studies investigating the possible interaction between anxiety and face-race to compare these theories. Recent studies included in this review found that both anxiety and race influence face-recognition accuracy but found no interaction. Potential moderators existing in reviewed studies, however, might have influenced their results. Separately, in some studies reviewed, anxiety induced during retrieval impacted recognition, contrasting with the conclusions of previous reviews. Recommendations for future research are given to address moderators potentially impacting results observed previously.

Dimensionality and Measurement Invariance of the State-Trait Inventory for Cognitive and Somatic Anxiety (STICSA) and Validity Comparison With Measures of Negative Emotionality.

This study explored the factor structure of the State-Trait Inventory for Cognitive and Somatic Anxiety (STICSA) and measurement invariance between genders. We also measured concurrent and divergent validity of the STICSA as compared to the State-Trait Anxiety Inventory (STAI). A sample of 1064 (N Females = 855) participants completed questionnaires, including measures of anxiety, depression, stress, positive and negative affect. Confirmatory factor analyses supported the original factor structure of the STICSA, which was invariant between genders. Overall, the STICSA had superior concurrent and divergent validity as compared to the STAI. The somatic subscales were also significantly less correlated with depression, and positive and negative affect. Further, the somatic, as compared to cognitive anxiety STICSA subscales were less correlated with depression. This suggests that the STICSA, especially the somatic anxiety subscales, might hold the key to distinguishing between different types of anxiety, as well as between anxiety and depression.

Are Individual Differences in Information-Processing Styles Related to Transformational Leadership? A Test of the Cognitive Experiential Leadership Model.

The recently proposed Cognitive Experiential Leadership Model (CELM) states that leaders' preference for rational thinking and behavioral coping will be related to their level of transformational leadership. The CELM was based on research that principally used cross-sectional self-report methods. Study 1 compared both self-ratings and follower-ratings of leadership styles with leaders' self-rated thinking styles in 160 leader-follower dyads. Study 2 compared both self-ratings and coworker-ratings of leadership styles with leaders' self-rated thinking styles for 74 leaders rated by 607 coworkers. In both Studies, leaders' rational thinking, imaginative thinking, and behavioral coping correlated positively with their self-rated transformational leadership. However, only behavioral coping, but not rational thinking, was correlated with follower-rated (FR) transformational leadership in Study 1, and thinking styles were unrelated to other-rated transformational leadership in Study 2. These results partly support and partly challenge the CELM. Practically, this study suggests that leadership may be improved by leaders developing their capacity for behavioral coping.

Exploring the relationship between auditory hallucinations, trauma and dissociation.

BACKGROUND: It is clinically imperative to better understand the relationship between trauma, auditory hallucinations and dissociation. The personal narrative of trauma has enormous significance for each individual and is also important for the clinician, who must use this information to decide on a diagnosis and treatment approach. AIMS: To better understand whether dissociation contributes in a significant way to hallucinations in individuals with and without trauma histories. METHOD: Three groups of participants with auditory hallucinations were recruited, with diagnoses of: schizophrenia (without trauma) (n = 18), post-traumatic stress disorder (PTSD, n = 27) and comorbid schizophrenia and PTSD (SCZ+PTSD), n = 26). Clinician-administered measures included the PTSD Symptoms Scale Interview (PSSI-5), the Clinician-Administered Dissociative States Scale (CADSS) and the Psychotic Symptom Rating Scales (PSYRATS). RESULTS: Dissociative symptoms were significantly higher in participants with trauma histories (PTSD and SCZ+PTSD groups) and significantly correlated with hallucinations in trauma-exposed participants, but not in participants with schizophrenia (without trauma history). Hallucination severity was correlated with the CADSS amnesia subscale score, but depersonalisation and derealisation were not. CONCLUSIONS: Dissociation may be a mechanism in trauma-exposed individuals who hear voices, but it does not explain all hallucinatory experiences. The SCZ+PTSD group were in an intermediary position between schizophrenia and PTSD on dissociative and hallucination measures. The PTSD and SCZ+PTSD groups experienced dissociative phenomena much more frequently than the schizophrenia group, with a significant trend towards the amnesia subtype of dissociation.

Why Students Do Not Engage in Contract Cheating.

Contract cheating refers to students paying a third party to complete university assessments for them. Although opportunities for commercial contract cheating are widely available in the form of essay mills, only about 3% of students engage in this behaviour. This study examined the reasons why most students do not engage in contract cheating. Students (n = 1204) completed a survey on why they do not engage in contract cheating as well as measures of several individual differences, including self-control, grit and the Dark Triad traits. Morality and motivation for learning received the greatest endorsement for why students do not engage in contract cheating. Controlling for gender, individual differences predicted students' reasons for not contract cheating. This study supports the use of criminological theories relating to rational choice, self-control and opportunity to explain why students do not engage in contract cheating. Practically, this study may inform academic policies and assessment design that may reduce contract cheating.

Validation of the Measurement of Need Frustration.

Until recently, need frustration was considered to be the absence of need satisfaction, rather than a separate dimension. Whilst the absence of need satisfaction can hamper growth, experiencing need frustration can lead to malfunctioning and subsequent psychopathology. Therefore, examining these constructs separately is vital, as they produce different outcomes, with the consequences of need frustration potentially more severe. This study sought to examine predictors of need frustration using undergraduate students and individuals from the wider community (N = 510, females N = 404, M age = 24.15). Participants completed the new need satisfaction frustration scale and measures of anxiety, stress, depression, and negative and positive affect. Support for the position that need frustration is separate to Need Satisfaction and is related to psychological health problems (i.e., ill-being) was found. However, autonomy frustration was not found to be a significant predictor of ill-being. Extending previous research, this study found relationships of stress and somatic anxiety with need frustration. Further, a relationship between need frustration with anxiety and depression occurred, when these symptom dimensions were examined separately, through distinct questionnaires. Support for the construct of need frustration highlights the necessity of examining need frustration in addition to need satisfaction within future studies. Interventions specific to reducing need frustration, specifically competence and relatedness frustration within both the educational and workplace setting are outlined.

Soft Tissue and Skin Reinforcement with Acellular Dermal Matrix to Protect Implanted Cardioverters/Defibrillators and Pacemakers.

Cardiac pacemakers and implantable cardioverters/defibrillators are often placed in older patients with thin skin and scanty subcutaneous tissue. These devices and cardiac leads are at risk for progressive skin erosion and exposure leading to infection. To prevent this severe complication, we developed a reinforcing insertion of acellular dermal matrix. Twenty-two of 24 patients had successful implantation with long-term avoidance of skin erosion.

Trauma-intrusive hallucinations and the dissociative state.

BACKGROUND: Research has supported a model of dissociation mediating the experience of hearing voices in traumatised individuals. AIMS: To further understand this model by examining subtypes of the dissociative experience involved in trauma-intrusive hallucinations. METHOD: The study involved four hospitals, 11 psychiatrists and 69 participants assessed using the Psychotic Symptoms Rating scale, the PTSD Symptoms Scale Interview and the Dissociative Subtype of PTSD Score. RESULTS: In total, 59% (n = 41) of the participants heard voices and they were compared with the 41% (n = 28) who did not. The severity of PTSD symptoms did not predict experience of hearing voices. Regression analysis indicated that two scales of dissociation (derealisation/depersonalisation and loss of awareness) were equally good predictors of the extent of hearing voices. Adding other possible predictors (age of trauma <18, sexual violence) was relevant but did not enhance the prediction. CONCLUSIONS: This research supports the proposal that trauma-intrusive voices are mediated by symptoms of dissociation. The supported model describes general, rather than trauma specific, symptoms of dissociation mediating the experience of hearing voices. The concept of anchoring is discussed and suggests a potential treatment strategy, which could be useful in the clinical management of hearing voices. DECLARATION OF INTEREST: None.

Cross-Situational Self-Consistency in Nine Cultures: The Importance of Separating Influences of Social Norms and Distinctive Dispositions.

We assessed self-consistency (expressing similar traits in different situations) by having undergraduates in the United States ( n = 230), Australia ( n = 220), Canada ( n = 240), Ecuador ( n = 101), Mexico ( n = 209), Venezuela ( n = 209), Japan ( n = 178), Malaysia ( n = 254), and the Philippines ( n = 241) report the traits they expressed in four different social situations. Self-consistency was positively associated with age, well-being, living in Latin America, and not living in Japan; however, each of these variables showed a unique pattern of associations with various psychologically distinct sources of raw self-consistency, including cross-situationally consistent social norms and injunctions. For example, low consistency between injunctive norms and trait expressions fully explained the low self-consistency in Japan. In accord with trait theory, after removing normative and injunctive sources of consistency, there remained robust distinctive noninjunctive self-consistency (reflecting individuating personality dispositions) in every country, including Japan. The results highlight how clarifying the determinants and implications of self-consistency requires differentiating its distinctive, injunctive, and noninjunctive components.

Where pseudo-hallucinations meet dissociation: a cluster analysis.

OBJECTIVES: The possible link between cognitive areas of perception and integration of consciousness was examined using assessments of hallucinations and derealisation/depersonalization. METHODS: Sixty-five subjects in three main diagnostic groups - posttraumatic stress disorder (PTSD), borderline personality disorder (BPD) and schizophrenia - identified by their treating psychiatrist as hearing voices were surveyed regarding characteristics of hallucinations, derealisation/depersonalization, delusions and childhood/adult trauma. RESULTS: A cluster analysis produced two clusters predominantly determined by variables of hallucinations measures, childhood sexual abuse and derealisation/depersonalization scores. CONCLUSIONS: History of childhood trauma and variability in derealisation/depersonalization scores were better predictors of external, negative, uncontrollable voices than diagnosis of BPD or PTSD. The potential links between dissociative states and pseudo-hallucinations are discussed.

Low Intensity Epicardial Pacing During the Absolute Refractory Period Augments Left Ventricular Function Mediated by Local Catecholamine Release.

BACKGROUND: Biventricular epicardial (Epi) pacing can augment left ventricular (LV) function in heart failure. We postulated that these effects might involve catecholamine release from local autonomic nerve activation. To evaluate this hypothesis we applied low intensity Epi electrical stimuli during the absolute refractory period (ARP), thus avoiding altered activation sequence. METHODS: Anesthetized pigs (n = 6) were instrumented with an LV pressure (LVP) transducer, left atrial (LA) and LV Epi pacing electrodes, and sonomicrometer segment length (SL) gauges placed proximal and remote to the LV stimulation site. A catheter was placed into the great cardiac vein adjacent to the LV pacing site for norepinephrine (NE) analysis. During LA pacing at constant rate, 3 pulses (0.8 milliseconds, 2-3x threshold) were applied to the LV Epi electrodes during the ARP. An experimental run consisted of baseline, stimulation (10 minutes), and recovery (5 minutes), repeated 3 times before and after ß1 - receptor blockade (BB, metoprolol). RESULTS: ARP stimulation produced significant increases in cardiac function reflected by elevated LVP, LV, dP/dtmax , and reduced time to LV dP/dtmax . This was accompanied by increased coronary NE levels and increases in LVP versus SL loop area in the remote myocardial segment. In contrast, the proximal segment exhibited early shortening and decreased loop area. BB abolished the changes in SL and LV function despite continued NE release. CONCLUSION: These results demonstrate that ARP EPI stimulation induces NE release mediating augmented global LV function. This effect may contribute to the beneficial effect of biventricular Epi pacing in heart failure in some patients.

Stiff left atrial syndrome after catheter ablation for atrial fibrillation: clinical characterization, prevalence, and predictors.

BACKGROUND: There have been no studies of atrial diastolic function after catheter ablation of atrial fibrillation (AF). We encountered a few patients with symptomatic left atrial (LA) diastolic dysfunction and associated pulmonary hypertension (PH) that developed after catheter ablation for atrial fibrillation. Similar findings were described in patients after cardiac surgery and were referred to as the "stiff left atrial syndrome." OBJECTIVE: The purpose of this study was to prospectively quantify the incidence of patients developing PH associated with diastolic hemodynamic abnormalities of the LA after radiofrequency ablation of AF and to identify the possible predictors. METHODS: Between January 2009 and July 2010, data on 1,380 consecutive patients were prospectively collected. Before ablation and at follow-up, all patients had an echocardiogram to assess for the presence of PH. Patients with no echocardiographic evidence of PH but complaining of unexplained dyspnea with LA diastolic abnormalities were evaluated with right heart catheterization (RHC). Patients were included in the analysis if they developed new or worsening PH postablation with evidence of LA diastolic dysfunction by RHC or direct LA pressure measurement. All patients were evaluated for pulmonary vein stenosis and excluded if this condition was identified. RESULTS: The mean age was 62 ± 11 (75% male), and nonparoxysmal AF was the predominant arrhythmia (71%). New or worsening PH with associated LA diastolic abnormalities was detected in 19 (1.4%) patients after ablation. The prevalence of PH did not differ between AF types (P = .612). Compared with patients who did not develop PH, LA scarring (P <.001), diabetes (P = .026), and obstructive sleep apnea (OSA; P = .006) were more frequently observed among those who developed PH. In a multivariable logistic model, preprocedure LA size ≤45 mm (odds ratio [OR] = 6.13; P = .033), mean LA pressure (OR 1.14; P = .025), severe LA scarring (OR = 4.4; P = .046), diabetes mellitus (OR = 9.5; P = .004), and OSA (OR = 6.2; P = .009) were independently associated with the development of PH postablation. CONCLUSIONS: After radiofrequency catheter ablation of atrial fibrillation (RFCAF), PH with LA diastolic dysfunction or the so-called stiff LA syndrome is a rare but potentially significant complication of AF ablation. Severe LA scarring, LA ≤45 mm, diabetes mellitus, OSA, and high LA pressure are clinical variables that predict the development of this syndrome. The main clinical findings include dyspnea, congestive heart failure, PH, and large V waves on pulmonary capillary wedge pressure (PCWP) or LA pressure tracings in the absence of mitral regurgitation.

Salvage of pacemakers and automatic implantable cardioverter-defibrillators using dermis grafts.

BACKGROUND: Thin patients with thoracic pacemakers and automatic implantable cardioverter-defibrillators often have minimal tissue over the devices, with erosion through the surface a major concern. This erosion can lead to device infection and need for removal, or primary device infection can, in turn, lead to erosion. Even worse is exposure and infection of the leads to the heart, with fatalities having occurred. Pressure symptoms, as with shoulder seatbelt straps, can occur, and the visible deformity may be objectionable. METHODS: To correct these problems without device removal, we used a novel surgical approach. Thirteen patients had 15 grafts, of either the acellular dermal graft AlloDerm (LifeCell Corp, Branchburg, NJ [n = 13 for threatened exposure or pressure symptoms, including two repeats]) or autogenous dermis (n = 2 for existing open wounds with chronic drainage) placed over the devices. RESULTS: After all graft procedures, there was no skin breakdown; exposure and extrusion were completely prevented. Follow-up was 3 to 68 months (mean 36.8). The 2 open wound patients treated with dermis autografts had no recurrence of wound breakdown. Most patients with pressure symptoms had reduction in tenderness and pain. Patients liked the visible softening of the device contour, but not the subtly increased forward projection. The only immediate complication was one rapidly expanding hematoma leading to graft removal. One late complication was a mild infection, treated successfully. CONCLUSIONS: Acellular human dermal allografts, or live dermis autografts, provided significant protection over cardiac pacing devices in 13 patients with 15 grafts, with no subsequent surface exposures or extrusions.

Culture, cross-role consistency, and adjustment: testing trait and cultural psychology perspectives.

Trait and cultural psychology perspectives on cross-role consistency and its relation to adjustment were examined in 2 individualistic cultures, the United States (N=231) and Australia (N=195), and 4 collectivistic cultures, Mexico (N=199), the Philippines (N=195), Malaysia (N=217), and Japan (N=180). Cross-role consistency in trait ratings was evident in all cultures, supporting trait perspectives. Cultural comparisons of mean consistency provided support for cultural psychology perspectives as applied to East Asian cultures (i.e., Japan) but not collectivistic cultures more generally. Some but not all of the hypothesized predictors of consistency were supported across cultures. Cross-role consistency predicted aspects of adjustment in all cultures, but prediction was most reliable in the U.S. sample and weakest in the Japanese sample. Alternative constructs proposed by cultural psychologists--personality coherence, social appraisal, and relationship harmony--predicted adjustment in all cultures but were not, as hypothesized, better predictors of adjustment in collectivistic cultures than in individualistic cultures.

Reduction of pacemaker pressure symptoms using nonantigenic preserved human dermis grafts.

Skin pressure symptoms can occur in thin patients with pacemakers, with erosion through the skin surface a possibility. To correct this problem without device removal, two patients had nonantigenic preserved human dermis grafts placed over their pacemakers. This acellular nonantigenic human dermal substitute provided significant thickness over the devices and improvement in pressure symptoms.

Culture, Method, and the Content of Self-Concepts: Testing Trait, Individual-Self-Primacy, and Cultural Psychology Perspectives.

Three theoretical perspectives on cultural universals and differences in the content of self-concepts were tested in individualistic (United States, n = 178; Australia, n = 112) and collectivistic (Mexico, n = 157; Philippines, n = 138) cultures, using three methods of self-concept assessment. Support was found for both trait perspectives and the individual-self-primacy hypothesis. In contrast, support for cultural psychology hypotheses was limited because traits and other personal attributes were not more salient, or social attributes less salient, in individualistic cultures than collectivistic cultures. The salience of some aspects of self-concept depended on the method of assessment, calling into question conclusions based on monomethod studies.