The geometry of synchronization: quantifying the coupling direction of physiological signals of stress between individuals using inter-system recurrence networks.

In the study of synchronization dynamics between interacting systems, several techniques are available to estimate coupling strength and coupling direction. Currently, there is no general 'best' method that will perform well in most contexts. Inter-system recurrence networks (IRN) combine auto-recurrence and cross-recurrence matrices to create a graph that represents interacting networks. The method is appealing because it is based on cross-recurrence quantification analysis, a well-developed method for studying synchronization between 2 systems, which can be expanded in the IRN framework to include N > 2 interacting networks. In this study we examine whether IRN can be used to analyze coupling dynamics between physiological variables (acceleration, blood volume pressure, electrodermal activity, heart rate and skin temperature) observed in a client in residential care with severe to profound intellectual disabilities (SPID) and their professional caregiver. Based on the cross-clustering coefficients of the IRN conclusions about the coupling direction (client or caregiver drives the interaction) can be drawn, however, deciding between bi-directional coupling or no coupling remains a challenge. Constructing the full IRN, based on the multivariate time series of five coupled processes, reveals the existence of potential feedback loops. Further study is needed to be able to determine dynamics of coupling between the different layers.

Building high-quality interpersonal staff-client relationships with people with severe to profound intellectual disabilities and challenging behavior: Insights of professionals and relatives.

Background: Staff-client relationships impact the quality of support and life of people with severe to profound intellectual disabilities and challenging behavior, but are challenging to build due to clients' intense, complex and varying support needs. The present study explores the perspectives of professionals and relatives on what affects these interpersonal relationships. Method: 17 professionals and 11 relatives participated in focus groups and interviews. Data collection and analysis was performed in collaboration with a co-researcher. Data were synthesized thematically. Results: Interpersonal relationships constituted equivalence, striving for mutual understanding, trust and exploring clients' potential. The combination of staff characteristics (enthusiasm/passion, patience, resilience, creativity/humor, flexibility) and expertise (knowledge, vulnerability/sincerity, self-reflection) enabled staff to build these relationships. The importance of involving relatives was addressed. Contextual influences included the team (cooperation, flexibility, culture), organization (cooperation, boundary conditions) and setting (predictability, interior/atmosphere). Conclusions: The findings make practical knowledge explicit and scientifically underpinned for this specific population.

Physiological Measurements of Stress Preceding Incidents of Challenging Behavior in People With Severe to Profound Intellectual Disabilities: Longitudinal Study Protocol of Single-Case Studies.

BACKGROUND: Clients with severe to profound intellectual disabilities (SPID) and challenging behavior (CB) and the professional caregivers that support them are vulnerable to high stress levels, which negatively impact their well-being and the quality of care. CB is thought to result from an increase in the intensity and frequency of clients' stress experiences. In turn, staff members experience stress in dealing with this behavior, and stressed staff members might behave in ways that increase clients' stress levels, contributing to the origin and maintenance of CB. Research into these dyadic interactions between clients and staff is scarce for people with SPID, especially in real-life situations. The barriers of studying stress in this population include clients' difficulties in communicating stress experiences and the lack of an objective continuous measure of stress. OBJECTIVE: This paper presents a protocol for studying patterns of physiological stress in 15 client-caregiver dyads in the 30 minutes preceding incidents of CB compared to control periods without CB and the interplay between the stress levels of clients and professional caregivers. METHODS: We will conduct 15 single-case studies to assess patterns of physiological stress in dyads of clients with SPID and professional caregivers prior to CB in several Dutch residential institutes. Client-caregiver dyads will wear the Empatica E4 wristband for 20 sessions of 3 to 8 hours without interruptions of daily routines while caregivers report clients' CB. The physiological measures obtained will be electrodermal activity (microsiemens) and heart rate (beats per minute). A multilevel model with repeated measures at the incident level nested within the person level will be applied, employing separate models for electrodermal activity and heart rate to compare stress levels in the 30 minutes prior to incidents with control epochs. Covariates in the models include movement, temperature, and gender. In addition, cross-recurrence quantification analyses will be performed to study the synchronization between the stress levels of clients and professional caregivers. RESULTS: The Ethics Committee of the Radboud University (NL-number: NL71683.091.19) approved the study on February 12, 2020. In total, 15 organizations have declared their commitment to participate in the study. The first result is expected in the spring of 2022. CONCLUSIONS: Study results will demonstrate whether changes in patterns of electrodermal activity and heart rate are apparent in the 30 minutes preceding an incident of CB compared to baseline levels when the client does not engage in CB. The synchronization between caregivers' and clients' physiological stress levels will be explored with cross-recurrence quantification analyses. Insights into the physiological stress levels of clients and caregivers may contribute to a reduction of CB and an improvement of both clients' and caregivers' safety and well-being. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/24911.

Individualized behavioral change of externalizing and internalizing problems and predicting factors in residential youth care.

The present study examined individualized behavioral change of externalizing and internalizing problems of adolescents in residential youth care, divided into different change groups (improvement, no change, or deterioration), by using the reliable change index. We also identified demographic and clinical factors that may predict individual behavioral change. A naturalistic dataset was used which consisted of adolescents referred to open or compulsory residential care who had outcome measures at the beginning and end of treatment. In total 742 reports of behavior problems were included: the sample consists of 265 adolescents with self-reports, 341 adolescents with group care worker reports, and 136 adolescents with parent reports. Only 42 adolescents had three sources of report, 202 adolescents had two sources of report, and 212 adolescents had one source of report. The majority of adolescents (50-73%) showed nonsignificant change in either externalizing or internalizing problems during their stay in residential care, regardless of informant. Higher problem severity at the beginning of treatment was a significant predictor of improvement in externalizing and internalizing problems throughout treatment, but the other factors (i.e., age, gender, ethnicity, and treatment duration) showed no effect. In conclusion, this study shows that with the current system of monitoring, more than half of the adolescents in residential care do not show significant change over time. This may indicate either that residential stay does not necessarily cause a significant change in problems for all adolescents, or that the system currently used for treatment monitoring is suboptimal in detecting such a change. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

The effect of positive and negative movie alcohol portrayals on transportation and attitude toward the movie.

BACKGROUND: This study examined the effects of alcohol portrayals on transportation and attitude toward a movie. In addition, we examined whether positive and negative movie alcohol portrayals affect transportation into and attitude toward the movie. METHODS: A within-subject design was used in which participants were exposed to 8 different movie clips containing alcohol (positive or negative context) or no alcohol portrayals in a controlled laboratory setting. A total of 159 college students (84 males and 75 females) ages 18 to 30 participated in the experiment. Transportation and attitude toward the movie were measured after each movie clip. RESULTS: Participants were more transported into and had a more positive attitude toward movie clips with alcohol portrayals compared to the same movie clips with no alcohol portrayal. In addition, participants were more transported into movie clips with negative alcohol (NA) portrayals compared to clips with positive alcohol (PA) portrayals. For attitude toward the movie, opposite results were found. Participants had a more positive attitudes toward clips with PA portrayals compared to clips with NA portrayals. CONCLUSIONS: The way alcohol is portrayed in movies may contribute to how people evaluate and get transported in movies.

Self-control and the effects of movie alcohol portrayals on immediate alcohol consumption in male college students.

BACKGROUND: In movies, alcohol-related cues are frequently depicted and there is evidence for a link between movie alcohol cues and immediate alcohol consumption. Less is known about factors influencing immediate effects movie alcohol exposure on drinking. The exertion of self-control is thought to be important in avoiding or resisting certain temptations. AIMS: The aim of the present study was to assess the immediate effects of movie alcohol portrayals on drinking of male social drinkers and to assess the moderating role of self-control in this relation. It was hypothesized that participants would drink more when exposed to movie alcohol portrayals and that especially participants with low self-control would be affected by these portrayals. METHODS: A between-subjects design comparing two movie conditions (alcohol or no portrayal of alcohol) was used, in which 154 pairs of male friends (ages 18-30) watched a 1-h movie in a semi-naturalistic living room setting. Their alcohol consumption while watching was examined. Participants completed a questionnaire assessing self-control as well as their self-reported weekly alcohol use. A multivariate regression analysis was conducted to test the effects of movie condition on alcohol comsumption. RESULTS: Self-control moderated the relation between movie condition and alcohol consumption. Assignment to the alcohol movie condition increased alcohol consumption during the movie for males with high self-control but not for males with low self-control. CONCLUSION: Viewing a movie with alcohol portrayals can lead to higher alcohol consumption in a specific sample of young men while watching a movie.

Alcohol portrayals in movies, music videos and soap operas and alcohol use of young people: current status and future challenges.

AIMS: To provide an overview of studies of the effects of alcohol portrayals in movies, music videos and soap operas on alcohol consumption among young people. Moreover, we highlight important issues that need to be addressed in future research. METHODS: This paper reviews the current literature on alcohol portrayals on-screen and the associated gaps and challenges in alcohol media research. RESULTS: Thirteen longitudinal studies, 8 cross-sectional studies and 6 experimental studies examined the effects of alcohol portrayals on-screen on alcohol consumption among young people. They showed a relation between on-screen alcohol exposure and onset and progression of alcohol consumption. A distinction can be made between long-term effects and immediate effects on alcohol consumption. Only lately, more attention has been paid to processes underlying the effects of on-screen alcohol exposure. CONCLUSION: Replication of findings and development of new research designs is essential. On-screen alcohol exposure does not affect everyone. It is important to test individual differences in susceptibility to on-screen alcohol portrayals. Further, not all media alcohol portrayal might provoke similar effects. It is therefore essential to test the effect of different types of alcohol portrayals.

The effect of alcohol advertising on immediate alcohol consumption in college students: an experimental study.

BACKGROUND: Survey studies have emphasized a positive association between exposure to alcohol advertising on television (TV) and the onset and continuation of drinking among young people. Alcohol advertising might also directly influence viewers' consumption of alcohol while watching TV. The present study therefore tested the immediate effects of alcohol advertisements on the alcohol consumption of young adults while watching a movie. Weekly drinking, problem drinking, positive and arousal expectancies of alcohol, ad recall, attitude, and skepticism toward the ads were tested as moderators. METHODS: An experimental design comparing 2 advertisement conditions (alcohol ads vs. nonalcohol ads) was used. A total of 80 men, young adult friendly dyads (ages 18 to 29) participated. The study examined actual alcohol consumption while watching a 1-hour movie with 3 advertising breaks. A multivariate regression analysis was used to examine the effects of advertisement condition on alcohol consumption. RESULTS: Assignment to the alcohol advertisement condition did not increase alcohol consumption. In addition, no moderating effects between advertisement condition and the individual factors on alcohol consumption were found. CONCLUSIONS: Viewing alcohol advertising did not lead to higher alcohol consumption in young men while watching a movie. However, replications of this study using other samples (e.g., different countries and cultures), other settings (e.g., movie theater, home), and with other designs (e.g., different movies and alcohol ads, cumulative exposure, extended exposure effects) are warranted.

Exposure to alcohol commercials in movie theaters affects actual alcohol consumption in young adult high weekly drinkers: an experimental study.

The present pilot study examined the effects of alcohol commercials shown in movie theaters on the alcohol consumption of young adults who see these commercials. A two (alcohol commercials vs. nonalcohol commercials) by two (high weekly alcohol consumption vs. low weekly alcohol consumption) between-participant design was used, in which 184 young adults (age: 16-28 years) were exposed to a movie that was preceded by either alcohol commercials or nonalcohol commercials. Participants' actual alcohol consumption while watching the movie ("Watchmen") was examined. An analysis of variance (ANOVA) was conducted to examine the effects of the commercial condition on alcohol consumption. An interaction effect was found between commercial condition and weekly alcohol consumption (p < .001). Alcohol consumption among high weekly alcohol drinkers was higher in the alcohol commercial condition than in the nonalcohol commercial condition, whereas no differences were found in alcohol consumption between commercial conditions among low weekly alcohol drinkers. No gender differences were found in the association between exposure to alcohol commercials, weekly drinking, and alcohol use. Thus, exposure to alcohol commercials prior to a movie in a movie theater can directly influence alcohol consumption among high weekly alcohol consumers.

Do we act upon what we see? Direct effects of alcohol cues in movies on young adults' alcohol drinking.

AIMS: Ample survey research has shown that alcohol portrayals in movies affect the development of alcohol consumption in youth. Hence, there is preliminary evidence that alcohol portrayals in movies also directly influence viewers' drinking of alcohol while watching movies. One process that might account for these direct effects is imitation. The present study therefore examined whether young people imitate actors sipping alcohol on screen. METHODS: We observed sipping behaviours of 79 young adults (ages 18-25) watching a 60-min movie clip, 'What Happens in Vegas', in a semi-naturalistic home setting. Each of the 79 participants was exposed to 25 alcohol cues. Two-level logistic regression analyses were used to analyse whether participants in general imitated actors' sipping during this clip. In addition, we applied proportional hazard models in a survival analysis framework (Cox regression) to test whether there was a difference in imitation of the cues between male and female participants, and to test whether the timing of the actors' sipping throughout the movie played a role. RESULTS: The findings showed that participants were more likely to sip in accordance with the actors' sipping than without such a cue. Further, we found that men were more likely to imitate actors' sipping than females and that participants tended to respond to actors' sipping at the beginning of the movie rather than at the end. CONCLUSION: Exposure to actors sipping alcohol in a movie seems to have an immediate impact on the drinking behaviour of viewers, via the mechanism of imitation.

Effects of alcohol portrayals in movies on actual alcohol consumption: an observational experimental study.

AIMS: This study uses an experimental design to assess the effects of movie alcohol portrayal on alcohol consumption of young adults while watching a movie. Gender, weekly alcohol use and identification with the movie actor/character were assessed as moderators. DESIGN: A two (sex) × two (movie: alcohol or no portrayal of alcohol) between-subject design was used. SETTING: Participants watched a contemporary movie in a semi-naturalistic living room setting. PARTICIPANTS: A total of 122 same-sex, young adult dyads (ages 18-29 years) participated in the experiment. MEASUREMENTS: Their actual alcohol consumption while watching was examined. A multivariate regression analysis was used to examine the effects of the movie condition on alcohol consumption. FINDINGS: Assignment to movie alcohol increased alcohol consumption during the movie for men but not women. Identification and weekly alcohol consumption did not moderate the relation between movie condition and alcohol consumption. CONCLUSIONS: Viewing a movie with alcohol portrayal can lead to higher alcohol consumption in young men while watching the movie.

Exposure to soda commercials affects sugar-sweetened soda consumption in young women. An observational experimental study.

The present study examines the direct effects of television commercials advertising soda on actual sugar-sweetened soda consumption among young women. An experimental-observational study design was used, in which 51 female students (ages 18-29) were exposed to a 35-min movie clip, interrupted by two commercial breaks consisting of soda or water commercials. Their actual soda consumption while watching the movie clip was examined. An analysis of variance was used to examine the effects of commercial condition on soda consumption. Thirst and first glass consumed before the first commercial break were added as covariates in the analyses. Results indicated that participants assigned to the condition with soda commercials consumed 1.3 ounces more soda than participants in the water commercial condition. Exposure to soda commercials while watching a movie can have a strong influence on increasing sugar-sweetened soda consumption in young women.