Racial Differences in Nursing Home Quality of Life Among Residents Living With Alzheimer's Disease and Related Dementias

ObjectivesAmong nursing home (NH) residents with Alzheimer's disease (AD) and AD-related dementias (AD/ADRD), racial/ethnic disparities in quality of care exist. However, little is known about quality of life (QoL). This study examines racial/ethnic differences in self-reported QoL among NH residents with AD/ADRD. Methods: Validated, in-person QoL surveys from 12,562 long-stay NH residents with AD/ADRD in Minnesota (2012-2015) were linked to Minimum Data Set assessments and facility characteristics. Hierarchical linear models assessed disparities in resident-reported mean QoL score (range, 0-100 points), adjusting for case-mix and facility factors. Results: Compared to White residents, racially/ethnically minoritized residents reported significantly lower total mean QoL scores (75.53 points vs. 80.34 points, p < .001). After adjustment for resident- and facility-level characteristics, significant racial/ethnic differences remained, with large disparities in food enjoyment, attention from staff, and engagement domains. Discussion: Policy changes and practice guidelines are needed to address racial/ethnic disparities in QoL of NH residents with AD/ADRD.

Shared Activities as a Protective Factor Against Behavioral and Psychological Symptoms of Dementia and Caregiver Stress

Background and Objectives

Most persons with dementia experience behavioral and psychological symptoms (BPSD). While there is evidence that structured activity programs can be beneficial for persons with dementia and their caregivers, it is not well understood how joint engagement in shared activities affects BPSD and caregiver stress. The purpose of this study was to examine the moderating effect of doing a shared activity on the BPSD and caregiver stress.

Research Design and Methods

This study used an intensive longitudinal observational design in which caregivers completed baseline and once-a-day diary surveys for 21 days. Caregivers were asked whether they did a pleasant noncare activity with their relative, the presence of 8 BPSD, and their stress level. A moderation model in a structural equation model examined the relationship between these variables.

Results

Our sample consisted of 453 caregivers (87.4% female, 51.4% non-Hispanic White, mean age 53 years [standard deviation {SD}: 14]) and person living with dementia whose mean age was 79 years (SD: 9). On days when the caregivers engaged in a shared activity together with person living with dementia, there was a significant decrease in the BPSD (estimate -0.038, standard error [SE] = 0.016, 95% confidence interval [CI]: -0.069, -0.007, p value = 0.018). The effects of engaging in a shared activity decreased the impact of caregiver stress by 0.052 (estimate -0.052, SE = 0.018, 95% CI: -0.087, -0.017, p value = 0.004). At the between-person level, no differences were found in BPSD across caregivers who engaged or did not engage in shared activities.

Discussion and Implications

The results of our study indicate that doing a shared activity is associated with reduced BPSD among persons with dementia and may buffer the impact of caregiver stress on BPSD. Shared activities should be considered a key intervention component for dementia caregivers.

Advancing Gerontology through Exceptional Scholarship (AGES): a Mentorship Initiative for Early Career Faculty

Mentorship is critical to supporting professional development and growth of new and emerging faculty members. Working with the Gerontological Society of America (GSA), we created the Advancing Gerontology through Exceptional Scholarship (AGES) Initiative as a mentorship model to promote productivity and peer support for new and early career faculty members. In this commentary, we highlight the AGES Program as a prototype to facilitate peer support, collective learning, and co-authorship opportunities to advance new and early career faculty members, especially in the field of aging. Moreover, we identify four crucial strategies that cultivated and refined our AGES Program including: i) ensuring flexibility to address mentee needs; ii) establishing check-ins and accountability to enhance productivity; iii) fostering peer support and collective learning; and iv) delivering motivational and educational activities. Drawing on our experience with the AGES Program, this commentary provides recommendations to support other groups looking to develop high-quality mentorship programs to support new and early career faculty members in academia.

Using Hybrid Effectiveness Studies to Facilitate Implementation in Community-Based Settings: Three Case Studies in Dementia Care Research

The pipeline from discovery to testing and then implementing evidence-based innovations in real-world contexts may take 2 decades or more to achieve. Implementation science innovations, such as hybrid studies that combine effectiveness and implementation research questions, may help to bridge the chasm between intervention testing and implementation in dementia care. This paper describes hybrid effectiveness studies and presents 3 examples of dementia care interventions conducted in various community-based settings. Studies that focus on outcomes and implementation processes simultaneously may result in a truncated and more efficient implementation pipeline, thereby providing older persons, their families, health care providers, and communities with the best evidence to improve quality of life and care more rapidly. We offer post-acute and long-term care researchers considerations related to study design, sampling, data collection, and analysis that they can apply to their own dementia and other chronic disease care investigations.

Healthcare Utilization and Advance Care Planning among Older Adults Across Cognitive Levels

This study examined the impact of advance care planning (ACP) on healthcare utilization among older adults with normal cognition and impaired cognition/dementia. Using datasets from the Health and Retirement Study, we conducted a cross-sectional study on 17,698 participants aged 51 years and older. Our analyses included survey descriptive and logistic regression procedures. ACP measures included a living will and durable power of attorney for healthcare. Healthcare utilization was measured using the days spent in hospitals, hospice care, nursing homes, and home care. Of the participants, 77.8% had normal cognition, and 22% had impaired cognition/dementia. The proportion of impaired cognition/dementia was higher among racially minoritized participants, single/widowed participants, and those who lived alone and were less educated. The results showed that having an ACP was associated with longer stays in hospitals, nursing homes, and home healthcare in all participants.

"I Have Accepted My Father's Death; I was not Sad but Relieved." Adaptive Grief Responses for Bereaved Dementia Family Caregivers: A Scoping Review

This scoping review explores findings from the psychological and medical literature on the adaptive grieving experiences of bereaved dementia family caregivers and integrates what healthcare professionals can do to support bereaved dementia family caregivers transition into a post-death role. Bereaved dementia family caregivers are particularly susceptible to prolonged grief disorder post-death due to the protracted caregiving demands and progressive course of the illness. The mention of caregiver grief while the person with dementia is living is quite common in the literature; however, limited research focuses on the bereaved dementia family caregiver and the methods they use to grieve adaptively. Three overarching adaptive grieving themes emerged from the review: 1) social health, 2) emotional and spiritual fitness, and 3) reclaiming activities. Given the growing prevalence of bereaved family dementia caregivers, understanding how they might most adaptively grieve and experience the greatest possible well-being should be a top focus for research.

Connecting Dementia Caregivers to Recommended Services: Care to Plan

The current mixed methods, embedded study evaluated the use of an online tool (Care to Plan [CtP]) that generates tailored service and support recommendations for dementia caregivers as well as information that can connect dementia caregiver users to recommended resources. Forty-three dementia caregivers identified in a health care system were randomly assigned to receive either CtP or usual care. The embedded, mixed methods design resulted in no quantitative, direct evidence for CtP's efficacy. Qualitative data revealed important insights into facilitators of and barriers to CtP use. Qualitative data also demonstrated that CtP helped caregivers obtain a better awareness of their needs and experiences. Clinicians may find CtP useful as an initial tool to spur memory care/case management and facilitate conversations about caregivers' needs and resources to meet individualized challenges. [Journal of Gerontological Nursing, 49(10), 5-11.].

Simultaneously Developing Interventions for Low-/Middle-Income and High-Income Settings: Considerations and Opportunities

Most older adults reside in low- and middle-income countries (LMICs) but most research dollars spent on interventions to improve the lives of older adults are awarded to researchers in high-income countries (HICs). One approach to improve the implementation of evidence-based innovations for older adults in LMICs is designing interventions that are relevant to LMICs and HICs simultaneously. We propose that researchers in HICs could partner with stakeholders in an LMIC throughout the intervention design process to better position their intervention for the implementation in that LMIC. We provide an example study from an adaptation of the Resources for Enhancing Caregiver Health II in Vietnam, which did not use this strategy but may have benefited from this strategy. We then turn to several considerations that are important for researchers to contemplate when incorporating this strategy. Finally, we explore incentives for creating interventions that are relevant to both HICs and LMICs for funders, intervention designers, and intervention receivers. Although this is not the only strategy to bring interventions to LMICs, it may represent another tool in researchers' toolboxes to help expedite the implementation of efficacious interventions in LMICs.

The Basic Psychological Need Satisfaction and Frustration Scales probably do not validly measure need frustration

In basic psychological needs theory (BPNT), the separable constructs of need satisfaction and need frustration are theorized as pivotally related to psychopathology and broader aspects of well-being. The Basic Psychological Need Satisfaction and Frustration Scales (BPNSFS; Chen et al., 2015) have rapidly emerged as the dominant self-report measure in the BPNT domain, with translated versions available in a wide range of languages and a plethora of versions adapted for specific populations and life contexts. Through (a) an extended conceptual discussion of the BPNSFS and (b) a collection of complementary data analyses in eight samples, we demonstrate that the BPNSFS probably does not validly measure need frustration. Most importantly, we conclude that the ostensible distinction between need frustration and need satisfaction in the BPNSFS is likely primarily a method artifact caused by different item keying directions, given the way the measure currently assesses the intended constructs. If so, then the use of the BPNSFS may be generating misleading conclusions, obstructing sound investigation of current BPNT. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

A Qualitative Analysis of Mechanisms of Benefit in the Residential Care Transition Module: A Telehealth Intervention for Caregivers of Relatives With Dementia Living in Residential Long-Term Care

This study sought to determine the perceived benefits of the Residential Care Transition Module (RCTM), a novel multi-component, psychoeducational/psychosocial, telehealth intervention for caregivers of cognitively impaired relatives living in residential long-term care (RLTC). Few support programs exist for these caregivers. Determining the intervention's mechanisms of benefit will provide actionable clinical and research information regarding which key features aspects RLTC and public health agencies should offer their families. We conducted semi-structured interviews with 30 purposively selected participants randomly assigned to receive the RCTM. Additionally, an open-ended survey question solicited feedback at 4 (n = 90), 8 (n = 79), and 12 months (n = 77). Available qualitative data were analyzed for thematic content. Participants endorsed 9 mechanisms of benefit. Six mechanisms were related to RCTM content: education dementia progression and dementia behavior management, personalized resource provision, strategies for communication and engagement with the care recipient (CR) and others, management of multiple roles, and relaxation exercises. Three mechanisms were related to coaching: emotional support, knowledgeability, and being a neutral third party. Common benefits attributed to RCTM included improvement in mood, caregiving confidence, and communication and interactions with CR and others. Using qualitative data and analyses, we discovered the most valued aspects of the RCTM intervention. These mechanisms of benefit have not been described in the literature. Notably, we were unable to detect mechanisms of benefit in a separate analysis utilizing quantitative data. Findings emphasize the importance of including qualitative measures in intervention research and selecting quantitative measures that reflect the intervention's real effects, if any.

Depressive Symptoms in Older African Immigrants with Mobility Limitations: A Descriptive Study

OBJECTIVES

Before, during, and after their immigration to the United States, immigrants face stressful life circumstances that may render them at risk for depressive symptoms. However, there is a dearth of research on the mental health of African immigrants. We performed secondary data analyses of two studies in the Baltimore-Washington area to describe and identify correlates of depressive symptoms in older African immigrants.

METHODS

Chi square tests, one-way ANOVAs, and linear regressions were used to describe and examine associations between depressive symptoms and immigrant-related risk factors.

RESULTS

This sample included 148 participants who had a mean age of 62 (SD ± 8.2). Clinical depressive symptoms were present in 8.1% of participants, and trouble falling asleep for more than half of the days was the most prevalent symptom (20%). Levels of education, income, and migration reasons differed significantly from clinical depressive symptoms, but these were not significantly associated with more depressive symptoms after controlling for covariates.

CONCLUSIONS

Longitudinal designs may further elucidate incidence, correlates, and long-term effects of depressive symptoms within this population.

CLINICAL IMPLICATIONS

Knowledge of depressive symptom burden and risk factors can inform timely assessment, referral, and treatment of depressive symptoms and other mental health outcomes in older African immigrants.

"We Moved Her Too Soon": Navigating Guilt Among Adult Child and Spousal Caregivers of Persons Living with Dementia Following a Move into Residential Long-Term Care

Guilt is a complex and multifaceted emotion navigated by many family caregivers. Guilt is sometimes experienced following a transition into a residential long-term care facility, even when the move is necessary given high care needs related to Alzheimer's disease and related dementias. This mixed methods study identifies and compares areas of guilt most frequently experienced by spouse and adult child caregivers (N=83) of a family member with dementia following transition into residential long-term care. Nearly half of caregivers reported experiencing guilt from their care recipient, other family members, or facility staff. Quantitative analyses explored variables that predict heightened feelings of guilt, and qualitative thematic analyses provided rich insight into subjective experiences of guilt. Person-specific and situational characteristics influenced caregiver guilt, including level of involvement in care, frequency and quality of visits, and perceptions of the residential long-term care facility. We identify specific opportunities for tailored couple and family psychology interventions including communication strategies, decision-making approaches, focusing on positives, psychoeducation, self-forgiveness exercises, stress management and self-care activities, and validation. The present work informs how counseling interventions can provide practical support by highlighting specific clinical mechanisms that help to alleviate common facets of caregiver guilt following a transition into residential long-term care. Critically, we distinguish variation between spouses and adult children to design treatment plans that best support clients who are caring for a person living with dementia in residential long-term care.

Association Between Fear of Pain and Sports-Related Concussion Recovery in a Pediatric Population

OBJECTIVE

To determine whether an association exists between fear of pain and recovery time from sports-related concussion in a pediatric population.

DESIGN

Prospective observational study.

SETTING

Primary outpatient sports medicine clinic of a large pediatric hospital.

PATIENTS

One hundred twenty-eight pediatric patients aged 8 to 18 years who presented to clinic with a primary diagnosis of concussion from September 2018 to March 2020. Inclusion criteria included presentation within 2 weeks of injury and symptomatic on initial visit. Patients who sustained a concussion because of motor vehicle collisions or assault were excluded.

INDEPENDENT VARIABLES

There was no intervention. Study participants who met inclusion criteria were administered the Fear of Pain Questionnaire (FOPQ) at their initial visit.

MAIN OUTCOME MEASURES

Time to clinical recovery was the main outcome measure and was determined by the fellowship-trained sports medicine physician based on resolution of concussion symptoms, resumption of normal physical and cognitive daily activities, no use of accommodations or medications, and normalization of physical exam.

RESULTS

There was a significant difference in FOPQ scores for those with prolonged recovery (M = 33.12, SD = 18.36) compared with those recovering in fewer than 28 days (M = 26.16, SD = 18.44; t [126] = -2.18, P = 0.036).

CONCLUSIONS

Consistent with the adult literature, we found that pediatric patients are more likely to have a prolonged recovery from concussion when they have higher fear of pain.

Delivering Personalized Recommendations to Support Caregivers of People Living With Dementia: Mixed Methods Study

BACKGROUND

Estimates suggest that 6.2 million Americans aged ≥65 years are living with Alzheimer dementia in 2021, and by 2060, this number could more than double to 13.8 million. As a result, public health officials anticipate a greater need for caregivers of persons with Alzheimer disease or related dementia and support resources for both people living with dementia and their caregivers. Despite the growing need for dementia caregiver support services, there is a lack of consensus regarding how to tailor these services to best meet the heterogeneous needs of individual caregivers. To fill this gap, Care to Plan (CtP), a web-based tool for caregivers of people living with dementia, was developed to provide tailored support recommendations to dementia caregivers.

OBJECTIVE

The aim of this study is to formally explore the feasibility, acceptability, and utility of CtP for 20 family members of people living with dementia within a health system over a 1-month time period using a mixed methods parallel convergent design.

METHODS

A moderately sized health system in the mid-Atlantic region was selected as the site for CtP implementation, where 20 caregivers who were family members of people living with dementia were enrolled. The web-based CtP tool was used by caregivers and facilitated by a health care professional (ie, a senior care navigator [SCN]). Caregivers were given a 21-item review checklist to assess barriers and facilitators associated with reviewing CtP with an SCN. Following the 21-item review checklist, semistructured telephone interviews, which included 18 open-ended questions, focused on the facilitators of and barriers to CtP implementation and recommendations for future implementation.

RESULTS

Quantitative results suggested that 85% (17/20) of caregivers indicated that CtP was helpful and 90% (18/20) would recommend CtP to someone in a similar situation. The qualitative analysis identified 4 themes regarding facilitators of and barriers to implementation: caregiver factors, SCN factors, CtP tool system factors, and recommendations and resources factors.

CONCLUSIONS

CtP was found to be not only feasible but also a valuable tool for caregivers seeking resources for themselves and their people living with dementia. Long-term evaluation findings aim to generate results on how CtP can be integrated into care plans for caregivers and how SCNs can provide additional support for caregivers of people living with dementia over an extended period.

Open science in dementia care embedded pragmatic clinical trials

Few dementia care interventions have been translated to healthcare contexts for those who need them. Embedded pragmatic clinical trials (ePCTs) are one design that can expedite the timeframe of research translation to clinical practice. As the National Institutes of Health (NIH) and other funders commit immense new resources to increasing the nation's capacity to conduct dementia care ePCTs, we call on psychologists to employ their extensive expertise in open science to improve the quality of dementia care ePCTs. This article provides several recommendations to enhance the transparency and reporting rigor of ePCTs in dementia care and other chronic disease contexts. We illustrate these recommendations in the context of a recent pilot pragmatic trial known as the Porchlight Project. Porchlight provided training to volunteers who serve clients and caregivers to help them provide more "dementia capable" support. Notably this trial did not include a special effort to make use of open science practices. We discuss the benefits and costs had the Porchlight Project incorporated open science principles. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Longitudinal Comparison of Stability and Sensitivity in Quality of Life Scores Among Nursing Home Residents With and Without Diagnoses of Alzheimer's Disease and Related Dementias

BACKGROUND AND OBJECTIVES

Prevalence of nursing home residents with Alzheimer's disease and related dementias (ADRD) has increased along with a growing consensus that person-centered ADRD care in nursing homes should maximize quality of life (QoL). However, concerns about whether residents with ADRD can make appropriate QoL judgments persist. This study assesses the stability and sensitivity of a self-reported, multidomain well-being QoL measure for nursing home residents with and without ADRD.

RESEARCH DESIGN AND METHODS

This study linked the 2012-2015 Minnesota Nursing Home Resident QoL and Satisfaction with Care Survey, Minimum Data Set 3.0 (nursing home assessments), and Minnesota Department of Human Services Cost Reports. The QoL survey included cohort-resident pairs who participated for 2 consecutive years (N = 12 949; 8 803 unique residents from 2012-2013, 2013-2014, and 2014-2015 cohorts). Change in QoL between 2 years was conceptualized as stable when within 1.5 SD of the sample average. We used linear probability models to estimate associations of ADRD/Cognitive Function Scale status with the stability of QoL summary and domain scores (eg, social engagement) and the absolute change in QoL summary score, controlling for resident and facility characteristics.

RESULTS

Most (86.82%) residents had stable QoL summary scores. Residents with moderate to severe cognitive impairment, irrespective of ADRD, were less likely to have stable summary scores than cognitively capable residents without ADRD (p < .001), but associations varied by QoL domains. Among those with stable summary QoL scores, changes in health/functional status were associated with absolute changes in summary QoL score (p < .001), suggesting sensitivity of the QoL measure.

DISCUSSION AND IMPLICATIONS

QoL scores were similarly stable over time for most residents with and without ADRD diagnoses and were sensitive to changes in health/functional status. This self-reported QoL measure may be appropriate for nursing home residents, regardless of ADRD diagnosis, and can efficaciously be recommended to other states.

Age Differences in Determinants of Self-Rated Health among Recipients of Publicly Funded Home-and-Community-Based Services

This research examined determinants of self-rated health (SRH) of publicly funded home-and-community-based services (HCBS) recipients and tested if the effects of determinants differ between older recipients and younger recipients with disabilities. Using Minnesota's data of 2015-2016 National Core Indicators - Aging and Disabilities survey (n = 3,426), this study revealed that functional status and community inclusion had both direct and indirect effects on SRH, with negative mood as a mediator. Community inclusion had a more pronounced effect on SRH in younger recipients than in older recipients. HCBS should address psychosocial needs and be tailored for recipients of different age groups.

Reflections on a registered report replicating a body of dyadic cross-sectional research

This article reflects on a new kind of registered report (RR) that replicated the work of an early career researcher. The research items targeted in this RR were peer-reviewed, cross-sectional, dyadic studies to which the first author of this RR had contributed. The findings being replicated are not noteworthy for their prestige or representativeness of the wider field. Instead, this method of replication may have several benefits and less desirable qualities for the researcher and research team whose work is being replicated, for science more broadly, and for relationship science specifically, reviewed herein. The authors hope that this reflection inspires researchers to improve upon their methodology by incorporating replication of their work early and often into their own research process.

Dissemination and Implementation of Evidence-Based Dementia Care Using Embedded Pragmatic Trials

There are many nonpharmacologic interventions tested in randomized clinical trials that demonstrate significant benefits for people living with Alzheimer's disease (AD) and AD-related dementia, their care partners, or professional care providers. Nevertheless, with few exceptions, proven interventions have not been translated for delivery in real-world settings, such as home care, primary care, hospitals, community-based services, adult day services, assisted living, nursing homes, or other healthcare systems (HCSs). Using embedded pragmatic clinical trial (ePCT) methods is one approach that can facilitate dissemination and implementation (D&I) of dementia care interventions. The science of D&I can inform the integration of evidence-based dementia care in HCSs by offering theoretical frameworks that capture field complexities and guiding evaluation of implementation processes. Also, D&I science can suggest evidence-based strategies for implementing dementia care in HCSs. Although D&I considerations can inform each stage of dementia care intervention development, it is particularly critical when designing ePCTs. This article examines fundamental considerations for implementing dementia-specific interventions in HCSs and how best to prepare for successful dissemination upstream in the context of ePCTs, thereby illustrating the critical role of the D&I Core of the National Institute on Aging Imbedded Pragmatic Alzheimer's Disease and AD-Related Dementias Clinical Trials Collaboratory. The scientific premise of the D&I Core is that having the "end" in mind, upfront in the design and testing of dementia care programs, can lead to decision-making that optimizes the ultimate goal of wide-scale D&I of evidence-based dementia care programs in HCSs. J Am Geriatr Soc 68:S28-S36, 2020.

Do You See What I See? Actor and Partner Attachment Shape Biased Perceptions of Partners

The present research examined how actor and partner attachment insecurity relates to biases in perceptions of partners' core relationship-relevant constructs. Across three dyadic studies ( Ncouples = 333, Nindividuals = 666), we examined attachment anxiety and avoidance as predictors of over- or underestimation of partners' relationship satisfaction, commitment, and responsiveness, using partners' own reports as the reference point for evaluating bias. Actors higher in avoidance and actors with partners higher in avoidance perceived their partners to be less satisfied and committed. In addition, actors higher in avoidance and actors higher in anxiety displayed a pessimistic bias, perceiving their partners to be less satisfied and committed than their partners reported being. Finally, actors with partners higher in avoidance displayed an optimistic bias, perceiving their partners to be more satisfied and committed than their partners reported being. Results underscore the importance of adopting a dyadic perspective on perceptual biases in romantic relationships.

A response surface analysis of expected and received support for smoking cessation: Expectancy violations predict greater relapse

People attempting to stop smoking cigarettes (quitters) hold expectations about the extent to which their partner will provide helpful support during a quit attempt. However, these expectations may not align with their perceptions of the helpfulness of the support they receive. We examine expected and received helpful support during a quit attempt. We hypothesized that receiving less helpful support than expected (i.e., creating an expectancy violation) would be associated with the greatest return to smoking. Sixty-two quitters completed a 21-day ecological momentary assessment (EMA) study. They reported expected support at baseline and support receipt and smoking during the EMA phase. At follow-up, they completed an expelled breath carbon monoxide test. Analyses using polynomial generalized linear models with response surface analysis indicated that smoking outcomes depended on the joint influence of expected and received helpful support. As hypothesized, when quitters expected more helpful support than they received, they were more likely to smoke in the first 24h and the last seven days of the EMA, and they provided higher carbon monoxide readings at follow-up. These results are consistent with an expectancy violation explanation: quitters are more likely to smoke when they perceive their partner has failed to provide support that is as helpful as expected. Given the importance of support for smoking cessation, many researchers have attempted to experimentally increase provision of support. The current findings suggest that partner support interventions might backfire if the quitter is led to expect more helpful support than the partner is able to provide.

Let it go: Relationship autonomy predicts pro-relationship responses to partner transgressions

OBJECTIVE

The purpose of the present research is to better understand how relationship autonomy-having more self-determined reasons for being committed to a relationship-contributes to pro-relationship responses to transgressions in romantic relationships (e.g., forgiveness and accommodation).

METHOD

Study 1 employed a cross-sectional design (N = 350) and Study 2 used a weekly diary (N = 121) to test associations between relationship autonomy and pro-relationship responses to transgressions. Studies 3 and 4 utilized dyadic designs (Study 3: N = 200 couples, 400 individuals; Study 4: N = 275 couples, 550 individuals) to determine how both partners' relationship autonomy is associated with pro-relationship responses.

RESULTS

Results revealed that relationship autonomy is robustly associated with pro-relationship responses to transgressions, both as general tendencies and as responses to idiosyncratic transgressions. Results of actor-partner interdependence model (APIM) analyses in Studies 3 and 4 provide evidence that one's partner's relationship autonomy is important for promoting pro-relationship responses as well. Study 4 also found that people perceive that partners respond better to transgressions if their partner is high in relationship autonomy.

CONCLUSIONS

This research provides consistent and compelling evidence that the degree of self-determination underlying commitment is important for understanding how people respond to transgressions in their relationships, beyond their current levels of commitment.

An Actor–Partner Interdependence Model of Attachment and Need Fulfillment in Romantic Dyads

The present research tested the unique associations between attachment and basic psychological need fulfillment in relationships. Past research shows that anxious and avoidant attachment are associated with distinct patterns of relationship behaviors, wherein anxious attachment is related to excessive attention to the relationship and avoidant attachment is related to detachment from the relationship. Specifically, we explored the role of romantic partner’s attachment in predicting each other’s experiences of relatedness, autonomy, and competence. Across two samples of undergraduate romantic couples ( nsample 1 = 156, nsample 2 = 264), one’s own anxious and avoidant attachment predicted generally lower basic psychological need fulfillment. Having a more anxiously attached partner predicted higher relatedness but lower autonomy, whereas having a more avoidantly attached partner predicted lower relatedness but higher autonomy need fulfillment. These results extend prior research, suggesting that one’s partner’s anxious and avoidant attachment has distinct implications for one’s own outcomes.

Prevent the blue, be true to you: Authenticity buffers the negative impact of loneliness on alcohol-related problems, physical symptoms, and depressive and anxiety symptoms

This study investigated authenticity as a moderator of the association between loneliness and depressive symptoms, anxiety, physical symptoms, and alcohol-related problems. It was expected that loneliness and health outcomes would be negatively related and that relationship would be weaker among those higher in authenticity. Significant interactions emerged between authenticity and loneliness for each outcome such that authenticity mitigated the relationship between higher loneliness and negative health outcomes. Results suggest that authenticity may be an underutilized resource for lonely individuals and warrants future investigation. The potential implications are diverse and could be incorporated in college adjustment and health promotion programs.