Physiological synchrony in supportive discussions: An examination of co-rumination, relationship type, and heterogeneity

During times of stress, we look to close others for support. Social support conversations are critical for relationship maintenance and well-being. Yet, certain ways of talking about problems-such as co-ruminating-can exacerbate stress. Since social support and co-rumination are both dyadic processes, it is important to examine physiological responses during these conversations in a dyadic manner. Little research has examined physiological synchrony of the sympathetic nervous system (SNS) during social support conversations or co-ruminative conversations. The current research capitalizes on an experimental manipulation of co-rumination using a sample of close friends (147 dyads) and romantic partners (113 dyads) to examine physiological covariation in the context of support. Across both samples, dyads exhibited significant physiological covariation in pre-ejection period reactivity (PEP). Contrary to our hypothesis, dyads in the co-rumination condition did not show more covariation. Close friend dyads did, however, exhibit more covariation as compared to romantic dyads. We also found significant variability in physiological covariation across dyads, with a minority of dyads exhibiting negative covariation of PEP reactivity. The homogeneity of the samples limits the generalizability of the findings and highlights the need for more diverse samples in future work. These findings underline the need for further exploration into the mechanisms that contribute to distinct patterns of physiological synchrony, the conditions in which negative synchrony occurs, and what predicts especially strong positive synchrony. This work extends our understanding of physiological synchrony of the sympathetic nervous system during support conversations and emphasizes the importance of considering heterogeneity in physiological processes.

How is companionship related to romantic partners' affect, relationship satisfaction, and health behavior? Using a longitudinal dyadic score model to understand daily and couple-level effects of a dyadic predictor

Companionship is related to better affect and relationship satisfaction, but few studies have examined both partners' perspectives over time and the link between companionship and health. In three intensive longitudinal studies (Study 1: 57 community couples; Study 2: 99 smoker-nonsmoker couples; Study 3: 83 dual-smoker couples), both partners reported daily companionship, affect, relationship satisfaction, and a health behavior (smoking in Studies 2 and 3). We proposed a dyadic score model that focuses on the couple level for companionship as a dyadic predictor with considerable shared variance. On days with higher companionship, couples reported better affect and relationship satisfaction. When partners differed in companionship, they also differed in affect and relationship satisfaction. For smoking, a different picture emerged: Whereas smokers with nonsmoking partners smoked less on average with higher companionship, smokers with smoking partners smoked more on days with higher companionship. Findings show companionship as a consequential relationship construct deserving further study. Using the dyadic score model acknowledged both partners' perspectives on companionship. It demonstrated higher precision for detecting effects of partner averages in a dyadic predictor compared with traditional approaches, tests for effects of partner differences in a dyadic predictor and in outcome while maintaining the focus on the dyad.

Decomposing variance in co-rumination using dyadic daily diary data

It is unknown how co-rumination, or perseverating on problems or feelings with another person, unfolds in the daily lives of romantic couples. Using a variance decomposition procedure on data from a 14-day dyadic diary, we assessed how much variance in co-rumination was attributable to temporally stable and varying factors, as well as whether co-rumination is better measured as a couple-level or individual-level process. Within-person, within-couple fluctuations in co-rumination contributed most (~33%) to the total variance and summary scores based on these fluctuations were reliable. Stable between-couple differences accounted for ~14% of the total variance and could also be reliably assessed. However, within-couple agreement in co-rumination was low, such that the reliability at the level of within-couple change was inadequate. Research is needed to understand these divergent perceptions of co-rumination and potential downstream consequences. We conclude by considering how these results inform theory and can be applied to similar dyadic constructs.

Implementation of automated personalised breast radiotherapy planning techniques with scripting in Raystation

OBJECTIVE

Implement scripted automatic breast planning (AP) for breast techniques within Raystation.

METHODS

Manual plans (MPs) were re-planned and compared with AP plans for whole breast (WB), partial breast (PB), hybrid volumetric modulated arc therapy simultaneous integrated boost (VMAT SIB) and VMAT nodal plans.

RESULTS

WB AP plans took 7 min comparing well to MP. One WB AP failed a mandatory dose constraint. Small statistically significant differences showed improved coverage for AP at expense of slightly hotter plans, however absolute differences were small (mean differences < 1% or D _0.5cc<0.2 Gy). PB AP plans took 9 min, showing improved coverage (V _24.7Gy97.6 vs 96.4 %). One PB AP case failed a mandatory constraint. Other dosimetric differences were non-significant. SIB AP plans took 14 min with one case failing a mandatory constraint with minor differences compared with MP except larger V _42.8Gy (3 vs 1.5 %) and more MU. VMAT AP plans took 12 min and were hotter for PTVp_4000 but had higher nodal coverage. Contra_Lung V _2.5Gy was higher (8.8 %) than MP plans (6.5 %).

CONCLUSION

Automatic planning of modern breast techniques has been successfully introduced using a commercial planning system. AP plans are very similar to MP, requiring little manual interaction for most cases with significant timesaving potential.

ADVANCES IN KNOWLEDGE

Scripted breast plans produced within minutes for WB, PB, SIB and VMAT. Successfully introduced into large busy department. Plans similar to manual plans, requiring little manual interaction.

The associations of COVID-19 percent positivity rate, relationship quality, and season with daily anxiety and depression in couples living in NYC

Background

The COVID-19 pandemic changed nearly every aspect of daily life and had detrimental effects on mental health. Yet, impacts have been heterogeneous. We tested whether fluctuations in local COVID-19 percent positivity rates were associated with daily anxiety and depression in couples living in NYC, as well as whether these associations varied by relationship quality or season. We expected that adverse impacts of COVID-19 may be attenuated by high-quality relationships and during warmer months, or that people may habituate over time.

Methods

Data on seven-day rolling average COVID-19 percent positive rate each day in NYC were merged with a 14-day dyadic diary study of cohabiting couples living in NYC between August 2020 through April 2021 (232 individuals from 116 couples; mean age 28.42 years, 52.59% female, 53.02% White). Dyadic multilevel models estimated the association COVID-19 positivity rate, season (sine and cosine of the calendar date), baseline relationship quality, and all two-and three-way interactions of these variables with daily anxiety and depression. Covariates included weekend and COVID-positive case within the couple.

Results

Anxiety and depression mirrored COVID-19 positivity rates, and there was some evidence for habituation over time. Significant two-and three-way interactions suggested that being in a high-quality relationship buffered the association of COVID-19 positivity rate with both anxiety and depression during months when cases were low. Anxiety was elevated for individuals in high- (v. low-) quality relationships during the December-January surge.

Conclusion

Seven-day rolling average COVID-19 percent positivity rate was associated with daily anxiety and depression among couples living in NYC. There was some evidence that individuals habituated to this stressor over time and that high-quality relationships were protective for mental well-being; however, there was some suggestion that couples in high-quality relationships may have engaged in processes such as co-rumination during surges, worsening their daily anxiety.

Responsive social support serves important functions in clinical communication: Translating perspectives from relationship science to improve cancer clinical interactions

Patient-clinician interactions are critical to patient-centered care, including in cancer care contexts which are often defined by multiple patient-clinician interactions over an extended period. Research on these dyadic interactions has been guided by perspectives in clinical communication science, but the study of clinical communication has not been fully integrated with perspectives on interpersonal interactions from relationship science research. An overlapping concept in both fields is the concept of responsive socialsupport. In this article, we discuss responsiveness as a concept that offers opportunities for connections between these two disciplines. Next, we focus on how relationship science can be applied to research in clinical settings. We discuss how three areas of relationship science define responsiveness and have potential for extension to clinical communication: (1) (in)visibility of social support, (2) attachment orientations, and (3) shared meaning systems. We also discuss how social biases can impede responsiveness and suggest research avenues to develop ideas and understand potential challenges in connecting these two fields. Many opportunities exist for interdisciplinary theory development that can generate momentum in understanding interpersonal processes in cancer care.

COVID-19 distress and interdependence of daily emotional intimacy, physical intimacy, and loneliness in cohabiting couples

Introduction

COVID-19 has had a profound impact on relationship functioning, though effects have been heterogeneous. Reasons for divergent effects on relationship functioning remain unclear. Theoretical models suggest that it is not just stress exposure that leads to adverse relationships outcomes, but also subjective response to these stressors. Using data from a 14-day intensive longitudinal study of romantic dyads, we hypothesized that COVID-19-related distress would adversely impact one's own and one's partner's report of relationship functioning, on average. Interdependence at the between-couple and within-couple level was also examined.

Methods

Participants were 104 female-male romantic couples cohabiting the New York metropolitan area (Mage = 28.86, SDage = 7.69) between August 2020 - April 2021. Couples reported COVID-19 distress during a baseline interview and daily relationship functioning for 14 days. Multilevel models were specified for six outcomes simultaneously: female and male partner daily physical intimacy, emotional intimacy, and loneliness. Interrelationships of the intercepts of the six outcomes were specified, reflecting between-couple associations of each partner's stable outcome tendencies. Interrelationships of the daily residuals of the six outcomes were also specified, reflecting within-couple associations at the daily level.

Results

Female partner COVID-19 distress was inversely associated with her own emotional and physical intimacy and positively associated with her own and her partner's loneliness. Male COVID-19 distress was associated with his own loneliness only. There was significant interdependence at the between- and within-couple level, such that greater loneliness in either partner was associated with less intimacy in each member of the couple.

Discussion

Only one partner effect for COVID-19 distress emerged, such that female partner distress was associated with male partner loneliness; however, interdependence at the between- and within-couple level suggested that distress may adversely impact relational well-being over time. Future studies should examine reciprocal relationships between COVID-19-related distress and relationship functioning.

Mood and judgment in a dyadic stress context

The 1980s and 1990s witnessed a surge of psychological research addressing the role of affect in social judgments. Evaluations of others were shown to be shaped, at least in part, by a person's incidental mood in the moment of social evaluation; while negative moods instigated negative interpersonal evaluations, positive moods instigated positive interpersonal evaluations. Interestingly, these effects only emerged when the reason for the evaluator's mood was not obvious. Over 30 years later, we expand these findings to the dyadic domain. Rather than conceptualize interpersonal evaluations as occurring solely within an individual, we introduce the Dyadic Affect Infusion/Diffusion (DAID) model to suggest that interpersonal evaluations occur as fundamentally dyadic phenomena. Using 6 weeks of daily diary data from 311 couples in which one member approached a stressful event, we show that (a) mood influences relationship evaluations at both the intraindividual (i.e., affect infusion) and interindividual (i.e., affect diffusion) levels, (b) both affect infusion and affect diffusion are turned off by the availability of attributional information, and (c) these effects are better explained by affect infusion/diffusion rather than by several alternative mechanisms. Taken together, the DAID model bolsters the view that individualistic approaches to emotion and social cognition are insufficient and require theory and data at the dyadic and group levels of analysis. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Age-related change in task-evoked amygdala-prefrontal circuitry: A multiverse approach with an accelerated longitudinal cohort aged 4-22 years

The amygdala and its connections with medial prefrontal cortex (mPFC) play central roles in the development of emotional processes. While several studies have suggested that this circuitry exhibits functional changes across the first two decades of life, findings have been mixed - perhaps resulting from differences in analytic choices across studies. Here we used multiverse analyses to examine the robustness of task-based amygdala-mPFC function findings to analytic choices within the context of an accelerated longitudinal design (4-22 years-old; N = 98; 183 scans; 1-3 scans/participant). Participants recruited from the greater Los Angeles area completed an event-related emotional face (fear, neutral) task. Parallel analyses varying in preprocessing and modeling choices found that age-related change estimates for amygdala reactivity were more robust than task-evoked amygdala-mPFC functional connectivity to varied analytical choices. Specification curves indicated evidence for age-related decreases in amygdala reactivity to faces, though within-participant changes in amygdala reactivity could not be differentiated from between-participant differences. In contrast, amygdala-mPFC functional connectivity results varied across methods much more, and evidence for age-related change in amygdala-mPFC connectivity was not consistent. Generalized psychophysiological interaction (gPPI) measurements of connectivity were especially sensitive to whether a deconvolution step was applied. Our findings demonstrate the importance of assessing the robustness of findings to analysis choices, although the age-related changes in our current work cannot be overinterpreted given low test-retest reliability. Together, these findings highlight both the challenges in estimating developmental change in longitudinal cohorts and the value of multiverse approaches in developmental neuroimaging for assessing robustness of results.

Physiological coregulation during social support discussions

Close relationships are proposed to function as dynamic regulatory systems, whereby partners jointly regulate each other's emotions and physiology to maintain an equilibrium level of responding--a process known as coregulation. Little is known, however, regarding when coregulation emerges. We hypothesized that because social support interactions involve explicit interpersonal emotion regulation attempts, they might be especially likely to engender stabilizing patterns of coregulation that entrain partners' responses toward an equilibrium level. We conducted a dyadic laboratory experiment in which romantic couples engaged in social support and control discussions as cardiovascular responses were measured. To assess dyadic coregulation, we used dynamical systems modeling with Bayesian estimation to capture the frequency of oscillations around an equilibrium level and changes in amplitudes over time. Results indicated there was coregulation across discussions as a whole, as well as differences in coregulation by discussion type and gender. Stabilizing coregulatory dynamics-indicated by patterns of oscillations around an equilibrium level and decreases in amplitudes as the discussions progressed-were more pronounced during social support (vs. control) discussions, especially when the male partner received support. There was also substantial between-dyad heterogeneity in couples' coregulation trajectories, whereby some couples showed pronounced coregulatory dynamics whereas other did not. Overall, this work suggests that social support interactions may be a key context when coregulation emerges and thereby offers novel insights into how relationships might contribute to well-being. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Shared Reality Can Reduce Stressor Reactivity

When a person faces a stressor alongside someone else, do they get more or less stressed when the other person agrees that the situation is stressful? While an equally stressed partner could plausibly amplify stress by making the situation seem more real and worthy of distress, we find that social validation during co-experienced stressors reduces reactivity. Specifically, the psychological experience of shared reality calms some people down. In Study 1, 70 undergraduate females who jointly faced a stressful event with someone else reported feeling less anxious when the other person felt the same way about the stressor, relative to when the other person appraised the situation in the opposite way or provided no indication of their appraisal. These findings were reflected in participants' physiological reactivity, especially in the parasympathetic nervous system. In Study 2, we generalize these findings to co-experienced stressors in the daily lives of 102 heteronormative romantic couples in the New York City area. In line with tend-and-befriend theory, we found that shared reality during co-experienced stressors reduced anxiety for almost all females (99% of the sample) and for a minority of males (42% of the sample). Together, these findings unify major theories in health and social psychology by implying that shared reality reduces stressor reactivity, and that this effect is partially moderated by sex.

Couple Communication in Cancer: Protocol for a Multi-Method Examination

Cancer and its treatment pose challenges that affect not only patients but also their significant others, including intimate partners. Accumulating evidence suggests that couples' ability to communicate effectively plays a major role in the psychological adjustment of both individuals and the quality of their relationship. Two key conceptual models have been proposed to account for how couple communication impacts psychological and relationship adjustment: the social-cognitive processing (SCP) model and the relationship intimacy (RI) model. These models posit different mechanisms and outcomes, and thus have different implications for intervention. The purpose of this project is to test and compare the utility of these models using comprehensive and methodologically rigorous methods. Aims are: (1) to examine the overall fit of the SCP and RI models in explaining patient and partner psychological and relationship adjustment as they occur on a day-to-day basis and over the course of 1 year; (2) to examine the fit of the models for different subgroups (males vs. females, and patients vs. partners); and (3) to examine the utility of various methods of assessing communication by examining the degree to which baseline indices from different measurement strategies predict self-reported adjustment at 1-year follow up. The study employs a longitudinal, multi-method approach to examining communication processes including: standard self-report questionnaires assessing process and outcome variables collected quarterly over the course of 1 year; smartphone-based ecological momentary assessments to sample participant reports in real time; and laboratory-based couple conversations from which we derive observational measures of communicative behavior and affective expression, as well as vocal indices of emotional arousal. Participants are patients with stage II-IV breast, colon, rectal, or lung cancer and their spouses/partners, recruited from two NCI-designated comprehensive cancer centers. Results will be published in scientific journals, presented at scientific conferences, and conveyed to a larger audience through infographics and social media outlets. Findings will inform theory, measurement, and the design and implementation of efficacious interventions aimed at optimizing both patient and partner well-being.

Modeling heterogeneity in the simultaneous emotional costs and social benefits of co-rumination

Co-rumination is the act of perseverating on problems or negative emotions with another person. Past research has shown that co-rumination has tradeoffs, as it is related to more anxiety and depressive symptoms, yet also heightened feelings of closeness and better relationship quality. However, there has been little repeated measures work, leaving unknown the influence of within-person changes in co-rumination on individuals' functioning. Using data from 1,504 adolescents collected as part of a seven-wave study over 4 years, we hypothesized that at times when adolescents coruminated above their own average level of co-rumination, they would report more anxiety and depressive symptoms, as well as increased closeness with friends at concurrent timepoints. Moreover, we investigated heterogeneity in these effects, exploring whether there was variability in whether adolescents experienced simultaneous costs and benefits of increased co-rumination. The results reveal that the average adolescent reported associated increases in anxiety symptoms, depressive symptoms, and closeness with friends at times when they reported coruminating at higher-than-typical levels. Yet, there was significant heterogeneity in these effects, as some adolescents solely experienced costs of co-rumination and others experienced just benefits. Moreover, adolescents who experienced stronger-than-average effects of co-rumination on anxiety and depressive symptoms reported less of an increase in closeness with friends. These findings offer important insight into how co-rumination is associated with social-emotional functioning and have implications for recommending best practices for seeking support and discussing problems with close others. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Physical effects of daily stressors are psychologically mediated, heterogeneous, and bidirectional

Prior research shows that daily stressors lead to greater psychological distress. A separate body of research links daily stressors to physical symptoms such as backaches and stomach problems. We integrate these literatures by positing an interconnected causal system, whereby stressors lead to psychological distress which, in turn, leads to physical symptoms. Our integrated approach also includes causal effects in the opposing directions: Psychological distress can increase physical symptoms and physical symptoms can increase psychological distress. Put simply, causal effects are bidirectional. This finding illuminates the concept of feedback loops, which have never been investigated in the stress literature until now. We find that reverberating feedback between stressors and distress equilibrates after just one and a half loops and that feedback between stressors and physical symptoms does not actually reach a full loop. Because of this, feedback loops have only minor consequences for physical symptoms by the end of the day. Finally, we discuss the aforementioned phenomena with between-person differences at the forefront, showing how some people are as much as four times as reactive as the average person, some people are not reactive at all, and other people are reactive in reverse directions (e.g., distress leads to fewer physical symptoms). We empirically support these claims using daily diary data from three separate studies that together represent diverse ages, geographic regions, relationship statuses, and racial identities. Once established, we consider the implications of our integrated causal feedback system in relation to existing knowledge and highlight critical areas for future study. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Physical activity after cardiac rehabilitation: Explicit and implicit attitudinal components and ambivalence

OBJECTIVE

Physical activity is crucial in the treatment of cardiac disease. In addition to sociocognitive theories of behavior change, attitudinal ambivalence and nonconscious factors have also been demonstrated to predict physical activity. We propose an extension to the theory of planned behavior with a dual-systems approach including explicit and implicit attitudes, and different types of attitudinal ambivalence as moderators to predict the physical activity of patients after discharge from inpatient cardiac rehabilitation.

METHOD

The sample comprised N = 111 cardiac patients who provided daily diary reports of intention, cognitive, affective, and implicit attitudes for 21 days after discharge (86% male, M_age = 62, SD_age = 11, n = 2,017 days). Daily moderate-to-vigorous (MVPA) and light (LPA) physical activity were measured using accelerometers. Five types of ambivalence were calculated. Analyses included Bayesian multilevel modeling.

RESULTS

Patients with more positive affective attitudes and more positive implicit attitudes had a higher intention. Higher ambivalence weakened the affective attitudes-intention relationship. On days with more positive implicit attitudes than usual, intention was lower, but only when ambivalence was low. Patients with higher ambivalence engaged in less MVPA. On days with extremely low ambivalence, implicit attitudes were negatively associated with tomorrow's MVPA. Patients with more positive affective attitudes engaged in more LPA, but only when their ambivalence was very low. On days with higher ambivalence than usual, the next day's LPA was shorter. However, another type of ambivalence showed the opposite effect.

CONCLUSIONS

The results emphasize the importance of affective and implicit attitudes and ambivalence for the physical activity of cardiac patients. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Longitudinal changes in amygdala, hippocampus and cortisol development following early caregiving adversity

Although decades of research have shown associations between early caregiving adversity, stress physiology and limbic brain volume (e.g., amygdala, hippocampus), the developmental trajectories of these phenotypes are not well characterized. In the current study, we used an accelerated longitudinal design to assess the development of stress physiology, amygdala, and hippocampal volume following early institutional care. Previously Institutionalized (PI; N = 93) and comparison (COMP; N = 161) youth (ages 4–20 years old) completed 1–3 waves of data collection, each spaced approximately 2 years apart, for diurnal cortisol (N = 239) and structural MRI (N = 156). We observed a developmental shift in morning cortisol in the PI group, with blunted levels in childhood and heightened levels in late adolescence. PI history was associated with reduced hippocampal volume and reduced growth rate of the amygdala, resulting in smaller volumes by adolescence. Amygdala and hippocampal volumes were also prospectively associated with future morning cortisol in both groups. These results indicate that adversity-related physiological and neural phenotypes are not stationary during development but instead exhibit dynamic and interdependent changes from early childhood to early adulthood.

Has the Effect of the American Flag on Political Attitudes Declined Over Time? A Case Study of the Historical Context of American Flag Priming

We report findings from a meta-analysis on all published and unpublished studies from our labs (total N = 9,656) examining the priming effect of the American flag on political attitudes. Our analyses suggest that, consistent with the studies we originally published in 2011 (T. J. Carter et al., 2011b), American flag primes did create politically conservative shifts in attitudes and beliefs during the initial time period when data were collected (even excluding the published studies), but this effect has since declined over time to be roughly zero, though we believe that other interpretations, including false positives, are plausible. We discuss possible interpretations of this decline effect and the importance of considering the historical context inrelation to the priming effects of symbols whose meaning is not static over time. We also highlight the value of publicly posting data, emptying file drawers, and conducting direct as well as conceptual replications.

Social emotion regulation strategies are differentially helpful for anxiety and sadness

Little is understood about how emotion regulation strategies typically used to regulate one's own emotions can be used to help others in distress, a process we refer to as social emotion regulation. We integrated research on social support, the self-regulation of emotion, and appraisal theories to hypothesize that different kinds of support and emotion regulation strategies should be differentially helpful for others, depending on the kind of emotion they are experiencing. Specifically, we predicted that helping others to actively modify their situation, as opposed to their appraisals and emotional responses, will be more effective for those experiencing anxiety as anxiety is a response to appraising threat in one's environment. However, helping others to modify their appraisals and emotions should be more effective for those experiencing sadness as sadness is a response to an irrevocable loss. To test this, we created a novel paradigm in which regulation targets were recruited online to write about personal events causing anxiety or sadness and regulation providers were recruited to provide written help to the targets. Study 1 supported the hypothesis using strategies drawn from the social support literature (advice vs. emotional support). Study 2 used strategies drawn from the literature on the self-regulation of emotion (situation modification vs. reappraisal) to demonstrate that as predicted, different strategies are believed to be differentially helpful depending on the target's emotion and when adjusting for individual differences in social and affective functioning, targets judge social emotion regulation strategies to be differentially helpful when implemented by providers. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Social Support and Antibody Responses to Vaccination: A Meta-Analysis

BACKGROUND

Social support and social integration have been linked to lower rates of morbidity and mortality. However, the biological mechanisms responsible for such links need greater attention. Vaccine paradigms provide an integrative window into immune system involvement in the protective influence of social support/integration.

PURPOSE

The main aim of this article was to conduct a meta-analytic review of the association between social support/social integration and antibody responses to vaccines. Exploratory analyses also examined effect sizes and confidence intervals as a function of several factors to inform future research.

METHOD

A literature search was conducted using the ancestry approach and with PsycInfo, Medline, and the Psychology and Behavioral Science Collection by crossing the exact keywords of social support or social integration with vaccine or antibodies. The review identified nine studies with a total of 672 participants.

RESULTS

The omnibus meta-analysis showed that social support/social integration was related to higher antibody levels following vaccination, but the average effect size was small and the lower bound of the confidence interval included zero (Zr = 0.06 [-.04, .15]). These results did not appear to differ much as a function of the operationalization of social relationships, participant age, or follow-up period, although effect sizes appeared larger for studies using a primary antigen.

CONCLUSIONS

These data provide some evidence that social support may be linked to antibody responses to vaccines. However, effect sizes are mostly small and zero overall effect cannot be ruled out. Future studies would benefit from larger sample sizes and greater consideration of methodological issues associated with secondary immune responses to antigen.

Usability and Acceptability of a Smartphone App to Assess Partner Communication, Closeness, Mood, and Relationship Satisfaction: Mixed Methods Study

Background

Interpersonal communication is critical for a healthy romantic relationship. Emotional disclosure, coupled with perceived partner responsiveness, fosters closeness and adjustment (better mood and relationship satisfaction). On the contrary, holding back from disclosure is associated with increased distress and decreased relationship satisfaction. Prior studies assessing these constructs have been cross-sectional and have utilized global retrospective reports of communication. In addition, studies assessing holding back or perceived partner responsiveness have not taken advantage of smartphone ownership for data collection and have instead required website access or use of a study-provided device.

Objective

This study aimed to examine the (1) usability and acceptability of a smartphone app designed to assess partner communication, closeness, mood, and relationship satisfaction over 14 days and (2) between-person versus within-person variability of key constructs to inform the utility of their capture via ecological momentary assessment using the participants’ own handheld devices.

Methods

Adult community volunteers in a married or cohabiting partnered relationship received 2 smartphone prompts per day, one in the afternoon and one in the evening, for 14 days. In each prompt, participants were asked whether they had conversed with their partner either since awakening (afternoon prompt) or since the last assessment (evening prompt). If yes, a series of items assessed enacted communication, perceived partner communication, closeness, mood, and relationship satisfaction (evening only). Participants were interviewed by phone, 1 week after the end of the 14-day phase, to assess perceptions of the app. Content analysis was employed to identify key themes.

Results

Participants (N=27; mean age 36, SD 12 years; 24/27, 89% female; 25/27, 93% white and 2/27, 7% Hispanic) responded to 79.2% (555/701) of the total prompts sent and completed 553 (78.9%) of those assessments. Of the responded prompts, 79.3% (440/555) were characterized by a report of having conversed with one’s partner. The app was seen as highly convenient (mean 4.15, SD 0.78, scale: 1-5) and easy to use (mean 4.39, SD 0.70, scale: 1-5). Qualitative analyses indicated that participants found the app generally easy to navigate, but the response window too short (45 min) and the random nature of receiving notifications vexing. With regard to the variability of the app-delivered items, intraclass correlation coefficients were generally <0.40, indicating that the majority of the variability in each measure was at the within-person level. Notable exceptions were enacted disclosure and relationship satisfaction.

Conclusions

The findings of this study support the usability and acceptability of the app, with valuable user input to modify timing windows in future work. The findings also underscore the utility of an intensive repeated-measures approach, given the meaningful day-to-day variation (greater within-person vs between-person variability) in communication and mood.

Regulatory effectiveness of social support

Receiving social support can entail both costs and benefits for recipients. Thus, theories of effective support have proposed that support should address recipients' needs to be beneficial. This paper proposes the importance of support that addresses recipients' self-regulatory needs. We present a novel construct-regulatory effectiveness of support (RES)-which posits that support that addresses recipients' needs to understand their situation (truth) and to feel capable of managing their situation (control) will engender support benefits. We hypothesized that receiving support higher on RES would predict beneficial support outcomes. We further hypothesized that these effects would be especially pronounced for self-regulation relevant outcomes, such as better mood and increased motivation, which, in turn, can be important for successful self-regulation. We established the construct validity of RES and then investigated its effects in daily life and in laboratory support discussions. In 8 studies and a meta-analysis pooling across studies, results showed that RES predicted self-regulation relevant support outcomes, and these effects of RES were stronger than the effects of perceived responsiveness, a construct that is known to enhance interpersonal relationships. Furthermore, RES was linked to self-regulatory success: Participants who received support higher on RES were more motivated to perform well on a stressful speech, which subsequently predicted better speech performance. These findings enhance knowledge of effective social support by underscoring the importance of addressing recipients' self-regulatory needs in the support process. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Self-esteem change during the transition from university to work

Objective

The current study examined whether the transition from university to work, a major developmental milestone in young adulthood, was related to stability and change in self‐esteem.

Method

Self‐esteem was assessed in the last year of their master's program (T1) of 163 27‐year old students and 14 months later, when they had graduated and half of them had started a full‐time job (T2). Daily diaries were used to assess the occurrence of achievement‐ and affiliation‐related experiences on 14 consecutive days at T1 and T2. We compared the full‐time job beginners and a comparison group without a full‐time job with regard to their mean‐level change, rank‐order stability and correlated change of self‐esteem and daily experiences.

Results

First, job beginners increased in self‐esteem, but the difference to the mean‐level change of the comparison group was only small. Second, self‐esteem was less stable among job beginners than among the comparison group. Third, the changes in achievement‐related daily experiences and self‐esteem correlated positively in the job‐beginner group but not in the comparison group.

Conclusions

The findings underline the role of daily experiences during life transitions for individual differences in self‐esteem change. The discussion calls for accounting for unique transition experiences to advance theory and research on self‐esteem development.

Visible and Invisible Social Support: How, Why, and When

Social relationships can be a vital source of help in difficult times. However, attempts to provide social support that is visible—direct and recognized by recipients as help—can sometimes have unintended negative effects. By contrast, invisible support—provided indirectly such that recipients do not interpret the behavior as help—can circumvent potential negative effects. In this article, we synthesize empirical evidence on support visibility using three organizing questions: How do support attempts differ in visibility? Why is invisible support often more beneficial than visible support? When is invisible support, as opposed to visible support, needed? The answers to these questions can illuminate mechanisms of effective support generally, help explain known variability in support outcomes, and stimulate further research.

Links Between Communication and Relationship Satisfaction Among Patients With Cancer and Their Spouses: Results of a Fourteen-Day Smartphone-Based Ecological Momentary Assessment Study

Cancer treatment poses significant challenges not just for those diagnosed with the disease but also for their intimate partners. Evidence suggests that couples' communication plays a major role in the adjustment of both individuals and in the quality of their relationship. Most descriptive studies linking communication to adjustment have relied on traditional questionnaire methodologies and cross-sectional designs, limiting external validity and discernment of temporal patterns. Using the systemic-transactional model of dyadic coping as a framework, we examined intra- and inter-personal associations between communication (both enacted and perceived) and relationship satisfaction (RS) among patients with stage II-IV breast or colorectal cancer and their spouses (N = 107 couples). Participants (mean age = 51, 64.5% female patients, and 37.4% female spouses) independently completed twice-daily ecological momentary assessments (EMA) via smartphone for 14 consecutive days. Items assessed RS and communication (expression of feelings, holding back from expression, support and criticism of partner, and parallel ratings of partner behavior). Linear mixed models employing an Actor Partner Interdependence Model were used to examine concurrent, time-lagged, and cross-lagged associations between communication and RS. Expressing one's feelings was unassociated with RS. Holding back from doing so, in contrast, was associated with lower RS for both patients and spouses in concurrent models. These effects were both intrapersonal and interpersonal, meaning that when individuals held back from expressing their feelings, they reported lower RS and so too did their partner. Giving and receiving support were associated with one's own higher RS for both patients and spouses in concurrent models, and for patients in lagged models. Conversely, criticizing one's partner and feeling criticized were maladaptive, associated with lower RS (own and in some cases, partner's). Cross-lagged analyses (evening RS to next-day afternoon communication) yielded virtually no effects, suggesting that communication may have a stronger influence on short-term RS than the reverse. Findings underscore the importance of responsive communication, more so than expression per se, in explaining both concurrent and later relationship adjustment. In addition, a focus on holding back from expressing feelings may enhance the understanding of RS for couples coping with cancer.

Initial elevation bias in subjective reports

People's reports of their thoughts, feelings, and behaviors are used in many fields of biomedical and social science. When these states have been studied over time, researchers have often observed an unpredicted and puzzling decrease with repeated assessment. When noted, this pattern has been called an "attenuation effect," suggesting that the effect is due to bias in later reports. However, the pattern could also be consistent with an initial elevation bias. We present systematic, experimental investigations of this effect in four field studies (study 1: n = 870; study 2: n = 246; study 3: n = 870; study 4: n = 141). Findings show clear support for an initial elevation bias rather than a later decline. This bias is larger for reports of internal states than for behaviors and for negative mental states and physical symptoms than for positive states. We encourage increased awareness and investigation of this initial elevation bias in all research using subjective reports.

Interpersonal Processes of Couples' Daily Support for Goal Pursuit: The Example of Physical Activity

Little is known about how couples' social support facilitates the pursuit of important goals in daily life. Using an interpersonal perspective, we examined the effects of support provision and receipt on same-day physical activity, and studied the role of partners' joint engagement in activities. One hundred nineteen heterosexual couples reported on target persons' received and partners' provided support across 28 diary days, yielding 2,854 valid days. A dyadic report on couples' joint engagement was obtained from a subset of 88 couples. Target persons' daily activity was objectively assessed via accelerometers. On days with high versus low levels of provided support, target persons' activity was 25 min higher. Support receipt mediated 20% of this effect. Joint engagement accounted for around half of the effects of provided and received support. Support provision is uniquely linked to goal implementation in everyday life. Joint engagement in activities may be one explanation for how support is facilitated.

Using Smartphone-Based Support Groups to Promote Healthy Eating in Daily Life: A Randomised Trial

BACKGROUND

Although many people intend to eat healthily, they often fail to do so. We report the first randomised trial testing whether smartphone-based support groups can enhance healthy eating.

METHODS

Adults (N = 203) were randomised to the support or control condition (information), and to one of two eating goals (increasing fruit and vegetable/decreasing unhealthy snack consumption). After baseline, participants received information on their assigned eating goal, and completed a 13-day electronic diary. During Days 4-10, support participants were asked to support each other in achieving their eating goal in smartphone-based groups. The primary outcome was daily servings of fruit/vegetables or unhealthy snacks. Maintenance of intervention effects was assessed on Days 11-13, and at 1-month and 2-month follow-ups.

RESULTS

Support participants showed a gradual increase in healthy eating over time, and ate 1.4 fruits and vegetables more, 95% CI [0.3, 2.6], or 0.8 unhealthy snacks less, 95% CI [-1.4, -0.2] than controls on Day 10. Most effects were not maintained at follow-ups.

CONCLUSIONS

Smartphone-based groups can promote fruit and vegetable consumption and decrease unhealthy snack intake. This study extends previous findings of the benefits of support groups, and sheds light on the temporal dynamics of behavior change.

Population- and Individual-Level Changes in Life Satisfaction Surrounding Major Life Stressors

How do stressful life events impact well-being, and how does their impact differ from person to person? In contrast to work focusing on discrete classes of responding, the current study examines the adequacy of a model where responses to stressors are characterized by a population average and continuous variability around that average. Using decades of yearly data from a large German longitudinal study examining effects of divorce, spousal loss, and unemployment, we found that (1) in the overall population, life satisfaction was diminished for years preceding stressors and only incompletely recovered with the passage of time, and (2) there were large between-person differences around the average response, following normal and heavier-tailed continuous distributions rather than discrete classes. These findings provide a multilevel model of responses to stressors and suggest that individual differences can be understood in terms of continuous variation around what is typical for a given event and population.

Autonomous Motivation and Fruit/Vegetable Intake in Parent-Adolescent Dyads

INTRODUCTION

Autonomous motivation (motivation to engage in a behavior because of personal choice, interest, or value) is often associated with health behaviors. The present study contributes to research on motivation and eating behaviors by examining (1) how autonomous motivation is correlated within parent-adolescent dyads and (2) whether parent- and adolescent-reported autonomous motivation predicts the parent-adolescent correlation in fruit and vegetable (FV) intake frequency.

METHODS

Data were drawn from the Family Life, Activity, Sun, Health, and Eating (FLASHE) Study, a cross-sectional U.S. survey of parent-adolescent dyads led by the National Cancer Institute and fielded between April and October 2014. In 2016, data were analyzed from dyads who had responses on a six-item self-report measure of daily frequency of FV consumption and a two-item self-report measure of autonomous motivation for consuming FVs.

RESULTS

Parents' and adolescents' reports of autonomous motivation and FV intake frequency were positively correlated. Both parents' and adolescents' autonomous motivation predicted higher levels of their own FV intake frequency and that of their dyad partner (p-values ≤0.001). These effects of autonomous motivation explained 22.6% of the parent-adolescent correlation in FV intake frequency. Actor effects (one's motivation predicting their own FV intake frequency) were stronger than partner effects (one's motivation predicting their partner's FV intake frequency).

CONCLUSIONS

Parent-adolescent similarity in autonomous motivation for healthy eating may contribute to similarity in eating behaviors. Future research should further examine how individual-level health behavior correlates influence health behaviors within dyads.

Positive valence bias and parent-child relationship security moderate the association between early institutional caregiving and internalizing symptoms

Institutional caregiving is associated with significant deviations from species-expected caregiving, altering the normative sequence of attachment formation and placing children at risk for long-term emotional difficulties. However, little is known about factors that can promote resilience following early institutional caregiving. In the current study, we investigated how adaptations in affective processing (i.e., positive valence bias) and family-level protective factors (i.e., secure parent-child relationships) moderate risk for internalizing symptoms in previously institutionalized (PI) youth. Children and adolescents with and without a history of institutional care performed a laboratory-based affective processing task and self-reported measures of parent-child relationship security. PI youth were more likely than comparison youth to show positive valence biases when interpreting ambiguous facial expressions. Both positive valence bias and parent-child relationship security moderated the association between institutional care and parent-reported internalizing symptoms, such that greater positive valence bias and more secure parent-child relationships predicted fewer symptoms in PI youth. However, when both factors were tested concurrently, parent-child relationship security more strongly moderated the link between PI status and internalizing symptoms. These findings suggest that both individual-level adaptations in affective processing and family-level factors of secure parent-child relationships may ameliorate risk for internalizing psychopathology following early institutional caregiving.

Daily Supportive Equity in Close Relationships

Receiving support in committed relationships has frequently been associated with negative psychological outcomes in the recipient, such as increased distress. The authors hypothesized that these negative effects could be offset by support recipients' reciprocation of support, that is, by creating a sense of supportive equity. To investigate this hypothesis, the authors obtained daily reports of mood and of received and given emotional support from both partners in 85 couples throughout a 4-week period. Reciprocity in support transactions was associated with higher levels of positive mood and lower levels of negative mood. In line with previous research, receiving support without reciprocation was associated with increases in negative mood. Giving support, regardless of receipt, was associated with a decrease in negative mood.

Individual differences in adjustment to spousal loss: A nonlinear mixed model analysis

The study of within-person change lies at the core of developmental research. Theory and empirical data suggest that many of these developmental processes are not linear. We describe a broad class of multilevel models that allows for nonlinear change — nonlinear mixed models. To demonstrate the utility of these models, we present a nonlinear mixed model analysis of adjustment to conjugal loss. Coming from a perspective of the individual as a regulatory system, our model predicts a faster rate of adjustment immediately following the loss and diminished adjustment as time since the loss increases, approaching an equilibrium level of well-being. This model allows us to estimate various aspects of the adjustment trajectory and individual differences in these trajectories, including multiple ways that pre- and post-loss factors can explain variability in the adjustment process. The model provides new insights into an important phenomenon that cannot be gleaned from linear models and other methods of trajectory analysis. We discuss the strengths and limitations of this type of analysis relative to other methods.

A Dyadic Perspective on Speech Accommodation and Social Connection: Both Partners' Rejection Sensitivity Matters

Findings from confederate paradigms predict that mimicry is an adaptive route to social connection for rejection-sensitive individuals (Lakin, Chartrand, & Arkin, 2008). However, dyadic perspectives predict that whether mimicry leads to perceived connection depends on the rejection sensitivity (RS) of both partners in an interaction. We investigated these predictions in 50 college women who completed a dyadic cooperative task in which members were matched or mismatched in being dispositionally high or low in RS. We used a psycholinguistics paradigm to assess, through independent listeners' judgments (N = 162), how much interacting individuals accommodate phonetic aspects of their speech toward each other. Results confirmed predictions from confederate paradigms in matched RS dyads. However, mismatched dyads showed an asymmetry in levels of accommodation and perceived connection: Those high in RS accommodated more than their low-RS partner but emerged feeling less connected. Mediational analyses indicated that low-RS individuals' nonaccommodation in mismatched dyads helped explain their high-RS partners' relatively low perceived connection to them. Establishing whether mimicry is an adaptive route to social connection requires analyzing mimicry as a dyadic process influenced by the needs of each dyad member.

Vicarious Fear Learning Depends on Empathic Appraisals and Trait Empathy

Empathy and vicarious learning of fear are increasingly understood as separate phenomena, but the interaction between the two remains poorly understood. We investigated how social (vicarious) fear learning is affected by empathic appraisals by asking participants to either enhance or decrease their empathic responses to another individual (the demonstrator), who received electric shocks paired with a predictive conditioned stimulus. A third group of participants received no appraisal instructions and responded naturally to the demonstrator. During a later test, participants who had enhanced their empathy evinced the strongest vicarious fear learning as measured by skin conductance responses to the conditioned stimulus in the absence of the demonstrator. Moreover, this effect was augmented in observers high in trait empathy. Our results suggest that a demonstrator's expression can serve as a "social" unconditioned stimulus (US), similar to a personally experienced US in Pavlovian fear conditioning, and that learning from a social US depends on both empathic appraisals and the observers' stable traits.

Differential Effects of Oxytocin on Agency and Communion for Anxiously and Avoidantly Attached Individuals

Oxytocin promotes prosocial behavior, especially in those individuals who are low in affiliation (e.g., avoidantly attached individuals), but can exacerbate interpersonal insecurities in those preoccupied with closeness (e.g., anxiously attached individuals). One explanation for these opposing observations is that oxytocin induces a communal, other-orientation. Becoming more other oriented should help those people who focus on the self to the exclusion of others, but could be detrimental to those who are other focused but have little sense of an agentic self. Using a within-subjects design, we administered intranasal oxytocin and placebo to 40 males and measured their agency (self-orientation) and communion (other-orientation). Oxytocin produced a slight increase in communion for the average participant; however, as predicted, avoidantly attached individuals were especially likely to perceive themselves as more communal ("kind," "warm," "gentle," etc.) after receiving oxytocin than after receiving the placebo. There was no main effect of oxytocin on agency for the average participant; however, anxiously attached individuals showed a selective decrease in agency ("independent," "self-confident," etc.) following administration of oxytocin. These data help explain the complex social effects of oxytocin.

Brain mediators of the effects of noxious heat on pain

Recent human neuroimaging studies have investigated the neural correlates of either noxious stimulus intensity or reported pain. Although useful, analyzing brain relationships with stimulus intensity and behavior separately does not address how sensation and pain are linked in the central nervous system. In this study, we used multi-level mediation analysis to identify brain mediators of pain--regions in which trial-by-trial responses to heat explained variability in the relationship between noxious stimulus intensity (across 4 levels) and pain. This approach has the potential to identify multiple circuits with complementary roles in pain genesis. Brain mediators of noxious heat effects on pain included targets of ascending nociceptive pathways (anterior cingulate, insula, SII, and medial thalamus) and also prefrontal and subcortical regions not associated with nociceptive pathways per se. Cluster analysis revealed that mediators were grouped into several distinct functional networks, including the following: somatosensory, paralimbic, and striatal-cerebellar networks that increased with stimulus intensity; and 2 networks co-localized with "default mode" regions in which stimulus intensity-related decreases mediated increased pain. We also identified "thermosensory" regions that responded to increasing noxious heat but did not predict pain reports. Finally, several regions did not respond to noxious input, but their activity predicted pain; these included ventromedial prefrontal cortex, dorsolateral prefrontal cortex, cerebellar regions, and supplementary motor cortices. These regions likely underlie both nociceptive and non-nociceptive processes that contribute to pain, such as attention and decision-making processes. Overall, these results elucidate how multiple distinct brain systems jointly contribute to the central generation of pain.

Learning biases underlying individual differences in sensitivity to social rejection

People vary greatly in their dispositions to anxiously expect, readily perceive, and strongly react to social rejection (rejection sensitivity [RS]) with implications for social functioning and health. Here, we examined how RS influences learning about social threat. Using a classical fear conditioning task, we established that high compared to low individuals displayed a resistance to extinction of the conditioned response to angry faces, but not to neutral faces or nonsocial stimuli. Our findings suggest that RS biases the flexible updating of acquired expectations for threat, which helps to explain how RS operates as a self-fulfilling prophecy.

Fluctuations in depression and well-being are associated with sexual risk episodes among HIV-positive men

OBJECTIVE

Research has suggested a weak association between depression and sexual risk behavior in men who have sex with men (MSM). The purpose of this study was to investigate the relationship between within-person fluctuations in depression and well-being and episodes of sexual risk-taking among HIV-positive MSM.

METHODS

One hundred six sexually active HIV-positive MSM living in New York City completed a structured weekly survey over 6 weeks. In Weeks 1, 3, and 5, they responded to items assessing their sexual behavior, depression, and well-being in the prior week. Multilevel logistic regression analyses were conducted to explore the relationship between changes in levels of depression and well-being, and episodes of unprotected anal intercourse (UAI).

RESULTS

Within-person deviations from participants' average levels of depression and well-being were associated with the probability of risk. The probability of a risk episode was higher in weeks when depression was higher than participants' average levels (any UAI episode: odd ratio [OR] = 1.71, 95% confidence interval [CI] [1.00, 2.90], p < .05; serodiscordant UAI episode: OR = 2.49, 95% CI [1.31, 4.73], p < .05). The probability of a risk episode was lower in weeks when well-being was higher than participants' average levels (any UAI: OR = 0.40, 95% CI [0.22, 0.74], p < .05; serodiscordant UAI: OR = 0.42, 95% CI [0.22, 0.81], p < .05). Between-person differences in depression and well-being were not associated with risk episodes (ps > .05).

CONCLUSION

This study is among the first to examine the association of within-person changes in depression and well-being with sexual risk behavior in a diverse sample. It contributes new evidence to literature exploring the relationship between depression and sexual risk. Future research should employ longitudinal designs to explore pathways linking within-person changes in depression with risk behavior.

The onset of suicidal ideation in childhood and adolescence

Event history analysis is used to address questions about the timing of first suicidal ideation during preadolescence and adolescence. Are suicidal thoughts atypical during development? Does the age trajectory of suicidal thoughts parallel that of suicidal actions? Do factors that moderate the risk of suicidal actions also moderate the risk of suicidal thoughts, and does their influence vary by developmental stage? Based on life history data from 364 college students, results indicate that suicidal thoughts in childhood are typical and that the risk of such thoughts begins to increase by age nine. Risk rates are affected by demographic factors (gender, race) and by the experience of parental absence. However, the influence of these factors depends on developmental stage, with whites being at increased risk only during adolescence, and parental absence having its strongest effect during preadolescence. In sum, this study suggests that many children and adolescents contemplate suicide, that the risk of doing so begins to increase at an early age, and that clear similarities exist between those groups at heightened risk for suicidal thought and those at heightened risk for suicidal action. Moreover, this study illustrates the power of employing an analytic technique suitable for modeling transitions. Finally, it highlights the need to model differential influences on suicidal ideation at different stages in development.

Understanding the costs of support transactions in daily life

The benefits of close relationships for mental and physical health are well documented. One of the mechanisms presumed to underlie these effects is social support, whereby close others provide practical and emotional assistance in times of need. Although there is no doubt that generalized perceptions of support availability are beneficial, research examining actual instances of support receipt has found unexpectedly mixed results. Receiving support sometimes has positive effects, but null or even negative effects are common. In this article, we review our multimethod program of research that seeks to understand and explain the costs of receiving social support. We focus on reductions in the recipient's sense of relationship equity and self-efficacy as mechanisms of this effect and examine a number of other moderating factors. Although we have found that receiving support incurs costs on average, there is considerable variability yet to be explained. Using diary data from 312 persons preparing to take a challenging exam, we examined the potential of individual differences in neuroticism, agreeableness, and attachment insecurity to explain variability in experienced support costs. We close with new questions about why received support may be beneficial or benign in some situations while being especially toxic in others.

Social effects of oxytocin in humans: context and person matter

Building on animal research, the past decade has witnessed a surge of interest in the effects of oxytocin on social cognition and prosocial behavior in humans. This work has generated considerable excitement about identifying the neurochemical underpinnings of sociality in humans, and discovering compounds to treat social functioning deficits. Inspection of the literature, however, reveals that the effects of oxytocin in the social domain are often weak and/or inconsistent. We propose that this literature can be informed by an interactionist approach in which the effects of oxytocin are constrained by features of situations and/or individuals. We show how this approach can improve understanding of extant research, suggest novel mechanisms through which oxytocin might operate, and refine predictions about oxytocin pharmacotherapy.