Overeating and resulting obesity is a public health concern in the United States, and portion size is a factor that contributes to these problems (Zlatevska, Dubelaar, & Holden, 2014). The present research demonstrates that the granularity of labels used to describe portions also influences food consumption, independent of previously documented portion size effects. Across 6 studies and 7 different food items, we find a robust and reliable effect of portion size granularity labels on consumption intentions and food consumption. Having people think about food using fine-grained labels leads them to decrease their consumption intentions (Study 1, n = 80) and ultimately eat less food (Study 2a, n = 79; Study 2b, n = 79). This process operates by shifting people’s perceptions of the size of foods (rather than changing levels of construal) whereby portions described with fine-grained labels (e.g., “15 gummy candies”) are perceived to be bigger than portions described with gross-grained labels (e.g., “one serving;” Study 3, n = 200). In addition, granularity facilitates self-regulation of consumption for individuals with a weight-loss goal both when self-regulation is measured (Study 4, n = 160) and when we manipulate that mediator (Study 5, n = 300). Finally, a high-powered registered report replicated effects of granularity on consumption via shifts in perception and intentions with a diverse community sample (Study 6, n = 323). Implications for theory and practice are discussed. (PsycInfo Database Record (c) 2020 APA, all rights reserved)

Background: Alcohol use is prevalent in many societies and has major adverse impacts on health, but the availability of effective interventions limits treatment options for those who want assistance in changing their patterns of alcohol use. Objective: This study evaluated the new Daybreak program, which is accessible via mobile app and desktop and was developed by Hello Sunday Morning to support high-risk drinking individuals looking to change their relationship with alcohol. In particular, we compared the effect of adding online coaching via real-time chat messages (intervention group) to an otherwise self-guided program (control group). Methods: We designed the intervention as a randomized control trial, but as some people (n=48; 11.9%) in the control group were able to use the online coaching, the main analysis comprised all participants. We collected online surveys at one-month and three-months follow-up. The primary outcome was change in alcohol risk (measured with the alcohol use disorders identification test–consumption [AUDIT–C] score), but other outcomes included the number of standard drinks per week, alcohol-related days out of role, psychological distress (Kessler-10), and quality of life (EUROHIS-QOL). Markers of engagement with the program included posts to the site and comments on the posts of others. The primary analysis used Weighted Generalized Estimating Equations. Results: We recruited 398 people to the intervention group (50.2%) and 395 people to the control group (49.8%). Most were female (71%) and the mean age was 40.1 years. Most participants were classified as probably dependent (550, 69%) on the AUDIT–10, with 243 (31%) classified with hazardous or harmful consumption. We followed up with 334 (42.1%) participants at one month and 293 (36.9%) at three months. By three months there were significant improvements in AUDIT–C scores (down from mean 9.1 [SD 1.9] to 5.8 [SD 3.1]), alcohol consumed per week (down from mean 37.1 [SD 28.3] to mean 17.5 [SD 18.9]), days out of role (down from mean 1.6 [SD 3.6] to 0.5 [SD 1.6]), quality of life (up from 3.2 [SD 0.7] to 3.6 [SD 0.7]) and reduced distress (down from 24.8 [SD 7.0] to 19.0 [SD 6.6]). Accessing online coaching was not associated with improved outcomes, but engagement with the program (eg, posts and comments on the posts of others) were significantly associated with improvements (eg, in AUDIT–C, alcohol use and EUROHIS-QOL). Reduced alcohol use was found for both probably dependent (estimated marginal mean of 40.8 to 20.1 drinks) and hazardous or harmful alcohol users (estimated marginal mean of 22.9 to 11.9 drinks). Conclusions: Clinically significant reductions in alcohol use were found, as well as reduced alcohol risk (AUDIT–C) and days out of role. Importantly, improved alcohol-related outcomes were found for both hazardous or harmful and probably dependent drinkers. Since October 2016, Daybreak has reached more than 50,000 participants. Therefore, there is the potential for the program to have an impact on alcohol-related problems at a population health level, importantly including an effect on probably dependent drinkers. Trial Registration: Australian New Zealand Clinical Trials Registry: ACTRN12618000010291; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=373110 International Registered Report Identifier (IRRID): RR2-10.2196/9982

When conveying a message to an interlocutor, speakers need to code concepts in lexical expressions, a process known as lexical retrieval. There is evidence that speakers can take into account the dialectal background of their interlocutor to tailor their lexical retrieval; for instance, our pilot experiment showed that participants, when asked to guess the defined expression according to a definition, were more likely to produce American English (AE) expressions (e.g., apartment instead of flat) when the definition was spoken by an AE interlocutor than a British English (BE) interlocutor. It is possible that such an interlocutor effect arises from a top-down interlocutor model, from bottom-up accent details, or a combination of both. This registered report aimed to address this issue with two experiments. In Experiment 1, we observed that the interlocutor effect on lexical retrieval did not differ regardless of whether a definition was presented by the interlocutor via speaking (with accent details) or writing (without accent details), suggesting that the effect arises from top-down interlocutor modeling instead of bottom-up accent details. Experiment 2 interleaved two interlocutors with different dialects, one providing a spoken filler definition and the other a written target definition. Participants used more AE expressions for target definitions given by an AE interlocutor than a BE interlocutor, suggesting they maintained concurrent models for interlocutors and used them to retrieve dialect-congruent expressions. These findings highlight top-down influences of the communicative context in language production. (PsycInfo Database Record (c) 2025 APA, all rights reserved)

Background: Most survivors of cancer have multiple cardiovascular risk factors, increasing their risk of poor cardiovascular and cancer outcomes. The Automated Heart-Health Assessment (AH-HA) tool is a novel electronic health record clinical decision support tool based on the American Heart Association’s Life’s Simple 7 cardiovascular health metrics to promote cardiovascular health assessment and discussion in outpatient oncology. Before proceeding to future implementation trials, it is critical to establish the acceptability of the tool among providers and survivors. Objective: This study aims to assess provider and survivor acceptability of the AH-HA tool and provider training at practices randomized to the AH-HA tool arm within WF-1804CD. Methods: Providers (physicians, nurse practitioners, and physician assistants) completed a survey to assess the acceptability of the AH-HA training, immediately following training. Providers also completed surveys to assess AH-HA tool acceptability and potential sustainability. Tool acceptability was assessed after 30 patients were enrolled at the practice with both a survey developed for the study as well as with domains from the Unified Theory of Acceptance and Use of Technology survey (performance expectancy, effort expectancy, attitude toward using technology, and facilitating conditions). Semistructured interviews at the end of the study captured additional provider perceptions of the AH-HA tool. Posttreatment survivors (breast, prostate, colorectal, endometrial, and lymphomas) completed a survey to assess the acceptability of the AH-HA tool immediately after the designated study appointment. Results: Providers (n=15) reported high overall acceptability of the AH-HA training (mean 5.8, SD 1.0) and tool (mean 5.5, SD 1.4); provider acceptability was also supported by the Unified Theory of Acceptance and Use of Technology scores (eg, effort expectancy: mean 5.6, SD 1.5). Qualitative data also supported provider acceptability of different aspects of the AH-HA tool (eg, “It helps focus the conversation and give the patient a visual of continuum of progress”). Providers were more favorable about using the AH-HA tool for posttreatment survivorship care. Enrolled survivors (n=245) were an average of 4.4 (SD 3.7) years posttreatment. Most survivors reported that they strongly agreed or agreed that they liked the AH-HA tool (n=231, 94.3%). A larger proportion of survivors with high health literacy strongly agreed or agreed that it was helpful to see their heart health score (n=161, 98.2%) compared to survivors with lower health literacy scores (n=68, 89.5%; P=.005). Conclusions: Quantitative surveys and qualitative interview data both demonstrate high acceptability of the AH-HA tool among both providers and survivors. Although most survivors found it helpful to see their heart health score, there may be room for improving communication with survivors who have lower health literacy. Trial Registration: ClinicalTrials.gov NCT03935282; http://clinicaltrials.gov/ct2/show/NCT03935282

Background: The usual diagnosis of sarcopenia requires a dual-energy x-ray absorptiometry (DXA) exam, which has low accessibility in primary care for Latin American countries. Objective: The aim of this study is to design and validate software for mobile devices (Android, IOS) and computers, based on an adapted version of the diagnostic algorithm of sarcopenia proposed by the European Working Group on Sarcopenia in Older People (EWGSOP). Methods: Follow-up exams were conducted on 430 community-dwelling Chileans 60 years and older (mean 68.2 years, SD 4.9) participating in the IsaMayor and Alexandros cohorts designed to study sarcopenia and disability associated with obesity, respectively. All the participants from the cohorts were randomly selected from the registries of primary health care centers and, for this study, must have a DXA scan at baseline. The software (HTSMayor) was designed according to an adapted version of the algorithm proposed by the EWGSOP and was divided into four phases: longitudinal validation of diagnostic algorithm of sarcopenia, alpha version, beta version, and release version. The software estimates appendicular skeletal muscle mass (ASM) using an anthropometric equation or DXA measurements with Chilean cut-off points. The predictive validation of the algorithm was estimated, comparing functional limitations (at least one activity of daily living, two instrumental activities of daily living, or three mobility limitations), falls, and osteoporosis at follow-ups in patients with and without sarcopenia at baseline, using adjusted logistic models. Results: After a median follow-up of 4.8 years (2078.4 person-years), 37 (9.9%) new cases of sarcopenia, out of the 374 patients without sarcopenia at baseline, were identified (incidence density rate=1.78 per 100 person-years). ASM estimated with the anthropometric equation showed both a high sensitivity and specificity as compared with those estimated by DXA measurements, yielding a concordance of 0.96. The diagnostic algorithm of sarcopenia considered in the software with the equation showed both a high sensitivity (82.1%) and specificity (94.9%) when compared with DXA (reference standard). Adults without sarcopenia (at baseline) showed better physical performance (after approximately 5 years) than adults with sarcopenia. Loss of functionality was greater in adults with sarcopenia (OR 5.0, 95% CI 2.2-11.4) than in adults without sarcopenia. In addition, the risks of falls (OR 2.2, 95% CI 1.1-4.3) and osteoporosis (OR 2.8, 95% CI 1.2-6.6) were higher in older persons with sarcopenia than those without sarcopenia. The measurements and results were completed for the beta and release tests with a mean time of 10 minutes and 11 minutes, respectively. Conclusions: We developed and validated a software for the diagnosis of sarcopenia in older Chilean adults that can be used on a mobile device or a computer with good sensitivity and specificity, thus allowing for the development of programs for the prevention, delay, or reversal of this disease. To our knowledge, HTSMayor is the first software to diagnose sarcopenia.

Background: Smartphone apps promoting physical activity (PA) are abundant, but few produce substantial and sustained behavior change. Although many PA apps purport to induce users to compare themselves with others (by invoking social comparison processes), improvements in PA and other health behaviors are inconsistent. Existing literature suggests that social comparison may motivate PA for some people under some circumstances. However, 2 aspects of work that apply social comparison theory to PA apps remain unclear: (1) how comparison processes have been operationalized or harnessed in existing PA apps and (2) whether incorporating sources of variability in response to comparison have been used to tailor comparison features of apps, which could improve their effectiveness for promoting PA. Objective: The aim of this meta-review was to summarize existing systematic, quantitative, and narrative reviews of behavior change techniques in PA apps, with an emphasis on social comparison features, to examine how social comparison is operationalized and implemented. Methods: We searched PubMed, Web of Science, and PsycINFO for reviews of PA smartphone apps. Of the 3743 initial articles returned, 26 reviews met the inclusion criteria. Two independent raters extracted the data from these reviews, including the definition of social comparison used to categorize app features, the percentage of apps categorized as inducing comparison, specific features intended to induce comparison, and any mention of tailoring comparison features. For reference, these data were also extracted for related processes (such as behavioral modeling, norm referencing, and social networking). Results: Of the included review articles, 31% (8/26) categorized app features as prompting social comparison. The majority of these employed Abraham and Michie’s earliest definition of comparison, which differs from versions in later iterations of the same taxonomy. Very few reviews specified what dimension users were expected to compare (eg, steps, physical fitness) or which features of the apps were used to induce comparison (eg, leaderboards, message boards). No review referenced tailoring of comparison features. In contrast, 54% (14/26) reviews categorized features for prompting behavioral modeling and 31% (8/26) referenced tailoring app features for users’ personal goals or preferences. Conclusions: The heterogeneity across reviews of PA apps and the absence of relevant information (eg, about dimensions or features relevant for comparison) create confusion about how to best harness social comparison to increase PA and its effectiveness in future research. No evidence was found that important findings from the broader social comparison literature (eg, that people have differing preferences for and responses to social comparison information) have been incorporated in the design of existing PA apps. Greater integration of the mobile health (mHealth) and social comparison literatures may improve the effectiveness of PA apps, thereby increasing the public health impact of these mHealth tools.

Background Acute gastroenteritis (AGE) and acute respiratory infections (ARIs) cause significant pediatric morbidity and mortality. Developing childhood vaccines against major enteric and respiratory pathogens should be guided by the natural history of infection and acquired immunity. The United States currently lacks contemporary birth cohort data to guide vaccine development. Objective The PREVAIL (Pediatric Respiratory and Enteric Virus Acquisition and Immunogenesis Longitudinal) Cohort study was undertaken to define the natural history of infection and immune response to major pathogens causing AGE and ARI in US children. Methods Mothers in Cincinnati, Ohio, were enrolled in their third trimester of pregnancy, with intensive child follow-up to 2 years. Blood samples were obtained from children at birth (cord), 6 weeks, and 6, 12, 18, and 24 months. Whole stool specimens and midturbinate nasal swabs were collected weekly and tested by multipathogen molecular assays. Saliva, meconium, maternal blood, and milk samples were also collected. AGE (≥3 loose or watery stools or ≥1 vomiting episode within 24 hours) and ARI (cough or fever) cases were documented by weekly cell phone surveys to mothers via automated SMS text messaging and review of medical records. Immunization records were obtained from registries and providers. follow-up ended in October 2020. Pathogen-specific infections are defined by a PCR-positive sample or rise in serum antibody. Results Of the 245 enrolled mother–child pairs, 51.8% (n=127) were White, 43.3% (n=106) Black, 55.9% (n=137) publicly insured, and 86.5% (n=212) initiated breastfeeding. Blood collection was 100.0% for mothers (n=245) and 85.7% for umbilical cord (n=210). A total of 194/245 (79.2%) mother–child pairs were compliant based on participation in at least 70% (≥71/102 study weeks) of child-weeks and providing 70% or more of weekly samples during that time, or blood samples at 18 or 24 months. Compliant participants (n=194) had 71.0% median nasal swab collection (IQR 30.0%-90.5%), with 98.5% (191/194) providing either an 18- or 24-month blood sample; median response to weekly SMS text message surveys was 95.1% (IQR 76.5%-100%). Compliant mothers reported 2.0 AGE and 4.5 ARI cases per child-year, of which 25.5% (160/627) and 38.06% (486/1277) of cases, respectively, were medically attended; 0.5% of AGE (3/627) and 0.55% of ARI (7/1277) cases were hospitalized. Conclusions The PREVAIL Cohort demonstrates intensive follow-up to document the natural history of enteric and respiratory infections and immunity in children 0-2 years of age in the United States and will contribute unique data to guide vaccine recommendations. Testing for pathogens and antibodies is ongoing. International Registered Report Identifier (IRRID) RR1-10.2196/22222

Background: Recent evidence suggests the effectiveness of stepwise, targeted approaches for the prevention of lifestyle-related diseases with combinations of web-based and face-to-face interventions showing promising results. Objective: This paper reports on 1-year changes in health-risk behaviors, BMI, self-rated health, mental well-being, and risk of disease at 1-year follow-up after participation in a stepwise intervention that targeted persons at high risk of disease and persons with health-risk behavior. To this end, we distinguish between participants who took up the full intervention (web-based plus face-to-face) and those who received only the web-based intervention. Methods: The Early Detection and Prevention (Danish acronym: TOF) pilot study was conducted as a nonrandomized, 1-year follow-up intervention study in two municipalities in the Region of Southern Denmark. A total of 9400 citizens born between 1957 and 1986 (aged 29 to 60 years) were randomly sampled from participating general practitioner (GP) patient-list systems and were invited to take part in the study. Participants were subsequently stratified into risk groups based on their responses to a questionnaire on health-risk behavior and data from their GP’s electronic patient record (EPR) system. All participants received a digital personal health profile with individualized information on current health-risk behavior and targeted advice on relevant health-risk behavior changes. In addition, patients at high risk of disease, as indicated by their digital health profile, were offered a targeted intervention at their GP. Patients who were not deemed at high risk of disease but who exhibited health-risk behaviors were offered a targeted intervention at their municipal health center (MHC). At 1-year follow-up, health-risk behaviors, self-rated health, BMI, and mental well-being were reassessed by questionnaire, and current information on diagnoses and medical treatment was retrieved from the EPRs. Results: Of 598 patients at high risk of disease or with health-risk behavior, 135 took up the targeted intervention at their GP or MHC and 463 received the personal health profile only. From baseline to 1-year follow-up, the number of patients with unhealthy eating habits decreased, mean mental well-being increased, and smoking prevalence decreased in patients who had received the digital personal health profile alone. Among patients who took up the targeted intervention, unhealthy eating habits and sedentary lifestyles decreased and significant reductions in mean BMI were observed. At 1-year follow up, no health-risk behaviors were detected among 17.4% of patients who at baseline had exhibited health-risk behaviors or high risk of disease. Conclusions: A stepwise targeted preventive approach using web-based and face-to-face elements may lead to favorable lifestyle changes. Specifically, a web-based approach may improve smoking and eating habits and mental well-being, whereas supplementary face-to-face interventions may be necessary to improve exercise habits and BMI. Trial Registration: ClinicalTrials.gov NCT02797392; https://clinicaltrials.gov/ct2/show/NCT02797392

Background: Immigrant populations are often disproportionally affected by chronic diseases, such as type 2 diabetes mellitus (T2DM). Use of information and communication technology (ICT) is one promising approach for better self-care of T2DM to mitigate the social health inequalities, if designed for a wider population. However, knowledge is scarce about immigrant populations’ diverse electronic health (eHealth) activities for self-care, especially in European countries. Objective: With a target group of first-generation immigrants from Pakistan in the Oslo area, Norway, we aimed to understand their diverse eHealth activities for T2DM self-care in relation to immigration-related user factors specific to this target group: proficiency in relevant languages (Urdu, Norwegian, English), length of residence in Norway, and diagnosis of T2DM compared with general user factors (age, gender, education and digital skills, and self-rated health status). Methods: Data were from a survey among the target population (N=176) conducted in 2015-2016. Using logistic regression, we analyzed associations between user factors and experiences of each of the following eHealth activities for T2DM self-care in the last 12 months: first, information seeking by (1) search engines and (2) Web portals or email subscriptions; second, communication and consultation (1) by closed conversation with a few acquaintances using ICT and (2) on social network services; and third, active decision making by using apps for (1) tracking health information and (2) self-assessment of health status. Using Poisson regression, we also assessed the relationship between user factors and variety of eHealth activities experienced. The Bonferroni correction was used to address the multiple testing problem. Results: Regression analyses yielded the following significantly positive associations: between Urdu literacy and (1) information seeking by Web portals or email subscriptions (odds ratio [OR] 2.155, 95% CI 1.388-3.344), (2) communication and consultation on social network services (OR 5.697, 95% CI 2.487-13.053), and (3) variety (estimate=0.350, 95% CI 0.148-0.552); between length of residence in Norway and (1) communication and consultation by closed conversation with a few acquaintances using ICT (OR 1.728, 95% CI 1.193-2.503), (2) communication and consultation on social network services (OR 2.098, 95% CI 1.265-3.480), and (3) variety (estimate=0.270, 95% CI 0.117-0.424); between Norwegian language proficiency and active decision making by using apps for self-assessment of health status (OR 2.285, 95% CI 1.294-4.036); between education and digital skills and active decision making by using apps for tracking health information (OR 3.930, 95% CI 1.627-9.492); and between being a female and communication and consultation by closed conversation with a few acquaintances using ICT (OR 2.883, 95% CI 1.335-6.227). Conclusions: This study implies immigration-related factors may confound associations between general user factors and eHealth activities. Further studies are needed to explore the influence of immigration-related user factors for eHealth activities in other immigrant groups and countries. International Registered Report: RR2-DOI 10.2196/resprot.5468

Background: There is a clear need for enhanced mental health assessment, depressive symptom (DS) evaluation being no exception. A promising approach to this aim is using virtual reality (VR), which entails the potential of adding a wider set of assessment domains with enhanced ecological validity. However, whilst several studies have used VR for both diagnostic and treatment purposes, its acceptance, in particular how exposure to virtual environments affects populations with psychiatric conditions remains unknown. Objective: This study aims to report on the acceptability, usability, and cybersickness levels of a pilot VR environment designed for the purpose of differentiating between individuals with DSs. Methods: The exploratory study, conducted in Italy, included 50 healthy controls and 50 young adults with mild-to-moderate DSs (without the need for a formal diagnosis). The study used an observational design with approximately 30 minutes of VR exposure followed by a self-report questionnaire battery. The battery included a questionnaire based on the Theoretical Framework of Acceptability, the System Usability Scale as well as the Simulator Sickness Questionnaire. Results: Results indicate that the majority found VR acceptable for the purposes of mental health screening and treatment. However, for diagnostics, there was a clear preference for VR to be used by mental health professionals as a supplementary tool, as opposed to a stand-alone solution. In practice, following exposure to the pilot VR environment, generally, good levels of acceptability and usability were reported, but areas in need of improvement were identified (such as self-efficacy). Self-reported cybersickness levels were comparable to literature averages but were considerably higher among those with DSs. Conclusions: These findings raise questions about the potential interplay between underlying somatic symptoms of depression and VR-induced cybersickness and call for more attention from the scientific community both in terms of methodology as well as potential clinical and theoretical implications. Conclusively, user support indicates a potential for VR to aid mental health assessment, but further research is needed to understand how exposure to virtual environments might affect populations with varying severity and other forms of psychiatric symptoms.

Psychopathic personality disorder (PPD) is a widely recognized disorder that has been associated with high levels of dysfunction across clinical, forensic, occupational, and social settings. The psychopathy construct displays robust connections to social and interpersonal dysfunction; however, research investigating these associations thus far largely relies on total or domain-level scores. This study aimed to employ a higher degree of abstraction to examine associations between psychopathy symptoms and various interpersonal outcomes at different levels of the psychopathy trait hierarchy. The Comprehensive Assessment of Psychopathic Personality (Cooke et al., 2012) was used, allowing for the highest level of nuance, with 33 individual symptom scales. A variety of different interpersonal outcome variables were collected using multiple methods. A university sample ( N = 669) was used and informant reports ( N = 337) were collected. Consistent with our hypotheses, correlation analyses indicated that there were distinct, and at times unique, associations between symptoms and interpersonal outcomes. Furthermore, regression models and dominance analyses showed taking a symptom-level approach can add incremental information over factor scores, particularly for self-reported outcomes. Future research should seek to replicate these findings across populations to elucidate any consistent patterns that could aid in the assessment and treatment of PPD. (PsycInfo Database Record (c) 2024 APA, all rights reserved) (Source: journal abstract)

In an era where digital imagery has become ubiquitous, the ease of creating fake or AI-generated images poses a critical challenge to credibility assessment. Repetition increases the credibility of written and verbal information. Does this credibility gain also apply to pictures? Participants were exposed to both genuine and AI-generated images, followed by a credibility assessment phase including repeated and new images. We found that participants judged repeated images as more credible than new images, regardless of whether those images were genuine or AI-generated. This repetition effect remained consistent across diverse image categories with low between-image variability. These findings highlight a potent mechanism for the spread of visual misinformation: Images repeatedly shared across social media platforms may gain unwarranted credibility through mere exposure, regardless of their authenticity. However, the precise cognitive mechanisms underlying the repetition effect for pictures—and whether they differ from those established for verbal information—remain important questions for future research. (PsycInfo Database Record (c) 2025 APA, all rights reserved)

Background: Generalized anxiety disorder (GAD) is common among university students due to academic pressure and financial uncertainty, among other challenges. Despite the need, the receipt of available psychological services is often low. Objective: This study investigates the feasibility of a digital unguided cognitive behavioral therapy (CBT)–based mobile app, Cerina, and examines the likely effects of this intervention in reducing GAD symptoms compared to the waitlist control group. Methods: Eligible students (n=158) with mild to moderate GAD symptoms were self-assessed through web-based questionnaires and were randomly allocated to the intervention group (n=79) or to the waitlist control group (n=79) following their informed consent. The intervention group had direct access to Cerina and followed CBT-based interactive sessions for 6 weeks. The waitlist control group participants had access to optional on-campus well-being services, and they were given access to Cerina 6 weeks after their randomization. Participants completed assessments on anxiety, depression, worry, and usability at three time points. Additionally, upon completing the intervention, they were invited to a web-based interview to understand the implementation of the intervention in more depth. Results: On average, 13% (10/79) intervention group participants dropped out, 61% (36/69) completed the core clinical content (2 sessions), and 12% (7/69) completed the desired number of sessions (6 or 7 sessions). Analyses of the completers (2 or more sessions) revealed significant group differences in GAD (mean 8.4, SD 3.7; t42=–2.25; P=.03; d=–0.7) and worry symptoms (mean 42.3, SD 10.8; t42=–2.50; P=.02; d=–0.8), as well as functional impairment (mean 16.7, SD 2.44; t42=–2.12; P=.04; d=–0.6) in favor of the intervention group at posttest with medium to large effect sizes. The intention-to-treat analyses confirmed significant group differences in GAD (mean 8.47, SD 2.7; t156=–2.23; P=.03; d=–0.4), and there were marginally nonsignificant group differences in worry symptoms (mean 41.5, SD 8.40; t156=–1.94; P=.05; d=–0.3) in favor of the intervention group at posttest with medium effect sizes. These results suggest that the intervention had a meaningful impact on reducing GAD symptoms and a modest impact on reducing worry symptoms among participants. Conclusions: The Cerina app showed promising results in reducing GAD symptoms among students. This result supports findings from other randomized controlled trials showing that digital CBT-based interventions are effective and feasible for a wide range of age groups and populations experiencing GAD symptoms. The low number of participants completing the recommended number of sessions suggests a usability issue. To address this, the intervention could be refined through an iterative design process informed by user feedback, and the long-term impact of specific engagement features in improving usability and retention could be assessed through extended evaluations. Trial Registration: ClinicalTrials.gov NCT06146530; https://clinicaltrials.gov/study/NCT06146530

Living animals reach their end-of-life through a stereotypic set of fascinating but poorly understood processes. The discovery, first in flies and later in nematodes and zebrafish, of the “Smurf phenotype” has provided a valuable tool to investigate ageing and its associated physiological changes. Using the Smurfs, we have shown an evolutionarily conserved end-of-life transition across Drosophilids, nematodes, and zebrafish. This tool has been key to identify the discontinuous nature of ageing and predict impending death from natural causes as well as from environmental stresses. This phenotype led us to propose a two-phase perspective of ageing: a first phase where individuals are apparently healthy and have low risk of mortality, but show an age-dependent and increasing risk of entering a second phase, marked by more pronounced hallmarks of ageing and a markedly increased risk of death. Here, we test whether these two consecutive phases of ageing separated by the Smurf transition are a conserved feature of ageing in the mammals using Mus musculus as a model. We performed a longitudinal longevity study using both males and females from two different mouse genetic backgrounds and by integrating physiological, metabolic, and molecular measurements with the life history of approximately 150 mice. We show the existence of a phenotypic signature typical of the last phase of life, observable at any chronological age. Validating the two-phase ageing model in a mammalian organism allows better characterization of the high risk of imminent death and would extend its implications to a broader range of species for ageing research. The Stage 1 version of this Registered Report was submitted on 19th January 2022.

The effects of gender stereotype threat on mathematical test performance in the classroom have been extensively studied in several cultural contexts. Theory predicts that stereotype threat lowers girls’ performance on mathematics tests, while leaving boys’ math performance unaffected. We conducted a large-scale stereotype threat experiment in Dutch high schools (N = 2064) to study the generalizability of the effect. In this registered report, we set out to replicate the overall effect among female high school students and to study four core theoretical moderators, namely domain identification, gender identification, math anxiety, and test difficulty. Among the girls, we found neither an overall effect of stereotype threat on math performance, nor any moderated stereotype threat effects. Most variance in math performance was explained by gender, domain identification, and math identification. We discuss several theoretical and statistical explanations for these findings. Our results are limited to the studied population (i.e. Dutch high school students, age 13–14) and the studied domain (mathematics).

We investigated how psychological distance influences goal contagion (the extent to which people automatically adopt another person’s goals). On the basis of construal-level theory, we predicted people would be more prone to goal contagion when primed with psychological distance (vs. closeness) because they would construe the other person’s behavior in terms of its underlying goal. Alternatively, we predicted people primed with psychological closeness (vs. distance) would be more prone to goal contagion because closeness may increase the personal relevance of another’s goals – a process not mediated by construal level. In two preregistered studies, participants read about a student whose behavior implied either an academic or a social goal. We manipulated (a) participants’ level of mental construal with a mind-set task (Study 1) and (b) their social distance from another person who showed academic or social behaviors (Study 2). We measured performance on an anagram task as an indicator of academic goal contagion. For Study 1, we predicted that participants reading about academic (vs. social) behaviors would show a better anagram performance, especially when primed with an abstract mind-set. For Study 2, we predicted that construal level and relevance effects might cancel each other out, because distance triggers both high-level construal and less relevance. In contrast to the construal-level hypothesis, the mind-set manipulation did not affect goal contagion in Study 1. In accordance with the relevance hypothesis, psychological proximity increased goal contagion in Study 2. We discuss how the findings relate to previous findings on goal contagion and imitation.

While nudges have been shown to be effective and are already being implemented, there is still a debate on the ethics of nudging. This debate specifically refers to the potential of nudges negatively affecting autonomy. It has been suggested that making a nudge transparent may resolve this issue. Whereas previous research has already demonstrated that transparency does not violate nudge effectiveness, it is unknown how transparency affects autonomy and related decision satisfaction and experienced pressure. In an online study with 905 participants, we investigated whether two variations of transparency influence the decision maker’s experience of autonomy, as well as their choice satisfaction and the experienced pressure to choose the nudged option. The results show that autonomy and satisfaction were high – and pressure low – across all conditions, and were therefore not influenced by transparency. Suggesting that nudges do not negatively affect autonomy and that transparency does also not increase it.

Previous research investigated the effects of power poses at the behavioral, subjective, and neuroendocrine level. However, it is not clear whether the same effects would be obtained also by just imagining, rather than adopting, a power pose. We planned to investigate this question by asking 200 participants to either perform or imagine a constrictive or an expansive body posture during 2 min and then measure the effect on a gambling decision task and on felt power. We followed a sequential analysis procedure by running the first 100 participants in the performed posture condition in order to check the presence of the power posing effect. Because no effect of power poses on gambling decision or on felt power was found, we ran the remaining 100 participants also in the performed instead of the imagined condition. The results after running 200 participants confirmed that power poses did not affect gambling decision. However, participants felt more powerful after adopting an expansive pose compared to a constrictive pose. Exploratory analyses found that this effect was mainly driven by male participants. In addition, participants rated themselves as being more able to adopt the expansive body posture and they reported to put more effort in adopting the restrictive body posture. Overall, our results indicate that the effect of power poses on behavior might not be as widespread as previously thought of and suggest that moderators should be investigated carefully in future research.

The purpose of the current research is to explore how mode of identification (glorification versus attachment) results in either schadenfreude “with a bad conscience” (S-BC) about disadvantaged peo...

The current study attempted to replicate results by Cuddy, Wilmuth, Yap, and Carney (2015) who showed that adopting high-power poses prior to a demanding job interview improved dominant behavior an...

What are the social signals of emotional tears? This question has fascinated scholars ever since Darwin. Studies have suggested several interpersonal effects of emotional tears. A recent article presented evidence in three studies that tearful individuals are not only perceived as warmer but also less competent than their non-tearful counterparts. However, the competence effect was relatively small, and a recent replication failed to find such an effect in two different populations while the warmth effect was replicated. This questions the generalizability of the effect of tears on perceived competence. To test whether individuals expressing emotional tears are really perceived as less competent and what boundary conditions such an effect might have, we specified a decision tree of three different studies in which we test differences between the original reference study and the replication. We replicated previous findings of the perceived (in)competence in Study 1 (n = 531) but observed a considerably smaller nonsignificant effect when proceeding to Study 2 (n = 471), which increased the number of stimuli. The earlier and now repeated replication failure can therefore likely be attributed to an increased variation in stimulus material. We conclude that there is not enough evidence to argue that one social outcome of tears signals a relative lack of competence as the effect seems to depend on the specific stimuli used.

Earlier work found that – compared to participants who adopted constrictive body postures – participants who adopted expansive body postures reported feeling more powerful, showed an increase in testosterone and a decrease in cortisol, and displayed an increased tolerance for risk. However, these power pose effects have recently come under considerable scrutiny. Here, we present a Bayesian meta-analysis of six preregistered studies from this special issue, focusing on the effect of power posing on felt power. Our analysis improves on standard classical meta-analyses in several ways. First and foremost, we considered only preregistered studies, eliminating concerns about publication bias. Second, the Bayesian approach enables us to quantify evidence for both the alternative and the null hypothesis. Third, we use Bayesian model-averaging to account for the uncertainty with respect to the choice for a fixed-effect model or a random-effect model. Fourth, based on a literature review, we obtained an empirically informed prior distribution for the between-study heterogeneity of effect sizes. This empirically informed prior can serve as a default choice not only for the investigation of the power pose effect but for effects in the field of psychology more generally. For effect size, we considered a default and an informed prior. Our meta-analysis yields very strong evidence for an effect of power posing on felt power. However, when the analysis is restricted to participants unfamiliar with the effect, the meta-analysis yields evidence that is only moderate.

How do people assess the likelihood of personal risk in online activity? In three pilot experiments and one preregistered experiment, we tested the motivational and cognitive mechanisms that shape self and social judgments of cyber security. In Pilot Studies 1–3, we probed for evidence of differential use of base rate information in forecasting the likelihood oneself or another person would engage in a risky behavior. In the preregistered experiment, we gathered direct evidence of differential use of base rate information through covert eye-tracking. Data suggest people self-enhance when assessing risk, believing they are less likely than others to engage in actions that pose a threat to their cyber security, particularly because they rely less on base rate information when predicting their own behavior compared to others’ behavior. Self and social judgments were not different when scenarios posed no risk. We discuss implications for self-insight and interventions to curb risky behavior in online activity.

In the current study, we sought to replicate the finding that adopting an open/expansive body posture increases subjective feelings of power, while also investigating how these body postures influe...

Defaults (i.e. preselected options that become effective without active choice) are becoming increasingly popular as the idea of nudging enters the political arena. Their interplay with individual ...

Researchers have argued that power poses are an effective way for individuals to empower themselves to achieve personal goals. However, in laboratory studies, individuals are often unaware of the f...

Understanding how prepared teachers are to use technology to enhance their teaching can assist researchers to support them better, yet the theoretical basis for understanding teachers' self-beliefs is in need of stronger empirical support. The first objective of this study was to replicate and extend prior research that empirically tested portions of the technology acceptance model (TAM) amongst pre-service teachers. The second objective was to empirically test an alternative set of antecedents of behavioural intentions to use technology based on the expectancy–value theory (EVT). Four theoretical models were tested using structural equation modelling with a sample of pre-service teachers (N = 249). Results provide support for the TAM and the extended TAM models, however, no support was found for the combined EVT and TAM models. We discuss the implications to promote teacher integration of technology in the classroom by creating facilitating conditions.

Conservation science needs more high-quality impact evaluations, especially ones that explore mechanisms of success or failure. Randomized control trials (RCTs) provide particularly robust evidence of the effectiveness of interventions (although they have been criticized as reductionist and unable to provide insights into mechanisms), but there have been few such experiments investigating conservation at the landscape scale. We explored the impact of Watershared, an incentive-based conservation program in the Bolivian Andes, with one of the few RCTs of landscape-scale conservation in existence. There is strong interest in such incentive-based conservation approaches as some argue they can avoid negative social impacts sometimes associated with protected areas. We focused on social and environmental outcomes based on responses from a household survey in 129 communities randomly allocated to control or treatment (conducted both at the baseline in 2010 and repeated in 2015–2016). We controlled for incomplete program uptake by combining standard RCT analysis with matching methods and investigated mechanisms by exploring intermediate and ultimate outcomes according to the underlying theory of change. Previous analyses, focused on single biophysical outcomes, showed that over its first 5 years Watershared did not slow deforestation or improve water quality at the landscape scale. We found that Watershared influenced some outcomes measured using the survey, but the effects were complex, and some were unexpected. We thus demonstrated how RCTs can provide insights into the pathways of impact, as well as whether an intervention has impact. This paper, one of the first registered reports in conservation science, demonstrates how preregistration can help make complex research designs more transparent, avoid cherry picking, and reduce publication bias.

In collaboration with the Authority for the Financial Markets in the Netherlands, we manipulate the content of official letters that instruct financial intermediaries to submit a mandatory self-assessment. As part of the Registered Report Process, we submitted our hypotheses, experimental procedure, and planned statistical analyses before data collection. We predicted that a request indicating a supportive regulatory attitude has a positive effect on reporting quality on average. We also predicted this effect to be stronger for small firms and for firms with a long-term orientation, and to become negative for firms with a short-term orientation. Planned analyses show that a supportive letter reduced reporting quality unless firms had a long-term orientation, supporting the moderating influence of time horizon, but providing no support for the expected average effect or for moderation by firm size.

We use experimental markets to examine whether providing consulting services to a non-audit client impacts audit quality. Our paper directly addresses concerns raised by the Public Company Accounting Oversight Board that the largest public accounting firms’ growth in their consulting practices threatens audit quality. We conduct an experiment proposed using a registration-based editorial process. We compare a baseline where the auditor does not provide consulting services to conditions where auditors provide consulting to audit clients or where auditors only provide consulting services to non-audit clients. Our unique design provides evidence on whether providing consulting to non-audit clients strengthens the salience of a client-cooperative social norm that reduces audit quality. We do not find differences in audit quality by condition in our planned analysis, however we find greater variation in audit quality in the conditions where auditors provide consulting services compared to the baseline. In unplanned analyses, our results suggest providing consulting services increases auditor cooperation with managers, increasing audit quality when managers prefer high audit quality and decreasing audit quality when managers prefer low audit quality.

In response to the increasing use of computer programs to process firm disclosures, this registered report develops a new measure of “scriptability” that reflects computerized, rather than human, information processing costs. We validate our measure using SEC filing-derived data from prior research and identify firm and disclosure characteristics related to it. In our planned hypothesis tests, we find some evidence that the speed of the market response to filings increases with scriptability, but find little evidence that scriptability affects the incidence and speed of news dissemination by Dow Jones. In additional analyses, we find that scriptability exhibits both positive and negative associations with changes in information asymmetry between market participants, depending on the filing, trading window, and measure examined. We also find little evidence that XBRL interacts with scriptability in a meaningful way. Overall, our study broadens our understanding of information processing costs and provides opportunities for new avenues of research.

We investigate executive employment gaps (hereafter, gaps) between the appointment of an external CEO at a public firm and the individual's prior executive position at a public company. These gaps cannot be reliably obtained from common databases. We hand-collect data for externally hired CEOs at public companies from 1992 to 2014. These CEOs represent approximately 40% of the 5,095 CEO successions and have a mean gap of 1.9 years. The gap increases to 3.2 years for the subset of new hires with a gap. We hypothesize that labor market frictions and executive skill sets contribute to the existence and length of these gaps. Using theories from labor economics, we predict (equilibrium) associations between two measures of “fit” (executive compensation and long-term match quality) and gaps (both existence and length). Finally, we provide descriptive evidence on what executives do (e.g., sit on boards, work for private consulting companies, or consume leisure) during their gaps. This project was subject to and published through a registered report process. Any tests that were not included in the accepted proposal are marked as unplanned analyses.

The position of left-wing authoritarianism (LWA), contrary to its right-wing counterpart, has long been contested within the psychological literature. Efforts to examine the nature of LWA have recently been revived. This research has, however, (1) been done exclusively in Western, liberal societies without any legacy of LWA ideas and (2) mostly ignored the economic axis of political beliefs. Previous operationalizations thus might capture only a specific constellation of LWA attitudes that are not universally representative. In this registered report, across three studies (total N = 1213), we developed a new reconceptualized LWA scale—the SLAV scale—and assessed its validity. The SLAV scale showed good factorial validity (with four interrelated but distinct domains of Anticapitalist Sentiment, Anticonventionalism, Antihierarhical aggression, and Censorship of right-wing ideas) and related expectedly to previous operationalizations of LWA. Moreover, we found expected correlations of SLAV domains to variables of political and social beliefs, and cognitive style. The one key exception is that the relations of SLAV to RWA and ideologically neutral authoritarianism were predominantly negative or non-significant. We consider the implications of our findings for research on authoritarianism in general, as well as how our results illustrate the need to reexamine the label of LWA.

Using an experiment to rule out reverse causality, we examine whether a small investment in a company's stock leads investors to purchase more of the company's products and adopt other views and preferences that benefit the company. We preregister our research methods, hypotheses, and supplemental analyses via the Journal of Accounting Research’s registration-based editorial process. We find little evidence consistent with these hypotheses for the average investor in our sample using our planned univariate hypothesis tests, and planned Bayesian parameter estimation shows substantial downward belief revision for more optimistic ex ante expectations of the treatment effects. In planned supplemental analyses, however, we do find that the effects of ownership on product purchase behavior and on regulatory preferences are intuitively stronger for certain subgroups of investors—namely, for investors who are most likely to purchase the types of products offered by the company and for investors who are most likely to vote on political matters. The results contribute to our understanding of the benefits of direct stock ownership and are informative to public company managers and directors.

Aims and objectives The aim of the study was to test the association between subthreshold depression and self-care behaviours in adults with type 2 diabetes (T2D) attending a tertiary healthcare service. Background Suboptimal adherence to self-care behaviours is associated with poor glycaemic control. The estimated point prevalence of subthreshold depression in people with T2D is 17%. Two previous studies have examined the association between subthreshold depression and self-care behaviours in T2D, reported observations were inconsistent. Design A cross-sectional observational study. Methods We surveyed adults with T2D attending a tertiary healthcare facility in Nepal. Self-care behaviours and subthreshold depression were assessed using the Summary of Diabetes Self-care Activities and the Patient Health Questionnaire-9, respectively. We used linear and logistic regression to test the association of subthreshold depression with total and individual self-care behaviours. Our reporting complies with STROBE reporting guideline for observational research. Results Just over a third (37%) of the participants had subthreshold depression. People with subthreshold depression had slightly lower total diabetes self-care score compared to those with no depression. More than half of participants with subthreshold depression had suboptimal adherence to diet, physical activity and foot care. Subthreshold depression was associated with total self-care score (B = −0.27, 95% CI: −0.54, −0.01). In addition, association between subthreshold depression and diet adherence was observed (AOR = 0.26, 95% CI: 0.15, 0.44). Conclusions Subthreshold depression is associated with decreased adherence to self-care behaviour in people with T2D. Identification and treatment of subthreshold depression in T2D may lead to better adherence to diabetes self-care behaviours. Relevance to clinical practice The recognition and treatment of subthreshold depression warrants further investigation as a strategy to improve the adherence to self-care behaviours.

Objectives Patients' expectations for antibiotics are among the strongest predictors of clinicians' decisions to overprescribe antibiotics. In this registered report, we used a signal detection theory framework to investigate the experimental effects of the communication interventions that family physicians can use to reduce patients' diagnostic uncertainty, and consequently, their antibiotic expectations. Methods UK participants (N = 769) read hypothetical consultations for respiratory tract infections and were randomly assigned to one of three conditions: standard information (control), recommended information about the nature of the illness and antibiotic efficacy (recommended communication) or recommended information accompanied by point-of-care test results (recommended communication and CRP). Using a multilevel Bayesian probit regression, we estimated both decision bias (criterion) and sensitivity (d-prime). Results Aligned with our bias hypotheses, participants displayed a more liberal antibiotic bias in the control condition compared to both the recommended communication (Δc = −1.34, 95% CI [−1.57, −1.11]) and the recommended communication and CRP (Δc = −1.73, 95% CI [−1.99, −1.48]) conditions. They also showed greater liberal bias in the recommended communication condition compared to the recommended communication and CRP condition (Δc = −0.39, 95% CI [−0.65, 0.13]). Aligned with our sensitivity hypotheses, participants displayed significantly higher sensitivity in both the recommended communication (Δd' = 2.34, 95% CI [1.92, 2.79]) and the recommended communication and CRP (Δd' = 2.49, 95% CI [2.08, 2.95]) conditions compared to control. Conclusions Simple, evidence-based communication strategies—particularly when combined with diagnostic test results—can reduce antibiotic expectations, offering practical tools for clinicians to support appropriate prescribing.

Prior work suggests that awareness of stereotypes about a person’s in-group can affect a person’s behavior and performance when they complete a stereotype-relevant task, a phenomenon called stereotype susceptibility (Shih, Pittinsky, & Ambady, 1999). In a preregistered confirmatory design, we found that priming Asian women with social identities associated with math stereotypes did not influence their performance on a subsequent mathematics exam, and hypothesized moderators did not account for the effect. The conditions necessary to obtain the original results are not yet fully understood.

Depressive disorders often show recurrent courses that cannot be sufficiently prevented by existing therapeutic protocols. In other affective disorders, recurrence has been linked to three mechanisms –spontaneous recovery, accelerated new/relearning, and reinstatement– which are related to the preservation of disorder-related memory traces even through successful extinction-based interventions. Reconsolidation-interference protocols aim to directly alter such traces by reactivating and destabilizing them before intervention. While this approach has shown benefits in fear, craving, and trauma-related symptoms, its application to depression remains untested. To our knowledge, this study provides the first experimental evidence of its utility in depression-like states. Sixty participants took part in a three-day, three-group, double-blind randomized controlled trial. On day one, helplessness was induced using a modified unsolvable anagram task. On day two, participants were randomized into three groups undergoing different interventions while completing another cognitive demanding task: (1) extinction, where participants experienced success from start to finish; (2) reconsolidation, where participants briefly reexperienced failure before succeeding; or (3) reactivation, where failure repeated. On day three, the helplessness task was presented again to evaluate susceptibility for recurrence across conditions. Behavioral, self-report, and EEG data were collected. Across test days, participants showed reduced motivation and performance, attributing failure to personal ability, confirming successful helplessness induction. However, interventions at day two produced no robust group differences on behavioral, self-report, or EEG measures. Exploratory analyses suggested that brain-derived neurotrophic factor (BDNF) levels may have mediated outcomes. Findings do not confirm reconsolidation-based behavioral interference as effective for depression-like helplessness. Nonetheless, exploratory results highlight BDNF as a potential mediator, warranting further study on its role in postretrieval extinction effects in depression.

Partition dependence is the phenomenon in which individuals’ evaluations of probabilities are influenced by the partitioning of the information in the way the information is presented or framed. In a Registered Report experiment with an American online Prolific sample (N = 603), we conducted a replication and extension of Studies 1a, 1b, 3 and 4 from a classic article by Fox and Rottenstreich (Fox & Rottenstreich 2003 Psychol. Sci. 14, 195–200 (doi:10.1111/1467-9280.02431)) demonstrating the phenomenon. They showed that participants’ estimations of an event’s likelihood shifted based on minor adjustments of the framing that suggested a change in partitioning perspective (‘ignorance prior’ priming). Based on a pre-registered replication evaluation criterion, we concluded a mostly successful replication of the findings of Fox and Rottenstreich (2003). Specifically, we found support for partition dependence in scenarios from Study 1a Items 1 and 2, Study 1b and Study 3, with weaker effects, yet with no consistent support for Study 1a Item 3 and Study 4. Our extensions further explored the robustness of partition dependence by examining participants’ probability evaluations of complementary events (happen versus not happen) and the impact of task order on judgement and decision making. Overall, the findings suggest support for partition dependence, yet as more nuanced and context-dependent than expected, and the need for further research to understand its mechanisms, robustness and implications across different contexts. Materials, data and code are available on at https://osf.io/g9czs/. This Registered Report has been officially endorsed by Peer Community in Registered Reports: https://doi.org/10.24072/pci.rr.100877.