Matthew W. Kirkhart

Examining the role of positive and negative affect in recovery from spine surgery

Summary Multivariable mixed‐model linear regression analyses illustrated the unique relation between postoperative positive affect and functional status and postoperative negative affect and pain interference and disability after spine surgery. Abstract Consistent evidence supports a significant association between lower positive affect and higher negative affect and increased pain and disability in adults with chronic pain. However, examining this relation in surgical populations has received little empirical consideration. The primary purpose of this study was to determine whether preoperative and postoperative positive and negative affect predict pain, disability, and functional status after spine surgery. A secondary objective was to assess the relation of depression to postoperative outcomes compared with positive and negative affect. Participants were 141 patients treated by spine surgery for lumbar or cervical degeneration. Data collection occurred at baseline and 6 weeks and 3 months postoperatively. Affect was measured with the Positive and Negative Affect Schedule. Multivariable mixed‐model linear regression analyses found that preoperative variables were not predictive of postoperative pain, disability and functional status. However, multivariable postoperative analysis found that 6‐week positive affect predicted functional status, and 6‐week negative affect predicted pain interference and pain‐related disability at 3 months following surgery. Postoperative depression demonstrated statistically significant and stronger associations with pain intensity, pain interference, and pain‐related disability at 3‐month follow‐up, as compared with negative affect. Results suggest that positive affect and depression are important variables to target when seeking to improve postoperative outcomes in a spine surgery population. Recommendations include postoperative screening for positive affect and depression, and treating depression as well as focusing on rehabilitation strategies to bolster positive affect so as to improve functional outcomes after spine surgery.

The relation between elevation and self-reported prosocial behavior: Incremental validity over the Five-Factor Model of Personality

With the development of the field of positive psychology, new constructs have made their way into the literature. One such construct, elevation, represents a positive moral emotion that is experienced when one witnesses the kind, moral behavior of others (Haidt, 2003). To date, few researchers have examined this construct. The current study examined elevation by locating it in the factor space of the Five-Factor Model of Personality, and determined its relation to the constructs of spiritual transcendence and self-reported prosocial behavior. A total of 188 student participants were recruited. Results indicated that Extraversion, Openness to Experience, Agreeableness, spiritual transcendence, and self-reported prosocial behavior were all positively correlated with elevation. Moreover, the results indicated that elevation provided significant incremental validity in predicting self-reports of prosocial behavior over and above the Five-Factor Model of Personality and spiritual transcendence. Clinical implications, limitations, and suggestions for future research are considered.

The nature of declarative and nondeclarative knowledge for implicit and explicit learning

Abstract Using traditional implicit and explicit artificial-grammar learning tasks, the author investigated the similarities and differences between the acquisition of declarative knowledge under implicit and explicit learning conditions and the functions of the declarative knowledge during testing. Results suggested that declarative knowledge was not predictive of or required for implicit learning but was related to consistency in implicit learning performance. In contrast, declarative knowledge was predictive of and required for explicit learning and was related to consistency in performance. For explicit learning, the declarative knowledge functioned as a guide for other behavior. In contrast, for implicit learning, the declarative knowledge did not serve as a guide for behavior but was instead a post hoc description of the most commonly seen stimuli.

Probable PTSD and Impairment in Witnesses of Work-Related Fatalities

According to the U.S. Bureau of Labor Statistics, steel, oil, and mining are among the nations most dangerous industries. This study assessed probable posttraumatic stress disorder (PTSD), depressive symptoms, life functioning, and well-being in a unique sample of 89 members of the United Steelworkers who reported directly witnessing an occupational fatality. Of the sample, 25.8% reported symptoms consistent with probable PTSD, while 21.3% reported symptoms consistent with subthreshold PTSD. These two groups differed significantly from the non-PTSD group on measures of depressive symptoms, well-being, and life functioning. These findings highlight the further need for assessment and intervention for workers exposed to fatalities.

INTRUSIVE EFFECTS OF IMPLICITLY PROCESSED INFORMATION ON EXPLICIT MEMORY

This study described the interference of implicitly processed information on the memory for explicitly processed information. Participants studied a list of words either auditorily or visually under instructions to remember the words (explicit study). They were then visually presented another word list under instructions which facilitate implicit but not explicit processing. Following a distractor task, memory for the explicit study list was tested with either a visual or auditory recognition task that included new words, words from the explicit study list, and words implicitly processed. Analysis indicated participants both failed to recognize words from the explicit study list and falsely recognized words that were implicitly processed as originating from the explicit study list. However, this effect only occurred when the testing modality was visual, thereby matching the modality for the implicitly processed information, regardless of the modality of the explicit study list. This “modality effect” for explicit memory was interpreted as poor source memory for implicitly processed information and in light of the procedures used, as well as illustrating an example of “remembering causing forgetting.”

Effect of pastoral crisis intervention training on resilience and compassion fatigue in clergy: A pilot study.

There has been growing concern about the emotional impact that responding to traumatic events might have on crisis interventionists. Pastoral care providers often provide crisis intervention services; however, many of these individuals have not received formal training in crisis intervention. This study used a longitudinal design to assess the effect of formal training in pastoral crisis intervention (PCI) in a sample of 39 clergy who completed a 3-day course. Demographic and standardized questionnaires, including the Connor-Davidson Resilience Scale-2 item (CD-RISC2) and the Professional Quality of Life Scale Version 5 (ProQOL), assessed resilience, and the two subcomponents of compassion fatigue (Burnout and Secondary Traumatic Stress), respectively. The clergy who received the training evidenced significantly higher resilience scores and significantly lower burnout and secondary traumatic stress scores, approximately 1 year after the training. These results provide preliminary support for the possible efficacy of formal training in PCI in clergy. Implications for intervention and additional assessment are offered.

Examining the Positive Cognitive Triad: A Link Between Resilience and Well-Being:

Extant literature links higher levels of resilience to overall well-being; however, the underlying mechanisms explaining this relation are unclear. Replicating and extending the study of Mak, Ng, and Wong, the present study investigated the “positive cognitive triad” of hope, world-view, and self-esteem as a possible mediator between resilience and well-being for the first time in an American sample. Participants (n = 198) completed online surveys of self-esteem, hope, view of the world, and resilience. Consistent with expectations, the triad was a significant mediator of the relation between resilience and well-being. These findings underscore the importance of developing interventions targeting the positive cognitive triad and examining the triad within the context of mental illness. Limitations and areas for future research are discussed.

Political Affiliation, Probable PTSD, and Symptoms of Depression in Iraq and Afghanistan Combat Veterans: A Pilot Study

Abstract Ideological commitment of military personnel has been associated with mitigating trauma and protecting mental health. This pilot study assessed whether Democratic and Republican political affiliation differentially predicted probable posttraumatic stress disorder (PTSD) and symptoms of depression in 62 male Iraq and Afghanistan combat veterans. The Liberalism-Conservatism Scale, the PTSD Checklist-Military Version (PCL-M), and the Patient Health Questionnaire–9 (PHQ-9) were assessment measures. Results revealed that Democratic combat veterans had stronger liberal attitudes than Republican combat veterans (r = 0.95). Moreover, of the 50% of the entire sample higher than the cutoff score of 50 on the PCL-M, 84.8% were Democrats compared with 10.3% of Republicans. On the PHQ-9, 46.9% of Democrats compared with 3.7% of Republicans were higher than the cutoff score of 20. These initial results suggest possible mechanisms of action, including differences in shattered world view assumptions, willingness to disclose emotional concerns, and physiological reactions between Democratic and Republican combat veterans.