Actor-partner Interdependence Model Research Articles

Perception of disease, dyadic coping, and the quality of life of oncology patients in the active treatment phase and their life partners: an approach based on the actor-partner interdependence model.

The aim of this study based on the Systemic Transactional Model was to examine the relationship between dyadic coping and (1) disease perception and (2) quality of life of a sample of cancer patients and their life partners. This cross-sectional study included 138 oncological dyads. The following questionnaires were used: Stress Appraisal Measure, Dyadic Coping Inventory, and European Organisation for Research and Treatment of Cancer QLQ-C30. Data collected was analysed by applying the actor-partner interdependence model. The perception of the disease as a threat as well as its centrality significantly negatively influences the positive forms of dyadic coping whilst the perception of the disease as a challenge has a significant positive influence on them. Dyadic coping does not influence symptoms but has significant influences on global health/quality of life. This study has highlighted new information regarding how couples cope with cancer. The results encourage the inclusion of the perception of the disease and dyadic coping in interventions that aim to improve the quality of life of cancer patients and their life partners.

Predictors of psychoneurological symptoms in cancer caregivers over time: Role of caregiving burden, stress, and patient symptoms.

In cancer patients, stress is associated with a psychoneurologic (PN) symptom cluster of depressed mood, anxiety, pain, fatigue, and sleep disturbance. The stress of caregiving may trigger similar symptoms among caregivers and warrants investigation. The purpose of this analysis was to characterize correlates of PN symptom burden in cancer caregivers. Cancer patient-caregiver dyads (n = 29) provided eight weekly symptom reports using a web-based survey. Primary and secondary stressors of caregiving were also assessed. Mixed models accounting for repeated measurement were used to assess the between- and within-dyad predictors of caregiver PN symptom burden. The interaction of patient PN symptom burden and stress was tested. Exploratory cross-lagged Actor-Partner Interdependence Models were used to assess the week-to-week interdependence between patient and caregiver symptoms. Caregivers most frequently reported feeling anxious (44% on average across timepoints), sleep problems (31%), fatigue (25%), and depressed mood (24%). Mixed models indicated that within dyads, greater hours of care and more patient symptoms were associated with greater caregiver PN symptom burden. Greater baseline perceived stress was also associated with higher caregiver PN symptom burden and moderated the association between patient and caregiver PN symptom burden. Cross-lagged Actor-Partner Interdependence Models indicated longitudinal interdependence among survivor and caregiver symptom burden. The findings provide preliminary evidence of the interrelationship of PN symptom burden in caregivers and patients and the potential for stress to amplify this interrelationship, with implications for symptom management and supportive care practice.

Couple communication quality and family resilience among Chinese gynecologic cancer patients and their spouses: a dyadic study

The purpose of this study was to explore the couple communication process for gynecologic cancer (GC) patients and their spouses. Particular attention was given to examining the relationship between couple communication quality and family resilience for GC dyads. In this cross-sectional study, 354 dyads were recruited from a gynecology ward of a public hospital in China. The patients and their spouses completed the Couples' Communication Quality Scale and the Family Hardiness Index. This study used the actor-partner interdependence model (APIM) to examine the effect of couple communication quality on family resilience in distinguishable GC dyads. Both GC patients and their spouses reported a moderate level of couple communication quality and family resilience, but spouses reported better couple communication and family resilience than patients. With the exception of perceived response, for which only a patient actor effect was observed, the factors of couple communication quality had significant actor effects on family resilience for both patients and spouses. Additionally, four significant partner effects were found: spouse self-disclosure, stress coping, and productive action positively predicted patients' family resilience, while patient normalcy crafting positively predicted spouses' family resilience. This study not only highlights the need for couple-based communication strategies for developing family resilience but also identifies differences in the experiences of patients and their partners, which provides a direction for future intervention research. Through the development of interventions at a dyadic level, spouses can be encouraged to actively engage in communication, which may promote mutual family resilience in a larger sense.

Psychological Aspects of Infertility - Results from an Actor-Partner Interdependence Analysis.

Introduction For some patients, undergoing medical treatment for infertility is a cause of major emotional stress which the couple needs to deal with together; it can be said that infertility is a shared stressor. From the literature it is known that a subjectively perceived sense of self-efficacy supports the patient's ability to cope adaptively with an illness. As the basis for this study, we assumed that high levels of self-efficacy are associated with low psychological risk scores (e.g., for anxiety or depressiveness), both in the patient themselves and in their partner. Accordingly, in infertility patients, targeted support to promote helpful self-efficacy expectations could represent a new counselling strategy that could enable psychologically vulnerable patients to better cope with the treatment procedure and treatment failures of medically assisted reproduction, making these patients less at risk with regard to psychosocial factors. Methods 721 women and men attending five fertility centers in Germany (Heidelberg, Berlin), Austria (Innsbruck), and Switzerland (St. Gallen, Basel) completed the SCREENIVF-R questionnaire to identify psychological risk factors for amplified emotional problems, as well as the ISE scale to measure self-efficacy. Using paired t-tests and the actor-partner interdependence model, we analyzed the data of 320 couples. Results Considering the study participants as couples, women had a higher risk score than men for four out of five risk factors (depressiveness, anxiety, lack of acceptance, helplessness). In all of the risk areas, it was possible to identify a protective effect from self-efficacy on the patient's own risk factors (actor effect). There was a negative correlation between the men's self-efficacy level and the women's feelings of depressiveness and helplessness (partner effect, man → woman). The women's self-efficacy levels had a positive correlation with acceptance and access to social support in the men (partner effect, woman → man). Conclusion Because infertility is generally something that a couple has to deal with together, future studies should focus on couples as the unit of analysis instead of just analyzing the men and women separately. In addition, couples therapy should be the gold standard in psychotherapy for infertility patients.

Harmonious passion and procrastination: an exploration based on actor–partner interdependence model

PurposeConsidering the potential economic losses this might bring about, researchers have begun to explore ways to mitigate procrastination. Drawing on the job demands-resources model and the spillover-crossover model, this study aims to investigate the association between harmonious passion and procrastination at the intra- and interpersonal levels.Design/methodology/approachThis study used a two-wave multisource questionnaire survey to acquire 256 cases nested in 128 coworker dyads from two hotels in Shanghai. Multilevel analysis and the actor–partner interdependence model were adopted to examine the hypotheses.FindingsThe results indicate that employees’ harmonious passion is indirectly negatively associated with procrastination (i.e., cyberslacking and soldiering) through workplace well-being at the intrapersonal level; employees’ harmonious passion is indirectly negatively associated with their coworkers’ procrastination (i.e., cyberslacking and soldiering) through the coworkers’ workplace well-being; and the crossover influence of employees’ harmonious passion on coworkers’ workplace well-being is contingent upon interpersonal conflict at the dyadic level, such that the crossover influence is stronger in condition of low rather than high interpersonal conflict.Practical implicationsHotels are suggested to provide training programs to employees for enhancing their capabilities to maintain harmonious passion and promote their communication skills to decrease the likelihood to experience interpersonal conflict.Originality/valueThis study offers a comprehensive insight into the association between harmonious passion and procrastination in hospitality employees, which extends the understanding of the outcomes of harmonious passion and the profit of harmonious passion at the interpersonal level.

Examining actor–partner effects between social dominance, relationship power, sexism, and marital quality

AbstractObjectiveThis study aimed to investigate the actor–partner effects of attitudes toward group‐based inequality as measured by social dominance orientation (SDO) and marital quality, and the indirect actor–partner effects of SDO on marital quality via ambivalent sexism and partners' perceptions of their own relationship power toward their partner.BackgroundPrevious research suggests that certain social attitudes play a role in relationship processes. However, it is unclear whether broader views on social inequality could have an effect on partners' marital quality.MethodNinety heterosexual married couples in Turkey (N = 180) responded via an online survey on SDO, marital quality, relationship power, and ambivalent sexism. Actor–partner interdependence model (APIM) and actor–partner interdependence model of mediation (APIMeM) were conducted to examine the direct and indirect actor–partner effects.ResultsFor indirect effects, men's SDO was negatively associated with their marital quality through their relationship power and hostile sexism. No significant indirect effects were found for women. However, women's relationship power was positively and their benevolent sexism was negatively associated with their own and their partners' marital quality.ConclusionOur findings help develop a more comprehensive understanding of how the political, social, and personal aspects of our lives are connected with one another.ImplicationsOur study points to the importance of exploring the topic of men's and women's views toward social inequality and its effects on their close relationships in clinical practice and relational education.

An actor-partner model of partner phubbing, mobile phone conflict, and relationship satisfaction between romantic partners in Liberia

Using the Actor-Partner Interdependence Model, this study investigates among Liberian couples whether partner phubbing predicts relationship satisfaction, both directly and indirectly via mobile phone conflict. Moreover, this study examines whether phubbing by men is less likely to lead to conflict than that by women given the differential power relations and income distributions in Liberian romantic couples. Using data from married, cohabiting, and couples living apart ( N = 128) in Liberia, a direct link was found between the phubbing behavior of women and partner’s (men) relationship satisfaction. Moreover, men and women’s phubbing behavior predicted their own and their partner’s experience of mobile phone conflict, which in turn predicted a decrease in relationship satisfaction. Power imbalance between men and women, as well as income disparity, were found to influence some of the relationships between partner phubbing, phone conflict, and relationship satisfaction, but did not give substantial support to the hypotheses that women would elicit more conflict than men in couples characterized by high power imbalance and income inequality. Overall, the study shows the importance of examining interdependence effects in phubbing research and supports that there is meaningful cross-cultural variation that warrants further scrutinizing.

Dyadic effects of cognitive function on depressive symptoms among middle-aged and older Chinese couples.

Although cognitive function and depressive symptoms have been suggested to be closely related, less attention has been paid to this association within married couples. This study explored the reciprocal dyadic relationship between cognitive function and depressive symptoms over time. This study used four waves of data from the China Health and Retirement Longitudinal Study and analyses were restricted to middle-aged and older couples aged 45 or older. Actor-partner interdependence model adjusted for confounding factors was employed to examine the reciprocal association between cognitive function and depressive symptoms at both the individual and couple levels. Measures of cognitive function consisted of episodic memory and mental status. Depressive symptoms were measured by the Center for Epidemiological Studies Depression scale. For both husbands and wives, cognitive function was reciprocally associated with depressive symptoms at the individual level. Spouses' lower cognitive function was significantly linked to their partners' greater depressive symptoms. However, ones' depressive symptoms were not related to their partners' cognitive function. These findings expand our knowledge about the dyadic relationship between cognitive function and depressive symptoms in Chinese couples. Effects of interventions for depression in middle-aged and older adults may be enhanced by considering the marital context.

Psychometric properties of the Spanish version of the Dyadic-Familial Relationship Satisfaction Scale

The Dyadic-Familial Relationship Satisfaction Scale (DFRSS) is a valid and reliable instrument to assess dyadic and familial dimensions of relationship satisfaction in cohabitant couples with children. The main goal of this research was to validate the Spanish version of the DFRSS (Sp-DFRSS) following the guidelines for cross-cultural adaptations. Three studies were conducted. In Study 1 (n = 151), an exploratory factor analysis using principal axis factoring and oblimin rotation was performed to examine the factor structure of the Sp-DFRSS. In Study 2 (n = 500), a confirmatory factor analysis showed that a two factor model (dyadic and familial) provided the best fit to the data. In Study 3 (n = 100), we examined relationship satisfaction using the Actor-Partner Interdependence Model. The Sp-DFRSS as a whole and its subscales presented adequate reliability in the three studies, with Cronbach’s alphas ranging from 0.87 to 0.95. Moreover, convergent and divergent validity of the Sp-DFRSS was analyzed in Studies 1, 2 and 3, and significant correlations between the Sp-DFRSS’ subscales, life satisfaction, negative and positive affect, attachment (anxiety and avoidance), and psychological well-being were found. The Sp-DFRSS has good psychometric properties in terms of validity and reliability, so that it may be used by the Spanish-speaking scientific community to measure relationship satisfaction.

Internalized homonegativity moderates the association between attachment avoidance and emotional intimacy among same-sex male couples.

The present study aimed to examine dyadic associations between attachment insecurity and emotional intimacy in same-sex male couples, and to investigate whether and how each partner's internalized homonegativity (IH) moderated these associations. The sample included 138 same-sex male couples. Both dyad members completed self-report measures of attachment insecurity, emotional intimacy, and IH. The actor-partner interdependence model with moderation analysis was applied. Indicated that higher levels of actor's and partner's attachment anxiety and attachment avoidance were associated with lower actor's emotional intimacy. IH moderated the partner effects of attachment avoidance on emotional intimacy. The partner's higher attachment avoidance was associated with one's own lower emotional intimacy at low (but not high) levels of one's own IH and at high (but not low) levels of the partner's IH. Findings suggest that the partner's attachment avoidance may differently affect one's own emotional intimacy depending on the IH levels of both dyad members. Helping partnered sexual minority men decrease attachment insecurity while recognizing their own and their partners' IH may promote relationship quality.

In the quest for effective factors of satisfaction with life: Insights from intra-couple interaction and financial management variables.

The aim of the study was to investigate the factors affecting life satisfaction with reference to particular reports from both partners in the relationship. The study was conducted within a group of 500 heterosexual couples. The accuracy of the actor-partner interdependence models (APIM) which offer in-depth insights into the dyadic relationships between female and male partners were estimated. The results of the chi-square test enabled us to reject the hypothesis of actor indistinguishability, therefore the model proposing distinguishability with respect to gender was explored further. The results suggest that women's credit management behavior patterns predict changes in her assessment of well-being. Moreover, the financial behavior patterns of women have an impact on the assessment of well-being as reported by their male partners. Moreover, shared goals and values turned out to be significant with regard to the assessment of quality of life for both women and men. The obtained results provide an insight into the difficulties experienced within relationships and indicate the importance of the roles assumed in various areas of financial management.

부모와 초등학생의 자아존중감, 스마트폰 의존도, 공격성, 삶의 만족도 간 구조적 관계

Objectives The purpose of this study was to identify the actor and partner effects of parent-child's self-esteem on smartphone dependency, and to examine the structural relationships among parent-child's self-esteem, smartphone dependency with child’s aggression and life satisfaction. Methods The data on a total of 2,072 pairs of a child(4th-6th grade in an elementary school) and their parents from the Korean Children and Youth Panel Survey 2018 was utilized as the research material and analysis was conducted based on the Actor-Partner Interdependence Model(APIM). Structural Equation Model(SEM) with ML and item parceling was also conducted to examine the difference in the path coefficients between the gender through multigroup path analysis. Results Results were as follows. First, self-esteem had a negative actor effect on smartphone dependency for both the parents and the child. Also, self-esteem was shown to have the parents' partner effect on smartphone dependency, but the child's partner effect was not found. Second, both the parents and the child’s self-esteem also had a negative effect on child’s aggression while smartphone dependency had a positive effect on child’s aggression. Child’s self-esteem was shown to have a positive effect on his life satisfaction, but the parents’ self-esteem was not verified its effect. In addition, both parents and child's smartphone dependency and child’s aggression mediated the effect parent-child's self-esteem had on child’s life satisfaction. Third, no significant gender differences were verified. Conclusions This study suggests that parents’ self-esteem and smartphone dependency will be used as key components of child’s life satisfaction as well as the its relevance relationships among child’s self-esteem, smartphone dependency and aggression.

The Role of Fear of Intimacy as Mediator between Self-Differentiation and Marital Relationship Satisfaction: A Dyadic Model

From the lens of Bowen's systemic family theory, this study employed the actor–partner interdependence model (APIM) to investigate the mediating effect fear of intimacy has on the association between self-differentiating and both partners’ relationship satisfaction. One hundred and forty-four non-clinical married couples ( N = 288) in enduring relationships were recruited. Results for actor effects revealed two mediating paths whereby, among both partners, self-differentiation was associated with their relationship satisfaction via fear of intimacy. Partner effect revealed that wives’ higher self-differentiation was associated with their lower fear of intimacy, which was linked, in turn, to husbands’ higher relationship satisfaction; unlike husbands’ fear of intimacy, which had no effect. Our results support Bowen's theoretical assumptions positing that self-differentiation indicates the ability for intimacy, which affects couple relationship satisfaction. Interestingly, the results highlight the role of the wives’ capability to establish intimate relationships on the husbands’ relationship satisfaction.

I am feeling stressed, are you?: Breast cancer patients and caregivers' inter-psychophysiological symptoms during the first year of breast cancer treatment

ObjectiveBreast cancer treatment can be a stressful time for both the patient and their caregiver. Both patients and caregivers can experience increases psychophysiological distress (e.g., pain interference, fatigue, anxiety, depressive symptoms, perceived health); however, it is not clear how psychophysiological distress before treatment is linked to distress during the first year of treatment both interpersonally and intrapersonally. MethodsThe present study recruited 54 patient-caregiver dyads during diagnosis before breast cancer treatment started. Both patients and caregivers complete self-reported surveys at baseline (before treatment), then 6-weeks, 6-months, and 12-months after the start of treatment. Specifically, we examine trajectories of psychophysiological change using Actor-Partner Interdependence Models (APIMs) Growth Curve Models and clinically specific times of psychophysiological influence using APIM path analyses. ResultsResults indicate that patient and caregiver psychophysiological distress before treatment is linked to psychophysiological distress during the first year of treatment both intrapersonally and interpersonally but somewhat differently depending on the symptom. For example, for perceived health there are no interpersonal effects and for fatigue caregivers appear to experience the majority of psychophysiological distress effects. ConclusionOur findings suggest that medical practitioners could evaluate patients and their caregivers for psychophysiological distress prior to breast cancer treatment and consider referrals to therapy or psychoeducation to help with symptom management throughout the first year of treatment.

The influence of patient and caregiver depression on patient self-care and caregiver contribution to self-care in ostomy: A dyadic analysis.

To explore the association between patient and caregiver depression and patient self-care and caregiver contribution to self-care in the context of ostomy care. Self-care is essential for ostomy patients and their caregivers. The ostomy self-care process can be considered a dyadic phenomenon in which the patient and the caregiver interact together and work as a team. The presence of depressive symptoms may limit the patient's ability to perform self-care and caregivers' abilities to engage in caregiving tasks. Research into the dyadic influence of depression on self-care behaviours from the perspective of ostomates and their caregivers is still in its infancy. Secondary analysis of a multicentre, cross-sectional study. The STROBE checklist was used to report the present study. Patient-caregiver dyads were recruited from eight ostomy outpatient clinics from February 2017 to May 2018. Depression was assessed with the nine-item Patient Health Questionnaire in both patients and caregivers. Patient self-care was evaluated with the Ostomy Self-Care Index, and caregiver contribution to self-care was assessed with the Caregiver Contribution to Ostomy Self-Care Index. Both instruments measure the dimensions of maintenance, monitoring and management. The actor-partner interdependence model was performed for the dyadic analysis. In total, 252 patient-caregiver dyads (patients: 69.8% male, mean age 70.05; caregivers: 80.6% female, mean age 58.7) were enrolled. Patient depression was positively associated with caregiver contribution to self-care maintenance. Caregiver depression was negatively associated with self-care management. These findings add a better understanding of the reciprocal influence of dyadic depression on patient and caregiver contributions to self-care in ostomy contexts was found. Patient and caregiver depression influence patient self-care and caregiver contribution to self-care. Therefore, clinicians should assess and treat depression in both members of the dyad to improve self-care.

Older Parents’ Cynical Hostility and Their Relationships with Their Adult Children: A Longitudinal Dyadic Study of North American Couples

Older adults' relationships with their children are often a source of reciprocal emotional and instrumental support, but also of strain. Cynical hostility is a cognitive schema, according to which people cannot be trusted. Previous studies showed that cynical hostility has adverse implications for social relationships. Little is known about the possible outcomes of parental cynical hostility on older adults' relationships with their children. Two waves of the Health and Retirement Study and Actor-Partner Interdependence Models were used to examine the way spouses' cynical hostility at Time 1 is associated with their own and their spouse's relationship with the children at Time 2. Both partners' cynical hostility predicts his or her own strain in the relationship with the children, and for husbands, their spouse's cynical hostility also predicts strain. For husbands only, their own cynical hostility is associated with reduced perceived support from their children. Finally, a husband's cynical hostility is associated with both partners' reduced contact with their children. These findings illuminate the social and familial costs of cynical hostility in old age, suggesting that older adults with higher levels of cynical hostility may be more susceptible to strained relationships with their children.

Adult attachment as a predictor of maternal gatekeeping among new parents

AbstractThis study examined the associations between expectant couples' adult attachment styles and new mothers' gatekeeping (i.e., maternal behaviors that may inhibit or encourage father involvement in parenting) at the transition to parenthood. Data were drawn from a study of 182 different‐gender dual‐earner couples followed from the third trimester of pregnancy through 3 months postpartum. In the third trimester, expectant parents reported their attachment anxiety and avoidance. At 3 months postpartum, mothers and fathers reported on mothers' gate opening and gate closing behaviors. Also, at 3 months postpartum, maternal gate opening and gate closing were coded during mother–father–infant interactions in play and caregiving. Actor–Partner Interdependence Models were conducted in IBM SPSS AMOS 21.0. Findings indicated that higher maternal anxiety predicted higher mother‐reported maternal gate closing, whereas higher paternal avoidance and higher paternal anxiety predicted lower father‐reported maternal gate opening. During caregiving, higher paternal anxiety predicted higher observed maternal gate closing, and higher maternal anxiety predicted lower observed maternal gate opening. Findings reveal the importance of attachment in coparenting relationships among new parents, as attachment anxiety and avoidance may shape maternal behaviors encouraging or hindering father involvement in parenting.

Effects of mandatory homeschooling during COVID-19 on conflict in romantic couples.

In early 2020, schools across Canada closed due to the COVID-19 pandemic, requiring parents to homeschool their children. We examined the association between homeschooling and romantic conflict among couples during the COVID-19 pandemic. Canadian couples (N = 756) completed online measures, including whether they were homeschooling, hours spent homeschooling, and romantic conflict during the month of April 2020. Two hundred ten couples (27.8%) reported that they were homeschooling their children during this period, with 173 (22.9%) couples homeschooling due to the pandemic. Multilevel regressions were used to examine the association between homeschooling status and romantic conflict, and actor-partner interdependence models (APIMs) were used to examine the association between homeschooling hours and romantic conflict among homeschoolers. In our APIM analyses, significant links between hours spent homeschooling and romantic conflict were observed, even when controlling for demographic variables. We found significant actor effects, where an individual's own homeschooling hours were positively related to the conflict they enacted toward their partner, and significant partner effects, where the partner's homeschooling hours were positively related to conflict received by the individual. Among all couples, we found significant positive associations between homeschooling status (i.e., nonhomeschooler or homeschooler) and both types of romantic conflict. However, these associations were nonsignificant when controlling for demographic variables. Our findings suggest the number of hours spent in homeschooling may be an important contributor to romantic conflict between partners during the pandemic. We discuss implications for schools and governments in providing additional support for families homeschooling children during mandated school closures. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

"A laugh a day keeps the failure away": The role of self-enhancing humor and host country community embeddedness in career satisfaction of dual-earner expatriate couples.

For dual-earner expatriate couples (DEECs), it is particularly challenging to achieve career satisfaction after relocating to another country and the associated career transitions. While studies have addressed the strenuous career pathways of individuals in DEECs, the identification and empirical analysis of resources that may contribute to the attainment of career satisfaction remains a desideratum. This research investigates the impact of self-enhancing humor and community embeddedness on individual career satisfaction and the crossover effects of humor on that of the partners in DEECs. Using data from 109 DEECs in Europe and Actor-Partner Interdependent Model (APIM), the results show that embeddedness in one's community mediated the relationship between humor and career satisfaction. The study also unfolded the crossover effects of humor within couples: Men's humor promoted their female partner's community embeddedness, which, in turn, promoted women's career satisfaction. This study entails fruitful implications for future research on DEECs and practical recommendations for relevant stakeholders to facilitate the careers of DEECs.

Dyadic positive and negative religious coping among older Singaporean couples and marital satisfaction.

Difficulties faced in life can affect marital relationships and such troubles may be dealt with in a multitude of ways, including coping religiously. The present study examined how religious coping, either in a positive or negative manner, may have an impact on marital satisfaction. Importantly, this association was studied dyadically in a sample of religiously diverse (Buddhists, 32.3%; Taoists, 17.6%; protestant Christians, 14.1%; and others who did not identify with a specific religion, 19.1%), married older Singaporean adults (N = 1928; 964 couples). Using actor-partner interdependence modeling, we found significant actor, partner, and combined actor-partner effects for positive and negative religious coping on marital satisfaction. Specifically, marital satisfaction was highest when both spouses reported high levels of positive religious coping and low levels of negative religious coping. Taken together, these findings suggest that it is the simultaneous act of either greater positive or lower negative religious coping by both spouses that is related to higher marital satisfaction. (PsycInfo Database Record (c) 2022 APA, all rights reserved).