The purpose of this study is to present an exploratory investigation into the possibility of developing a projective technique for measuring interpersonal responsiveness. The projective technique explored here is a form of drawing analysis based on the drawing of a group made by each subject in a tested population.

The study of metacognition is rooted in the observation of behaviors under states of uncertainty (e.g., Smith et al., 1995). Individuals who are more responsive to uncertainty tend to show greater interference effects in a Stroop color-word naming task compared to those who are less responsive to uncertainty (Washburn, Smith, & Taglialatela, 2005). Individual differences in Stroop interference also have been shown to reflect relative differences in response competition (Washburn, 1994) and rule-maintenance ability (Kane & Engle, 2003). Why would individuals who respond to uncertainty most adaptively be characterized by the worst attention-control skills? The current study was designed to measure the individual contribution of sensitivity to response competition and rule maintenance ability to the pre-established relationship between Stroop interference and uncertainty responsiveness. Though participants performed as expected in both tasks, the previously reported relationship between Stroop interference and uncertainty responsiveness was not observed.

Extant literature suggests not only that social relationships are one context in which individuals may pursue personal strivings (Rusbult, Finkel & Kumashiro, 2009a), but also that individuals may assess their marital satisfaction based on their goal-striving successes (Li & Fung, 2011). Indeed, the degree to which partners appear to be responsive to one another's goals and ideals, termed partner responsiveness, has been linked with personal and relational well-being (Reis, Clark & Holmes, 2004; Rusbult et al., 2009a). Virtues such as commitment, trust, and compassion have been theoretically and empirically associated with upward cycles of partner responsiveness and personal and relational well-being (Canavello & Crocker, 2010; Reis & Gable, 2015). Partner responsiveness has also been consistently linked with goal attainment and well-being in the context of social relationships (Drigotas, 2002). The present study sought to bridge these two literatures by examining the potential mediating role of partner responsiveness between virtues and goal attainment. Data for the present study came from a cross-sectional survey of 840 heterosexual married couples living across the United States. Hypotheses were analyzed using an actor-partner interdependencemodel (Kenny, Kashy & Cook, 2006). Results suggested that partner responsiveness partially mediated actor effects of virtue on goal attainment, but fully mediated the partner effects of virtue on goal attainment. Gender effects emerged such that the direct effects of virtues on goal attainment were stronger for husbands than for wives. These results indicate that within-dyads (Kenny et al., 2006) gender difference variables (e.g. percent of family income earned) are likely to account for these differences. Study limitations and suggestions for future research are discussed.

Maternal responsiveness to infant needs is critical to child development. Few studies have attempted to identify basic processes that underlie responsiveness. Parenting theory suggests that distress tolerance (DT) may be important to understanding dysfunctional parenting. Distress tolerance refers to an individual’s ability to withstand subjective internal distress (e.g., uncomfortable thoughts, feelings). Despite its significance in the study of psychopathology, DT is not a well validated construct. Thus, the primary objectives of the present study were 1) to validate the construct of DT in a sample of perinatal women, and 2) to examine the concurrent and longitudinal associations between perinatal DT and maternal responsiveness. Eighty-six pregnant women in their third trimester and their respective informants completed an online survey of DT. At 4-months postpartum, a research team collected observational assessments of maternal responsiveness and a second assessment of self-reported DT. Factorial validity of DT was demonstrated through confirmatory factor analysis and suggested that DT is best represented as a multidimensional construct. Convergent validity of DT was demonstrated by small to moderate correlations (r’s = .16-.53) between self- and informant ratings of DT. Results of path analyses demonstrated a small association (r=.19) between prenatal DT and responsiveness; however, no association was found between postpartum DT and responsiveness. These findings suggest that targeting DT during pregnancy may improve outcomes for women and their infants. Distress tolerance skills are used in a number of empirically supported psychotherapies. Similarly, these skills could be incorporated into existing prenatal programs and parenting interventions to increase responsiveness and, ultimately, improve child outcomes.

Although research has begun to examine the factors which facilitate forgiveness in romantic relationships, there is currently limited empirical research examining the partner behaviours which promote or alternatively thwart forgiveness in romantic relationships. I examined the role of perceived partner responsiveness (showing understanding and validation) in mediating the link between offers of amends and forgiveness for real-life hurtful events. Results showed that perceived partner responsiveness emerged as a key predictor of forgiveness and as an important mediator of the relationship between amends and forgiveness. This meditational model was further moderated by event severity and relationship satisfaction, such that at high levels of event severity and low levels of relationship satisfaction, both amends and responsiveness showed unique, positive direct effects on forgiveness. Finally, exploratory analyses indicated that not all forgiveness-seeking behaviours are “created equal”—verbal behaviours that directly address the hurtful event appear to convey sincere amends and responsiveness while those behaviours (verbal and non-verbal) which do not directly address the hurtful event undermine forgiveness.

Although research has begun to examine the factors which facilitate forgiveness in romantic relationships, there is currently limited empirical research examining the partner behaviours which promote or alternatively thwart forgiveness in romantic relationships. I examined the role of perceived partner responsiveness (showing understanding and validation) in mediating the link between offers of amends and forgiveness for real-life hurtful events. Results showed that perceived partner responsiveness emerged as a key predictor of forgiveness and as an important mediator of the relationship between amends and forgiveness. This meditational model was further moderated by event severity and relationship satisfaction, such that at high levels of event severity and low levels of relationship satisfaction, both amends and responsiveness showed unique, positive direct effects on forgiveness. Finally, exploratory analyses indicated that not all forgiveness-seeking behaviours are “created equal”—verbal behaviours that directly address the hurtful event appear to convey sincere amends and responsiveness while those behaviours (verbal and non-verbal) which do not directly address the hurtful event undermine forgiveness.

Feeling that a partner is responsive to one’s needs is crucial to intimacy (Reis, Clark, & Holmes, 2004). Just as the well-known expression, “the squeaky wheel gets the grease,” suggests that people who voice the most complaints elicit the most support from others, existing theory and research suggest that the more one expresses one’s emotions, the more one’s partners should behave responsively—with caring, understanding, and validation (Reis et al., 2004; Reis & Shaver, 1988). However, I suspected that when a person frequently expresses negativity, individual negative disclosures seem less diagnostic of true distress, and thus elicit less responsiveness from partners. Building on Biernat, Manis, and Nelson’s (1991) shifting standards model, I predicted that people use person-specific standards—taking into account the expresser’s typical (baseline) level of negative expressivity—when interpreting a close other’s negative disclosures. Results of six studies employing both correlational and experimental methods supported the hypothesis that people who frequently express negativity may have the severity of their distress underestimated and elicit less concern and responsiveness from their partners when they make negative disclosures. These findings provide insight into why even close relationship partners may fail to behave responsively to each other’s negative disclosures.

Introduction: Understanding health service user perceptions of the quality of care is critical to developing measures to increase the utilisation of healthcare services. To relate patient experiences to a common set of standards, the World Health Organization (WHO) developed the concept of health system responsiveness. This measures what happens during user’s interactions with the system, using a common scale, and requires that the user has had a specified encounter, which they evaluate. The concept of responsiveness has only been used in a very few studies previously to evaluate healthcare sub-systems, such as mental healthcare. Since the concept of responsiveness had not been previously applied to a middle income country, such as Iran, there is a need to investigate its applicability and to develop a valid instrument for evaluating health system performance. The aim of this study is to assess the responsiveness of the mental healthcare system in Tehran, the capital of Iran, in accordance with the WHO responsiveness concept. Methods: This thesis is a health system research, based on qualitative and quantitative methods. During the qualitative phase of the study, six focus group discussions were carried out in Tehran, from June to August 2010. In total, 74 participants, comprising 21 health providers and 53 users of the mental healthcare system, were interviewed. Interviews were analysed through content analysis. The coding was synchronised between the researchers through two discussion sessions to ensure the credibility of the findings. The results were then discussed with two senior researchers to strengthen plausibility. Responses were examined in relation to the eight domains of the WHO’s responsiveness model. In accordance with the WHO health system responsiveness questionnaire and the findings of the qualitative studies, a Farsi version of the Mental Health System Responsiveness Questionnaire (MHSRQ) was tailored to suit the mental healthcare system in Iran. This version was tested in a cross-sectional study at nine public mental health clinics in Tehran. A sample of 500 mental health services patients was recruited and subsequently completed the questionnaire. The item missing rate was used to check the feasibility, while the reliability of the scale was determined by assessing the Cronbach’s alpha and item total correlations. The factor structure of the questionnaire was investigated by performing confirmatory factor analysis (CFA). To assess how the domains of responsiveness were performing in the mental healthcare system, I used the data collected during the second phase of the study. Utilising the same method used by the WHO for its responsiveness survey, we evaluated the responsiveness of outpatient mental healthcare, using a validated Farsi questionnaire. Results: There were many commonalities between the findings of my study and the eight domains of the WHO responsiveness model, although some variations were found. Effective care was a new domain generated from my findings. In addition, the domain of prompt attention was included in two newly labelled domains: attention and access to care. Participants could not differentiate autonomy from choice of healthcare provider, believing that free choice is part of autonomy. Therefore these domains were unified under the name of autonomy. The domains of quality of basic amenities, access to social support, dignity, and confidentiality were considered important for the responsiveness concept. Some differences regarding how these domains should be defined were observed, however. The results of the qualitative study were used to tailor a Farsi version of the MHSRQ. A satisfactory feasibility, as the item missing value was lower than 5.2%, was found. With the exception of the access domain, the reliability of the different domains in the questionnaire was within a desirable range. The factor loading showed an acceptable uni-dimensionality of the scale, despite the fact that the three items related to access did not perform well. The CFA also indicated good fit indices for the model (CFI = 0.99, GFI = 0.97, IFI = 0.99, AGFI = 0.97). The results of the mental healthcare system responsiveness survey showed that, on average, 47% of participants reported experiencing poor responsiveness. Among the responsiveness domains, confidentiality and dignity were the best performing factors, while autonomy, access to care and quality of basic amenities were the worst performing. Respondents who reported their social status as low were more likely to experience poor responsiveness overall. Autonomy, quality of basic amenities and clear communication were dimensions that performed poorly but were considered to be highly important by the study participants. Conclusion and implications: This is the first time that mental healthcare system responsiveness has been measured in Iran. Our results showed that the concept of responsiveness developed by the WHO is applicable to mental health services in this country. Dignity and confidentiality were domains which performed well, while the domains of autonomy, quality of basic amenities and access performed poorly. Any improvement in these poorly performing domains is dependent on resources. In addition, attention and access to care, which were rated high in importance and poor in performance, should be priority areas for intervention and the reengineering of referral systems and admission processes. The role of subjective social status in responsiveness should be further studied. These findings might help policymakers to better understand what is required for the improvement of mental health services.

Glucose is the primary metabolic signal reflecting the current energy state of the body. Glucose influences the excitability of neurons in the area postrema (AP), a circumventricular organ (CVO), prompting my interest in investigating whether the subfornical organ (SFO), another sensory CVO can also detect glucose. Using patch-clamp electrophysiology, we investigated the influence of changing glucose concentrations on the excitability of SFO neurons. In dissociated SFO neurons, altering the bath concentration of glucose (1mM, 5mM, 10mM) influenced the excitability of 49% of neurons tested (n=67). Glucose-inhibited (GI, hyperpolarized by increased glucose or depolarized by decreased glucose) and glucose-excited (GE, depolarized by increased glucose or hyperpolarized by decreased glucose) neurons were observed. GI neurons (27%, n=18) depolarized in response to decreased glucose (n=10, mean 4.6 ± 1.0 mV) or hyperpolarized in response to increased glucose (n=8, mean -4.4 ± 0.8 mV). In contrast, GE neurons (22%, n=15) depolarized in response to increased glucose (n=9, mean 6.4 ± 0.4) or hyperpolarized in response to decreased glucose (n=6, mean -4.8 ± 0.6 mV). These data show that glucose acts on a subpopulation of SFO neurons to produce both excitatory and inhibitory actions. Using voltage-clamp recordings two groups of SFO neurons were identified: those producing an outward current (GI) and those producing an inward current (GE) in response to increasing concentrations of glucose from 1 to 10 mM (n=23). The mean glucose-induced inward current had a reversal potential of -24 ± 12 mV (mean input resistance 2.0 ± 0.4 GΩ, n= 5), suggesting it may be mediated by a NSCC. The mean glucose-induced outward current (mean input resistance 1.7 ± 0.3 GΩ, n=7) had a mean reversal potential of -78 mV ± 1.2 mV (n = 5), suggesting it may be mediated by an activation of either K+ or Cl-current (ECl = -67 mV, EK = -89 mV). The SFO has projections to the PVN, a regulator of energy balance. I investigated the effects of increasing concentrations of glucose (1 to 10 mM) on the membrane potential of dissociated SFO neurons projecting to the PVN. Thirty percent of SFO-PVN neurons tested (n=10) responded with membrane hyperpolarizations (mean -4.2 ± 0.8 mV, n=3) suggesting a proportion of these cells are GI neurons. These data indicate that SFO neurons are glucose-responsive, which supports a role for the SFO as a regulator of energy balance. / Thesis (Master, Physiology) -- Queen's University, 2009-09-24 20:20:33.319

Momentary lapses of responsiveness frequently impair vigilance and sustained goal-directed behaviour, sometimes with serious consequences. The literature underpinning research into lapses of responsiveness has generally referred to these lapses as sustained attention lapses. Currently, this literature is divided between two competing theories. On one hand, there is the mindlessness theory and, on the other, the resource depletion theory. Mindlessness theorists propose that sustained attention lapses result from the subject disengaging from sustained tasks due to their monotony and low exogenous support for attention. Conversely, the resource depletion theorists propose that sustained attention lapses arise because demands for endogenus attentional resources outstrip supply, which leads to substantially delayed response and/or errors. In the present study, the predictions from the mindlessness and resource depletion theories were investigated by contrasting performance on attention tasks that differed in cognitive workloads. In the lesser demanding task, participants performed a simple psychomotor vigilance test (PVT). In the more demanding task, the PVT was undertaken concurrently with a continuous tracking task. The higher workload imposed by the dual task should reduce task monotony and the higher attentional requirement should increase the demand for attentional resources. If the mindlessness theory is correct the dual task should result in improved vigilance and reduce sustained attention lapses. If the resource theory is correct, the added attentional demand in the dual task should decrease vigilance and increase sustained attention lapses. However, there are other types of lapses that the literature has not always clearly separated from lapses of sustained attention. One such lapse is the microsleep. Microsleeps are brief periods of non-responsiveness (0.5–15 s) associated with overt signs of drowsiness. The two theories of vigilance impairment provide contrasting explanations in the traditional vigilance literature, but neither theory addresses lapses due to microsleep events, which remains largely ignored. Microsleeps are thought to emanate from a homeostatic drive for sleep/rest and a complex interaction between the brain’s arousal and attention systems and, therefore, depend on the type of task being undertaken to modulate propensity for microsleeps. For example, a more demanding and engaging task should counteract the homeostatic drive for sleep and rest by increasing arousal. If true, tasks that increase cognitive workloads may lead to a reduction in microsleeping propensity. We aimed to test the proposal that microsleep propensity is mediated by task by including in our study a continuous tracking task, which has previously been shown to elicit microsleeps. This task may, because of its consistency and repetitiveness, be considered a boring task. Moreover, it lacks any sudden stimulus onsets and, therefore, can be considered a less engaging task than the dual-task, which features sudden onsets. If more microsleeps were found in the tracking task compared to the dual task this would provide support for the proposition that a task-generated increase in mindlessness would increase microsleep rates. Conversely, if more microsleeps occur during the dual-task, then this suggests that factors other than mindlessness influence microsleeping. Twenty-three non-sleep deprived participants – 12 females and 11 males – with an average age of 26.3 years (range 21–40 years) and an average Epworth Sleepiness Score of 5.1 (range 0–10), completed the tasks during the early afternoon. They completed the two different tasks separately and concurrently (as a dual task), with the three conditions presented in a counterbalanced order. The PVT task was an extended 30-min version of the standard 10-min PVT used in many vigilance studies to match the duration of the continuous tracking task. In this task, the participant had to respond to a discrete randomly-presented visual stimulus. As per convention, failure to respond within 500 ms constituted an attention lapse. The 30-min continuous tracking task required the participant to use a floor-mounted joystick, to monitor and track a target randomly-moving on a computer screen. In this second task, lapses show as periods of flat tracking that, when associated with overt signs of sleepiness and at least 80 % partial eye-closure, are classified as microsleeps. The dual task was the PVT and tracking tasks being undertaken concurrently. Both sustained attention lapses and microsleep rates were affected by task differences. Using only the results from participants who had at least one sustained attention lapse in either the PVT or dual task (N = 23), it was found that a participant was more likely to experience a sustained attention lapse during the more demanding dual task then the PVT task (median 15 vs. 3; range 1–74 vs. 0–76, Wilcoxon z = 3.7, p = .001). Conversely, of those participants who had at least one microsleep in either the tracking or dual task (N = 12), they were more likely to experience a microsleep during the more monotonous tracking task than the dual task (median 0 vs. 0; range 0–18 vs. 0–1, Wilcoxon z = 2.3, p = .022). Time-on-task also had an effect. Sustained attention lapses increased with time-on-task during the PVT task and dual task (χ2 5, N 23 = 48.69, p = .001; and χ2 5, N 23 = 16.33, p = .006 respectively). Moreover, sustained attention lapses increased at a greater rate during the more cognitively demanding dual task (F5, 264 = 4.02, p = .002). Microsleeps also increased with time-on-task, but only during the tracking task and not during the dual task χ2 2, N 23 = 6.72, p = .035). The pattern of results supports the resource depletion theory over the mindlessness theory. When the cognitive workload increased, sustained attention lapses were more frequent. Conversely, the results also demonstrated that when the cognitive workload was decreased, the risk of lapsing due to microsleeps increased. Clarifying this relationship between cognitive workload and two types of lapses of responsiveness, sustained attention lapses and microsleeps, is important if we are to avoid inadvertently increasing lapses of responsiveness. Both sustained attention lapses and microsleeps can have serious real-life consequences and, therefore, any contribution towards a potent, preventative strategy is important.