Browsing by Subject "Moderation"

Now showing 1 - 3 of 3
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    Coping is Complicated: Examining the Roles of Coping Strategies and Pain Self-Efficacy for Black Veterans with Chronic Pain
    (2024-12) Procento, Philip Matthew; Hirsh, Adam T.; Matthias, Marianne S.; Rand, Kevin L.; Stewart, Jesse C.
    Black patients with chronic pain routinely receive insufficient pain management, which contributes to myriad worse outcomes. This inadequate care stems from various factors, including systemic marginalization, provider bias, and patient-level factors. The present study focused on two patient factors: pain self-efficacy and coping strategies. It explored whether the relationship of pain intensity and pain interference was explained by active (less interference) and passive (greater interference) coping strategies, and it investigated if pain self-efficacy strengthened or weakened these mediating relationships. As part of a larger study, Black veterans with chronic pain completed measures assessing pain interference, coping strategies, and self-efficacy. Simple mediation analyses indicated that the relationship between pain intensity and interference was mediated by passive, but not active, coping. Higher pain intensity predicted greater passive coping, which led to worse pain interference. A parallel mediation analysis affirmed this mediating effect when controlling for active coping. Moderated mediation analyses found that pain self-efficacy moderated the mediating effect of passive, but not active, coping. Participants with lower (vs. higher) pain self-efficacy used more passive coping (in absolute terms) across pain intensity levels, but those with higher (vs. lower) self-efficacy experienced greater increases in their passive coping as their pain intensity increased. A parallel moderated mediation analysis affirmed this moderated mediation effect when controlling for active coping. These results suggest that passive coping is a possible mechanism by which pain intensity leads to interference among Black veterans with chronic pain, and that self-efficacy modulates this effect. Future research should replicate these results in other patient samples, investigate other possible moderators (e.g., PTSD), and design interventions to reduce the use of passive coping strategies while simultaneously increasing pain self-efficacy.
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    Internalized Racism and Mental Health: The Moderating Role of Collective Racial Self-Esteem
    (MDPI, 2024-10-29) Sanders, Steven M.; Williams, Tiffany R.; Berry, April T.; Garcia-Aguilera, Claudia; Robinson, Kiera; Martin, Reniece; Jones, Paigean; Psychiatry, School of Medicine
    Internalized racism is the internalization of beliefs about racism and colonization that contribute to the acceptance of negative messaging or stereotypical misrepresentations that inform perceptions about worth and ability. Internalized racism is associated with psychological distress in racially diverse people. Collective racial self-esteem is a potential protective factor that can serve as a moderator in reducing distress and facilitating psychological well-being. The sample for the present study consisted of 526 participants who self-identified as African American, Asian American/Pacific Islander, Latinx American, or American of Arab or Middle Eastern descent. The researchers used regression with the Process macro to investigate the potential moderating properties of collective racial self-esteem on the relationship between internalized racism and psychological distress in the sample. The findings indicated that specific domains of collective racial self-esteem moderated the internalized racism-psychological distress relationship.
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    Metacognition moderates the relationship between self-reported and clinician-rated motivation in schizophrenia
    (Elsevier, 2020-03-01) Luther, Lauren; Bonfils, Kelsey A.; Fischer, Melanie W.; Johnson-Kwochka, Annalee V.; Salyers, Michelle P.; Psychology, School of Science
    Introduction Prior work has found varied relationships between self-reported and clinician-rated motivation measures in schizophrenia, suggesting that moderators might impact the strength of this relationship. This current study sought to identify whether metacognition – the ability to form complex representations about oneself, others, and the world – moderates the relationship between self-reported and clinician-rated motivation measures. We also explored whether clinical insight and neurocognition moderated this relationship. Methods Fifty-six participants with a schizophrenia-spectrum disorder completed the Motivation and Pleasure Self-Report Scale and the clinician-rated motivation index from the Heinrichs-Carpenter Quality of Life Scale. Results Metacognition significantly moderated the relationship; self-reported and clinician-rated motivation were positively and significantly correlated only when metacognition was relatively high. Neither clinical insight nor neurocognition moderated the relationship. Discussion Metacognition appears to be a key variable impacting the strength of the relationship between self-reported and clinician-rated motivation measures and may help to partly explain the varied relationships observed in prior work. Using a metacognitive framework to guide assessment interviews and targeting metacognition in psychosocial treatments may help to improve the synchrony between self-perceptions and clinician ratings of motivation.