Psychological Sciences

Introduction: Children and adolescents are not impervious to the unprecedented epidemic of opioid misuse in the United States. In 2016 more than 88,000 adolescents between the ages of 12–17 reported misusing opioid medication, and evidence suggests that there has been a rise in opioid-related mortality for pediatric patients. A major source of prescribed opioids for the treatment of pain is the emergency department (ED). The current study sought to assess the complex relationship between opioid administration, pain severity, and parent satisfaction with children’s care in a pediatric ED.

Methods: We examined data from a tertiary pediatric care facility. A health survey questionnaire was administered after ED discharge to capture the outcome of parental likelihood of providing a positive facility rating. We abstracted patient demographic, clinical, and top diagnostic information using electronic health records. Data were merged and multivariable models were constructed. 

Results: We collected data from 15,895 pediatric patients between the ages of 0–17 years (mean = 6.69; standard deviation = 5.19) and their parents. Approximately 786 (4.94%) patients were administered an opioid; 8212 (51.70%) were administered a non-opioid analgesic; and 3966 (24.95%) expressed clinically significant pain (pain score >/= 4). Results of a multivariable regression analysis from these pediatric patients revealed a three-way interaction of age, pain severity, and opioid administration (odds ratio 1.022, 95% confidence interval, 1.006, 1.038, P = 0.007). Our findings suggest that opioid administration negatively impacted parent satisfaction of older adolescent patients in milder pain who were administered an opioid analgesic, but positively influenced the satisfaction scores of parents of younger children who were administered opioids. When pain levels were severe, the relationship between age and patient experience was not statistically significant.

Conclusion: This investigation highlights the complexity of the relationship between opioid administration, pain severity, and satisfaction, and suggests that the impact of opioid administration on parent satisfaction is a function of the age of the child.

INTRODUCTION: Treatment indications for oligometastatic/oligoprogressive lung tumors are growing. Safety and lack of detrimental effect on patients' quality of life are critical for novel local therapies. METHODS: We tested that the additive effect of pulsed electric field (PEF) ablation with lower-dose stereotactic body radiation therapy (SBRT) on health-related quality of life (HRQoL) as a secondary endpoint in a prospective clinical trial. FACT-Lung Cancer Subscale (FACT-LCS) and FACT-General domain surveys were collected at screening, 3 months, and 12 months. Functional clinical data included forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and diffusing capacity of the lung for carbon monoxide (DLCO). RESULTS: Six patients with eight tumors were enrolled. Baseline well-being domain scores were: Physical 25.9 (Std Dev 2.3), Social 21.0 (Std Dev 6.9), Emotional 17.3 (Std Dev 4.7), Functional 21.2 (Std Dev 5.8), and LCS 19.4 (Std Dev 5.3). There were no significant changes following combined modality treatment in HRQoL domain scores or pulmonary function metrics after treatment. Lower EWB and SWB were associated with worse FVC and FEV1. CONCLUSION: In this small pilot study, no clinically meaningful declines in pulmonary function or patient-reported quality of life were observed at 3 months following combination therapy.

The unequal mathematics education system in the U.S. highlights the need to examine racial and ethnic differences in mathematics subjective task values as precursors to participation in mathematics-related careers. We investigated whether and to what extent mathematics subjective task values (i.e., interest, utility, and attainment) vary across the four largest U.S. racial/ethnic groups (i.e., Asian, Black, Latine, and White) among boys and girls, separately. We also tested whether these patterns replicated across high school years and across datasets. Using two U.S. large-scale longitudinal datasets (i.e., CAMP and HSLS), results showed that adolescents of color reported higher mathematics subjective task values than White adolescents, with differences favoring Asian over White adolescents and Black over Latine adolescents. These patterns were consistent across gender, though slightly more pronounced among boys, and replicated across both datasets. The findings demonstrate racial and ethnic variability in mathematics values within gender groups, highlighting the need for intersectional approaches to understanding adolescents’ motivational experiences and identifying the barriers that prevent Black and Latine adolescents from fully leveraging their motivational strengths in mathematics learning.

Growing work underscores the importance of understanding disturbances in positive valence or emotional processes in psychopathology. Despite evidence that substance use disorders, such as cannabis misuse, are associated with positive emotion processes, few studies have examined associations between cannabis use and clinically relevant disorders that centrally feature positive emotions (such as bipolar spectrum disorders) and associated positive emotion processes. The present study investigates associations between self-reported cannabis use and bipolar spectrum disorder (BSD) risk and mood severity, as well as three well-studied positive valence processes (i.e., positive emotion experience, reward responsiveness, and positive emotion valuation). Emerging adult college students who endorsed cannabis use (N = 968) were recruited from nine North American universities. Higher self-reported BSD risk was associated with greater cannabis-related interference with daily life, but not cannabis use frequency or difficulty stopping. Furthermore, higher positive emotion experience was associated with lower cannabis frequency, interference with life, and difficulty stopping. Greater reward responsiveness was associated with decreased cannabis interference in daily life. These findings highlight the importance of clinically relevant and basic positive emotion-relevant processes in understanding cannabis use.

Previous studies have identified a pattern of jointly elevated sympathetic vasoconstriction (indexed by total peripheral resistance, TPR) and increased cardiac vagal tone (indexed by heart rate variability, HRV) in non-Hispanic Black (NHB) adults relative to non-Hispanic White (NHW) counterparts in the United States, referred to as the cardiovascular conundrum. Whether a similar pattern is observed in other minority ethnic groups, and the role of emotion regulation strategies and socioeconomic status (SES), remains unclear. This study examined ethnic differences in TPR and HRV in emerging adults with Asian (n = 183), NHB (n = 82), Hispanic/Latino (n = 228), and NHW (n = 554) backgrounds, and tested the moderating role of emotion regulation strategies (expressive suppression and cognitive reappraisal) and SES. NHB adults showed higher resting TPR (suggesting greater vascular strain) and HRV compared to NHW counterparts and other minority groups. Although all minority groups reported greater use of expressive suppression than NHW adults, this was associated with higher TPR and HRV values only in the NHB group, particularly at lower SES. In contrast, greater use of cognitive reappraisal was associated with lower TPR in NHB individuals. These findings suggest that associations between emotion regulation strategies and cardiovascular parameters may differ across sociocultural contexts. In particular, expressive suppression may be linked to physiological patterns consistent with increased vascular strain among NHB emerging adults, especially under conditions of socioeconomic disadvantage.

Shared memories of event details are crucial to eyewitness testimony. When different people encode or recall the same event, similar scene-specific neural activity patterns emerge across individual brains. However, it remains unclear whether these patterns are specific to event details and how test expectancy (i.e., expecting free recall or general memory tests) and misinformation affect them. In this study, 100 participants were randomly assigned to view one of two versions of each event. Both versions featured identical scenarios, but with different details. About half of the participants were informed about the upcoming free recall before viewing events, while the others were told to expect a general memory test. Functional magnetic resonance imaging was used to record their brain activity during four stages: viewing original events, initial free recall, reading misinformation, and final free recall of original events. The neuroimaging data were analyzed based on the similarity of neural patterns across participants. Test expectancy increased the similarity of detail-specific neural activity patterns between individuals when they viewed original events in brain regions relevant for visual attention. Misinformation increased the likelihood of people forming shared false memories of event details. People who formed shared false memories exhibited similar detail-specific patterns of activity in the dorsomedial prefrontal cortex when reading misinformation. People who formed shared true memories exhibited similar detail-specific patterns of activity in the inferior parietal lobe when viewing original events, as well as in the ventrolateral prefrontal cortex and middle temporal gyrus when recalling them after exposure to misinformation. Our findings revealed that different brain regions of the default mode network play distinct roles in the encoding and recall of event details shared by individuals.