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Suppressing the expression of negative emotions tends to undermine individuals' and their partners' wellbeing. However, sometimes expressive suppression may be relatively innocuous given that individuals commonly withhold negative emotions in order to maintain close relationships, and this may be especially the case when expressive suppression is enacted by people who exhibit amplified expressions of negative emotions, such as those high in attachment anxiety. The current research examined when and for whom expressive suppression may be more or less costly by testing whether the curvilinear effect of individuals' expressive suppression on individuals' and partners' outcomes is moderated by individuals' attachment anxiety. Our results across 3 dyadic studies revealed a linear effect of expressive suppression when predicting individuals' outcomes: greater expressive suppression had costs for individuals (lower relationship satisfaction, reported responsiveness and discussion success, and greater discussion threat). Furthermore, in 4 of the 5 models, a moderated curvilinear effect of expressive suppression emerged when predicting partners' outcomes. For individuals low in attachment anxiety, low levels of expressive suppression did not incur costs for their partners' relationship satisfaction, perceptions of individuals' responsiveness, discussion success, and discussion threat. Once expressive suppression surpassed moderate levels, however, greater expressive suppression had a detrimental effect on partners' outcomes. In contrast, for individuals high in attachment anxiety, the negative effect of moderate-to-high levels of expressive suppression on partners' outcomes was attenuated. These novel results demonstrate how considering curvilinear methods can uncover when and for whom expressive suppression may be more or less costly in intimate relationships. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Suppressing emotional expressions can hide one's needs from relationship partners and thus prevent partners from providing support. Nevertheless, suppressing expressions may help people maintain more favorable evaluations of partners who are ultimately unsupportive because people may attribute a lack of support to partners being unaware of their needs. Thus, given that depressive symptoms reduce provisions of support, people with partners experiencing depressive symptoms may remain more satisfied to the extent that they previously suppressed emotional expressions. We tested these ideas in 1 experiment, 1 cross-sectional study, and 1 longitudinal study. In Study 1, participants imagined either expressing or suppressing their emotions, imagined their partner was either supportive or unsupportive to their needs, and reported their perceptions of their partner. In Studies 2 and 3, newlywed couples reported their depressive symptoms, their marital satisfaction, and the extent to which they suppressed their emotional expressions cross-sectionally (Study 2) or every year for 2 years (Study 3). Results revealed that people with unsupportive partners or partners high in depressive symptoms made more benevolent attributions for their partners' unsupportive behavior and remained more satisfied with their partners to the extent that they suppressed their emotional expressions; however, people with supportive partners or partners low in depressive symptoms became more dissatisfied with their partners to the extent that they suppressed their emotional expressions. These results highlight the benefits of dyadic theoretical perspectives by revealing that qualities of the partner moderate the effects of expressive suppression. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

In this article, we synthesize existing literatures across numerous domains to introduce a novel model—the Relationship Problem Solving (RePS) model—for understanding the process through which romantic partners influence one another to resolve relationship problems. The first section briefly describes the key constructs and stages of the model. The second section details the interpersonal behaviors that influence various intrapersonal factors (e.g., affect, self-efficacy) that ultimately influence partners’ motivation and ability to progress through the stages of the model. The third section uses the model to generate novel predictions that suggest that the effectiveness of these interpersonal behaviors often depends on contextual factors. Finally, the fourth section discusses the implications of this model for understanding relationship problem solving, highlights the need to consider the role of context in the problem-solving process, and offers numerous specific predictions to be addressed by future research.

Although forgiveness can have numerous benefits, it can also have a notable cost-forgiveness can allow transgressors to continue behaving in ways that can be hurtful (McNulty, 2010, 2011). Accordingly, two studies tested the prediction that the implications of forgiveness for whether the partner transgresses or fails to behave benevolently depend on whether forgivers regulate partners away from future transgressions and toward benevolent behaviors. Study 1 was an experimental study of emerging adult couples in which participants were (a) asked to report their partners' tendencies to engage in partner-regulation behaviors, (b) led to believe their partners were either forgiving or unforgiving, and (c) given the opportunity to transgress against their partners. Study 2 was a longitudinal study of newlywed couples in which participants were (a) asked to report their tendencies to forgive their partners, (b) observed during problem-solving discussions, and then (c) asked to report their satisfaction with their partners' considerateness every 6 months for 4 years. Both studies provided evidence that direct oppositional partner-regulation behaviors moderate the implications of forgiveness for partner behavior. Among intimates who demanded more change, forgiveness was associated with the partner transgressing less (Study 1) and compromising more (Study 2), as well as participants being more satisfied with their partners' considerateness over time (Study 2); among intimates who demanded less change, forgiveness was associated with these outcomes in the opposite direction. These findings suggest that supplementing forgiveness with partner-regulation behaviors can help nondistressed couples avoid the undesirable outcomes and maximize desirable outcomes associated with forgiveness. (PsycINFO Database Record

Previous literature examining parent-child aggression (PCA) risk has relied heavily upon mothers, limiting our understanding of paternal risk factors. Moreover, the extent to which factors in the couple relationship work in tandem with personal vulnerabilities to impact PCA risk is unclear. The current study examined whether personal stress and distress predicted PCA risk (child abuse potential, over-reactive discipline style, harsh discipline practices) for fathers as well as mothers and whether couple functioning mediated versus moderated the relation between personal stress and PCA risk in a sample of 81 couples. Additionally, the potential for risk factors in one partner to cross over and affect their partner's PCA risk was considered. Findings indicated higher personal stress predicted elevated maternal and paternal PCA risk. Better couple functioning did not moderate this relationship but partially mediated stress and PCA risk for both mothers and fathers. In addition, maternal stress evidenced a cross-over effect, wherein mothers' personal stress linked to fathers' couple functioning. Findings support the role of stress and couple functioning in maternal and paternal PCA risk, including potential cross-over effects that warrant further inquiry.

Contemporary perspectives on relationship commitment posit that intimates decide whether or not to maintain a relationship based on their commitment to that relationship, and that they base such commitment partially on their current satisfaction with that relationship. Nevertheless, given that ending a relationship requires knowing about both the current state of the relationship and the likely future state of the relationship, we propose that people base their commitment to a relationship more on their expected future satisfaction with the relationship than on their current satisfaction with that relationship. Six studies provided evidence for these ideas. Study 1 demonstrated that expected satisfaction is shaped by not only current satisfaction but also several unique indicators of the likelihood of future satisfaction, including anticipated life events, plans to improve the relationship, and individual differences. Then, using a combination of cross-sectional, experimental, and longitudinal methods, Studies 2 through 6 demonstrated that (a) expected satisfaction was a stronger predictor of relationship commitment, maintenance behaviors, and/or divorce than was current satisfaction and (b) expected satisfaction mediated the association between current satisfaction and these outcomes. These findings highlight not only the need to incorporate expected satisfaction into extent perspectives on commitment, but also the importance of expectations for decision-making processes more broadly. (PsycINFO Database Record

Neurocognitive impairment has been found to be a marked feature in bipolar disorder (BD), also in the early phase of the illness. The longitudinal course of neurocognitive functioning, however, remains sparsely investigated. The aims of the study were to investigate the course of neurocognitive function in BD I, and to what degree neurocognitive change or stability is observed also on the individual level. Forty-two patients and 153 comparable healthy controls were assessed at baseline and one-year follow-up. Compared to the healthy control (HC) group BD I patients perform significantly poorer at both baseline and follow-up across all neurocognitive domains and on most neurocognitive subtests. Neurocognitive impairment remained stable for most patients from baseline to follow-up, both on a group level and when investigating individual trajectories, indicative of a relatively stable course of neurocognitive functioning in the early phase of BD I.

Background There are indications that low S-25(OH)D is associated with increased disease severity in psychotic disorder. Our first aim was to investigate the relations between low S-25(OH)D and positive, negative and depressive symptoms. Our second aim was to explore if associations between S-25(OH)D and symptoms were influenced by levels of inflammatory markers. Methods Participants (N = 358) with a medical history of one or more psychotic episodes were recruited. Current symptomatology was assessed by The Structured Interview for the Positive and Negative Syndrome Scaleanalyzed by a five-factor model. The Calgary Depression Scale for Schizophrenia was used to assess depression and suicidal ideation. Blood samples were analyzed for S-25(OH)D, CRP, sTNF-R1, IL-Ra and OPG. We performed bivariate correlations and multiple regression models to evaluate the effect of S-25(OH)D on the outcomes. Results Low S-25(OH)D was significantly associated with negative symptoms (adjusted R2 = 0.113, F(6,357) = 8.58, p < 0.001) and with depression (adjusted R2 = 0.045, F(4,357) = 5.233, p < 0.001) when adjusting for possible confounding factors (i.e. gender, education, diagnose, hospitalization status, ethnicity, season and thyroid status). CRP was correlated with both S-25(OH)D (rho = − 0.13, p = 0.02) and negative symptoms (rho = 0.14, p = 0.01), but did not act as a mediator. The correlations between S-25(OH)D and the inflammatory markers sTNF-R1, IL-Ra and OPG were not significant. Conclusion There is a strong association between low S-25(OH)D and higher negative and depressive symptoms in psychotic disorders. Randomized controlled trials should be performed to investigate the effect of vitamin D supplementation as adjuvant treatment strategy in patients with prominent negative or depressive symptoms. © 2016. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/

People regularly encounter tempting alternatives to their relationship partners, and it has been argued that paying attention to desirable alternatives increases the risk of infidelity. However, whether the temptation of noticing attractive alternatives leads to actual infidelity should depend on the ability to resist such temptation. More specifically, taking heed of attractive others should increase the likelihood of infidelity only when people lack self-regulatory ability. One experiment and one longitudinal study of newlyweds both demonstrated that the implications of attending to attractive alternatives for infidelity depended on participants' self-regulatory ability to resist such temptations. Specifically, the tendency to notice attractive alternatives was associated with greater infidelity among those with poorer self-regulatory ability, but not among those with greater self-regulatory ability. These results further understanding about how people can maintain and protect their relationships in the face of temptation. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Intimates often discuss the causes of, and solutions to, their relationship problems with their partners, and this information can shape partners' behavior and thus facilitate problem resolution. Partners' ability to encode and later recall such discussions should lead to greater declines in the severity of those problems. This brief report presents the results from a broader longitudinal study in which newlywed couples completed tasks assessing their working memory capacity (WMC), engaged in problem-solving discussions, recalled those discussions after a short delay, and then reported the severity of the problems discussed over the course of a year. Greater WMC among partners was associated with greater declines in the severity of a relationship problem, mediated by partners' recall of the discussion of that problem, suggesting that WMC facilitated the long-term memory encoding of the problem discussion. This study is among the first to suggest that individual differences in basic cognitive abilities may affect conversation processing and recall, and thereby close relationships. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Direct and overt visible support promotes recipients' relationship satisfaction but can also exacerbate negative mood. In contrast, subtle and indirect invisible support can bypass costs to mood, but it is unclear whether it undermines or boosts relationship satisfaction. Because invisible support is not perceived by recipients, its relational impact may be delayed across time. Thus, the current research used three dyadic daily diary studies (total N = 322 married couples) to explore, for the first time, both the immediate (same day) and lagged (next day) effects of visible and invisible support on recipients' mood and relationship satisfaction. Consistent with prior research, visible support was associated with recipients reporting greater relationship satisfaction and greater anxiety the same day. In contrast, but also consistent with prior research, invisible support had no significant same-day effects, and thus avoided mood costs. Nevertheless, invisible support was associated with recipients reporting greater relationship satisfaction the next day. Study 3 provided evidence that such effects emerged because invisible support was also associated with greater satisfaction with partners' helpful behaviors (e.g., household chores) and relationship interactions (e.g., time spent together) on the next day. These studies demonstrate the importance of assessing different temporal effects associated with support acts (which may otherwise go undetected) and provide the first evidence that invisible support enhances relationship satisfaction but does so across days. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Three studies demonstrated that conception risk was associated with increased motivations to manage weight. Consistent with the rationale that this association is due to ovulatory processes, Studies 2 and 3 demonstrated that it was moderated by hormonal contraceptive (HC) use. Consistent with the rationale that this interactive effect should emerge when modern appearance-related concerns regarding weight are salient, Study 3 used a 14-day diary to demonstrate that the interactive effects of conception risk and HC use on daily motivations to restrict eating were further moderated by daily motivations to manage body attractiveness. Finally, providing evidence that this interactive effect has implications for real behavior, daily fluctuations in the desire to restrict eating predicted daily changes in women’s self-reported eating behavior. These findings may help reconcile prior inconsistencies regarding the implications of ovulatory processes by illustrating that such implications can depend on the salience of broader social norms.

Intimates regularly confront their partners to motivate them to change undesirable behaviors. Nevertheless, contextual perspectives suggest that qualities of the partner may determine the implications of such attempts. Consistent with these ideas, a pilot study of romantic relationships, an observational study of newlyweds, and a diary study of married couples demonstrated that partner depression moderates the association between confrontational partner-regulation behaviors and partners’ motivation, such that confrontational behaviors were associated with marginally greater motivation to resolve problems among partners who were experiencing relatively few depressive symptoms, but significantly less motivation among partners who were experiencing relatively more depressive symptoms. Furthermore, Study 2 provided evidence for the mechanism of these effects—relationship self-efficacy. Finally, these studies also demonstrated that benevolent behaviors were particularly motivating for partners who were experiencing more depressive symptoms. These findings highlight the important roles played by depression, relationship self-efficacy, and context in interpersonal communication.

Objectives Due to limited research on the association between recurrence of mood episodes and the longitudinal course of neurocognitive functioning in early phase bipolar I disorder (BD I), the impact of recurrence on neurocognition remains unclear. Further, a strong correlation between neurocognitive impairment and functional impairment has been demonstrated. The longitudinal relationship between neurocognitive impairment and functional outcome in relation to recurrence is, however, not established. Methods The current study investigated the longitudinal relationship between neurocognition, recurrence of mood episodes and functional outcome in a sample of first-treatment (FT) BD I patients (N = 42), with and without relapse, during a 1-year follow-up period. The longitudinal course of neurocognitive functioning in the patients was also compared to that of a group of healthy controls (N = 143). Results Compared to both patients with relapse and healthy controls, no-relapse patients showed neurocognitive improvements. The polarity of the relapse episodes was mostly depressive, and for the no-relapse patients, reduction of symptoms was associated with neurocognitive improvement. No-relapse patients showed better global and occupational functioning. Conclusions The current study found different neurocognitive and functional trajectories in FT BD I patients with and without relapse, with differences at follow-up to some degree being mediated by current symptoms. The current findings highlight the importance of treatment focusing on neurocognition and symptom states with the aim of improving functional recovery.

Do people who feel good about themselves have better relations with others? Although the notion that they do is central to both classic and modern theories, there is little strong evidence to support it. We argue that one reason for the lack of evidence is that prior research has relied exclusively on explicit measures of self- and relationship evaluation. The current longitudinal study of newlywed couples used implicit measures of self- and partner evaluation, as well as explicit measures of self-, relationship, and partner evaluation, to examine the link between self-evaluations and changes in relationship evaluations over the first 3 years of marriage. Whereas explicit self-evaluations were unrelated to changes in all interpersonal measures, implicit self-evaluations positively predicted changes in implicit partner evaluations. This finding adds to previous research by highlighting the importance of automatic processes and implicit measures in the study of close interpersonal relationships.

Attachment theory provides a useful framework for predicting marital infidelity. However, most research has examined the association between attachment and infidelity in unmarried individuals, and we are aware of no research that has examined the role of partner attachment in predicting infidelity. In contrast to research showing that attachment anxiety is unrelated to infidelity among dating couples, 2 longitudinal studies of 207 newlywed marriages demonstrated that own and partner attachment anxiety interacted to predict marital infidelity, such that spouses were more likely to perpetrate infidelity when either they or their partner was high (vs. low) in attachment anxiety. Further, and also in contrast to research on dating couples, own attachment avoidance was unrelated to infidelity whereas partner attachment avoidance was negatively associated with infidelity indicating that spouses were less likely to perpetrate infidelity when their partner was high (vs. low) in attachment avoidance. These effects emerged controlling for marital satisfaction, sexual frequency, and personality, did not differ across husbands and wives, and did not differ across the two studies, with the exception that the negative association between partner attachment avoidance and own infidelity only emerged in one of the two studies. These findings offer a more complete understanding of the implications of attachment insecurity for marital infidelity and suggest that studies of unmarried individuals may not provide complete insights into the implications of various psychological traits and processes for marriage.

There is little knowledge about the role of the duration of untreated bipolar (DUB) illness in first-treatment bipolar disorder I (BD I), its association with symptoms at start of first treatment, and development over the first year, and limited knowledge about factors that influence the length of DUB. Substance use has shown to delay identification of primary psychiatric disorders, and while cannabis use is common in BD the role of cannabis in relationship to DUB is unclear. The aim of the present study is to examine the associations between DUB and key clinical outcomes at baseline in BD I, and at one year follow-up, and to evaluate the influence of cannabis use. Patients with first-treatment BD I (N=62) completed comprehensive clinical evaluations, which included both DUB and the number of previous episodes. There were no significant associations between DUB and key clinical outcomes. Longer duration from first manic episode to treatment was associated with risk of starting excessive cannabis use after onset of the bipolar disorder. The main finding is the lack of significant associations between features of previous illness episodes and clinical outcomes. Long duration of untreated mania seems to increase the risk for later cannabis use.

BACKGROUND AND PURPOSE The purpose of this study was to collect information regarding healthcare worker (HCW) vaccination policies in Utah family practice clinics. METHODS The study was conducted in Utah family practice clinics in the most densely populated counties in the state and was a cross-sectional descriptive design. Data were collected from 91 family practice clinic managers. Descriptive statistics were performed, as well as a content analysis for open-ended items. CONCLUSIONS HCWs are employed in environments where infectious diseases can be easily spread from person to person, thus, vaccinations can be instrumental in protecting the health of HCWs and patients alike. In Utah, 56.8% of family practice clinics had either no vaccination policy for HCWs or had a policy with no consequences for noncompliance. Utah family practice clinics need to implement changes to create and maintain HCW vaccination policies. IMPLICATIONS FOR PRACTICE Nurse practitioners can be leaders and change agents by working with their county and state health departments to create state-wide policies that mirror the position statements from the American Nurses Association and the American Association of Nurse Practitioners.

Should intimates respond to their interpersonal mistakes with self-criticism or with self-compassion? Although it is reasonable to expect self-compassion to benefit relationships by promoting self-esteem, it is also reasonable to expect self-compassion to hurt relationships by removing intimates’ motivation to correct their interpersonal mistakes. Two correlational studies, 1 experiment, and 1 longitudinal study demonstrated that whether self-compassion helps or hurts relationships depends on the presence versus absence of dispositional sources of the motivation to correct interpersonal mistakes. Among men, the implications of self-compassion were moderated by conscientiousness. Among men high in conscientiousness, self-compassion was associated with greater motivation to correct interpersonal mistakes (Studies 1 and 3), observations of more-constructive problem-solving behaviors (Study 2), reports of more accommodation (Study 3), and fewer declines in marital satisfaction that were mediated by decreases in interpersonal problem severity (Study 4); among men low in conscientiousness, self-compassion was associated with these outcomes in the opposite direction. Among women, in contrast, likely because women are inherently more motivated than men to preserve their relationships for cultural and/or biological reasons, self-compassion was never harmful to the relationship. Instead, women’s self-compassion was positively associated with the motivation to correct their interpersonal mistakes (Study 1) and changes in relationship satisfaction (Study 4), regardless of conscientiousness. Accordingly, theoretical descriptions of the implications of self-promoting thoughts for relationships may be most complete to the extent that they consider the presence versus absence of other sources of the motivation to correct interpersonal mistakes.

Do shy people struggle to maintain their relationships just as they struggle to develop them? The current research addressed this question through one cross-sectional and one longitudinal study in which recently married couples reported their levels of shyness, relationship self-efficacy, marital problem severity, and marital satisfaction. Multilevel modeling revealed that (a) shyness was negatively associated with concurrent marital satisfaction in Study 1 and with declines in marital satisfaction in Study 2, (b) the association between shyness and satisfaction was mediated by low levels of relationship self-efficacy in Study 1 and Study 2, and (c) the association between relationship self-efficacy and concurrent marital satisfaction was mediated by concurrent marital problems in Study 1, and the association between relationship self-efficacy and declines in marital satisfaction was mediated by worsening marital problems in Study 2. These findings join a growing body of research demonstrating the cognitive mechanisms through which personality shapes relationships.

Objectives Explanatory factors for the observed neurocognitive impairment in early-stage bipolar I disorder (BD-I) have received little attention. The current study investigated neurocognitive functioning in first-treatment (FT) BD-I compared to FT schizophrenia (SCZ), and healthy controls (HCs), and the effect of history of psychosis and previous episodes in the two clinical groups. Methods A total of 202 FT patients with BD-I (n = 101) and SCZ spectrum disorder (n = 101), in addition to HCs (n = 101), were included. A comprehensive neurocognitive test battery was used to assess verbal learning and memory, executive functioning, processing speed, and attention and working memory. Neurocognitive functioning and the effect of history of psychosis and number of previous episodes were analyzed using separate multivariate analyses of variance and correlation analysis. Results FT patients with BD-I performed intermediately between FT SCZ spectrum patients and HCs on all measures. Compared to HCs, FT BD-I showed impaired functioning across all neurocognitive domains. No differences in neurocognitive functioning were observed in psychotic versus nonpsychotic FT patients with BD-I. With the exception of an association between number of manic episodes and two measures of executive function in FT BD-I, no associations were found between number of episodes and neurocognitive performance. Conclusions Neurocognitive impairments were present in FT BD-I, and were not explained by history of psychosis or number of previous psychotic or depressive episodes. There were indications that executive function could be associated with number of previous manic episodes.

How are hormonal contraceptives (HCs) related to marital well-being? Some work suggests HCs suppress biological processes associated with women’s preferences for partner qualities reflective of genetic fitness, qualities that may be summarized by facial attractiveness. Given that realizing such interpersonal preferences positively predicts relationship satisfaction, any changes in women’s preferences associated with changes in their HC use may interact with partner facial attractiveness to predict women’s relationship satisfaction. We tested this possibility using two longitudinal studies of 118 newlywed couples. Trained observers objectively rated husbands’ facial attractiveness in both studies. In study 1, wives reported their marital satisfaction every 6 mo for 4 y and then reported the history of their HC use for their relationship. In study 2, wives reported whether they were using HCs when they met their husbands and then their marital satisfaction and HC use every 4 mo for up to three waves. In both studies, and in an analysis that combined the data from both studies, wives who were using HCs when they formed their relationship with their husband were less satisfied with their marriage when they discontinued HCs if their husband had a relatively less attractive face, but more satisfied if their husband had a relatively more attractive face. Beginning HCs demonstrated no consistent associations with marital satisfaction. Incongruency between HC use at relationship formation and current HC use was negatively associated with sexual satisfaction, regardless of husbands’ facial attractiveness. These findings suggest that HC use may have unintended implications for women’s close relationships.

The aim of this study was to investigate the associations between recent cannabis use, current symptomatology and age at onset of first manic, depressive and psychotic episodes in a large sample with first-treatment bipolar I disorder (BD I).One hundred one patients with first-treatment Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) bipolar I disorder were included as part of the Thematically Organized Psychosis study. The Structural Clinical Interview for DSM-IV was used for DSM-IV diagnosis and identification of episodes of illness. Earlier suicide attempts were recorded. Manic, depressive and psychotic symptoms were rated using the Young Mania Rating Scale, Inventory of Depressive Symptoms and Positive and Negative Syndrome Scale correspondingly. Cannabis use within the six last months was recorded.After controlling for confounders, recent cannabis use was significantly associated with lower age at onset of first manic and psychotic episode, but not with onset of first depressive episode (both P 0.05). Recent use was also associated with more lifetime suicide attempts (P 0.01). No group differences were found on symptom levels.The present study confirms earlier findings of an association between cannabis use and a lower age at onset. Recent cannabis use was also associated with more lifetime suicide attempts. The current findings suggest that recent cannabis use is associated with a more severe course of illness in the early phase of BD I.

Cannabis use seems to play a causal role in the development of psychotic disorders. Recent evidence suggests that it may also precipitate onset in bipolar disorder. We here investigate if there is a dose-response relationship between cannabis use and age at onset in bipolar disorder, and whether there are interactions between cannabis use and illness characteristics (presenting polarity and presence of psychosis). Consecutively recruited patients with a DSM-IV, SCID verified diagnosis of bipolar I, II or NOS disorder (n=324) participated. Two-way ANCOVAS were used to investigate the effect of levels of cannabis use (10 times during one month lifetime,10 times during one month lifetime or a cannabis use disorder) on age at onset, including interaction effects with illness characteristics, while controlling for possible confounders. There was a significant association indicating a dose-response relationship between cannabis use and age at onset, which remained statistically significant after controlling for possible confounders (gender, bipolar subtype, family history of severe mental illness and alcohol or other substance use disorders). There were no interaction effects between cannabis use and presenting polarity or presence of psychosis. Doses of cannabis used may affect the age at onset of bipolar disorder.

[Correction Notice: An Erratum for this article was reported in Vol 104(6) of Journal of Personality and Social Psychology (see record 2013-18890-002). The title of the article is incorrect.] Increasing interdependence in an intimate relationship requires engaging in behaviors that risk rejection, such as expressing affection and asking for support. Who takes such risks and who avoids them? Although several theoretical perspectives suggest that self-esteem plays a crucial role in shaping such behaviors, they can be used to make competing predictions regarding the direction of this effect. Six studies reconcile these contrasting predictions by demonstrating that the effects of self-esteem on behaviors that risk rejection to increase interdependence depend on relational self-construal-that is, the extent to which people define themselves by their close relationships. In Studies 1 and 2, participants were given the opportunity to disclose negative personal information (Study 1) and feelings of intimacy (Study 2) to their dating partners. In Study 3, married couples reported the extent to which they confided in one another. In Study 4, we manipulated self-esteem and relational self-construal, and participants reported their willingness to engage in behaviors that increase interdependence. In Studies 5 and 6, we manipulated the salience of interpersonal risk, and participants reported their willingness to engage in behaviors that risk rejection to increase interdependence. In all 6 studies, self-esteem was positively associated with behaviors that can increase interdependence among people low in relational self-construal but negatively associated with those behaviors among people high in relational self-construal. Accordingly, theoretical descriptions of the role of self-esteem in relationships will be most complete to the extent that they consider the degree to which people define themselves by their close relationships.

Background: The worldwide diversity of dietary intakes of n-6 and n-3 fatty acids influences tissue compositions of n-3 long-chain fatty acids (LCFAs: eicosapentaenoic, docosapentaenoic, and docosahexaenoic acids) and risks of cardiovascular and mental illnesses. Objective: We aimed to estimate healthy dietary allowances for n-3 LCFAs that would meet the nutrient requirements of 97-98% of the population. Design: Deficiency in n-3 LCFAs was defined as attributable risk from 13 morbidity and mortality outcomes, including all causes, coronary heart disease, stroke, cardiovascular disease, homicide, bipolar disorder, and major and postpartum depressions. Dietary availability of n-3 LCFAs from commodities for 38 countries and tissue composition data were correlated by best fit to each illness in deficiency risk models. Results: The potential attributable burden of disease ranged from 20.8% (all-cause mortality in men) to 99.9% (bipolar disorder). n-3 LCFA intake for Japan (0.37% of energy, or 750 mg/d) met criteria for uniformly protecting >98% of the populations worldwide. n-3 LCFA intakes needed to meet a tissue target representative of Japan (60% n-3 in LCFA) ranged from 278 mg/d (Philippines, with intakes of 0.8% of energy as linoleate, 0.08% ofenergy as α-linolenate, and 0.06% of energy as arachidonic acid) to 3667 mg/d (United States, with 8.91% of energy as linoleate, 1.06% of energy as α-linolenate, and 0.08% of energy as arachidonic acid). Conclusions: With caveats inherent for ecologic, nutrient disappearance analyses, a healthy dietary allowance for n-3 LCFAs for current US diets was estimated at 3.5 g/d for a 2000-kcal diet. This allowance for n-3 LCFAs can likely be reduced to one-tenth of that amount by consuming fewer n-6 fats.

Clinical intervention trials and animal studies indicate that increasing dietary intakes of long chain n-3 FA or reducing linoleic acid intake may reduce aggressive and violent behaviors. Here we examine if economic measures of greater n-6 consumption across time and countries correlate with greater risk of homicide. Linoleic acid available for human consumption was calculated from World Health Organization disappearance data for 12 major seed oils in the food supply for the years 1961 to 2000 in Argentina, Australia, Canada, the United Kingdom, and the United States (US). Homicide mortality rates, adjusted for age, were obtained from the central judicial authority of each country. Apparent linoleic acid intake from seed oil sources ranged from 0.29 en% (percentage of daily food energy) (Australia 1962) to 8.3 en% (US 1990s). Greater apparent consumption of linoleic acid correlated with higher rates of homicide mortality over a 20-fold range (0.51-10.2/100,000) across countries and time in an exponential growth regression model (r = 0.94, F = 567, P0.00001). Within each country, correlations between greater linoleic acid disappearance and homicide mortality over time were significant in linear regression models. Randomized controlled trials are needed to determine if reducing high intakes of linoleic acid by seed oils with alternative compositions can reduce the risk of violent behaviors. These dietary interventions merit exploration as relatively cost-effective measures for reducing the pandemic of violence in Western societies, just as dietary interventions are reducing cardiovascular mortality. Low linoleate diets may prevent behavioral maladies that correctional institutions, social service programs, and mental health providers intend to treat.

The inotropic effect of histamine on the human myocardium consists of two opposing components: positive, H2-mediated, and negative, H1-mediated. Because adenosine is known to antagonize histamine H2-responses, we assessed whether adenosine may unmask H1-mediated histamine responses in human myocardium. We found that adenosine modulates the stimulatory effects of histamine on pectinate muscles isolated from human right atrium and converts them as a function of its concentration from positive to negative. Further, histamine potentiated the tendency of adenosine to induce cardiac arrest. The H1-blocker pyrilamine antagonized the adenosine-induced suppression of the positive inotropic and chronotropic effects of histamine. Thus, our data indicate that the negative inotropic and chronotropic effects of histamine in the presence of adenosine result in part from an antagonism of H2-mediated increases in rate and contractility, and in part from an unmasking of H1-mediated decreases in the same parameters. Adenosine and histamine may be co-released in response to hypoxia or ischemia. In spite of the protection that adenosine may afford the human myocardium against excessive histamine stimulation, adenosine may also unmask the inhibitory actions of histamine, promoting dysrhythmia, and negative inotropic and chronotropic effects.

Cyclic adenosine 3′,5′-monophosphate (cAMP)–elevating agents, such as β 2 -adrenergic receptor (β 2 -AR) agonists and phosphodiesterase (PDE) inhibitors, remain a mainstay in the treatment of obstructive respiratory diseases, conditions characterized by airway constriction, inflammation, and mucus hypersecretion. However, their clinical use is limited by unwanted side effects because of unrestricted cAMP elevation in the airways and in distant organs. Here, we identified the A-kinase anchoring protein phosphoinositide 3-kinase γ (PI3Kγ) as a critical regulator of a discrete cAMP signaling microdomain activated by β 2 -ARs in airway structural and inflammatory cells. Displacement of the PI3Kγ-anchored pool of protein kinase A (PKA) by an inhaled, cell-permeable, PI3Kγ mimetic peptide (PI3Kγ MP) inhibited a pool of subcortical PDE4B and PDE4D and safely increased cAMP in the lungs, leading to airway smooth muscle relaxation and reduced neutrophil infiltration in a murine model of asthma. In human bronchial epithelial cells, PI3Kγ MP induced unexpected cAMP and PKA elevations restricted to the vicinity of the cystic fibrosis transmembrane conductance regulator (CFTR), the ion channel controlling mucus hydration that is mutated in cystic fibrosis (CF). PI3Kγ MP promoted the phosphorylation of wild-type CFTR on serine-737, triggering channel gating, and rescued the function of F508del-CFTR, the most prevalent CF mutant, by enhancing the effects of existing CFTR modulators. These results unveil PI3Kγ as the regulator of a β 2 -AR/cAMP microdomain central to smooth muscle contraction, immune cell activation, and epithelial fluid secretion in the airways, suggesting the use of a PI3Kγ MP for compartment-restricted, therapeutic cAMP elevation in chronic obstructive respiratory diseases.

Adrenergic stimulation of the heart engages cAMP and phosphoinositide second messenger signaling cascades. Cardiac phosphoinositide 3-kinase p110 gamma participates in these processes by sustaining beta-adrenergic receptor internalization through its catalytic function and by controlling phosphodiesterase 3B (PDE3B) activity via an unknown kinase-independent mechanism. We have discovered that p110 gamma anchors protein kinase A (PKA) through a site in its N-terminal region. Anchored PKA activates PDE3B to enhance cAMP degradation and phosphorylates p110 gamma to inhibit PIP3 production. This provides local feedback control of PIP3 and cAMP signaling events. In congestive heart failure, p110 gamma is upregulated and escapes PKA-mediated inhibition, contributing to a reduction in beta-adrenergic receptor density. Pharmacological inhibition of p110 gamma normalizes beta-adrenergic receptor density and improves contractility in failing hearts.

Because histamine and adenosine are coreleased from the ischemic heart, we investigated the effects of their interaction on human myocardium. Surgical specimens of human right atrium (i.e., pectinate muscles) responded to histamine with increases in spontaneous rate and contractile force. Adenosine, and the A1-selective adenosine agonist N6-cyclopentyladenosine (CPA), reduced the spontaneous rate and suppressed the positive chronotropic and inotropic effects of histamine. CPA was more potent than adenosine in slowing the spontaneous rate and in suppressing histamine's positive chronotropic effect, suggesting that the responses to CPA and adenosine are A1-mediated. CPA was also more potent than adenosine in attenuating histamine's positive inotropic effect on human ventricular papillary muscle. The adenosine-induced suppression of histamine's effects on pectinate muscles was mimicked by carbachol, which like adenosine is known to attenuate H2-mediated histamine-induced adenylate cyclase activation. The H1-selective histamine antagonist pyrilamine potentiated histamine's chronotropic and inotropic responses, and inhibited the attenuation of these responses by adenosine or carbachol. In contrast, pyrilamine failed to modify the adenosine-induced attenuation of the cardiac stimulatory effects of dimaprit, an H2-selective histamine agonist. Our data suggest that adenosine-induced suppression of histamine's positive chronotropic and inotropic effects on human myocardium results both from an A1-mediated attenuation of H2-stimulatory effects and from the uncovering of H1 negative chronotropic and inotropic effects. Thus, the results of the histamine-adenosine interaction may exceed the "retaliatory" purpose of adenosine release and uncover H1-mediated myocardial depression.

Because platelet-activating factor (PAF) has prominent depressant effects on cardiac contractility in various mammalian species, we assessed the negative inotropic effect of PAF on non-coronary perfused human right atrial pectinate muscles paced at constant rate. We found that PAF is a potent negative inotropic agent (EC50 approximately equal to 160 pM), whose action is unmodified by atropine, indomethacin and the leukotriene receptor antagonist compound FPL 55712. The negative inotropic effect of PAF was, however, antagonized by drugs known to inhibit PAF-induced platelet aggregation: the order of relative potency was SRI 63-441 greater than CV-3988 greater than alprazolam greater than or equal to triazolam; i.e., the same order in which these compounds antagonize the effects of PAF on platelets. Thus, the potent negative inotropic effect of PAF on human myocardium is independent of coronary flow changes, involves neither cholinergic mechanisms nor arachidonate metabolites and is probably mediated by specific receptors.