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Full-Text Articles in Social and Behavioral Sciences

Alcohol Use Variability In A Community-Based Sample Of Nonstudent Emerging Adult Heavy Drinkers, Cathy Lau-Barraco, Abbly L. Braitman, Amy L. Stamates, Ashley N. Linden-Carmichael Nov 2016

Alcohol Use Variability In A Community-Based Sample Of Nonstudent Emerging Adult Heavy Drinkers, Cathy Lau-Barraco, Abbly L. Braitman, Amy L. Stamates, Ashley N. Linden-Carmichael

Psychology Faculty Publications

BACKGROUND: While nonstudent emerging adults are at elevated risk for experiencing alcohol-related problems, there remains a paucity of research devoted specifically to addressing drinking in this group.

OBJECTIVES: The present study sought to offer unique insights into nonstudent drinking by examining drinking variability across 30 days using a retrospective diary method. Specific aims were to: (1) compare within- and between-person variability in alcohol use across 30 days, and (2) determine the extent to which central social-cognitive between-person factors (i.e., social expectancies, perceived drinking norms, social drinking motivations) predict between-person alcohol use as well as within-person variability in drinking.

METHODS: Participants …


Multiple Imputation Of Missing Data In Structural Equation Models With Mediators And Moderators Using Gradient Boosted Machine Learning, Robert J. Milletich Ii Oct 2016

Multiple Imputation Of Missing Data In Structural Equation Models With Mediators And Moderators Using Gradient Boosted Machine Learning, Robert J. Milletich Ii

Psychology Theses & Dissertations

Mediation and moderated mediation models are two commonly used models for indirect effects analysis. In practice, missing data is a pervasive problem in structural equation modeling with psychological data. Multiple imputation (MI) is one method used to estimate model parameters in the presence of missing data, while accounting for uncertainty due to the missing data. Unfortunately, commonly used MI methods are not equipped to handle categorical variables or nonlinear variables such as interactions. In this study, we introduce a general MI framework that uses the Bayesian bootstrap (BB) method to generate posterior inferences for indirect effects and gradient boosted machine …


Effects Of Auditory Vection Speed And Directional Congruence On Perceptions Of Visual Vection, Isabella Alexis Gagliano Oct 2016

Effects Of Auditory Vection Speed And Directional Congruence On Perceptions Of Visual Vection, Isabella Alexis Gagliano

Psychology Theses & Dissertations

Spatial disorientation is a major contributor to aircraft mishaps. One potential contributing factor is vection, an illusion of self-motion. Although vection is commonly thought of as a visual illusion, it can also be produced through audition. The purpose of the current experiment was to explore interactions between conflicting visual and auditory vection cues, specifically with regard to the speed and direction of rotation. The ultimate goal was to explore the extent to which aural vection could diminish or enhance the perception of visual vection. The study used a 3 × 2 within-groups factorial design. Participants were exposed to three levels …


Game-Framing Cognitive Assessments To Improve Applicant Perceptions, Andrew Burnett Collmus Oct 2016

Game-Framing Cognitive Assessments To Improve Applicant Perceptions, Andrew Burnett Collmus

Psychology Theses & Dissertations

Research has shown that although cognitive testing is key to quality hiring, applicants often react poorly to cognitive ability tests. Applicant reactions theory indicates that time-length judgments of a selection procedure can affect applicant perceptions. It was thus hypothesized that game-framing, the act of labeling something a game without changing the content, would cause participants to perceive that time was moving faster while completing a battery of cognitive ability tests. Similarly, it was expected that game-framing would increase test motivation and decrease test anxiety. Perceived length was tested as a mediator for the effects of game-framing on test anxiety and …


Body Image And Quality Of Life Among Postsurgical Bariatric Patients, Amy Leigh White Oct 2016

Body Image And Quality Of Life Among Postsurgical Bariatric Patients, Amy Leigh White

Psychology Theses & Dissertations

In recent decades, bariatric surgery has become an increasingly popular intervention for the treatment of morbid obesity. Bariatric surgery leads to substantial improvements in physical health (e.g., weight loss, increased life expectancy) and psychological health (e.g., body image, quality of life). After bariatric surgery, many patients undergo subsequent surgical procedures to remove excess skin (“body contouring”), which are also associated with positive medical and psychological outcomes.

The present study sought to expand upon existing research into the psychosocial outcomes of bariatric surgery, investigate correlates of patients’ desire for body contouring, and determine whether presurgical motivations were associated with postsurgical outcomes. …


Psychometric Functioning Of The Mmpi-A Restructured Form Vrin-R, Trin-R, Crin, And Cannot Say Scales With Varying Degrees Of Randomness, Acquiescence, Counter-Acquiescence, And Omitted Items, Amy C. Pitta Oct 2016

Psychometric Functioning Of The Mmpi-A Restructured Form Vrin-R, Trin-R, Crin, And Cannot Say Scales With Varying Degrees Of Randomness, Acquiescence, Counter-Acquiescence, And Omitted Items, Amy C. Pitta

Psychology Theses & Dissertations

The MMPI-A-RF (Archer, Handel, Ben-Porath & Tellegen, 2016) is a new measure of adolescent personality and psychopathology derived from the MMPI-A (Butcher, Williams, Graham, Archer, Tellegen, Ben-Porath & Kaemmer, 1992) item pool. Similar to the MMPI-A, the MMPI-A-RF includes indexes designed to assess non-content-based responding and omitted items. Building on Handel, Ben-Porath, Tellegen & Archer’s study (2010) on adults, the current study utilized computer simulation of random, acquiescent, counteracquiescent, and omitted responses to examine how adolescent validity scale and RC scale scores are affected by increasing degrees of non-content-based responding. Further, RC scale validity coefficients were examined to see how …


Prejudice Toward Atheists In The United States As Related To Perceived Prevalence, Wanda D. Brooks Oct 2016

Prejudice Toward Atheists In The United States As Related To Perceived Prevalence, Wanda D. Brooks

Psychology Theses & Dissertations

By manipulating mortality salience (MS) in place of life-threatening events to stimulate death-related thoughts, the current research contributes to the body of research supporting Terror Management Theory. It was hypothesized that religious participants should exhibit cultural worldview defense by scoring higher in anti-atheist prejudice following the MS manipulation than would those in the control condition. Further, this research extends the current research into Terror Management Theory as a cause for conflict among out-groups and explores its effects on cultural worldviews in the area of prejudice toward atheists. This includes examining how the perception of an increasing prevalence of atheists contributes …


Reconceptualizing Women's Stem Experiences: Building A Theory Of Positive Marginality, Valerie N. Streets Oct 2016

Reconceptualizing Women's Stem Experiences: Building A Theory Of Positive Marginality, Valerie N. Streets

Psychology Theses & Dissertations

Since the 1980s, disciplines such as psychology and sociology have discussed the construct of positive marginality. Positive marginality describes the perception that belonging to a non-dominant cultural or demographic group can be advantageous rather than oppressing. To date, research on positive marginality has explored the construct in a qualitative manner across a number of demographic groups (e.g., Jewish women in social sciences, African American women in predominantly Caucasian workplaces). Because women are largely underrepresented in science, technology, engineering, and mathematics (STEM) fields, the current research examined positive marginality in a STEM context. This research advances the existing understanding of positive …


A Daily Diary Investigation Of Behavioral Disinhibition And Alcohol-Related Aggression, Brynn Elizabeth Sheehan Oct 2016

A Daily Diary Investigation Of Behavioral Disinhibition And Alcohol-Related Aggression, Brynn Elizabeth Sheehan

Psychology Theses & Dissertations

Experimental demonstrations and theoretical developments have identified that the ability to control one’s own behavior (i.e., trait self-control, state self-regulation) may be particularly influential in the prediction of aggression and alcohol-related aggression. The research investigating alcohol-related aggression, however, has neglected a large body of research focused on state variation of self-regulation. Consequently, the current study aimed to use a daily diary methodology design to examine associations between daily alcohol use and aggressive behaviors (i.e., direct, indirect), as well as the influence of trait self-control and state self-regulation on these relationships. Participants were 105 (80% female) college student drinkers. Mean age …


Association Between Combat, Morally Injurious Experiences, Spiritual Injury, And Alcohol Use Among Active Duty Military Personnel And Veterans, Allison T. Robbins Oct 2016

Association Between Combat, Morally Injurious Experiences, Spiritual Injury, And Alcohol Use Among Active Duty Military Personnel And Veterans, Allison T. Robbins

Psychology Theses & Dissertations

Literature has supported that, along with physical and psychological injuries, combat profoundly impacts veterans’ moral and spiritual belief systems and may contribute to negative health behaviors. Moral injury is a developing construct related to negative consequences associated with war-zone stressors that transgress military veterans’ deeply held values and belief systems. Additionally, spiritual injury addresses negative responses to an event that damages their relationship with God, self, and others, and alienates an individual from that which gives meaning to their lives. The purpose of the present study was to examine the relationship between combat exposure, morally injurious experiences (MIEs), spiritual injury, …


A Taxonomy Of Effective Leader Behaviors In The Construction Industry, Enrique Leonardo Cabrera-Caban Aug 2016

A Taxonomy Of Effective Leader Behaviors In The Construction Industry, Enrique Leonardo Cabrera-Caban

Psychology Theses & Dissertations

The construction industry is a major part of the United States economy, but it is also one of the most dangerous and high-risk industries. The industry is currently facing a shortage of effective leadership, and leaders face unique challenges in coordinating multiple teams of subcontractors on projects. The first step in remedying this shortage is to identify the behaviors of an effective construction leader. To address this need, a taxonomy of effective leader behaviors in construction was developed using grounded theory methodology and rated by construction industry subject matter experts. Archival focus group data from 10 focus groups in three …


Department Of Psychology Newsletter, Department Of Psychology, Old Dominion University Jul 2016

Department Of Psychology Newsletter, Department Of Psychology, Old Dominion University

Department of Psychology Newsletters

Summer/Fall 2016 issue of Old Dominion University's Department of Psychology Newsletter.


Forces At Work: Workforce Perspectives In Print Journalism Amid Paradigm Shift, Stephanie Bernat Jul 2016

Forces At Work: Workforce Perspectives In Print Journalism Amid Paradigm Shift, Stephanie Bernat

Communication & Theatre Arts Theses

Print newspapers are in an age of disruption that has radically affected readership, news consumption, news production and news distribution. As such, the industry has experimented with new business models that incorporate online, including blog-style reporting, short-format stories, and investigatory reporting via social media. This experimentation could be identified as a Kuhnian pre-paradigmatic phase of a print news industry in crisis. Meanwhile the workforce of print newspapers is experiencing a disruption of identity as what it means to be a journalist has changed in reaction. Exodus of journalists from print newspapers has been both involuntary through layoffs and voluntary as …


Do Trait Positive And Trait Negative Affect Predict Progress And Discharge Outcomes In An Inpatient Medical Rehabilitation Population, Valerie Dominique Ward Jul 2016

Do Trait Positive And Trait Negative Affect Predict Progress And Discharge Outcomes In An Inpatient Medical Rehabilitation Population, Valerie Dominique Ward

Psychology Theses & Dissertations

Differences in emotional adjustment were examined as predictors of medical rehabilitation gains within an inpatient setting. Specifically, the International Positive Affect and Negative Affect Schedule Short Form (I-PANAS-SF), along with the Functional Independence Measure (FIM), were administered to adult patients during their inpatient medical rehabilitation hospitalizations. The I-PANAS-SF was used to examine if trait affect plays a significant role in rehabilitative treatment, as well as final outcomes (i.e. total number of days spent in rehabilitative treatment, and amount of measurable cognitive and physical improvement). Previous research has demonstrated significant correlations between emotional constructs such as trait affect and medical outcomes. …


The Relationship Between Resilience, Attachment, And Emotional Coping Styles, Jennika K. Jenkins Jul 2016

The Relationship Between Resilience, Attachment, And Emotional Coping Styles, Jennika K. Jenkins

Psychology Theses & Dissertations

The construct of resilience has been widely associated with the ability to adequately cope with stressors, which leads to positive long-term health outcomes. Attachment and emotional coping style literatures have both been tentatively linked to resilience, with dismissive and secure attachment styles as well as the repressive coping style positively associated with resilience. However, both avoidantly attached and repressive individuals employ coping strategies that allow them to dissociate from negative emotions, which seems to contradict the stress adaptive quality of resilience. The goal of this study was to explore the theoretical parallel between the attachment and emotional coping styles literature …


Computational Modeling Of Facial Response For Detecting Differential Traits In Autism Spectrum Disorders, Manar D. Samad Jul 2016

Computational Modeling Of Facial Response For Detecting Differential Traits In Autism Spectrum Disorders, Manar D. Samad

Electrical & Computer Engineering Theses & Dissertations

This dissertation proposes novel computational modeling and computer vision methods for the analysis and discovery of differential traits in subjects with Autism Spectrum Disorders (ASD) using video and three-dimensional (3D) images of face and facial expressions. ASD is a neurodevelopmental disorder that impairs an individual’s nonverbal communication skills. This work studies ASD from the pathophysiology of facial expressions which may manifest atypical responses in the face. State-of-the-art psychophysical studies mostly employ na¨ıve human raters to visually score atypical facial responses of individuals with ASD, which may be subjective, tedious, and error prone. A few quantitative studies use intrusive sensors on …


Life After An Autism Spectrum Disorder Diagnosis: A Comparison Of Stress And Coping Profiles Of African American And Caucasian Caregivers, Takeshia Williams Jul 2016

Life After An Autism Spectrum Disorder Diagnosis: A Comparison Of Stress And Coping Profiles Of African American And Caucasian Caregivers, Takeshia Williams

Psychology Theses & Dissertations

Though the prevalence of autism spectrum disorder continues to rise, limited research to date has studied the impact of culture on stress and coping for families after they are diagnosed. This study explored the relationship between caregiver’s ethnic culture and caregiver reports of stress and coping behaviors when caring for a child with autism. Specifically, this study used discriminate function analysis to contrast the stress and coping profiles of Caucasian caregivers to African American caregivers that are more acculturated with the majority culture and African American caregivers that ascribe to more traditional values. A sample of 103 participants was recruited, …


Buffering The Associations Between Negative Mood States And The Incentive Salience Of Alcohol: A Brief Mindfulness Induction, Adrian J. Bravo Jul 2016

Buffering The Associations Between Negative Mood States And The Incentive Salience Of Alcohol: A Brief Mindfulness Induction, Adrian J. Bravo

Psychology Theses & Dissertations

The present study examined drinking to cope (DTC) motives and state mindfulness (via a brief mindfulness induction) as two distinct factors that may enhance (DTC) and reduce (state mindfulness) the association between negative mood states (i.e., sadness and anxiety) and the incentive salience of alcohol (i.e., subjective alcohol craving and attentional bias for alcohol-related cues) among college student drinkers. Participants were 207 undergraduate students from a large, southeastern university in the United States that consumed at least one drink per typical week in the previous month. The majority of participants identified as being either White, non-Hispanic (n = 81; 39.1%), …


An Etiological Model Of Posttraumatic Stress Disorder In Female Oef/Oif/Ond Veterans: Adding Military Sexual Trauma As A Risk Factor, Erin Doty Kurtz Jul 2016

An Etiological Model Of Posttraumatic Stress Disorder In Female Oef/Oif/Ond Veterans: Adding Military Sexual Trauma As A Risk Factor, Erin Doty Kurtz

Psychology Theses & Dissertations

Studies on posttraumatic stress disorder (PTSD) in returning Iraq and Afghanistan veterans have involved limited focus on the specific risk and protective factors for female veterans and how these may differ from factors identified for male veterans. Additionally, models incorporating risk and protective factors for PTSD in female veterans have yet to include military sexual trauma (MST) as a risk factor. Given the prevalence of MST among female service members, this study examined whether MST predicts PTSD diagnosis in addition to other frequently examined variables (premilitary trauma exposure, combat exposure, postmilitary trauma, and perceived social support). In addition, the degree …


Measuring Team Collaboration And Effects Of Target Guidance In A Visual Search Task, Christopher Morley Jul 2016

Measuring Team Collaboration And Effects Of Target Guidance In A Visual Search Task, Christopher Morley

Psychology Theses & Dissertations

Many professional tasks, including military operations and medical operations, involve a team of operators searching for a target on a common visual display. Previous works on collaborative visual search employed analysis of mean response time (RT) and error rates, which may not offer direct measurement of the capacity of a team nor changes in performance across task time. Workload capacity, indexed by the capacity coefficient, C(t), measures performance efficiency for cognitive systems with multiple and concurrent information-processing channels (Townsend & Nozawa, 1995). The current study applied a workload capacity analysis to quantify performance efficiency of pairs of participants in a …


Fake It Until You Make It? Female Leaders’ Emotional Expression Management And Subordinates’ Gender Stereotypes, Rebecca C. Garden Jul 2016

Fake It Until You Make It? Female Leaders’ Emotional Expression Management And Subordinates’ Gender Stereotypes, Rebecca C. Garden

Psychology Theses & Dissertations

As part of their organizational role, leaders manage their emotional expressions for the purpose of maintaining influence over followers, a concept that has received far less attention than the impact of other leadership behaviors. Further, there is almost no existing research regarding an employees’ reactions to the female supervisors’ emotional expression management (EEM), or the influence of subordinates’ underlying gender stereotypes on the relationship between leaders’ EEM and subordinate outcomes. To gain a better understanding of how EEM and the followers’ perception of gender roles interactively influence affective and attitudinal outcomes, this study used multi-source data from female leaders and …


Caffeinated Alcohol Use In A Daily Context, Ashley N. Carmichael Jul 2016

Caffeinated Alcohol Use In A Daily Context, Ashley N. Carmichael

Psychology Theses & Dissertations

Caffeinated alcoholic beverage (CAB) use is associated with a range of substance-related problems. Few have examined socio-environmental and cognitive factors that may relate to CAB use and influence associations between use and negative consequences. Moreover, much research on CABs has been based on cross-sectional and retrospective reports, which can be subject to recall biases. The current research aimed to address the gaps in our understanding of use patterns by conducting a daily diary study. Participants were 122 (73.8% women) heavy drinking, college student CAB users. Mean age was 20.39 (SD = 2.08) years. Students completed a baseline questionnaire and up …


Understanding The Determinants Of Parental Decision-Making And Harsh Parenting Behavior, Ralitsa Stoyneva Maduro Jul 2016

Understanding The Determinants Of Parental Decision-Making And Harsh Parenting Behavior, Ralitsa Stoyneva Maduro

Psychology Theses & Dissertations

The high prevalence and negative consequences of hash parenting among US parents is well-documented. However, intervention and prevention efforts aimed at reducing the rates of harsh parenting have had limited success. A goal of this paper was to provide a novel method of studying parenting behavior; moving beyond correlational findings. Specifically, I argued that preventing harsh parenting has been a challenge, in part because of lack of understanding of the decision-making processes underlying the behavior. In an effort to incorporate tradition decision making methodology, I designed a between subjects, single-blind, randomized experiment. The experimental manipulations were design to induced emotional …


Relationship Investment And Unwanted Pursuit: An Experimental Study, Phoebe Tabb Hitson Jul 2016

Relationship Investment And Unwanted Pursuit: An Experimental Study, Phoebe Tabb Hitson

Psychology Theses & Dissertations

A significant positive correlation exists between relationship investment and the perpetration of unwanted pursuit among previous romantic partners. However, no experimental research has been conducted to enhance researchers’ knowledge of this phenomenon. This study contributed to the literature on unwanted pursuit by making investment an experimentally manipulated variable. Specifically, I employed fictional relationship scenarios with varying levels of investment to assess experimentally the impact of investment on an individual’s willingness to engage in unwanted pursuit after a breakup. It was hypothesized that higher investment would increase participants’ tendency to engage in unwanted pursuit. In addition, participants’ past perpetration of unwanted …


Executive Dysfunction As A Trait Marker For Depression In Children And Adolescents, Emily Oettinger Jul 2016

Executive Dysfunction As A Trait Marker For Depression In Children And Adolescents, Emily Oettinger

Psychology Theses & Dissertations

Perinatal depression has been recognized as a public health problem in the United States, which is important because of the demonstrated wide-reaching negative effects of maternal depression on child outcomes. Some evidence suggests that maternal depression is a risk factor for executive dysfunction in children. By contrast, there is abundant evidence that maternal depression is a risk factor for later child depression. Therefore, this study focuses on executive dysfunction in children as a potential trait marker for later depression in childhood and adolescence, utilizing data from the NICHD Study of Early Child Care and Youth Development. Participants were from 10 …


Acculturation And Enculturation, Perception Of Depressive Symptoms, And Help-Seeking Behaviors Among Korean Americans, Kristoffer Park Jul 2016

Acculturation And Enculturation, Perception Of Depressive Symptoms, And Help-Seeking Behaviors Among Korean Americans, Kristoffer Park

Psychology Theses & Dissertations

The literature suggests that acculturation, enculturation, and the perception of mental health symptoms are some of the factors that explain help-seeking behaviors in Asian Americans. While there has been previous research addressing these concerns for Asian Americans as a unified ethnic group, few studies have examined these factors to explain help-seeking behaviors specifically in Korean Americans. 107 Korean Americans were recruited from Korean American churches in a large metropolitan city in the southeast region. Participants completed an online questionnaire, which included instruments assessing acculturation (AVS-R) and enculturation (EAVS-AA-R) levels as well as their perception of how problematic depressive symptoms were …


Effects Of Visibility And Alarm Modality On Workload, Trust In Automation, Situation Awareness, And Driver Performance, Smruti J. Shah Jul 2016

Effects Of Visibility And Alarm Modality On Workload, Trust In Automation, Situation Awareness, And Driver Performance, Smruti J. Shah

Psychology Theses & Dissertations

Driving demands sustained driver attention. This attentional demand increases with decreasing field visibility. In the past researchers have explored and investigated how collision avoidance warning systems (CAWS) help improve driving performance. The goal of the present study is to determine whether auditory or tactile CAWS have a greater effect on driver performance, perceived workload, system trust, and situation awareness (SA). Sixty-three undergraduate students from Old Dominion University participated in this study. Participants were asked to complete two simulated driving sessions along with Motion Sickness Susceptibility Questionnaire, Background Information Questionnaire, Trust Questionnaire, NASA Task Load Index Questionnaire, Situation Awareness Rating Technique …


The Relationship Between Trauma-Related Shame, Disordered Behaviors, And Contextual Factors Of Sexual Trauma Beyond Trait-Shame And Sex-Guilt, Michele Laaksonen Jul 2016

The Relationship Between Trauma-Related Shame, Disordered Behaviors, And Contextual Factors Of Sexual Trauma Beyond Trait-Shame And Sex-Guilt, Michele Laaksonen

Psychology Theses & Dissertations

Relatively little is known about the effect of contextual factors of sexual trauma (age at trauma, type of trauma, perpetrator gender, tactics, and relationship) and trauma-related shame and risk-taking motivations. Therefore, the current study aimed to examine this relationship among a sample of 360 undergraduate women with histories of sexual trauma, hypothesizing that trauma-related shame and motivations for participation in extreme sports, drinking games, and sex would differ based on the contextual factors of sexual trauma and the past experience of non-sexual trauma. Age was related to the linear combination of trauma-related shame and risk-taking motivations. Furthermore, contact, relationship, and …


A Counselor’S First Encounter With Non-Death Loss: A Phenomenological Case Study On New Counselor Preparation And Experience In Working With Non-Death Loss, Charles P. Carrington Jul 2016

A Counselor’S First Encounter With Non-Death Loss: A Phenomenological Case Study On New Counselor Preparation And Experience In Working With Non-Death Loss, Charles P. Carrington

Counseling & Human Services Theses & Dissertations

New counselors graduating from a CACREP master’s program are presumed to have competency to work with the common issues seen in clients. This study examined the lived experience and impact on new counselors when working with clients struggling with overt or covert non-death losses. Through qualitative case study of multiple (n=8) new counselors, the study presents the phenomenon of real-life experiences of counselors when first encountering clients with an issue of loss. Of primary interest was how new counselors identified loss in client’s issues, how they applied theory of interventions, the counselors level of confidence in training and preparedness to …


Examining Attitudes, Norms, And Control Toward Safety Behaviors As Mediators In The Leadership-Safety Motivation Relationship, Gargi Sawhney Jul 2016

Examining Attitudes, Norms, And Control Toward Safety Behaviors As Mediators In The Leadership-Safety Motivation Relationship, Gargi Sawhney

Psychology Theses & Dissertations

Research on occupational safety has been on the rise in recent years, owing to the high rates of deaths and disabilities that occur in the workplace. Findings suggest that unsafe behaviors and work-related accidents and injuries can be reduced through increasing employee safety motivation. Additional research has recognized leadership as a source of employee safety motivation. However, most studies have empirically assessed safety motivation and its antecedents using a cross-sectional design. Therefore, the aims of the current study were to examine effects of various safety-specific leader behaviors, following the full-range leadership model, on safety motivation using a time-lagged study design. …