Understanding Models of Performance Enhancement
from the Perspective of Emotion Regulation
Zella E. Moore
Frank L. Gardner
Frank L. Gardner
Recent years have witnessed immense growth in the emotion sciences. In particular, the concept of emotion regulation, and the strategies used to support such regulation have received a great deal of theoretical and empirical attention (Gross & Thompson, 2007). To date, there has been little effort to incorporate these scientific advances into the discipline of sport psychology. The current paper therefore seeks to consider both traditional and more contemporary approaches to performance enhancement from the perspective of emotion regulation, thereby offering suggestions for future research and practice.
Psychological skills training (PST) procedures, also referred to as mental skills training procedures, have been the primary intervention approaches for sport psychology professionals seeking to enhance athletic performance for well over three decades (Gardner & Moore, 2006). These procedures have historically been based upon a coping model (Meichenbaum, 1977),which has hypothesized that providing skills to enhance self-control (i.e., the capacity to control “negative” internal processes such as cognitions, physical sensations, and emotions) allows an individual to more effectively respond to and cope with high stress situations. While the efficacy of these procedures has been recently challenged (Gardner & Moore, 2006), they have remained the dominant model for providing psychosocial intervention for performance enhancement, especially within North America. Over the last decade, however, based upon extant research in clinical psychology which has challenged the notion that internal experiences need to be controlled or lessened in order to enhance psychological functioning (Hayes et al., 1999), newer acceptance based models of performance enhancement have been developed. These models seek to promote a modified relationship with internal experiences such as cognitions, sensations, and/or emotions rather than seeking to change their form or frequency (Gardner & Moore, 2007).
Whereas traditional PST models tend to view emotions as an “enemy” that needs to be defeated by being controlled or reduced, contemporary acceptance based behavioral therapies (ABBTs) seek to help the individual develop a different relationship with their emotions rather than emphasizing control or reduction of internal states. Using research terminology, the traditional PST model views emotion as a dependent variable, with pre-post intervention reduction seen as evidence of successful intervention. On the other hand, the more contemporary ABBT models view emotion as an independent variable to be manipulated or utilized, in some way, toward a more behaviorally based pre-post intervention outcome.
As might be expected with models of intervention that are philosophically different, the two models also hypothesize different mechanisms of action, that is,the processes by which they work (Gardner, 2009). The traditional models posit that changes in cognitive processes, reduction of experienced affect, and/or development of self-control skills are the vehicle by which these interventions work. The PST models, however, have not demonstrated empirical evidence in support of their assumed mechanism of action (Gardner & Moore, 2006). Conversely, acceptance-based models of performance enhancement, represented first and most clearly by the mindfulness-acceptance-commitment (MAC) approach to performance enhancement (Gardner & Moore, 2001, 2004, 2007), which have supportive empirical data for their efficacy, suggest that the intervention procedures works via a different hypothesized mechanisms of action (Moore, 2009).
Recent advances in the emotion sciences, specifically with regard to the processes underlying the regulation of emotional experiences, may shed light on ways to view these differing models from a single lens. In fact, this could offer possible ways in which traditional PST procedures can be used in a complimentary fashion with ABBTs, perhaps offering a theoretical and practical rapprochement between these seemingly divergent practice models in sport psychology. In providing this possible unifying theme, we must first consider the nature and function of human emotion.
From a functionalist perspective, emotions have evolved due to their value in helping us adapt to the situations and problems that we face as human beings. Emotion theorists have emphasized the importance of emotions in readying behavioral and physiological responses, facilitating decision making, and effectively navigating the myriad of interpersonal situations that we face (Gross & Thompson, 2007).Yet, emotions can have a maladaptive function when they occur in inappropriate situations, are too intense, are of excessive duration, and/or in some way interfere with goal-directed functional behavior.
Emotion, as currently conceived, consists of three fundamental components (Barlow et al., 2011). The first of these is a physiological component that gives rise to a subjective “feeling” state. The second is a cognitive component that consists of the variety of thoughts and images that occur with specific emotions. These first two components of emotion constitute the experience of emotion. Finally, the third component is a behavioral action tendency that reflects an individual’s learned manner of behaviorally responding to the experience of emotion. This component constitutes the expression of emotion. Thus, emotion can be seen as being a multi-component process that includes both the experience and expression of specific affect such as anger, anxiety, and sadness. Of course, the distinction of whether a given emotion is adaptive or maladaptive is contextual, and must include the question of whether it does or does not promote functional goal-directed action. Understanding this fully requires attention to a critical process that determines whether one’s emotion promotes goal-directed behavior or behavior in the service of avoidance of or escape from the experience of emotion itself. This process is calledemotion regulation.
Emotion regulation (ER) involves both internal and external processes responsible for experiencing, expressing, and modulating one’s emotions in the service of goal achievement (Thompson, 1994). ER processes can be either automatic or effortful (Gross &Thompson, 2007; Thompson), and include skills and strategies for monitoring, evaluating, experiencing, expressing, and modifying emotional reactions. It is important to note that ER can at times involve modulating the intensity or frequency of emotional states, but also involves the capacity to generate and sustain emotions when necessary and appropriate (Calkins & Hill, 2007).Moreover, ER processes are not solely focused on what might be considered “negative” emotions (i.e., anger and anxiety) but can include positive emotion (i.e., happiness) regulation as well (Gross & Thompson). In essence, ER constitutes a variety of processes that allow an individual to respond appropriately to the demands of his or her environment. While a comprehensive discussion of the processes involved in ER is beyond the scope of this article (see Gross, & Thompson for a comprehensive review), these processes include a variety of active cognitive and behavioral strategies. According to Gross and Thompson, there are two fundamental categories of emotion regulation strategies: (a) antecedent-focused strategies(i.e., prior to emotion being elicited), and (b) the response-focused strategy(i.e., after the emotion has been elicited).
Antecedent-focused emotion regulation strategies occur prior to the generation of emotion and are intended to modulate the forthcoming emotional experience (Gross & Thompson, 2007). Specific antecedent-focused strategies include:
While there are numerous antecedent-focused strategies, the literature indicates that there is one response-focused emotion regulation strategy, which occurs after the generation of emotion (Gross & Thompson, 2007). Ultimately intended to either reduce or tolerate the experience and expression of emotion, the strategy is referred to as response modulation. The response modulation strategy specifically involves attempts to influence emotional response tendencies, that is, the intensity and/or duration of one’s emotional experience and associated expression.
None of these emotion regulation strategies are either adaptive or maladaptive in and of themselves, and in fact, all people utilize these strategies on a daily basis as a component of our overall emotional experience as we navigate our way through life (Gross & Thompson, 2007). Instead, these strategies become maladaptive when (a) there is an overuse of any given emotion regulation strategy (to the exclusion of others), or (b) strategies are used to excessively control, limit, or even eliminate emotional experiences rather than pursuing personal goals and values along with the experience of emotion (Aldoa, Nolen-Hocksema, & Schwiezer, 2010; Barlow et al., 2011). In fact, recent evidence suggests that the excessive use of emotion regulation strategies for the purpose of excessively and unrealistically trying to control, reduce, or eliminate the experience of emotion appears to be a core transdiagnostic process for a wide range of psychopathological conditions such as generalized anxiety disorder, mood disorders, posttraumatic stress disorder, eating disorders, and borderline personality disorder, among others (Aldoa, Nolen-Hocksema, & Schwiezer, 2010; Barlow et al., 2011; Hayes, Wilson, Strosahl, Gifford, & Follette, 1996; Kashdan,Barrios, Forsyth, & Steger, 2006).
As previously noted, there have been two primarymodels of psychosocial intervention for the enhancement of athletic and other high-level performance. The first has been the traditional models of psychological (mental) skills training, and the second has been the more recent acceptance-based models of performance enhancement. It has previously been suggested that while the traditional PST model is considered to be the dominant approach in sport psychology (especially in North America), it has lacked a coherent and consistent over-arching theory by which to understand its possible relationship to human performance. As such, the PST model has not theoretically identified nor empirically tested specific mechanisms of action for its variety of techniques (i.e., goal-setting, self-talk, relaxation, imagery; Gardner, 2009). The contemporary acceptance-based models have directly explicated (and in some cases empirically tested) proposed mechanisms of action for its techniques (Gardner & Moore, 2007). However, despite the theoretical and empirical disparities between the two dominant models, the effective use of both traditional and more contemporary models of performance enhancement may be best understood from the context of emotion regulation and emotion regulatory strategies.
Based on the above considerations, the primary purpose of this article is to discuss each emotion regulation strategy in terms of the adaptive and maladaptive ways in which each may be used in the context of athletic performance, and how intervention techniques utilized in both models may target each emotional regulation strategy for its further development and/or modification. This process will serve to (a)highlight similarities and differences between these two current sport psychology intervention models,(b) offer suggestions with respect to which model might be most beneficial for which type of client, and) suggest ways in which strategies and techniques from both models may be seen as complementary. In this way, we hope to bridge the theoretical and empirical divide currently seen in the field of sport psychology, and offer new directions for both research and practice.
In this antecedent-focused emotion regulation strategy, an individual essentially chooses whether or not to enter into a situation that may elicit emotional responses. In the athletic domain, adaptive use of situation selection may be seen in circumstances in which athletes avoid social situations that might be either tempting (i.e., late night activities) or frustrating (i.e., social events that may include reporters and/or photographers) and thus avoid the possibility of “finding” trouble, or in circumstances in which the athlete chooses to engage in calm precompetitive situations rather than more frenetic and stressful ones. On the other hand, excessive or maladaptive uses of situation selection could include avoiding off-season training or even injury rehabilitation in order to avoid boredom, pain/discomfort, task difficulty, anxiety, etc. While all athletes at one time or another utilize situation selection to avoid a particularly noxious situation or experience, it is when use of this strategy becomes frequent that negative consequences ensue. In an effort to combat the overuse of situation selection and its maladaptive consequences, practitioners using PST procedures might use goal-setting as a technique to enhance necessary goal-directed behavior and to move the athlete beyond situation selection. Since the athlete was using situation selection as a means of avoiding some aspect of the training experience, goal-setting may be used to reduce the behavioral avoidance caused by this emotion regulation strategy. From the acceptance-based perspective, ABBT procedures would likely focus on exposure-based strategies to develop greater distress tolerance and further promote behaviorally-activated commitment to values-driven behavior, as an alternative to the emotion-driven avoidant behavior at the heart of the excessive use of situation selection.
In this antecedent-focused emotion regulation strategy, once an individual chooses to enter a situation, he or she may act on the situation in an effort to modify its emotional impact. An athlete may choose to engage in active coping by assertively speaking to a teammate or coach when an interpersonal conflict may occur, or may react with humor during a tense bus-ride on the way to an important competition. These are examples of adaptive uses of situation modification. However, as with all emotion regulation strategies, maladaptive uses may also occur. For example, while superstitious behavior is common among athletes, there are occasions in which the behavior becomes pernicious. In these circumstances, the behaviors are more like the compulsive rituals seen in obsessive-compulsive disorder and the superstitions become safety behaviors. In such cases, the behaviors effectively reduce anxiety, yet after this the athlete believes that either positive outcomes and/or the absence of negative outcomes are in part the result of the superstitious behavior (i.e., the superstitious behavior becomes negatively reinforced) and not the skill set of the athlete. A less extreme example is the athlete who attempts to be humorous and/or chatty in a tense pre-competitive situation in order to modify the (to him or her) intolerable tension in the locker-room, and thus interferes with the concentration and pre-competitive preparation of teammates. The problematic use of this emotion regulation strategy is not based on its occasional use. Instead, it is the overuse of this strategy that is maladaptive, and such actions should be seen as another means of avoiding or escaping situations that elicit uncomfortable emotions. Traditional PST procedures that emphasize the development of effective communication and other interpersonal skills can serve a positive situation modification function when such communication can alter the emotion-eliciting components of athletic participation/competition (i.e., discussing roles and responsibilities with staff to reduce uncertainty about an upcoming competitive situation). Similarly, pre-competitive routines, a form of traditional behavioral stimulus control, are often used as a form of situation modification. In this regard, this technique reduces extraneous emotion-eliciting stimuli and promotes concentration on the competitive task at hand by reducing the available stimuli that may potentially trigger emotional reactions. In addition to these behaviorally oriented stimulus control-based pre-competitive routines, practitioners utilizing ABBT procedures are more likely to utilize mindfulness meditative exercises to promote a non-judging acceptance of, and in turn a decentering from, internal experiences. The result of this is greater tolerance of and/or comfort with the experience of emotion, thus reducing the need to modify a given situation in order to reduce, avoid, or escape associated emotional experiences.
Unlike the first two antecedent-focused emotion regulation strategies (situation selection and situation modification), attentional deployment does not seek to modify the person-environment interaction. Instead, in this emotion regulation strategy, the individual redirects attention within a given situation in order to influence an emotional experience. Adaptive efforts at attentional deployment often seen among competitive athletes involve redirecting attention from distracting or task-irrelevant stimuli (i.e., excessive precompetitive concerns about tickets or general arrangements for family coming to witness competitive events) onto more task-relevant stimuli (i.e., competitive strategy).Deep breath-oriented relaxation exercises (i.e., arousal control), often used within the PST armamentarium, can similarly be seen as an attentional deployment strategy if they are done prior to the onset of heightened arousal and are utilized as a means of redirecting attention from contemplation of future competitive situations (i.e., worry) to one’s own bodily activities (i.e., breathing).
In contrast, maladaptive forms of attentional deployment include rumination, worry, and distraction. Hayes and colleagues (2010) have referred to maladaptive attentional deployment strategies such as rumination and worry as avoidant concentration. In maladaptive forms of attentional deployment, individuals expend a great deal of time and effort analyzing and replaying historical events or planning and mentally rehearsing future events in an attempt to prevent or reduce the likelihood of a reoccurrence of emotional distress. At the core of these often-utilized strategies is the fact that attention is diverted from the present moment to the past or future. While counterintuitive, the empirical data strongly suggest that rumination and worry are negatively reinforced by their avoidance of the present and associated dampening of the full experience of emotion, including reduction in the physiological arousal component of the emotional experience. In essence, despite the increase in cognitive activity associated with directing attention to the replaying of the past and/or planning for the future, the individual actually (and subtly) experiences a lessening of uncomfortable physiological arousal (Borkovec, 1994; Borkovec & Hu, 1990; Gardner & Moore, 2006). This cognitive-avoidant function of rumination and worry is associated with a variety of negative outcomes such as impaired decision-making and the prevention of habituation to emotion-inducing stimuli (Butler & Gross, 2004). In addition, processes such as rumination and worry have been found to be associated with other forms of cognitive avoidance such as maladaptive perfectionism (Santanello & Gardner, 2007).
Finally, distraction is another (and possibly the most common) form of attentional deployment, and involves the refocusing of attention onto non-emotional aspects of a situation. The use of imagery scripts by PST-oriented sport psychologists can be seen as a strategy to promote an adaptive form of attentional deployment. These scripts may bypass the affective aspects of a given situation by focusing the athlete on performance-relevant positive behaviors, and thus modifying the affect-eliciting aspects of the situation. Similarly, as noted earlier, relaxation exercise can provide a similarly distracting attentional deployment function.
In contrast to traditional PST procedures such as imagery or relaxation that seek to control attention deployment processes, ABBT strategies are more likely to utilize mindfulness based interventions. Mindfulness exercises pursue effortless and automatic self-regulation of attention for the purpose of maintaining awareness of one’s immediate experience. There is no effort to attend to internal or external stimuli pre-defined as “good” or “bad,” but rather, the effort is to promote the idea that one will inevitably experience a wide variety of naturally occurring experiences. In turn, the development of mindfulness promotes an enhanced awareness of one’s internal and external experiences. Within a context of curiosity and acceptance, the development of mindfulness promotes greater attention to, and awareness of, present moment stimuli and contingencies, an outcome associated with high levels of human performance (Czikszentmihalyi, 1990; Gardner & Moore, 2007, 2010).
The final antecedent-focused emotion regulation strategy is cognitive modification, in which an individual seeks to modify a potential emotional response by changing the meaning or the frequency of thoughts about a particular situation. In essence, this familiar strategy involves the alteration of one’s appraisal about (i.e., how one thinks about) an impending situation. Empirical research suggests that antecedent reappraisal, that is, reframing or in some way modifying one’s thoughts about an impending situation, can have a positive impact on the emotional experience of confronting a given situation (Gross & John, 2003). For example, an athlete may reframe a stressful upcoming competition to one of challenge and fun. In this way, true reappraisal has obvious and clear benefits. However, many individuals (including competitive athletes) engage in suppression, that is, an attempt to control one’s thoughts not by reconsideration and logical reappraisal, but by (a) rote language substitution (i.e., efforts at simply applying positive self-statements);(b) efforts to “not think about” emotion eliciting situations (e.g., suppression, “though stopping”);and/or (c) resistance/non-acceptance of thought processes (i.e., “I can’t think this way,” “I would do anything to not think like this,” “Thinking this way will lead to failure”). In contrast to the benefits of cognitive reappraisal, cognitive suppression, particularly when used excessively, has been shown to have a number of pernicious outcomes, including reduced psychological well-being and actual increases in the frequency and intensity of negative thoughts and images (Gardner & Moore, 2007).Traditional PST’s use of self-talk modification procedures, if done in a rote, language replacement-oriented fashion as noted above, can easily promote a maladaptive emotion regulation strategy and in turn result in unanticipated negative outcomes. In fact, qualitative reviews of the literature have found that self-talk procedures used in sport psychology research have led to mixed and very often negative results, suggesting that these procedures are not empirically supported and should be reconsidered for standard use in the field (Gardner & Moore, 2006; 2007; Moore, 2003). The emotion regulation literature, and the theoretical material provided herein, may help to provide a theoretical explanation for these findings. As such, we suggest that while developing appropriate pre-event (antecedent) reappraisal strategies might very well be helpful to competitive athletes in specific situations, the use of self-statement modification as described above should be avoided in research programs and professional practice.
In contrast to traditional PST efforts to control or in some way modify cognitive processes, ABBT oriented practitioners take a very different stance with regard to thought processes. Rather than viewing thoughts as something to be controlled or reduced, the ABBT model sees human cognition as a natural and unavoidable part of human existence, including cognitive content that may be seen as either positive or negative. As such, the ABBT approach to the use cognitive modification as an emotion regulation strategy focuses on two things. First, the focus is on helping individuals become comfortable with accepting the full array of their thoughts as (a) naturally occurring, (b) neither good nor bad, right nor wrong, and (c) not requiring effort to eliminate, reduce, or control. Second, individuals are helped to develop a decentered perspective from their thoughts. In this regard, they come to view their thoughts as internal events that their mind is telling them, and they learn that their thoughts are not necessarily facts or absolute realities that must be seen as requiring action. This two-pronged approach to cognition seeks to modify the relationship one has with his or her thoughts, along with its power to direct or influence behavior, rather than modify the frequency and/or content of thoughts. This process is achieved through the combined use of mindfulness and cognitive defusion exercises (see Gardner & Moore, 2007, for a complete review of such ABBT procedures).
The final emotion regulation strategy is response modulation. This response-focused strategy occurs later in the emotion-generative process, occurring after the generation of emotion. This strategy is intended to in some way influence the experiential, behavioral, or physiological response tendencies associated with particular emotions. Interestingly, there appear to be two broad types of response modulation emotion regulation strategies – one of which has consistently been found to result in a wide array of negative outcomes, and one has uniformly been demonstrated to result in positive outcomes. Efforts at experiential and/or expressive suppression of emotion, that is, direct efforts at not experiencing or in any way expressing emotion, has consistently been shown in theoretical, experimental, and clinical research to result in maladaptive outcomes including impaired decision-making and the development and maintenance of psychopathology (Fairholme et al., 2010; Gross & John, 2003; Hayes et al., 1996; Kashdan et al., 2006; Menin et al., 2002). This desire to reduce, avoid, escape, or in some way limit the full experience of emotion has been termed experiential avoidance (Hayes et al., 2006; Gardner & Moore, 2007). While expressive suppression (i.e., experiential avoidance) of emotion has as its primary purpose the reduction of the emotional experience, empirical data have indicated that it in fact has a paradoxical effect of increasing both experiential and physiological components of emotion in healthy individuals (Gross & John). Given the above findings, and given the traditional goal of PST procedures to reduce “negative” emotions in an effort to create the ideal performance state, it can be hypothesized that efforts to control or in some way inhibit emotion can be expected on theoretical grounds to have a potentially deleterious impact on human performance. This is consistent with previous reviews of PST outcome literature suggesting that even when emotional suppression has in fact occurred as a result of the use of traditional PST strategies and procedures, no associated increases in competitive performance have been found (Gardner & Moore, 2006). Examples of response modulation as a function of PST procedures might be the use of relaxation exercises after the generation of emotion has already occurred or even the response-focused use of self-talk procedures, that is, efforts at cognitive modification after emotions have been generated (as opposed to the antecedent-focused use noted earlier). In contrast, adaptive emotion modulation strategies encourage acceptance of internal processes such as emotions, and thus allow for these normal and natural events to occur without the need to resist or otherwise modify them. The stance of acceptance which is promoted by ABBT models, allow for the rise and passage of emotions without the need to avoid or control the experience and thus allow for a more adaptive experience and ultimately expression of those emotions. In this context, emotions are seen as naturally occurring, which come and go, requiring no need for control. As these experiences thus require less active effort to control or avoid, they also become less distracting and in turn have less impact on competitive situations. This may offer an interesting theoretical perspective with regard to the suggestion in the PST literature that simulation training has been found to be a successful approach to performance enhancement (Hardy, Jones, & Gould, 1996). From an emotion regulation perspective, simulation training offers an opportunity for the full and complete experience of relevant emotional experiences without avoidance or control, thus allowing for the habituation of emotion eliciting stimuli and the development of greater tolerance/acceptance of experiences associated with competition (including emotional experiences). This therefore reduces the possibility that these experiences will become a performance distraction.
The difference in beliefs about, and emphasis on, the need for and importance of control vs. acceptance of emotional experience is probably the greatest single difference between the traditional PST and more contemporary ABBT models, and is the one where rapprochement is most problematic. Just as self-control is central to the coping skills models that are at the foundation of PST approaches, acceptance is foundational to the ABBT model.
An interesting consideration in the discussion of the theoretical and empirical differences between emotion control and emotion acceptance is the fact that this is the one emotion regulation strategy in which the culture of sports often reinforces maladaptive strategies for emotion regulation. The sport/athletic culture often views the experience and expression of emotion as in some way contrary to the concept of (mental) toughness, and as such, creates institutional-social reinforcement of an emotion regulation strategy that has clear maladaptive qualities. We have often wondered if the close relationship between sport psychology and the athletic culture has contributed to the slow adoption of the newer acceptance based models which suggest interventions that run contrary to the prevailing sporting culture.
Emotion Regulation Guided Psychological Skills Training
Given the above discussion, and the appreciation that many practitioners grounded in PST procedures are unlikely to completely abandon the strategies and techniques in which they have been trained, an unanswered question is: how can PST procedures be adapted to better fit with the extant empirical evidence of adaptive emotion regulation strategies? The answer to this question requires that the practitioner carefully consider the aforementioned emotion regulation function of PST procedures rather than the assumed performance enhancement outcomes of such techniques. From this perspective, the practitioner might consider the following guidelines for emotion regulation guided (traditional) psychological skills training practice:
Considering psychological skills training from the perspective of emotion regulation provides some explanation for the aforementioned problematic outcome research data on traditional PST model. As is the case in any scientifically based profession, the capacity for a discipline to openly and critically review its empirical base, consider relevant theoretical formulations in contemplating modifications of its procedures, and engage in empirical evaluation of those theoretically informed revisions is the hallmark of a mature science (Moore, 2009). As the young field of sport psychology attempts to demonstrate its professional maturity through this scientific process, the present article offers several possible practice modifications and research agendas. As for future research directions, researchers can consider and assess/evaluate emotion regulation strategies as a potential mechanism of action in performance enhancement efforts. Practice implications include considering the differing impact of a change vs. acceptance based strategy and philosophy in working with athletes; integrating traditional and acceptance based strategies in performance enhancement efforts; and choosing intervention strategies based on understanding both emotion regulation and which strategies the client is using in a maladaptive ways, with a practice focus on goal attainment and not the short-term reduction of negative experiences. These constitute important research directions and clear practice implications.
The purpose of this paper was to (a) discuss contemporary findings in emotion science, specifically with regards to emotion regulation strategies, (b) present an alternative explanation for the possible mechanism by which traditional psychological skills training procedures might be effective, and (c) suggest possible theoretically and empirically informed uses of psychological skills training procedures that might enhance their efficacy. In addition, it was hoped that comparing and contrasting traditional psychological skills training procedures with more contemporary acceptance-based behavioral procedures through the lens of emotion regulation might offer researchers and practitioner a greater understanding of the similarities and differences, as well as suggest some avenues of rapprochement between these two fundamentally different models.
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Author Note: Correspondence concerning this article should be addressed to Zella E. Moore, Psy.D., Department of Psychology, Manhattan College, 4513 Manhattan College Parkway, Riverdale, New York 10471. Phone: 718-862-7810. Email: [email protected]
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