Before people seek support for an issue, they must choose whom in their support network to approach. Two prominent supporter-selection hypotheses are the attachment figure hypothesis and the strong ties hypothesis, housed in psychology and sociology, respectively. People are expected to have a special preference for attachment figures and also for strong ties and to seek them more frequently than others. Despite the widespread acceptance of these hypotheses, neither has ever been tested, we argue, with the most appropriate methods for their claims. Moreover, no one has ever tested whether the 2 theories might not be independent, that is, whether one might subsume the other. To properly test the theories, one requires intranetwork, enacted support-seeking data, and the theories must be modeled not just separately but also simultaneously. The present article reports 3 such studies. In Studies 1 and 3, a sample of adults reported their supporter-selection decisions for a single stressful event, and in Study 2, a sample of emerging adults reported their supporter-selection decisions for a period of 2 weeks. Evidence showed that each theory uniquely predicted supporter-selection decisions. For each theory the data revealed both expected and unexpected findings. Attachment figures were selectively sought for support, but this preference did not get stronger as issues became more severe. Stronger ties were selected more often than weaker ties; however, the strong tie effect emerged as 2 independent effects rather than one (closeness and interaction frequency). Taken together, the studies supported both theories, but also suggest the need for further theoretical development.

The attachment figure construct is the centerpiece of attachment theory. Research has suggested that most adults have three to five such figures at any given time, many of whom are in normative attachment roles, such as mothers, fathers, and romantic partners, but some of whom are not, such as friends and other family members. An important challenge in attachment research is to identify who a given individual's unique attachment figures are. In this paper, we review the definitional criteria for attachment figures and summarize existing methods to identify idiographic attachment figures. While recognizing the advancements current measures have brought the field, we argue that they oversimplify the challenges in attachment figure identification. We argue that if one uses enacted behavioral data rather than perceived data to measure specific attachment criteria, one quickly encounters unsolvable complexities that preclude attachment figure classifications. This has deep implications for the status of attachment figure construct itself. We outline the implications for current attachment theory and discuss potential paths forward.

The assessment of medical mistrust is essential to progress in understanding behavioral health outcomes such as vaccine hesitancy, treatment adherence, and patient-practitioner relationships. To address limitations of existing medical mistrust scales and to address a need for clear psychometric information, a new Medical Mistrust Multiformat Scale (MMMS) was developed and tested. Study 1 included 741 Black and White participants with hypertension, with one subsample used for item selection and a second for cross-validation. Study 2 included 234 lower-income participants with diabetes or hypertension representing diverse racial/ethnic identities. All participants were recruited via marketing panels to complete online questionnaires. In both studies, the MMMS fit a unidimensional factor structure; items demonstrated high discrimination; and the scale was correlated with vaccine compliance. In Study 1, measurement invariance was demonstrated across Black and White groups. In Study 2, the MMMS correlated with additional tested outcomes regarding treatment adherence and patientpractitioner relationships, all effects remained significant after controlling for other related variables (conspiracy beliefs, race/ethnicity, political affiliation, stress), and the MMMS produced significantly larger convergent validity effects than a widely used existing mistrust scale. Results highlight the importance of medical mistrust and support use of the MMMS to assess mistrust in populations that include people with diverse racial/ethnic identities, people with chronic medical conditions, and people with lower incomes. Public Significance StatementIn this study, a new 6-item questionnaire was developed for assessing the extent to which people mistrust medical authorities (the Medical Mistrust Multiformat Scale). Results demonstrate that this scale performs better than a widely used existing scale and that medical mistrust is important for understanding vaccine hesitancy, adherence to medical treatment plans, and quality of patient-practitioner relationships.

This study tested a conceptual model identifying two distinct types of attitudes people may have toward following recommendations to prevent COVID-19. These attitudes were expected to be important for understanding types of systemic and social variables associated with health disparities such as racial discrimination, residential environment, lack of healthcare access, and negative healthcare experiences. The conceptual model was drawn from previous work examining adherence to medical recommendations that identified two distinct and consequential attitudes that influence behavior: perceived benefit (believing recommendations are effective and necessary) and perceived burden (experiencing recommendations as unpleasant or difficult). Approximately equal proportions of Black and White individuals living in the USA ( N = 194) were recruited to complete an online survey. A psychometric analysis indicated that perceived benefit and burden attitudes were two distinct and meaningful dimensions that could be assessed with high validity, and scales demonstrated measurement invariance across Black and White groups. In correlation analyses, benefit and burden attitudes were robustly associated with neighborhood violence, healthcare access, and healthcare experiences (but not with experiences of discrimination), and all these associations remained significant after accounting for subjective stress and political affiliation. These findings have implications for increasing compliance to public health recommendations and addressing health disparities.

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