Sunday, October 24, 2021

Asexual participants scored significantly lower on approach (but not avoidance) social motivation than both heterosexual & LGB participants, indicating they are less motivated to enhance positive experiences & behavior in their social relationships

Asexual Identity, Personality, and Social Motivations in a New Zealand National Sample. Lara M. Greaves, Samantha Stronge, Chris G. Sibley & Fiona Kate Barlow. Archives of Sexual Behavior, Oct 20 2021.

Abstract: Growing research interest in asexuality has led to several notable findings around the differences between asexual people and those with other sexual orientations. These findings have recently extended to personality, but questions remain around differences in personality between asexual people and others. Furthermore, qualitative and quantitative research disagrees about whether asexual people are less interested in close relationships than others. This paper used data from a nationally representative sample of self-identified asexual participants (Analysis 1: nwomen = 216, nmen = 54, ngender diverse = 13; Analysis 2: nwomen = 53, nmen = 19, ngender diverse = 3) and matched samples of heterosexual and lesbian, gay, and bisexual/plurisexual (LGB) participants (N’s = 75–283) drawn from the New Zealand Attitudes and Values Study (Ns = 19,396–54,183) to explore personality (Analysis 1) and approach and avoidance social motivations (Analysis 2). Compared to heterosexuals, asexual participants reported significantly lower extraversion, agreeableness, and conscientiousness, and higher emotionality, openness, and honesty-humility. Compared to those who identified as LGB, asexual participants reported significantly lower extraversion and agreeableness and higher honesty-humility. In addition, asexual participants scored significantly lower on approach (but not avoidance) social motivation than both heterosexual and LGB participants, indicating that they are less motivated to enhance positive experiences and behavior in their social relationships. These results help to clarify how personality and social motivations covary with sexual identity.

Brain imaging before and after COVID-19 in UK Biobank

Brain imaging before and after COVID-19 in UK Biobank. Gwenaƫlle Douaud et al. medRxiv Aug 18 2021.

Abstract: There is strong evidence for brain-related pathologies in COVID-19, some of which could be a consequence of viral neurotropism, or of neuroinflammation following viral infection. Most brain imaging studies have focused on qualitative, gross pathology in moderate to severe cases, most typically carried out on hospitalised patients. It remains unknown however whether the impact of SARS-CoV-2 infection can be detected in milder cases, in a quantitative and automated manner, and whether this can reveal possible mechanisms for the spread of the disease. UK Biobank scanned over 40,000 participants before the start of the COVID-19 pandemic, making it possible in 2021 to invite back hundreds of previously-imaged participants for a second imaging visit. Here, we studied the possible brain changes associated with the coronavirus infection using multimodal MRI data from 785 adult participants (aged 51–81) from the UK Biobank COVID-19 re-imaging study, including 401 adult participants who tested positive for SARS-CoV-2 infection between their two scans. We used structural, diffusion and functional brain scans from before and after infection, to compare longitudinal changes between these 401 SARS-CoV-2 cases and 384 controls who had either tested negative to rapid antibody testing or had no COVID-19 medical and public health record, and who were matched to the cases for age, sex, ethnicity and interval between scans. The controls and cases did not differ in blood pressure, body mass index, diabetes diagnosis, smoking, alcohol consumption, or socio-economic status. Using both hypothesis-driven and exploratory approaches, with false discovery rate multiple comparison correction, we identified respectively 68 and 67 significant longitudinal effects associated with SARS-CoV-2 infection in the brain, including, on average: (i) a more pronounced reduction in grey matter thickness and contrast in the lateral orbitofrontal cortex (min P=1.7×10-4, r=-0.14) and parahippocampal gyrus (min P=2.7×10-4, r=-0.13), (ii) a relative increase of diffusion indices, a marker of tissue damage, in the regions of the brain functionally-connected to the piriform cortex, anterior olfactory nucleus and olfactory tubercle (min P=2.2×10-5, r=0.16), and (iii) greater reduction in global measures of brain size and increase in cerebrospinal fluid volume suggesting an additional diffuse atrophy in the infected participants (min P=4.0×10-6, r=-0.17). When looking over the entire cortical surface, these grey matter thickness results covered the parahippocampal gyrus and the lateral orbitofrontal cortex, and extended to the anterior insula and anterior cingulate cortex, supramarginal gyrus and temporal pole. The increase of a diffusion index (mean diffusivity) meanwhile could be seen voxel-wise mainly in the medial and lateral orbitofrontal cortex, the anterior insula, the anterior cingulate cortex and the amygdala. These results were not altered after excluding cases who had been hospitalised. We further compared hospitalised (n=15) and non-hospitalised (n=386) infected participants, resulting in similar findings to the larger cases vs control group comparison, with, in addition, a marked reduction of grey matter thickness in fronto-parietal and temporal regions (all FDR-significant, min P=4.0×10-6). The 401 SARS-CoV-2 infected participants also showed larger cognitive decline between the two timepoints in the Trail Making Test compared with the controls (both FDR-significant, min P=1.0×10-4, r=0.17; and still FDR-significant after excluding the hospitalised patients: min P=1.0×10-4, r=0.17), with the duration taken to complete the alphanumeric trail correlating post hoc with the cognitive and olfactory-related crus II of the cerebellum (FDR-significant, P=2.0×10-3, r=-0.19), which was also found significantly atrophic in the SARS-CoV-2 participants (FDR-significant, P=6.1×10-5, r=-0.14). Our findings thus relate to longitudinal abnormalities in limbic cortical areas with direct neuronal connectivity to the primary olfactory system. Unlike in post hoc cross-sectional studies, the availability of pre- infection imaging data mitigates to some extent the issue of pre-existing risk factors or clinical conditions being misinterpreted as disease effects. We were therefore able to demonstrate that the regions of the brain that showed longitudinal differences post-infection did not already show any difference between (future) cases and controls in their initial, pre-infection scans. These brain imaging results may be the in vivo hallmarks of a degenerative spread of the disease — or of the virus itself — via olfactory pathways (a possible entry point of the virus to the central nervous system being via the olfactory mucosa), or of neuroinflammatory events due to the infection, or of the loss of sensory input due to anosmia. Whether this deleterious impact can be partially reversed, for instance after improvement of the hyposmic symptoms, or whether these are effects that will persist in the long term, remains to be investigated with additional follow up.

Men are more likely to seek help with their relationships online, are more expressive of their emotions (e.g., discussing the topic of “heartache”), & show language patterns generally consistent with more secure attachment

Dirty laundry: The nature and substance of seeking relationship help from strangers online. Charlotte Entwistle et al. Journal of Social and Personal Relationships, October 23, 2021.

Abstract: Interpersonal relationships are vital to our well-being. In recent years, it has become increasingly common to seek relationship help through anonymous online platforms. Accordingly, we conducted a large-scale analysis of real-world relationship help-seeking to create a descriptive overview of the nature and substance of online relationship help-seeking. By analyzing the demographic characteristics and language of relationship help-seekers on Reddit (N = 184,631), we establish the first-ever big data analysis of relationship help-seeking and relationship problems in situ among the general population. Our analyses highlight real-world relationship struggles found in the general population, extending beyond past work that is typically limited to counseling/intervention settings. We find that relationship problem estimates from our sample are closer to those found in the general population, providing a more generalized insight into the distribution and prevalence of relationship problems as compared with past work. Further, we find several meaningful associations between relationship help-seeking behavior, gender, and attachment. Notably, numerous gender differences in help-seeking and romantic attachment emerged. Our findings suggest that, contrary to more traditional contexts, men are more likely to seek help with their relationships online, are more expressive of their emotions (e.g., discussing the topic of “heartache”), and show language patterns generally consistent with more secure attachment. Our analyses highlight pathways for further exploration, providing even deeper insights into the timing, lifecycle, and moderating factors that influence who, what, why, and how people seek help for their interpersonal relationships.

Keywords: Relationship help-seeking, natural language analysis, relationship problems, attachment, social media

In the present study, we provide novel insights into the nature and substance of relationship problems—based on a sample of Reddit users—using natural language analysis methods. To our knowledge, this is the first study that has provided a large-scale, high-resolution, naturalistic view of relationship problems and relationship help-seeking in situ within the general population.

The first aim of the present study was to describe the demographic composition of online relationship help-seekers relative to those who typically seek help in more traditional/professional contexts. We examined the age and gender of individuals seeking relationship help online via the r/relationships subreddit, finding a greater percentage of men soliciting relationship help than women. Interestingly, this differs from traditional, professional contexts, where women are typically more willing and active in seeking help for their relationship problems compared to male partners (Stewart et al., 2016). This discrepancy in findings supports our notion that men may find anonymous, online relationship help settings preferable to in-person contexts, likely due to stigma attached to help-seeking behavior in men (Hammer et al., 2013Vogel et al., 2011). As mentioned above, these results could also be interpreted as an over-representation of help-seeking by female users relative to the baseline demographic composition of our sample (Duggan & Smith, 2013). Given that we do not have access to the demographics of passive users who do not post to the subreddit, we suggest that our conclusions on the contribution of gender toward the propensity to seek relationship help online be interpreted tentatively.

Those posting to the r/relationships platform were found to be considerably younger (average age 24 years) than people who typically seek relationship help in more traditional contexts (average age range 38–41 years; Duncan et al., 2020Schofield et al., 2015), with the majority of r/relationships users falling in the 18–24 age bracket. This finding suggests that the anonymous, convenient, and broadly accessible nature of the online help-seeking space enables those who traditionally under-represented or less likely to seek help (e.g., young men) by overcoming barriers related to stigma or resource availability. These results complement the wider support-seeking literature highlighting that online spaces provide greater opportunities for support-seeking through the erosion of barriers associated with traditional contexts (DeAndrea, 2015Vitak & Ellison, 2013). Notably, given that online relationship help-seeking is particularly common among younger age groups, it could be inferred that the informality of the online help-seeking environment is providing means for people to seek help and advice for more casual and early-stage relationships (e.g., at the “dating stage”) compared to the stage at which people more commonly seek professional relationship help (i.e., after several years of marriage).

Our topic modeling approach revealed 25 themes that help to illuminate the topography of relationship problems in the general public. Analysis of the distribution of themes revealed that the most commonly discussed topic on the r/relationships platform was “heartache,” supporting the notion that romantic dissolution and breakups are particularly distressing life events (LeFebvre et al., 2015). Moreover, the frequent discussion of feeling heartache is interesting given that this is not a specific relationship problem being discussed. Rather, people appear to simply be using the online platform to express their distress and seek general emotional support from others, suggesting that the emotional pain experienced following relationship problems or dissolution is perhaps the strongest motivator of reaching out for social support—more so than seeking to resolve any particular problem in and of itself.

What is particularly revealing from our analyses is that the main motivators identified for relationship help-seeking in the digital space were generally consistent with the main reasons for seeking relationships help identified from previous research in more traditional, professional contexts. Specifically, in line with previous research highlighting communication difficulty as the most common motivator for seeking professional relationship help (Doss et al., 2004Duncan et al., 2020Roddy et al., 2019), as well as being the leading cause for romantic breakups (Morris et al., 2015), communication was also found to be the most-discussed relationship problem within our sample (discounting the general topic of heartache). Other core themes captured from the r/relationships discussions are also consistent with the main reasons for professional relationship help-seeking, such as issues relating to intimacy, trust, finances, and housework. This consistency in relationship help-seeking motivators between anonymous, online contexts and more traditional, professional contexts strengthens the idea that many relationship problems are common and ubiquitous.

Critically, we find that in many cases, our results reflect more realistic real-world prevalences of relationship problems outside of therapeutic contexts. For example, the WHO reports that around 13% of surveyed women report some form of intimate partner abuse in the previous 12 months (World Health Organization, 2021); our analyses found that 12.14% of submissions contained a non-negligible reference to the “abuse” MEM theme, strongly contrasting with only 1.3% in intervention contexts (Roddy et al., 2019). Similarly, other relationship problems, such as communication difficulties and conflict, may be over-represented in traditional contexts (e.g., 27.2% in Roddy et al., 2019; our sample: 18%). Other themes showed strong convergence with past work. For example, we found highly similar rates of family/parenting problems being raised as reported in past work (7.12% in our sample; 6.6% in Roddy et al., 2019).

Our analysis of relationship problems revealed small, consistent gender differences. Among the more pronounced gender differences, men more commonly discussed themes of school (the largest gender difference), heartache, dating, partying, personal qualities, and language; women more commonly discussed themes related to finances, abuse, physical distance, and housework. Notably, the fact that the heartache theme was more commonly discussed by men emphasizes how men are at least as equally as affected by relationship problems as women and feel comfortable to express and seek support for their distress in online, anonymous settings. We therefore re-emphasize that existing gender differences identified within traditional contexts may at least partially be a result of stigmatization and pressure to conform to stereotypes. However, our finding that women discussed things like abuse, finances, and housework more than men instead indicates some continuation of gender norms “spilling over” into the online platform. Rather than eliminating or reversing gender norms, the anonymous online platform instead appears to provide a space where gender norms and stereotypes are relaxed, particularly those that carry strong stigma (e.g., expression of emotional distress by men).

Last, we explored the use of online relationship help-seeking as a digital trace for generating novel insights into the relationship between gender and romantic attachment. We examined gender differences in romantic attachment through the analysis of pre-selected linguistic markers of attachment states-of-mind, building on limited previous work in this domain. Overall, the general patterns of language used by men and women discussing their relationships on the r/relationships platform appears to suggest that women may be more prone to preoccupied attachment states, whereas men may be more inclined toward secure attachment states. These findings align, in part, with those from previous research suggesting that women are more prone to preoccupied attachment (Haydon et al., 2014)—and, importantly, extends them into everyday life in the real world. However, our findings run counter to previous research indicating that men are more prone to dismissive attachment (Haydon et al., 2014). While several explanations for such patterns are possible, we suggest that modern, online help-seeking platforms may allow men to behave in ways that contradict the dismissive stereotype, again highlighting the powerful role of stereotypes in in-person relationship help-seeking behavior (as similarly shown when considering cross-cultural differences; (Schmitt, 2003). Nevertheless, it is important to emphasize that we did not possess established measures of attachment style in our study. Moreover, we do not know the extent to which various attachment styles self-selected into the r/relationships platform, potentially skewing the representativeness of our sample.

Limitations and future directions

While the current study comprises a large, real-world sample, it is not a globally representative sample. Given that our data were collected from a single website—albeit one of the most visited websites in the world (Alexa, 2020)—our sample may be biased in ways consistent with its user base, both demographically (e.g., younger, male, American) and psychosocially. It is therefore possible, for example, that the skew toward men and younger people within our sample could simply be a product of the demographic composition of Reddit. Despite such limitations, our sample is large, diverse, and highly international, creating a strong starting and comparison point for future research in this domain.

We also note the tentative nature of our findings pending further exploration in samples with more varied measures. For instance, within our sample, we cannot say whether gender differences were confounded with the current “stage” of relationship problems people were experiencing. Indeed, the choice to seek help online versus professionally is likely shaped by complex interactions between characteristics of the individual, such as gender and age, and characteristics of the relationships, including specific relationship problems and stage of relationship, and the language that partners use to convey and make sense of those problems. While such intricacies are beyond the scope of the current study, future research should aspire to disentangle such complexities.

Regarding our findings involving various gender differences, it is possible that women are more likely to seek relationship help once their relationship problems are at a more severe stage (see, e.g., Ansara & Hindin, 2010), whereas men may be more likely to seek relationship help at a much earlier, less severe stage, for example. Indeed, gender differences in the themes discussed do seem to suggest that men may in fact be seeking support for relatively more casual, early-stage relationship problems compared to women. For example, men more commonly discussed lighter topics stereotypically associated with youth and greater immaturity, such as dating and partying, whereas women spent more time discussing more serious topics, such as abuse and finances. Were there gender differences in the stage of relationship problems for which people were soliciting help, it is possible that this may have at least partially driven our associations found between gender and attachment state. We are unable to determine the presence or absence of such effects within our current sample.

Last, although the present findings provide novel insights into relationship help-seeking in online anonymous contexts, the quality of the help and advice given within these contexts remains unaddressed. Although the anonymous and effortless nature of the online space indeed provides numerous benefits to help-seekers, we do not know whether the advice provided in such settings is of sufficient quality to facilitate healthier relationships. If the advice provided is of poor quality, relationship problems may be exacerbated, contributing to further interpersonal problems. We anticipate further analyses of anonymous, online relationship discussion platforms to determine the quality and subsequent implications of such advice.

Administrative Simplification and the Potential for Saving a Quarter-Trillion Dollars in Health Care

Administrative Simplification and the Potential for Saving a Quarter-Trillion Dollars in Health Care. Nikhil R. Sahni et al. JAMAOctober 20, 2021. doi:10.1001/jama.2021.17315

Nearly every industry in the US has experienced substantial improvements in productivity over the last 50 years, with 1 major exception: health care. In 2019, the US spent an estimated $3.8 trillion on health care, including an estimated $950 billion on nonclinical, administrative functions, and that number has increased despite major technological enhancements.1,2 This Viewpoint considers several specific steps that can be taken to simplify administration in health care and boost overall productivity in the economy.

To run any organization, a base of administration is necessary. A typical US services industry (for example, legal services, education, and securities and commodities) has approximately 0.85 administrative workers for each person in a specialized role (lawyers, teachers, and financial agents). In US health care, however, there are twice as many administrative staff as physicians and nurses, with an estimated 5.4 million administrative employees in 2017, including more than 1 million who have been added since 2001.3

The administrative complexity of health care is profound. There are multiple transaction nodes, including more than 6000 hospitals, 11 000 nonemployed physician groups (defined as hospital-affiliated and independent practices with 5 or more physicians),4 and 900 private payers; regulatory complexity (compliance requirements such as the Health Insurance Portability and Accountability Act and regulated markets such as Medicare Advantage); and contrasting incentives, for example, market-driven checks and balances, such as prior authorization.4 The sheer complexity associated with so many entities makes administrative simplification difficult.

A new report provides an extensive evaluation of administrative spending to determine which parts are necessary and which could be simplified.2 The analysis dissected profit and loss statements of individual health care organizations, estimated spending on specific processes, and compared administrative spending in health care with that of other industries. The conclusion of the report is that an estimated $265 billion, or approximately 28% of annual administrative spending, could be saved without compromising quality or access by implementing about 30 interventions that could be carried out in the next 3 years.2 This set of interventions works within the structure of today’s US health care system in order to preserve its market nature (eg, multipayer, multiclinician, multi–health care center) and the associated benefits (eg, world-leading innovation in care delivery).

The starting point is 5 functional areas that account for approximately 94% of administrative spending (see eTable in the Supplement). The largest of these is industry-agnostic corporate functions: general administration, human resources, nonclinical information technology, general sales and marketing, and finance. This functional area accounts for an estimated $375 billion of spending annually. The second-largest category is the financial transactions ecosystem, which includes claims processing, revenue cycle management, and prior authorization, accounting for an estimated $200 billion annually. The rest is made up of industry-specific operational functions, such as insurance underwriting (an estimated $135 billion annually), administrative clinical support operations such as case management (an estimated $105 billion annually), and customer and patient services such as call centers (an estimated $80 billion annually).

For each of these functional focus areas, known interventions that could reduce spending without harming patient care were considered. This meant using a financial and operational perspective for the analysis, but also acknowledging that these interventions could and likely will have broader benefits on other outcomes, such as access, quality, patient experience, physician satisfaction, and equity.

“Within” and “Between” Interventions at the Organizational Level

The individual organization level was used as the starting point, by looking at “within” interventions, those that can be controlled and implemented by individual organizations, and “between” interventions, those that require agreement to act between organizations but not broader, industry-wide change. This spending is amenable to interventions that address highly manual, inefficient workflows, such as patient admission and discharge planning in case management; poor data management and lack of standardization, such as nonstandardized submission processes for prior authorization forms; and disconnected tools and systems, for example, the lack of interoperability between the claims systems of payers and hospitals.

Organizations could potentially save an estimated $210 billion annually by addressing these issues.2 The majority of those savings reside in industry-agnostic corporate functions such as finance or human resources. Interventions that affect these functions include automating repetitive work such as generation of standard invoices and financial reports; using analytical tools for human resources departments to better predict and address temporary labor shortages; integrating a suite of tools and solutions to coordinate staffing for nurse managers; and building strategic communications platforms between payers and hospitals to send unified messages. These interventions have been adopted in the marketplace by some payers, hospitals, and physician groups, with a positive return on investment using current technology and nominal investment (that is, once the interventions are fully rolled out, the cost of implementation is generally paid off in about a year by the recurring savings). Research has shown that organizations that aggressively pursue industry-leading productivity programs are twice as likely to be in the top quintile of their peers as measured by economic profit.5

Since many of these interventions are relatively standard, the question that arises is why they have not been implemented to date. A common set of barriers to implementation currently exists, including high levels of complexity and overlapping compliance rules such as privacy guidelines and requirements on how and where data can be stored; the need to manage labor displacement in an industry that is a driver of workforce growth; contrasting incentives for payers, hospitals, and physician groups in a primarily fee-for-service reimbursement model; and lack of prioritization from industry leaders on administrative simplification. Successful organizations often have common lessons for implementation including prioritizing administrative simplification as a top strategic initiative; committing to transformational change vs incremental steps; engaging the broader partnership ecosystem for the right capabilities and investments; and disproportionally investing in the underlying drivers of productivity, such as technology and talent.

“Seismic” Interventions at the Industry Level

Some of the inertia at the organizational level reflects market failures that require industry-level intervention, including the necessary decision-makers and influencers from both the public and private sectors for a given intervention. For example, individual organizations alone cannot change the systemic lack of interoperability in the US health care system. A set of “seismic” interventions were identified that require broad, structural collaboration across the health care industry.2 These include new technology platforms such as the use of a centralized, automated claims clearinghouse; operational alignment such as standardizing medical policies across payers, for example, requiring the same set of diagnostics and clinical data before agreeing to cover a more complicated procedure or drug therapy; and payment design such as globally capitated payment models for segments of the care delivery system. These are meant to be examples of what is possible and are based on analogs from other industries that have undergone this type of change. If currently identified seismic interventions were undertaken, an estimated $105 billion of savings could occur annually.2 These savings would largely occur in the financial transactions ecosystem and industry-specific operational functions such as clinician credentialing and medical records management.

Launching these seismic interventions could be considerably more difficult than the within and between interventions. A framework that focuses on how to promote innovation in the public sector was applied to isolate the mechanism required to enable action for each seismic intervention.6 For example, individual organizations do not experience the financial pressure today that would bring them together to create a centralized automated clearinghouse (which is what happened in banking). Financial incentives could help overcome this inertia.

A set of common actions is necessary to galvanize this change. These actions include using interoperability frameworks to support high-value use cases such as the assembly of longitudinal patient records; creating public-private partnerships such as piloting a complete Health Information Exchange in 1 or more states; and selecting third parties, such as foundations, to research facts to galvanize movement (for example, a foundation-backed randomized trial of administrative interventions to validate the conditions for success).

Why Now?

Across the 3 types of interventions, the analyses suggest that simplifying administration could save the US health care system an estimated $265 billion annually after accounting for $50 billion of overlap between organizational and industry-level interventions.2 These savings, if realized, would be more than 3 times the combined 2019 budgets of the National Institutes of Health ($39 billion), the Health Resources and Services Administration ($12 billion), the Substance Abuse and Mental Health Services Administration ($6 billion), and the Centers for Disease Control and Prevention ($12 billon).7 In per capita terms, $265 billion is approximately $1300 for each adult in the US.

Economic downturn often leads to health system change. With COVID-19 creating enormous disruption to the health care system, a known opportunity to capture more than a quarter-trillion dollars in the next few years without compromising the US health care system’s ability to deliver care could be quite attractive. The sooner health care administration is simplified, the easier it will be for all to engage the US health care system.

2. Sahni  NR, Mishra  P, Carrus  B, Cutler  DM. Administrative Simplification: How to Save a Quarter-Trillion Dollars in US Healthcare. McKinsey & Company. October 20, 2021.

3. Sahni  NR, Kumar  P, Levine  E, Singhal  S. The Productivity Imperative for Healthcare Delivery in the United States. McKinsey & Company. February 27, 2019. Accessed September 17, 2021.

Arranged marriage... Parents and offspring overwhelmingly choose different partners: Parents and offspring disagreed over fitness-relevant traits of the potential spouse, and both parties sometimes used extreme methods to influence outcomes

Arranged Marriage Often Subverts Offspring Mate Choice: An HRAF-Based Study. Elizabeth Agey, Addison Morris, Maya Chandy, Steven J. C. Gaulin. American Anthropologist, October 18 2021.

Abstract: In many species, females and males form long-term mating bonds, but marriage—and especially arranged marriage—are uniquely human traits. While marriage practices impact many cultural phenomena, they also can have evolutionary (i.e., fitness) consequences. Strongly felt but not necessarily conscious mating preferences presumably evolved because they provide fitness benefits compared to random mating, and this prediction has been supported by experimental animal studies. Arranged marriage might similarly reduce fitness in humans, but only if parents regularly choose different mates for their offspring than offspring would choose for themselves. Here we report a broad ethnographic survey exploring whether parents and offspring disagree over partner choice in arranged marriages. Using the Human Relations Area Files, we reviewed 543 ethnographies to assess the relative frequencies of parent–offspring agreement and disagreement over partner choice, the reasons for disagreement, and the outcomes of disagreement. In all world areas, parents and offspring overwhelmingly choose different partners. Parents and offspring disagreed over fitness-relevant traits of the potential spouse, and both parties sometimes used extreme methods to influence outcomes. These findings suggest that arranged marriages may be useful for studying the effects of mate choice in humans and for assessing the unique dynamics of human mating systems.

Keywords: parent–offspring conflict, mate choice, cross-cultural