Coping through avoidance may explain gender disparities in anxiety

Acute stress yields a sex-dependent facilitation of signaled active avoidance in rats

Post-traumatic stress disorder (PTSD) is a debilitating disorder characterized by excessive fear, hypervigilance, and avoidance of thoughts, situations or reminders of the trauma. Among these symptoms, relatively little is known about the etiology of pathological avoidance. Here we sought to determine whether acute stress influences avoidant behavior in adult male and female rats. We used a stress procedure (unsignaled footshock) that is known to induce long-term sensitization of fear and potentiate aversive learning. Rats were submitted to the stress procedure and, one week later, underwent two-way signaled active avoidance conditioning (SAA). In this task, rats learn to prevent an aversive outcome (shock) by performing a shuttling response when exposed to a warning signal (tone). We found that acute stress significantly enhanced SAA acquisition rate in females, but not males. Female rats exhibited significantly greater avoidance responding on the first day of training relative to controls, reaching similar levels of performance by the second day. Males that underwent the stress procedure showed similar rates of acquisition to controls but exhibited resistance to extinction. This was manifest as both elevated avoidance and intertrial responding across extinction days relative to non-stressed controls, an effect that was not observed in females. In a second experiment, acute stress sensitized footshock unconditioned responses in males, not females. However, males and females exhibited similar levels of stress-enhanced fear learning (SEFL), which was expressed as sensitized freezing to a shock-paired context. Together, these results reveal that acute stress facilitates SAA performance in both male and female rats, though the nature of this effect is different in the two sexes. We did not observe sex differences in SEFL, suggesting that the stress-induced sex difference in performance was selective for instrumental avoidance. Future work will elucidate the neurobiological mechanisms underlying the differential effect of stress on instrumental avoidance in male and female rats.

Personality and Pain Outcomes in Rheumatic Disease: The Mediating Role of Psychological Flexibility

BACKGROUND

Chronic pain is associated with increased disability and vulnerability to emotional disorders. Personality and psychological flexibility (PF) describe interindividual differences that shape the adjustment to chronic pain. Specifically, PF was found to be associated with pain, fatigue, anxiety, and depression intensity. Although previous studies established strong correlations between personality and pain outcomes, evidence on the nature of this relationship is scarce. Therefore, the objective of this study is to explore the mediating effect of PF on the relationship between personality and distress.

METHODS

This transversal study included 108 participants (age M = 56.7, SD = 11.3) diagnosed with musculoskeletal chronic pain. Self-reported measures were administered by the medical care team. Multiple mediation models were performed for estimating the indirect effects on each outcome variable.

RESULTS

After controlling for age and gender covariates, we found that PF completely mediated the relationship between personality traits and all pain outcomes and partially mediated the impact of extraversion on anxiety. In addition, emotional stability also had an indirect effect on anxiety through PF.

CONCLUSIONS

Personality traits and PF are significant predictors of pain outcomes. PF represents a core process mediating the impact of personality traits on the perceived intensity of pain, fatigue, anxiety, and depression in patients with rheumatic disease. These results could facilitate the application of individualized psychological interventions in clinical contexts targeting the reduction of emotional avoidance and in chronic pain patients.

Acute stress yields a sex-dependent facilitation of signaled active avoidance in rats

Post-traumatic stress disorder (PTSD) is a debilitating disorder characterized by excessive fear, hypervigilance, and avoidance of thoughts, situations or reminders of the trauma. Among these symptoms, relatively little is known about the etiology of pathological avoidance. Here we sought to determine whether acute stress influences avoidant behavior in adult male and female rats. We used a stress procedure (unsignaled footshock) that is known to induce long-term sensitization of fear and potentiate aversive learning. Rats were submitted to the stress procedure and, one week later, underwent two-way signaled active avoidance conditioning (SAA). In this task, rats learn to prevent an aversive outcome (shock) by performing a shuttling response when exposed to a warning signal (tone). We found that acute stress significantly enhanced SAA acquisition rate in females, but not males. Female rats exhibited significantly greater avoidance responding on the first day of training relative to controls, reaching similar levels of performance by the second day. Males that underwent the stress procedure showed similar rates of acquisition to controls but exhibited resistance to extinction. This was manifest as both elevated avoidance and intertrial responding across extinction days relative to non-stressed controls, an effect that was not observed in females. In a second experiment, acute stress sensitized footshock unconditioned responses in males, not females. However, males and females exhibited similar levels of stress-enhanced fear learning (SEFL), which was expressed as sensitized freezing to a shock-paired context. Together, these results reveal that acute stress facilitates SAA performance in both male and female rats, though the nature of this effect is different in the two sexes. We did not observe sex differences in SEFL, suggesting that the stress-induced sex difference in performance was selective for instrumental avoidance. Future work will elucidate the neurobiological mechanisms underlying the differential effect of stress on instrumental avoidance in male and female rats.

Psychometric evidence of the Acceptance and Action Questionnaire-II (AAQ-II): an item response theory analysis in university students from Chile

BACKGROUND

Experiential avoidance (EA) is a psychological mechanism associated with several mental health disorders and is regarded as a relevant target by third-generation cognitive behavioral therapies. It has been mainly assessed through self-report questionnaires, and the AAQ-II is the most used tool. Its psychometric evidence has been mostly tested through the classical test theory (CTT) and very scarcely assessed through Item Response Theory (IRT).

METHODS

We used the Graded Response Model to examine its psychometric properties in Spanish-speaking university students (n = 1503; women = 995 (66.2%), mean age = 19.29, SD = 2.45). We tested whether the empirical data fit the model's predictions and estimated the dispersion of persons and items along the experiential avoidance continuum. Moreover, we examined category probability curves to identify the response probability of each answer. Likewise, an item-person map was made where the measurement of persons and items, both on the same scale and along the experiential avoidance continuum, could be observed jointly. Finally, we tested the gender invariance of the scale.

RESULTS

We found that the values of the individuals and the items were in the established range to be considered an adequate measure of EA. Additionally, we observed high discrimination indices for all items. The current version with seven answer options could not be optimal and should be tested in future studies. Finally, we found evidence of differential functioning by gender in one of the seven items of the instrument.

CONCLUSIONS

Our results indicate that the AAQ-II is a suitable tool for measuring EA and accurately classifying and differentiating EA levels in university students.

An investigation into mothers' experiences of their children's functional tic-like behaviour and tic attacks

OBJECTIVE

This is the first study to systematically explore the lived experiences of sudden and new onset of severe functional tics from the perspective of the mother's experiences and describes their attempts to access support services in the United Kingdom.

METHOD

Twenty-One mothers of young people aged between 12 to 17 years with functional tic-like behaviour (FTLB) took part in semi-structured interviews. Thematic analysis of the transcribed interviews revealed gaps and inconsistencies within the process of gaining access to professional services and a lack of support for the management of tics and functional tic-like movements, in addition to highlighting the impact it had on daily family life.

RESULTS

The themes generated included the occurrence and development of tics, the severity and intensity of symptoms, the psychological impact on the family and the need to make recommendations for a clear care pathway. Managing the impact of the FTLB and co-occurring conditions such as suicidal ideation and self-harm, as well as the physical and emotional trauma, commonly contributed to feelings of isolation and helplessness, which impacted negatively on the family's ability to function and participate in society.

CONCLUSIONS

The findings emphasize the urgent need to create a clear management pathway for those experiencing FTLB, including the need for more professionals with relevant knowledge, to improve the dialogue with families during the referral process, whilst prioritising the treatment of anxiety and other identified mental health concerns.

The association of childhood trauma with depressive and negative symptoms in recent onset psychosis: a sex-specific analysis

BACKGROUND

Childhood trauma may impact the course of schizophrenia spectrum disorders (SSD), specifically in relation to the increased severity of depressive or negative symptoms. The type and impact of trauma may differ between sexes. In a large sample of recent-onset patients, we investigated the associations of depressive and negative symptoms with childhood trauma and whether these are sex-specific.

METHODS

A total of 187 first-episode psychosis patients in remission (Handling Antipsychotic Medication: Long-term Evaluation of Targeted Treatment study) and 115 recent-onset SSD patients (Simvastatin study) were included in this cross-sectional study (men: n = 218; women: n = 84). Total trauma score and trauma subtypes were assessed using the Childhood Trauma Questionnaire Short Form; depressive and negative symptoms were rated using the Positive And Negative Symptoms Scale. Sex-specific regression analyses were performed.

RESULTS

Women reported higher rates of sexual abuse than men (23.5% v. 7.8%). Depressive symptoms were associated with total trauma scores and emotional abuse ratings in men (β: 0.219-0.295; p ≤ 0.001). In women, depressive symptoms were associated with sexual abuse ratings (β: 0.271; p = 0.011). Negative symptoms were associated with total trauma score and emotional neglect ratings in men (β: 0.166-0.232; p ≤ 0.001). Negative symptoms in women were not linked to childhood trauma, potentially due to lack of statistical power.

CONCLUSIONS

Depressive symptom severity was associated with different types of trauma in men and women with recent-onset SSD. Specifically, in women, depressive symptom severity was associated with childhood sexual abuse, which was reported three times as often as in men. Our results emphasize the importance of sex-specific analyses in SSD research.

Selective Mutism in Children With and Without an Autism Spectrum Disorder: The Role of Sensory Avoidance in Mediating Symptoms of Social Anxiety

The present study addressed the different contributors to social anxiety in children with Selective Mutism (SM), with and without co-occurring Autism Spectrum Disorder (ASD) (SM + ASD). Seventy-five parents completed an online composite questionnaire consisting of the symptoms of SM and ASD, anxiety and sensory measures. The results found the SM + ASD group showed significantly higher levels of social anxiety and sensory avoidance compared to the SM only group. However, a simple mediation model revealed sensory avoidance to be a mediator of this relationship between the diagnosis and social anxiety.. Therefore, higher levels of sensory avoidance may help to differentiate social anxiety between the groups and may also be a sign of ASD in children with SM who have and/or are yet to receive an ASD diagnosis.

Psychological distress, attitudes toward seeking help, and utilization of college counseling at a predominantly minority college

OBJECTIVE

This study examined psychological distress among students at a predominantly-minority college, attitudes toward seeking help, and utilization of college counseling services. Demographic variables and associations between 8 problem areas (depression, generalized anxiety, social anxiety, academic stress, eating concerns, family distress, hostility, substance use) were explored.

PARTICIPANTS

Participants were 347 students at a large public university.

METHODS

In 2016-2017, students completed a Web-based questionnaire providing information about their mental health, attitudes toward seeking help, and utilization of counseling services.

RESULTS

Psychological distress was significantly higher for LGBQT, Muslim and female students and lower for Christian affiliated and religious students. LGBQT students were less likely to seek psychological help than other students. Utilization of college counseling did not differ by race or gender.

CONCLUSIONS

Administrators at PMCs must increase their efforts to disseminate information about mental health services and reduce barriers to seeking help, particularly for LGBQT, female and Muslim students.

The relationship between coping and distress among faculty members and students during COVID-19 pandemic lockdown: The moderating effect of gender

OBJECTIVES

Previous research has documented significant associations between the COVID-19 pandemic lockdown, various mental health problems, and coping strategies. However, literature on the moderating role of gender on the relationship between distress and coping strategies during COVID-19 is almost nonexistent. Hence, the main objective of this study was two folds. To examine gender differences in distress and coping strategies, and to test the moderating effect of gender on the relationship between distress and coping among university faculty members and students during the COVID-19 pandemic.

METHOD

A cross-sectional web-based study design was used to collect data from the participants. A sample of 649 participants (68.9% university students and 31.1% faculty members) was selected. The General Health Questionnaire (GHQ-12) and the Coping Inventory for Stressful Situations (CISS) were used to collect data from the participants. The survey was sent out during the COVID-19 lockdown from May 12th to June 30th, 2020.

RESULTS

The results showed significant gender differences in distress and the three coping strategies. Women consistently scored higher on distress (p < 0.01), task-focused (p < 0.05), emotion-focused (p < 0.001), and avoidance coping (p < 0.01) compared to men. Gender moderated the relationship between emotion-focused coping and distress (p < 0.001) but not the relationship between distress and task-focused or avoidance coping.

CONCLUSION

Increased emotion-focused coping is associated with decreased distress among women while the use of emotion-focused coping by men predicted more distress. Workshops and programs focused on providing skills and techniques on how to cope with stressful situations induced by the COVID-19 pandemic are recommended.

The Association between Metacognitions and Worry: The Mediator Role of Experiential Avoidance Strategies

Although experiential avoidance is emphasized as an underlying factor for persevering worry, limited empirical attempt exists to integrate this concept with cognitive models explaining pathological worry. Therefore, the current study aims to investigate the mediator role of different experiential avoidance strategies in the relationship between metacognitions and worry-related symptoms. The study was conducted with a community sample consisting of 563 volunteer participants (405 females, 158 males) whose ages ranged between 18 and 40 (M = 25.56, SD = 4.72). Online data collection of self-report measures including demographic information form, Metacognitions Questionnaire-30, Multidimensional Experiential Avoidance Questionnaire, and Penn State Worry Questionnaire was applied. The results of the hierarchical regression analysis revealed that experiential avoidance predicted worry beyond metacognition. In addition, particular avoidant strategies, aversion/avoidance, procrastination, distraction, and distress endurance explained the associations between positive and negative metacognitive beliefs and worry. Current findings point to different avoidant strategies that might play a role in the intensification and maintenance of worry and suggest the benefits of incorporating acceptance and commitment-based interventions with metacognitive therapy for better therapeutic outcomes.

Gender and Public Perception of Disasters: A Multiple Hazards Exploratory Study of EU Citizens

Aim: To explore gender influence on individual risk perception of multiple hazards and personal attitudes towards disaster preparedness across EU citizens. Method: An online survey was distributed to 2485 participants from Spain, France, Poland, Sweden and Italy. The survey was divided into two parts. The first part examined perceived likelihood (L), perceived personal impact (I) and perceived self-efficacy (E) towards disasters due to extreme weather conditions (flood, landslide and storm), fire, earthquake, hazardous materials accidents, and terrorist attacks. The overall risk rating for each specific hazard was measured through the following equation R = (L × I)/E and the resulting scores were brought into the range between 0 and 1. The second part explored people’s reactions to the Pros and Cons of preparedness to compute the overall attitudes of respondents towards preparation (expressed as a ratio between −1 and 1). Results: Although we found gender variations on concerns expressed as the likelihood of the occurrence, personal consequences and self-efficacy, the overall risks were judged significantly higher by females in all hazards (p < 0.01). We also found that, in general, most respondents (both males and females) were in favour of preparedness. More importantly, despite the gender differences in risk perception, there were no significant differences in the attitudes towards preparedness. We found weak correlations between risks perceived and attitudes towards preparedness (rho < 0.20). The intersectional analysis showed that young and adult females perceived higher risks than their gender counterparts at the same age. There were also gender differences in preparedness, i.e., females in higher age ranges are more motivated for preparedness than men in lower age ranges. We also found that risk perception for all hazards in females was significantly higher than in males at the same education level. We found no significant differences between sub-groups in the pros and cons of getting ready for disasters. However, females at a higher level of education have more positive attitudes towards preparedness. Conclusions: This study suggests that gender along with other intersecting factors (e.g., age and education) still shape differences in risk perception and attitudes towards disasters across the EU population. Overall, the presented results policy actions focus on promoting specific DRR policies and practices (bottom-up participatory and learning processes) through interventions oriented to specific target groups from a gender perspective.

Active and avoidant coping profiles in children and their relationship with anxiety and depression during the COVID-19 pandemic

Active and avoidant coping styles are important dispositional factors in the development of anxiety and depression symptoms. Children use both active and avoidant coping strategies together in daily life. No studies have investigated the relationship between active–avoidant coping profiles and internalizing symptoms in children. The present study aimed to investigate children’s active–avoidant coping profiles and assess the relationship that active–avoidant coping profiles have with anxiety and depression symptoms. A two-wave longitudinal study was conducted among 322 Chinese children in the People’s Republic of China during the COVID-19 pandemic. Participants completed the Children’s Coping Strategies Checklist-Revised 1 at Time 1 and the Revised Child Anxiety and Depression Scale at Time 1 and 6 months later (Time 2). Four active–avoidant coping profiles were revealed: low active copers, high active copers, balanced copers, and avoidant copers. Low and high active copers had lower levels of anxiety and depression symptoms than balanced copers and avoidant copers. Avoidant copers showed a larger decrease in depression symptoms than balanced copers and high active copers during the COVID-19 pandemic. It is important to improve children’s active–avoidant coping profiles to relieve anxiety and depression symptoms.

Relations between stress, coping strategies, and prosocial behavior in U.S. Mexican college students

Objective: We explored the explanatory roles of active and avoidant coping in the link between stress and emotional prosocial behavior in U.S. Mexican college students. Participants: Participants included 148 college students (M_age = 23 years, 67% female, 84% born in the U.S.) who self-identified as Mexican or U.S. Mexican or noted that their parents or grandparents were of Mexican or U.S. Mexican origin. Methods: Introduction to Psychology students at state universities in California and Texas completed a self-report survey packet and received class credit for their participation. Data were analyzed via path analysis using Mplus 8.1 software. Results: U.S. Mexican college students' stress was indirectly associated with their emotional prosocial behavior through both active and avoidant coping strategies. Conclusions: Relations between stress and adjustment (i.e., emotional prosocial behavior) is dependent upon individuals' coping tendencies. U.S. Mexicans may cope with their stress by engaging in emotional prosocial behavior.

Social support coping styles and psychological distress during the COVID-19 pandemic: The moderating role of sex

BACKGROUND

The coronavirus disease 2019 (COVID-19) pandemic led to the onset and exacerbation of mental health problems, such as stress, anxiety, and depression; yet stay-at-home-orders affected individuals' ability to make use of social support as a coping skill in managing distress. We aimed to evaluate how social support (emotional and instrumental) and biological sex were associated with stress, anxiety, and depression early in the COVID-19 pandemic.

METHODS

Participants (n = 7256) had an average age of 50.13 years (SD = 16.75) and 51.6% were male. Using a cross-sequential design, seven cohorts of individuals completed baseline (T1) and one-month follow-up (T2) questionnaires online from March to July of 2020. We used a series of hierarchical regressions to identify types of social support (Brief-COPE, T1) associated with stress (Perceived Stress Scale-10, T1 and T2), anxiety and depression (Patient Health Questionnaire-4, T2).

RESULTS

Greater emotional support was associated with less perceived stress, anxiety and depression (all ps < 0.001), whereas greater instrumental support predicted increased distress (all ps < 0.036) on all four outcomes. Moderation analyses revealed that greater emotional social support was associated with lower perceived stress at T1 for both women and men, with a stronger association for women relative to men. For women, greater emotional social support predicted lower anxiety.

LIMITATIONS

Self-selection may have introduced bias and participant self-report on brief measures may not have fully captured coping and distress.

CONCLUSIONS

Interventions enhancing emotional social support strategies, which appear especially important for women, might help manage enduring stressors such as the COVID-19 pandemic.

Linking Childhood Maltreatment and Psychological Symptoms: The Role of Social Support, Coping Styles, and Self-Esteem in Adolescents

Psychological symptoms are common among adolescents in China, which are associated with various negative consequences. There has been a pressing need for additional research of factors responsible for the occurrence of psychological symptoms during this developmental period, among which childhood maltreatment, personal coping style, one's levels of social support, and self-esteem deserve our attention. The association between childhood maltreatment and psychological symptoms is evident; however, the possible mediating effect of the other three factors mentioned above remains unclear. Hence, the current study aims to investigate the possible mediating roles of social support, coping style, and self-esteem in the relationship between childhood maltreatment and the development of psychological symptoms among adolescents. An adolescent-based health survey was conducted between 2013 and 2014 in 15 schools in China. A total of 9,704 students (aged 11-19 years) were enrolled and measures on childhood maltreatment, social support, coping styles, self-esteem, and psychological symptoms were completed. It was found that childhood maltreatment was positively correlated with psychological symptoms and negative coping styles, and negatively correlated with social support, positive coping styles, and self-esteem (p < .001). Social support, coping styles, and self-esteem mediated the relationship between childhood maltreatment and psychological symptoms. The estimated effect of childhood maltreatment on the occurrence of psychological symptoms could be explained by the mediation of social support, positive coping styles, negative coping styles, and self-esteem, whose ratio of roles came to 13.8%, 7.5%, 20.9%, and 10.3%, respectively. These findings indicate a need to promote social support, self-esteem, and positive coping styles, and decrease the level of negative coping styles, to markedly reduce the impact of psychological symptoms of childhood maltreatment among adolescents.

Sex-based differences in cognitive anxiety and felt arousal of elite archers: a field study

This study compares the levels of felt arousal and cognitive anxiety between male and female archers across different competition stages. Fifty-seven professional recurve archers (28 men, 29 women) who participated in the Asian Archery Championships were recruited as participants. Their levels of felt arousal and cognitive anxiety were recorded during the stages of qualifying, individual elimination, and team competition using the Sport Grid-Revised. The results showed no sex-based differences in competitive anxiety when competition stages were considered. However, the female archers demonstrated higher levels of felt arousal and cognitive anxiety than the male archers across the different stages. Further, all archers regardless of sex showed higher cognitive anxiety in the individual elimination and team competition stages than the qualifying stage. The findings show sex-based differences in felt arousal and cognitive anxiety before competitions. In addition, increasing cognitive anxiety is likely associated with fundamental differences in levels of competition pressure at various stages of a match. It seems beneficial for athletes to focus on reducing gender stereotypes through preventive interventions and developing effective coping strategies toward competitive anxiety.

Relative deprivation and social anxiety among Chinese migrant children: Testing a moderated mediation model of perceived control and belief in a just world

To examine the relationship between relative deprivation and social anxiety, which affects mental health, and investigate the mediating role of perceived control and the moderating role of belief in a just world (BJW) in an understudied population in Asia, we surveyed 1573 rural-to-urban migrant children (48% female; M_age = 12.3, SD = 1.7) in southeast China. Relative deprivation was positively correlated with social anxiety; perceived control partially mediated this connection. Moreover, BJW moderated the indirect effect, which was stronger for male migrant children with lower levels of BJW. The limitations and practical implications of this study are discussed.

Exploring the Link Between Transdiagnostic Cognitive Risk Factors, Anxiogenic Parenting Behaviors, and Child Anxiety

Theoretical models suggest parent anxiety leads to increased anxiogenic parenting, an important etiological factor for child anxiety disorders. Evidence suggests that parents engage in anxiogenic parenting to reduce distress in response to their child's anxiety; however, further study of this mechanism is needed. Cognitive risk factors, including distress intolerance, anxiety sensitivity, emotion-related impulsivity, and repetitive negative thinking are promising to examine as they impact emotion regulation. This study examined whether an indirect association between parent anxiety and anxiogenic parenting via these risk factors exists, and if child anxiety moderated this effect. Findings demonstrated evidence for an indirect association via distress intolerance in mothers at high levels of child anxiety, but not low levels. An unmoderated indirect effect via emotion-related impulsivity was found. Anxiety sensitivity and repetitive negative thinking did not demonstrate significant indirect effects. These findings suggest distress intolerance and emotional-related impulsivity may be targets for parent-focused child anxiety treatments.

I won't comply because it is a hoax: Conspiracy beliefs, lockdown compliance, and the importance of psychological flexibility

The COVID-19 pandemic has brought unprecedented situations (government lockdowns, quarantines, etc.) and stressors (a seemingly “phantom” virus that can be lurking anywhere) causing uncertainty for the future, uncontrollable and unpredictable situations. It appears that especially during times of uncertainty and high stress, conspiracy theories flourish and these can affect the way individuals behave, especially in response to governmental recommendations for social isolation and quarantine. Psychological flexibility, we hypothesized, may act as a protective factor in the relation between COVID-19 distress, conspiracy theory beliefs and consequent behaving. In this respect, the aim of this paper was to examine how conspiracy theory beliefs, COVID-19 distress, adherence behavior, and psychological flexibility interact. Participants were 1001 individuals (802 women; Mage = 35.59years, SD = 10.07), who completed an online survey approximately one month after the first governmental measures of self-isolation and quarantine were enforced. Psychological flexibility was found to mediate the relation between conspiracy theory beliefs and compliance behavior. Further, being highly stressed appeared to increase the probability that a person will believe conspiracy theories, while such beliefs influenced whether a person would follow public health recommendations. Psychological flexibility appeared to be a protective factor at low and moderate distress levels. However, at high levels of COVID-19 distress, individuals prone to conspiracy theory beliefs would be less likely to conform to governmental public health recommendations irrespective of their psychological flexibility levels.

Exploring College Students' Biopsychosocial Spiritual Wellbeing and Problems during COVID-19 through a Contextual and Comprehensive Framework

College students in Kenya have experienced many mental health issues, and there is little well-grounded research on this topic. Therefore, in this current study, we aimed to explore college students’ biopsychosocial spiritual wellbeing and problems from an Ecological Systems Theory (EST) perspective. Due to lack of previous well-grounded mental health research and services, we collaborated with the college students from the beginning of the study and acted with them to shape the research. Based on all these, we called our theoretical framework for this current paper as exploring college students’ biopsychosocial spiritual wellbeing and problems from the EST perspective. We examined college students’ (N = 518) mental health experiences during the COVID-19 pandemic through six items to measure psychosomatic problems (sadness, anxiety, frustration, stress, loneliness, and withdrawal) and their coping mechanisms (talking to family/friends, physical exercise, social media, reading books, hobbies, spiritual activities, alcohol/drugs, COVID-19 information). Gender and age explained a trivial amount of variance, about 1%, in psychosomatic problems in model one. With the inclusion of the coping strategies and demographic factors (age and gender), the second model explained 24% of the variance in psychosomatic problems. In the second model, the highest effect size originated from talking to family/friends and use of social media. In addition, change in sleeping patterns, sadness, anxiety, and frustration were reported with one in three reporting “poor” or “fair” mental health. In light of the larger COVID-19 and college students’ mental health literature, we discussed the present findings and provided recommendations.

How Thai Women Manage Living in the Context of Intimate Partner Violence

Although there is literature that describes coping strategies of women who experience intimate partner violence (IPV), the definitions of common coping strategies and the two-dimensional model of coping styles (emotion-or problem-focused) may not fully delineate how these women manage their day-to-day lives. Using an Interpretive Description method and feminist standpoint principles, in-depth interviews were conducted with 40 Thai women regarding how they managed living in the context of IPV. Data were analyzed using an iterative thematic analysis procedure. In this study, the highly changeable and adaptive strategies use by participants could not be easily categorized into emotion-or action/problem-focused. Indeed, the strategies used by Thai women in this study were better described as survival focused. Based on our analysis, the process of managing their day-to-day life in the context of IPV revealed six major themes: keeping silent, disconnect between the fantasy of love and reality, seeking emotional support, ambivalence surrounding leaving, living with negative emotions, and despair and suicide. An undercurrent that was woven throughout multiple themes was the dominant lens of motherhood through which women made day-to-day decisions. These data also highlight the specific impacts that Thai society and religious beliefs have on increasing the risk of IPV and maintaining its duration. All levels of government, religious leaders, and public policy makers must engage in intersectoral initiatives to make public what is now private. Social and health service providers must create safe spaces where women can disclose IPV and where they can get funded multilevel supports to help them live independent of violence. The participants' stories give voice to why Thai health professionals need to fully engage with women to understand the past and current contexts of women's lives and how their experiences impact their health.

The motivations of donor-conceived adults for seeking information about, and contact with, sperm donors

RESEARCH QUESTION

How do the demographic characteristics, mental health experiences and disclosure experiences of donor-conceived adults shape motivations for seeking information about their sperm donors, contact with them, or both?

DESIGN

Sixty-nine Australian adults who conceived through sperm donors completed an online survey. Uniquely, information and contact seeking were investigated as two distinct concepts.

RESULTS

Participants reported a variety of demographic, mental health, disclosure and discovery experiences. Most had been motivated to seek information about their donor (88%), contact with them (71%), or both. The most commonly reported motivations for each act were for medical information, expanding their identity and curiosity. Logistic regression findings were significant for wanting medical information as a motivation for seeking donor information (P = 0.03). Endorsement of this motivation was associated with self-reported anxiety (P = 0.02) and less likely as participant age increased (P = 0.02). Motivation to contact donors for medical information was associated with self-reported anxiety (P = 0.02) and depression (P = 0.01), and more likely when the participant was raised in a household that included the recipient co-parent (P = 0.04). As years since disclosure or discovery increased, participants were less likely to report wanting medical information as a motivation (P = 0.02).

CONCLUSION

Overall, participants were motivated to obtain information and seek contact with sperm donors. Motivations for each were similar despite participants varying in age and reporting a range of circumstances regarding disclosure, some of which were adverse.

Convergence between clinician-rated and patient-reported PTSD symptoms in a specialized outpatient service: The moderator role of gender

PURPOSE

Posttraumatic stress disorder (PTSD) includes different symptoms: re-experiencing, avoidance of reminders and numbing, and hyperarousal. Although questionnaires are widely used, clinician-administered interviews provide a more comprehensive exploration of symptoms. Few studies examined the convergence between clinician-rated and patient-reported general severity and symptoms, with mixed findings. We explored the association between clinician-rated and patient-reported general severity and symptoms and the moderator role of gender in PTSD patients referred to a specialized outpatient service.

DESIGN AND METHODS

The Clinician-Administered PTSD Scale and Davidson Trauma Scale were administered to 56 patients.

FINDINGS

Patients classified by clinicians as with higher avoidance/numbing symptoms and women classified with higher hyperarousal symptoms reported higher general severity.

PRACTICE IMPLICATIONS

The assessment of the patients reporting high severity should focus on hyperarousal, particularly for women.

An exploration of the relationships of experiential avoidance (as measured by the aaq-ii and meaq) with negative affect, perceived stress, and avoidant coping styles

Background

Current psychotherapies seek to reduce experiential avoidance (EA) which has also been put forth as a risk factor for anxiety disorders, depression, and post-traumatic stress disorder. EA is a potentially maladaptive self-regulatory tendency to avoid negative thoughts, feelings, memories, physical sensations, and other internal experiences. One unresolved issue with the most commonly used measures of EA, the Acceptance and Action Questionnaire-II (AAQ-II) which measures EA as a single factor and the Multidimensional Experiential Avoidance Questionnaire (MEAQ) which measures EA as six subdimensions, is what exactly is being measured. The AAQ-II appears to measure negative affect (NA), some aspects of avoidant coping, and psychological distress. In addition, the relationships of all the MEAQ subscales have not been thoroughly examined with these other constructs. In the current study, the relationships of AAQ-II and MEAQ scores with NA, avoidant coping styles, and perceived stress were examined.

Methods

Two-hundred undergraduates (154 females and 46 males) completed the AAQ-II and MEAQ, the Distressed Type D Personality Scale (DS-14) which includes a measure of NA, the Brief COPE which measures coping styles, and the Perceived Stress Scale.

Results

Scores on the AAQ-II had moderate positive relationships with the MEAQ total score and all MEAQ subscales with the exception of distress endurance which had a moderate negative relationship. The AAQ-II had a stronger relationship with NA, avoidant coping, and perceived stress than did the MEAQ. All MEAQ subscales had a positive relationship to NA, avoidant coping, and perceived stress with the exception of distress endurance which had a negative relationship with these constructs. While the AAQ-II is limited as a unitary measure of EA the multiple dimensions of the MEAQ may involve an extraneous factor of distress endurance. Future work should examine the relationships of the MEAQ with NA, avoidant coping and perceived stress with clinical populations.

Depression and anxiety symptoms correlate with diurnal preference, sleep habits, and Per3 VNTR polymorphism (rs57875989) in a non-clinical sample

BACKGROUND

Evidences suggest that alterations in circadian rhythms trigger the development of mental disorders. Eveningness, sleep behavior, and circadian genes polymorphisms have been associated with depression and anxiety symptomatology. However, the mechanism underlying these interactions is not well understood. We investigated the contribution of diurnal preference, sleep habits, and PER3 VNTR polymorphism (rs57875989) to depression and anxiety symptoms in a Northeast sample from the Brazilian population.

METHODS

Eight hundred and four young adults completed the Morningness-Eveningness (MEQ), Munich Chronotype (MCTQ), Center for Epidemiologic Studies - Depression (CES-D), and Beck Anxiety Inventory (BAI) questionnaires. All participants were genotyped and linear regression was performed to test the interactions between the genetic /behavioral variants and depression/ anxiety symptoms.

RESULTS

Eveningness and sleep behaviors (bedtime, wake-up time, sleep duration, and midpoint of sleep) were correlated with depression symptomatology, specifically in somatic factors of the CES-D questionnaire. No correlation was found between diurnal preference/sleep habits with anxiety symptoms for both BAI total score and its factors. However, women with PER3^4/4 genotype showed less interpesonal affect in depression symptomatology and more anxiety symptoms in four factors of the BAI questionnaire.

LIMITATIONS

Mainly because this study was based on self-report questionnaires and was limited to undergraduate students aging 18 to 30 years old.

CONCLUSION

These results reinforce a role for sleep and diurnal preference in depression, and PER3 VNTR polymorphism in anxiety symptomatology, particularly in women.

A prospective study of cancer-related benefit finding in uveal melanoma patients

Little is known about contributors to the psychosocial impact of uveal melanoma, a rare cancer. Predictors and outcomes of benefit finding, a potentially favorable outcome, were investigated. Adults (n = 107) completed assessments prior to diagnosis of uveal melanoma and one week, three months and 12 months after diagnosis. Path analyses with the full information maximum likelihood estimation method were conducted. Objective disease impact on vision did not predict benefit finding (p > .05). Approach-oriented coping prior to diagnosis and one week later significantly predicted greater benefit finding 12 months later (p < .01). Avoidance-oriented coping at three months moderated the concurrent relationship of benefit finding and positive affect at 12 months (p < .001). This first study of predictors of benefit finding in uveal melanoma patients suggests that greater approach-oriented coping prospectively predicts higher benefit finding. Further, avoidance may condition the association of benefit finding with psychosocial outcomes.

Cognitive-behavioral intervention for test anxiety in adolescent students: do benefits extend to school-related wellbeing and clinical anxiety

Background and objectives: Cognitive-behavioral interventions have been shown to be effective treatments for test anxiety. Studies on school-aged populations, however, are lacking. Design and methods: In the present study we evaluated a six-session cognitive-behavioral intervention for test anxiety in a sample of secondary school students aged 14-16 years preparing for high-stakes examinations. Furthermore, we extended outcomes to include school-related wellbeing and clinical anxiety. A screening procedure was used to identify highly test anxious persons who were randomly allocated to intervention or wait-list control groups. Results: Test anxiety showed a large reduction following intervention compared to control group participants who showed a moderate reduction. Clinical anxiety showed a small to moderate reduction following intervention compared to control group participants who showed a negligible reduction. The reduction in clinical anxiety was mediated by concurrent reductions in test anxiety. Conclusion: This supports an integrative network approach that deactivating core aspects of anxiety can deactivate associated networks of anxiety symptoms. The intervention showed no impact on school-related wellbeing which increased at a similar rate for both intervention and control group participants. This is likely because test anxiety is just one contributor of many to school-related wellbeing. Implications for school-based treatments are discussed.

Mediating Effects of Specific Types of Coping Styles on the Relationship between Childhood Maltreatment and Depressive Symptoms among Chinese Undergraduates: The Role of Sex

Although childhood maltreatment is known to be associated with depressive symptoms, few studies have investigated the mediating effect of different types of coping styles on this association. It is unknown whether the impacts vary by sex. We investigated the mediating effects of different coping styles on the relationship between childhood maltreatment and depressive symptoms among Chinese undergraduates, as well as the role of sex in the mediated pathways. A total of 7643 college freshmen and sophomores (5665 females, 1978 males; 4215 freshmen, 3428 sophomores; mean age, 19.67 years) from two colleges in China completed a standard questionnaire on the details of childhood maltreatment, depressive symptoms, and coping styles. Childhood maltreatment was significantly correlated with all coping styles and depressive symptoms studied (p < 0.001). Problem solving, self-blame, help seeking, problem avoidance, and rationalization mediated the relationship between childhood maltreatment and depressive symptoms. The estimated ratio of the effect of childhood maltreatment on the occurrence of depressive symptoms can be explained by the mediation of problem solving, self-blame, help seeking, problem avoidance, and rationalization, which accounted for 15.1%, 25.6%, 7.4%, 1.6% and 1.6% of the total effect, respectively. Sex differences were found to have mediating effects on coping styles in terms of the relationship between childhood maltreatment and depressive symptoms. The findings illustrate the need to focus on coping styles and to employ sex-specific methods to effectively help college students reduce depressive symptoms associated with childhood maltreatment.

The Role of Socio-demographics in Adoption of Religious-Spiritual and Other Coping Strategies Among Muslim Chronic Patients with Hepatitis C in Pakistan

Coping has emerged as a vital indicator among patients in the chronic conditions. The current study examined the role of demographic characteristics (such as age, education, gender, marital status, residential background, family type and number of children) in adoption of coping (emotion-focused, problem-solving, religious-spiritual) strategies for nursing among hepatitis patients. A sample of 500 patients (of hepatitis C) was drawn from five most populous districts (Lahore, Faisalabad, Rawalpindi, Gujranwala and Multan) of Punjab, Pakistan, by using Epi Info software with an alpha level of 0.03. The data were collected using a well-structured multi-sectional interview schedule through multistage proportionate sampling technique. Descriptive analysis, regression analysis and reliability analysis were computed using SPSS (version 21.0). In the overall adoption of coping strategies, lower monthly household income, lower education, rural residences, nuclear family setting and married status were contributing to the adoption of higher coping strategies among Muslim chronic patients with hepatitis C. The results of socio-demographics are also discussed with other coping strategies (such as religious-spiritual coping strategies, problem-solving coping strategies, emotion-focused coping strategies and constructive coping strategies). It was the first quantitative study of adoption of coping strategies among Muslim hepatitis patients in Pakistan. The study highlighted the importance of socio-demographic resources to cope with chronic illness. The empirical findings would start a new discussion from hepatic, counseling and nursing perspective. For terminal patients, these socio-demographic characteristics can serve as a guideline to provide community sources of social support. Medical social workers and healthcare experts need to facilitate the efforts of patients to cope with chronic illness through revision of nursing policy according to the socio-demographic and spiritual-religious needs of the patients.

Sex differences in brain correlates of STEM anxiety

Anxiety is known to dysregulate the salience, default mode, and central executive networks of the human brain, yet this phenomenon has not been fully explored across the STEM learning experience, where anxiety can impact negatively academic performance. Here, we evaluated anxiety and large-scale brain connectivity in 101 undergraduate physics students. We found sex differences in STEM-related and clinical anxiety, with longitudinal increases in science anxiety observed for both female and male students. Sex-specific relationships between STEM anxiety and brain connectivity emerged, with male students exhibiting distinct inter-network connectivity for STEM and clinical anxiety, and female students demonstrating no significant within-sex correlations. Anxiety was negatively correlated with academic performance in sex-specific ways at both pre- and post-instruction. Moreover, math anxiety in male students mediated the relation between default mode-salience connectivity and course grade. Together, these results reveal complex sex differences in the neural mechanisms driving how anxiety is related to STEM learning.

Adverse childhood experiences and coping strategies: identifying pathways to resiliency in adulthood

OBJECTIVE

The current study examined whether coping strategies mediate the link between adverse childhood experiences (ACEs) and adult psychiatric and physical health outcomes.

METHODS

Data were drawn from wave I (N = 7108), wave II (N = 4963), and wave III (N = 3294) of the Midlife Development in the United States (MIDUS) Survey. An ACE count was created using seven aspects of early adversity based on prior literature. Coping variables were created using subscales of the COPE inventory. Psychiatric and health outcomes were assessed at baseline and at the 20-year follow-up. Bootstrapping mediation analyses were conducted using MPLUS to examine the link between ACEs and health outcomes and to determine if coping strategies mediate these relationships.

RESULTS

Results of path analyses in Mplus showed that ACEs, reported at Wave I, were associated with worse psychiatric and physical health outcomes at Wave III. ACEs at Wave I were associated with greater use of avoidant emotion-focused coping and lower use of problem-focused strategies at Wave II. Avoidant emotion-focused coping at Wave II partially mediated the relationship between ACEs, reported at Wave I, and psychiatric and physical health outcomes reported at Wave III. No significant mediation was detected for problem-focused coping.

CONCLUSIONS

Coping strategies may be an important point target for prevention or intervention for individuals who have experienced ACEs.

The moderating role of gender in siblings of adults with intellectual disabilities

Siblings play an important role in psychological and relational development in the lifecycle, especially if the family includes brothers or sisters with intellectual disability. The main objective of this study was to examine whether the relationships experienced by siblings of people with intellectual disability (ID-sibs) and siblings of people with typical development (TD-sibs) influence their ways of coping with stress and anxiety level, with particular emphasis on gender differences. The participants were 187 adults, of whom 104 (55.6%) were females aged 18 to 76 years (M = 29.42; SD = 11.93). Of our sample, 51.9% (N = 97) had a sibling with an intellectual disability and 48.1% (N = 90) had a sibling with typical development. The participants completed a self-report questionnaire that assessed demographics, sibling-relationship quality, anxiety, and coping orientations to problems experienced. The results show that women report a higher quality of relationship with ID-sibs compared to men and to women who have TD-sibs. The results further indicate that women with ID-sibs had higher levels of anxiety and used Transcendent-Oriented coping strategies more frequently. Lastly, gender moderated the relation between relationship quality and coping strategies in diverse ways in the two groups considered. The implications of the overall results are that sibling-focused interventions should focus on improving negative sibling relationships in order to reduce the impact of difficulties on TD siblings of both genders and that the content and delivery framework of interventions should be shaped accordingly.

Change-Point Analysis of Eye Movement Characteristics for Female Drivers in Anxiety

Driver hazard perception is highly related to involvement in traffic accidents, and vision is the most important sense with which we perceive risk. Therefore, it is of great significance to explore the characteristics of drivers' eye movements to promote road safety. This study focuses on analyzing the changes of drivers' eye-movement characteristics in anxiety. We used various materials to induce drivers' anxiety, and then conducted the real driving experiments and driving simulations to collect drivers' eye-movement data. Then, we compared the differences between calm and anxiety on drivers' eye-movement characteristics, in order to extract the key eye-movement features. The least squares method of change point analysis was carried out to detect the time and locations of sudden changes in eye movement characteristics. The results show that the least squares method is effective for identifying eye-movement changes of female drivers in anxiety. It was also found that changes in road environments could cause a significant increase in fixation count and fixation duration for female drivers, such as in scenes with traffic accidents or sharp curves. The findings of this study can be used to recognize unexpected events in road environment and improve the geometric design of curved roads. This study can also be used to develop active driving warning systems and intelligent human⁻machine interactions in vehicles. This study would be of great theoretical significance and application value for improving road traffic safety.

The Role of Experiential Avoidance and Parental Control in the Association Between Parent and Child Anxiety

Parenting behavior and practices contribute to the intergenerational relationship between parent and child anxiety, with parental control being a consistent predictor of child anxiety. Parental experiential avoidance refers to how a parent copes with their internal world in the context of parenting. Little is known about how this relatively new parenting concept relates to child anxiety. The current study tested the indirect effect of parent anxiety on child anxiety through parental control and parental experiential avoidance; the indirect effect of parent anxiety on parental control through parental experiential avoidance; and the moderating effect of parental experiential avoidance on the relationship between parental control and child anxiety. Using a cross-sectional design, parents (N = 85) from a community sample of 8–12-year-old children self-reported on a survey measuring parent anxiety, child anxiety, parental control, and parental experiential avoidance. A hierarchical regression indicated that parental experiential avoidance significantly predicted child anxiety and accounted for further variance in child anxiety, over, and above parental control. There was an indirect effect of parent anxiety on child anxiety through parental control and parental experiential avoidance. Parental experiential avoidance moderated the relationship between parental control and child anxiety, such that the relationship was only significant at high levels of parental experiential avoidance. The current study provides support for the role of parental experiential avoidance in an intergenerational understanding of anxiety. Future research should replicate the study with a clinical sample. Theoretical and practice implications are considered.

Associations between friend conflict and affective states in the daily lives of adolescents

This study examined the associations between friend conflict, defined as arguments with friends, and affective states using a daily diary design in a community sample of adolescents. Participants were 100 U.S. adolescents (13-17 years; 40% girls; 79% white). Adolescents completed an online survey on 14 consecutive evenings. Adolescents reported significantly higher anger/hostility, confusion, and tension/anxiety and less friendliness on days during which they experienced friend conflict relative to no-conflict days. However, no same-day associations for depressed affect, fatigue, or vigor were found. Adolescents experiencing friend conflict reported increased next-day anger/hostility, depressed affect, and tension/anxiety, but not other affective states. Higher levels of anger/hostility and depressed affect predicted an increased likelihood of next-day friend conflict. Conversely, higher levels of friendliness and vigor predicted a decreased likelihood of next-day friend conflict. These findings suggest that directional relationships between adolescents' friend conflicts and their affective states vary by affective domain.