A Transdiagnostic Model for Depression, Anxiety, and Obsessive-Compulsive Disorder

ABSTRACT

Depression, obsessive-compulsive disorder (OCD), and anxiety disorders (ADs) can seriously impair functionality. Studies have shown that there are common mechanisms in the emergence of these disorders. This study discussed unpredictability beliefs, family unpredictability, locus of control, intolerance of uncertainty, emotional regulation difficulties, and coping styles. In this study, a model created with these transdiagnostic variables that play a role in the emergence of depression, OCD, and ADs was tested. The sample of the study consisted of 795 people. The model explained a significant part of the variance in psychological symptoms. In addition to various limitations, it is thought that this study has important contributions to the field by examining the relationships between unpredictability beliefs and various variables for the first time, and bringing together many transdiagnostic factors related to psychological symptoms. In addition, it provides valuable information for clinicians as it provides a basis for intervention programs targeting many transdiagnostic mechanisms.

Pre-pandemic Predictors of Loneliness in Adult Men During COVID-19

Loneliness is a major public health issue, with its prevalence rising during COVID-19 pandemic lockdowns and mandated "social distancing" practices. A 2020 global study (n = 46,054) found that, in comparison to women, men experienced the greatest levels of loneliness. Although research on predictors of loneliness during COVID-19 is increasing, little is known about the characteristics of men who may be particularly vulnerable. Studies using prospective data are needed to inform preventative measures to support men at risk of loneliness. The current study draws on rare longitudinal data from an Australian cohort of men in young to mid-adulthood (n = 283; aged M = 34.6, SD = 1.38 years) to examine 25 pre-pandemic psychosocial predictors of loneliness during COVID-19 social restrictions (March-September 2020). Adjusted linear regressions identified 22 pre-pandemic predictors of loneliness across a range of trait-based, relational, career/home and mental health variables. Given the extensive set of predictors, we then conducted penalized regression models (LASSO), a machine learning approach, allowing us to identify the best fitting multivariable set of predictors of loneliness during the pandemic. In these models, men's sense of pre-pandemic environmental mastery emerged as the strongest predictor of loneliness. Depression, neuroticism and social support also remained key predictors of pandemic loneliness (R 2 = 26, including covariates). Our findings suggest that men's loneliness can be detected prospectively and under varying levels of social restriction, presenting possible targets for prevention efforts for those most vulnerable.

Beyond positive or negative: variability in daily parent-adolescent interaction quality is associated with adolescent emotion dysregulation

Previous work on the contribution of family environments to adolescent emotion dysregulation has tended to focus on broad parenting characteristics (such as warmth); however, it is possible that day-to-day variability in parenting may also relate to emotion dysregulation. The current study sought to test whether inconsistency in the quality of daily parent-youth interactions related to multiple indices of emotion dysregulation in adolescents. Two-hundred-twenty-two adolescents (ages 13-16; 53% female) participated with one parent. Adolescents completed 14-days of diary reporting on the quality of interactions with their parent (negative/neutral/positive) and their emotion dysregulation experiences for each day. Analyses reveal that, beyond the effects of average interaction quality, adolescents with greater variability in the quality of their interactions with their parent reported greater average emotion dysregulation across the days of diary recording and demonstrated greater variability in their ratings of daily emotion dysregulation. Findings were not accounted for by parental warmth or hostility, parent-reported trait-level emotion regulation, or day-level associations between study variables. In these ways, greater variability - and not merely greater negativity - during interactions between parents and adolescents was related to adolescent emotion dysregulation, suggesting that consistency in parent-adolescent relationships may be an important dimension of psychosocial risk to consider within families.

Predictability of Interruptions During Medication Administration With Related Behavioral Management Strategies

The aim of this qualitative study was to examine the nature of interruptions during medication administration. Focus groups were conducted with medical/surgical nurses (n = 15), critical care nurses (n = 13), and nurse managers/educators/specialists (n = 6). Most interruptions (78%) were predictable. Nurse-adopted strategies included blocking, engaging, mediating, multitasking, and preventing. Educational content was developed that relates behavioral strategies to respond to predictable and unpredictable interruptions.

Environmental mastery and depression in older adults in residential care

This study investigated the association between environmental mastery and depression in a sample of 96 older adults (aged 64–98 years) in residential care. The participants completed a scale that assessed depression along with measures for risk factors for depression such as functional capacity, self-evaluated physical health, bereavement experiences and environmental mastery. The results showed that 49 per cent of the variance in participants' scores in depression could be attributed to their self-reported level of environmental mastery. Given the complexity of depression and the likelihood of reduced environmental mastery among older adults in residential care, the construct was further assessed as a mediating variable between the risk factors and depression. With environmental mastery taken as such, the explained variance in depression increased to 56 per cent. It was concluded that environmental mastery may be one of the more important factors affecting the mental health of older adults living in residential care and that strategies for increasing the residents' environmental mastery are important to their psychological wellbeing. The discussion notes that among the questions needing further investigation are whether older adults who experience high environmental mastery make the transition from community living to residential nursing home care more successfully than others, and whether perceived mastery diminishes over time or occurs at the point of transition from community independent living to dependent supported living.

Toward a Typology of High-Risk Major Stressful Events and Situations in Posttraumatic Stress Disorder and Related Psychopathology

The diagnosis of posttraumatic stress disorder (PTSD) was introduced in 1980 with the publication of the Diagnostic and Statistical Manual of the American Psychiatric Association, Third Edition (DSM-III). DSM-III put forward a novel syndrome consisting of intrusive, avoidance/numbing, and arousal symptoms as distinctive psychopathology following exposure to traumatic events. The traumatic stressors, although expanded in later editions published in 1987 (DSM-III-R) and 1994 (DSM-IV), focus on life-threatening events and situations. However, at least 12 studies, most of them recent, have found associations between the PTSD symptoms and the PTSD symptom syndrome with stressors, such as unemployment and divorce that would not qualify, even in the broadened DSM-IV diagnosis, as traumatic stressors. These findings challenge the basic assumption on which the PTSD diagnosis is based, the assumption that exposure to life-threatening stressors is the primary cause of a unique set of stress response symptoms. The purpose of this paper is to show how to confront this challenge by developing a typology of stressful situations and events that can be tested systematically for their relation to the PTSD symptom syndrome and other relevant variables. The typology includes but is not limited to the types of situations and events defined as "traumatic" in the DSMs.

The mediating role of perceived control on the relationship between socioeconomic status and functional changes in older patients with coronary heart disease

Using a prospective design, this study examines the mediating effect of perceived control in explaining the predictive role of socioeconomic status (SES) in long-term changes in functional status as a consequence of the occurrence of coronary heart disease (CHD). We followed 221 older CHD patients by using a community-based survey. We collected data on patients' functional status before the onset of disease and 1 year after the diagnosis. Multiple linear regressions show that SES predicts functional changes only in relation to physical functioning. Furthermore, self-efficacy, but not mastery, mediates the predictive role of SES in changes in physical functioning in CHD patients. Self-efficacy is the only aspect of control that mediates the relation between SES and changes in physical functioning. Our findings provide a basis for future interventions in disadvantaged groups of older persons and new theoretical models of recovery processes.

Coregulation, Dysregulation, Self-Regulation: An Integrative Analysis and Empirical Agenda for Understanding Adult Attachment, Separation, Loss, and Recovery

An integrative framework is proposed for understanding how multiple biological and psychological systems are regulated in the context of adult attachment relationships, dysregulated by separation and loss experiences, and, potentially, re-regulated through individual recovery efforts. Evidence is reviewed for a coregulatory model of normative attachment, defined as a pattern of interwoven physiology between romantic partners that results from the conditioning of biological reward systems and the emergence of felt security within adult pair bonds. The loss of coregulation can portend a state of biobehavioral dysregulation, ranging from diffuse psychophysiological arousal and disorganization to a full-blown (and highly organized) stress response. The major task for successful recovery is adopting a self-regulatory strategy that attenuates the dysregulating effects of the attachment disruption. Research evidence is reviewed across multiple levels of analysis, and the article concludes with a series of testable research questions on the interconnected nature of attachment, loss, and recovery processes.

Personal mastery predicts pain, stress, fatigue, and blood pressure in adults with rheumatoid arthritis

Among individuals with rheumatoid arthritis (RA), stress-associated disease flare can severely impact well-being. Psychological factors such as personal mastery may buffer an individual from the negative effects of those flares. We tested the hypothesis that a high sense of personal mastery would prospectively predict stress reactivity. Measures of pain,perceived stress, fatigue, and mean arterial pressure (MAP) were collected before, during, and after two interpersonal stressors conducted on 73 individuals with RA. Factor analysis of the personal mastery scale yielded two independent factors: a 5-item "fatalism" component and a 2-item "control" component. Individuals with high fatalism scores reported overall greater joint pain at baseline and those scoring high on control exhibited lower MAP, and reported less stress and fatigue at baseline. After controlling for baseline differences, those high in control exhibited greater MAP increase during stress, and less drop in pain when compared to those low in control. These results suggest that individuals high in control may be more susceptible to the effects of acute stress; however, the overall beneficial aspects of high control outweigh the acute negative effects. Personal mastery may play a role in the experience of pain, stress, and fatigue for people with RA.