Modeling and mobile home monitoring of behavioral and psychological symptoms of dementia (BPSD)

With the increasing global aging population, dementia care has rapidly become a major social problem. Current diagnosis of Behavior and Psychological Symptoms of Dementia (BPSD) relies on clinical interviews, and behavioral rating scales based on a period of behavior observation, but these methods are not suitable for identification of occurrence of BPSD in the daily living, which is necessary for providing appropriate interventions for dementia, though, has been studied by few research groups in the literature. To address these issues, in this study developed a BPSD monitoring system consisting of a Psycho-Cognitive (PsyCo) BPSD model, a Behavior-Physio-Environment (BePhyEn) BPSD model, and an implementation platform. The PsyCo BPSD model provides BPSD assessment support to caregivers and care providers, while the BePhyEn BPSD model provides instantaneous alerts for BPSD enabled by a 24-hour home monitoring platform for early intervention, and thereby alleviation of burden to patients and caregivers. Data for acquiring the models were generated through extensive literature review and regularity determined. A mobile robot was utilized as the implementation platform for improving sensitivity of sensors for home monitoring, and elderly individual following algorithms were investigated. Experiments in a virtual home environment showed that, a virtual BPSD elderly individual can be followed safely by the robot, and BPSD occurrence could be identified accurately, demonstrating the possibility of modeling and identification of BPSD in home environment.

Association between subclinical epileptiform discharge and the behavioral and psychological symptoms in patients with Alzheimer's dementia

OBJECTIVES

Behavioral and psychological symptoms of dementia (BPSD) are highly prevalent in patients with Alzheimer's disease (AD), causing burdens on caregivers. Behavioral and psychological symptoms of dementia and subclinical epileptiform discharge (SED) increased with the disease course of AD. However, the interaction between them was still unknown. The present study aimed to evaluate the associations between SED and BPSD.

METHODS/DESIGN

Patients with AD from Kaohsiung Municipal Ta-tung Hospital were included in this study. International 10-20 system scalp electroencephalography (EEG) for 13 min was performed to detect SED. Behavioral and psychological symptoms of dementia was assessed by neuropsychiatric inventory (NPI) questionnaires. The occurrence of BPSD subsyndromes was compared between patients with and without SED.

RESULTS

Two hundred sixty-three adult patients qualified for the inclusion criteria and were enrolled in this study. The mean age of patients was 80.2 years, and approximately 62% were women. 17.1% of patients showed SED on EEG. Apathy was the most commonly reported BPSD subsyndrome in this cohort. There was no significant difference in the prevalence of BPSD between patients with and without SED. (75.6% vs. 67.4%, p = 0.2806). However, the NPI score of irritability subsyndrome was significantly higher in the SED (+) group (2.6 ± 3.7 vs. 1.2 ± 2.7, p = 0.0028). In addition, subclinical epileptiform discharge in the frontal lobe was associated with a considerably higher occurrence of hyperactivity subsyndrome, including irritability.

CONCLUSIONS

SED may not be a direct cause of BPSD, but the presence of SED may affect the manifestation of BPSD.

The association of physical activity and behavioral and psychological symptoms among a sample of hospitalized older adults living with dementia

OBJECTIVES

The aims of this study were to: (1) describe the prevalence of behavioral and psychological symptoms of dementia in hospitalized older adults living with dementia and (2) examine the association of physical activity and behavioral and psychological symptoms of dementia among hospitalized older adults living with dementia, after controlling for covariates.

METHODS

Physical activity was measured using the Physical Activity Survey and behavioral and psychological symptoms of dementia were measured using the Neuropsychiatric Inventory. Descriptive analysis and multiple linear regressions were run using baseline data on 294 older adults with dementia hospitalized on general medical units from an ongoing study entitled Function Focused Care for Acute Care Using the Evidence Integration Triangle.

RESULTS

Participants performed an average of 7.92 (SD = 4.49) of 34 possible activities "in the last 24 h" prior to the Physical Activity Survey administration. A total of 132 participants (45.5%) had at least one behavioral and psychological symptom of dementia. We found that physical activity was not associated with behavioral and psychological symptoms of dementia (b = 0.01; p = 0.56), after controlling for covariates.

CONCLUSIONS

Although this study found no evidence of an association between physical activity and behavioral and psychological symptoms of dementia, evidence of physical activity did not exacerbate these behaviors. Thus, given the benefits of physical activity, it is important to continue to encourage patients living with dementia to engage in activity.

Korean Family Caregivers' Experiences With Managing Behavioral and Psychological Symptoms of Dementia: Keeping Harmony in Daily Life

Behavioral and psychological symptoms of dementia (BPSD) are symptoms of dementia that family care-givers find difficult to manage. Competence in managing BPSD differs according to individual family caregiver. The current study investigated the competence in managing BPSD, focusing on family caregivers who were recognized as managing them well. Twenty-four Korean family caregivers (83% female, mean age = 67 years) living with persons with dementia (PWD) were interviewed. Four themes were derived from the content analysis: Entering and Looking into the World of PWD, Keeping Daily Life in Harmony With BPSD, Becoming an Expert in BPSD, and Balancing Between Caregiving and Myself. Family caregivers minimized the impact of BPSD and maintained life balance. As a result, they were able to continue a harmonious life with PWD. [Research in Gerontological Nursing, xx(x), xx-xx.].

Symptom-level modelling unravels the shared genetic architecture of anxiety and depression

Depression and anxiety are highly prevalent and comorbid psychiatric traits that cause considerable burden worldwide. Here we use factor analysis and genomic structural equation modelling to investigate the genetic factor structure underlying 28 items assessing depression, anxiety and neuroticism, a closely related personality trait. Symptoms of depression and anxiety loaded on two distinct, although highly genetically correlated factors, and neuroticism items were partitioned between them. We used this factor structure to conduct genome-wide association analyses on latent factors of depressive symptoms (89 independent variants, 61 genomic loci) and anxiety symptoms (102 variants, 73 loci) in the UK Biobank. Of these associated variants, 72% and 78%, respectively, replicated in an independent cohort of approximately 1.9 million individuals with self-reported diagnosis of depression and anxiety. We use these results to characterize shared and trait-specific genetic associations. Our findings provide insight into the genetic architecture of depression and anxiety and comorbidity between them.

Multivariate analysis of 1.5 million people identifies genetic associations with traits related to self-regulation and addiction

Behaviors and disorders related to self-regulation, such as substance use, antisocial behavior and attention-deficit/hyperactivity disorder, are collectively referred to as externalizing and have shared genetic liability. We applied a multivariate approach that leverages genetic correlations among externalizing traits for genome-wide association analyses. By pooling data from ~1.5 million people, our approach is statistically more powerful than single-trait analyses and identifies more than 500 genetic loci. The loci were enriched for genes expressed in the brain and related to nervous system development. A polygenic score constructed from our results predicts a range of behavioral and medical outcomes that were not part of genome-wide analyses, including traits that until now lacked well-performing polygenic scores, such as opioid use disorder, suicide, HIV infections, criminal convictions and unemployment. Our findings are consistent with the idea that persistent difficulties in self-regulation can be conceptualized as a neurodevelopmental trait with complex and far-reaching social and health correlates.

Child Psychological Functioning During the COVID-19 Lockdown: An Ecological, Family-Centered Approach

OBJECTIVE

To evaluate how sociodemographic characteristics and various aspects of parent well-being, family functioning, parent-child relationship, and child characteristics are related to psychological functioning in children aged 9 to 12 years during the COVID-19 lockdown.

METHOD

Participants included 144 children aged 9 to 12 years and their parents who lived in the province of Quebec, Canada, during the COVID-19 mandatory lockdown. Parents and children were administered a phone-based survey in which various child, parent, parent-child, and family characteristics were assessed.

RESULTS

Results showed that higher internalizing problems in children were related to greater depressive symptoms in parents, lower attachment security to parents, and greater aversion to aloneness in children. Results on externalizing behavior problems showed that more problems were associated with more family dysfunction and chaos and lower attachment security to parents. Finally, results on children's anxiety toward COVID-19 showed that more anxiety was associated with greater parental anxiety toward COVID-19 and more child aversion to aloneness.

CONCLUSION

Our findings showed that even during an unusual and stressful context such as a pandemic, proximal variables such as the attachment relationship that have been known to be closely associated with adaptation are significantly related to child psychological functioning. Such observations are important because they highlight factors that may accentuate child vulnerability in times of a pandemic and shed light on potential intervention targets.

Cultural Identity Conflict and Psychological Well-Being in Bicultural Young Adults: Do Self-Concept Clarity and Self-Esteem Matter?

ABSTRACT

The present study examined the relationship between cultural identity conflict and psychological well-being, as well as the role of self-concept clarity and self-esteem in mediating this linkage. Elevated cultural identity conflict was hypothesized to be associated with lower psychological well-being via both (lower) self-concept clarity and (lower) self-esteem, with self-concept clarity preceding self-esteem. In a cross-sectional design, 473 bicultural young adults (age range, 18-35) completed an online questionnaire assessing cultural identity conflict, self-concept clarity, self-esteem, emotional distress, psychopathological symptoms, and satisfaction with life. Correlation analyses revealed that elevated cultural identity conflict was positively associated with emotional distress and psychopathological symptoms, and negatively associated with satisfaction with life. Mediation analyses indicated that these associations were mediated by lower self-concept clarity and lower self-esteem. The results support the importance of interventions that foster the development of skills in bicultural young adults to obtain more self-concept clarity and promote self-esteem and psychological well-being.

Mental health and clinical psychological science in the time of COVID-19: Challenges, opportunities, and a call to action

COVID-19 presents significant social, economic, and medical challenges. Because COVID-19 has already begun to precipitate huge increases in mental health problems, clinical psychological science must assert a leadership role in guiding a national response to this secondary crisis. In this article, COVID-19 is conceptualized as a unique, compounding, multidimensional stressor that will create a vast need for intervention and necessitate new paradigms for mental health service delivery and training. Urgent challenge areas across developmental periods are discussed, followed by a review of psychological symptoms that likely will increase in prevalence and require innovative solutions in both science and practice. Implications for new research directions, clinical approaches, and policy issues are discussed to highlight the opportunities for clinical psychological science to emerge as an updated, contemporary field capable of addressing the burden of mental illness and distress in the wake of COVID-19 and beyond. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Mental health and clinical psychological science in the time of COVID-19: Challenges, opportunities, and a call to action

COVID-19 presents significant social, economic, and medical challenges. Because COVID-19 has already begun to precipitate huge increases in mental health problems, clinical psychological science must assert a leadership role in guiding a national response to this secondary crisis. In this article, COVID-19 is conceptualized as a unique, compounding, multidimensional stressor that will create a vast need for intervention and necessitate new paradigms for mental health service delivery and training. Urgent challenge areas across developmental periods are discussed, followed by a review of psychological symptoms that likely will increase in prevalence and require innovative solutions in both science and practice. Implications for new research directions, clinical approaches, and policy issues are discussed to highlight the opportunities for clinical psychological science to emerge as an updated, contemporary field capable of addressing the burden of mental illness and distress in the wake of COVID-19 and beyond. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Childhood deprivation experience, family pathways, and socioemotional functioning

Using the ECLS-K, a dataset following a nationally representative cohort of children from kindergarten through 8th grade in the United States (N ≈ 9,250), this study fills the following knowledge gaps. We captured childhood economic experiences by incorporating multiple forms of exposures to income-based deprivation-poverty depth (i.e., the severity of deprivation), spells (i.e., length of time in poverty), and income volatility (i.e., fluctuations in family income)-with a latent class analysis. We also examined how different patterns of economic experiences shaped adolescents' socioemotional functioning through family stress (parental depressive symptoms and punitive parenting) and family investment (provision of stimulating materials and parental school involvement) pathways via structural equation modeling. Our analysis indicated 6 classes of deprivation, and these deprivation patterns had both direct and indirect significant associations with children's locus of control and internalizing behaviors. Our structural equation modeling results further indicated that deprivation was associated with parental depressive symptoms, which were, in turn, associated with parents providing less cognitively stimulating materials to children and engaging less in children's school activities. These disadvantages were associated with unfavorable socioemotional functioning in 8th grade. The findings highlight the importance of family practitioners and psychologists recognizing and acting on the interconnections among deprivation, inequity, and child well-being. Our results also suggest considering variations in economic experiences and mechanisms when developing informed policies and programs. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Reconsidering the relation between parental functioning and child externalizing behaviors: A meta-analysis on child-driven effects

Guided by multiple theories illustrating the transactional nature of the relation between parents' and children's behaviors, the present meta-analysis provides synthesized evidence on the strength of child-driven effects in eliciting changes in parents' psychological stress and parenting practices. A meta-analysis of 45 independent samples with 640 effect sizes found significant positive associations between children's externalizing behaviors and parents' subsequent functioning (r = .087, 95% CI [.07, .10]). These associations were net of parents' functioning at baseline, and the strength of these associations was statistically comparable with the effects of parents on children's externalizing behaviors (r = .075, 95% CI [.06, .09]). In addition, the strength of the child-driven effects did not vary as a function of child gender, age, or the time interval between assessments. The implications of these findings with respect to research on the dynamic relation between parenting functioning and children's adjustment are discussed. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Parental depressive symptoms, parent-child dyadic behavioral variability, and child dysregulation

Parental depressive symptoms are associated with greater variability and inconsistency in parenting behavior as well as children's emotional and behavioral dysregulation. The present study explored whether such relations extended to dyadic processes, examining whether maternal and paternal depressive symptoms at child age 3½ interacted with concurrent higher dyadic behavioral variability (DBV) in mother-child free play to heighten children's emotional and behavioral dysregulation at age 4 (N = 100). Child dysregulation was measured as mother-reported emotional lability-negativity and externalizing problems, and DBV was measured as the number of transitions among dyadic behavioral states using state space grids. Parent behaviors included parent directives, positive reinforcement, and disengagement, and child behaviors included child compliance, persistence, and noncompliance, among others. Analyses also accounted for the degree of positive (compared to negative) behavioral content. Moderation analyses showed that DBV predicted greater child dysregulation only when maternal or paternal depressive symptoms were higher. Further, DBV was detrimental only when dyadic positive interaction content was low. Findings suggest DBV combined with low positive content in parent-child interactions is a particular risk factor for children's regulatory development. Fostering positive, predictable interaction patterns may be an important target for family interventions with a depressed parent. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Caffeine Consumption and Behavioral Symptoms in Nursing Home Residents: A Cross-Sectional Analysis

OBJECTIVE

Although behavioral changes are common in nursing home residents with dementia and caffeine is known to influence behavior in healthy adults, the effects of caffeine on the behavior of persons with dementia has received little attention. In this study we assessed the relationship of caffeine and behavioral symptoms in older persons with dementia.

DESIGN

A multicenter sub-cohort study embedded in the Elderly Care Physicians (ECP) training program.

SETTING

Dutch nursing homes associated with the ECP training program.

PARTICIPANTS

A total of 206 individuals with both diabetes and dementia resident in Dutch nursing homes.

MEASUREMENTS

Trainee ECPs collected data on caffeine consumption, cognition and behavioral symptoms using the NPI-NH, MDS-DRS and AES-C. Data on factors known to influence behavior in persons with dementia (e.g. marital status, kidney function, urinary tract infection and medication) were also collected.

RESULTS

Of the 206 participants, 70% showed behavioral symptoms. An increase in caffeine consumption was associated with a decrease in the presence of behavioral symptoms in the NPI-NH cluster affect and NPI-NH item agitation. Caffeine consumption groups also differed on the presence of disinhibition and depression. In addition, the severity of dementia influenced agitation, anxiety and the clusters affect and psychomotor.

CONCLUSION

In a large group of older persons with dementia resident in nursing homes, a low daily consumption of caffeine was associated with greater behavioral symptoms.

Use of Antipsychotics in Patients with Behavioral and Psychological Symptoms of Dementia: Results of a Spanish Delphi Consensus

BACKGROUND

Behavioral and psychological symptoms of dementia (BPSD) are difficult to manage and associated with poor outcome.

OBJECTIVES

The aim of this study was to reach consensus on the use of antipsychotics in patients with BPSD in Spain.

METHODS

A qualitative, multicenter, two-round Delphi study was carried out, with the participation of specialists involved in the care of dementia patients throughout Spain. They completed a 76-item questionnaire related to the identification of BPSD, treatment with antipsychotics, follow-up of patients, barriers for the use of atypical antipsychotics, and effects of antipsychotics on quality of life.

RESULTS

A total of 162 specialists in neurology, psychiatry, and geriatrics (61% men) with a mean (SD) age of 45.9 (10) years participated in the study. Almost all participants (96.9%) strongly agreed that atypical antipsychotics are safer and better tolerated than typical antipsychotics. There was agreement on the importance to review the indication and dose of the antipsychotic drug at least every 3 months. There was consistent high rate of agreement on the beneficial impact of atypical antipsychotics on the quality of life of patients with dementia and their caregivers. A consensus was also reached on the need of detecting BPSD in patients with dementia as it decreases the quality of life of both patients and caregivers, and the need to routinely screen for dementia in elderly patients with no previous psychiatric history in the presence of suggestive symptoms of BPSD. Finally, the participants in the study agreed that administrative barriers for the prescription of atypical antipsychotics in Spain hinder the access to this drug group and favor the prescription of typical antipsychotics.

CONCLUSIONS

The participants in the study agreed that atypical antipsychotics should be preferred to typical antipsychotics in the management of BPSD. Wide consensus was reached about the importance of early identification of BPSD in persons with cognitive impairment, the use and management of atypical antipsychotic drugs and their favorable impact on patients and caregiver's quality of life.

"Hey, we also have something to say": A qualitative study of Portuguese adolescents' and young people's experiences under COVID-19

OBJECTIVE

(1) To give adolescents and youth a voice and listen to the impact of coronavirus disease 2019 (COVID-19) in their lives; (2) to identify their coping strategies; (3) present lessons learned to be better prepared for future pandemics.

METHODS

Six hundred and seventeen participants from 16 to 24 years old (M = 19.2 years; F = 19.1 years) answered the online questionnaire during the pandemic lockdown. Sociodemographic data were analyzed with SPSS version 26 and qualitative data with MAXQDA 2020. Engel's Biopsychosocial model supported the analysis and data presentation.

RESULTS

in terms of impacts, stands out: biological-headaches and muscle pain; psychological-more time to perform pleasant and personal development activities, but more symptoms of depression, anxiety, and loneliness, longer screen time, and more substance use; social-increase of family conflicts and disagreements, loss of important life moments, contacts, and social skills, but it allows a greater selection of friendships. Regarding coping strategies, the importance of facing these times with a positive perspective, carrying out pleasurable activities, keeping in touch with family and friends, and establishing routines are emphasized. As lessons for future pandemics, the importance of respecting the norms of the Directorate-General for Health, the need for the National Health System to be prepared, as well as teachers and students for online learning, and studying the possibility of establishing routines with the support of television.

CONCLUSIONS

This study illustrates adolescents and young people's perception of the impacts of the pandemic upon them, as well as their competence to participate in the issues that directly affect them. Priorities to mitigate the impact of future pandemics are presented.

Detouring in the family system as an antecedent of children's adjustment problems

Guided by conceptualizations of relational boundaries from family systems theory, this study examined unique links between detouring (e.g., alliance between parents against child) and young children's psychological functioning after accounting for general family negativity and conflict. Participants in this longitudinal (i.e., 2 annual waves of data collection), multimethod (i.e., observation, survey, semistructured interview), multiinformant (i.e., parent, teacher, observer) study included 218 young children (mean [M] age = 5.76 years) and their families. The findings from cross-lagged panel analysis indicated that detouring uniquely predicted increases in children's externalizing problems, hostile attribution bias, and peer rejection and victimization over a 1-year period (i.e., the transition from kindergarten to first grade). Conversely, the findings failed to support a child effects model in that child adjustment problems did not predict increases in detouring or family negativity and conflict over time. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Impact of COVID-19 on Public Mental Health and the Buffering Effect of a Sense of Coherence

INTRODUCTION

It is claimed that the coronavirus disease 2019 (COVID-19) pandemic has had a negative impact on mental health. However, to date, prospective studies are lacking. Moreover, it is important to identify which factors modulate the stress response to the pandemic. Previously, sense of coherence (SOC) has emerged as a particularly important resistance factor.

OBJECTIVE

This prospective study aimed to assess the impact of the COVID-19 outbreak on mental health and to investigate the ability of pre-outbreak SOC levels to predict changes in psychopathological symptoms.

METHODS

This study assessed psychopathological symptoms and SOC before and after the COVID-19 outbreak as well as post-outbreak COVID-19-related traumatic distress in a German-speaking sample (n =1,591). Bivariate latent change score (BLCS) modeling was used to analyze pre- to post-outbreak changes in psychopathological symptoms and the ability of SOC to predict symptom changes.

RESULTS

Overall, there was no change in psychopathological symptoms. However, on an individual-respondent level, 10% experienced a clinically significant increase in psychopathological symptoms and 15% met cut-off criteria for COVID-19-related traumatic distress. Using BLCS modeling, we identified a high-stress group experiencing an increase in psychopathological symptoms and a decrease in SOC and a low-stress group showing the reversed pattern. Changes in SOC and psychopathological symptoms were predicted by pre-outbreak SOC and psychopathological symptom levels.

CONCLUSIONS

Although mental health was stable in most respondents, a small group of respondents characterized by low levels of SOC experienced increased psychopathological symptoms from pre- to post-outbreak. Thus, SOC training might be a promising approach to enhance the resistance to stressors.

Children's self-blame appraisals about their mothers' depressive symptoms and risk for internalizing symptoms

Maternal depressive symptoms are a robust predictor of children's risk for internalizing symptoms, yet not all children are negatively affected by exposure to their mothers' symptoms. The present study tested children's self-blame appraisals as a moderator of the association between maternal depressive symptoms and children's internalizing symptoms, controlling for children's negative attributional style. We hypothesized that the relation between maternal depressive symptoms and children's internalizing symptoms would be stronger for children who blamed themselves more for their mothers' symptoms. Participants were 129 mother-child dyads (M child age = 13.63, SD = 2.2; 52.7% female; 38.8% White, 31% African American, 22.5% Latinx/Hispanic) recruited from the community. Results indicated that maternal depressive symptoms were associated with higher levels of children's internalizing symptoms for children who reported higher, but not lower, levels of self-blame appraisals. Results were consistent using mothers' or children's reports of their own and each other's symptoms. The findings highlight the importance of assessing children's appraisals about their mothers' depressive symptoms, and suggest that preventive interventions should target children who endorse higher levels of self-blame appraisals. Furthermore, children's self-blame appraisals about mothers' depressive symptoms should be considered as a target of treatment for child internalizing disorders. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Incarceration and pandemic-related restrictions during COVID-19: An empathic understanding of two worlds

This paper explores parallels between experiences of confinement due to pandemic-related restrictions and confinement as a result of legal incarceration. We compare experiences of social isolation, lack of choice, and reduced access to resources while also acknowledging the existence of significant differences between the two situations. We describe the ways in which experiences of confinement as part of COVID-19 regulations can provide the general public with insight into difficulties associated with incarceration and the negative effect it can have on psychological health. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Sad Dads and Troubled Tots: Protective Factors Related to the Stability of Paternal Depression and Early Childhood Internalizing Problems

The present study tested the moderating role of interparental relationship quality and child inhibitory control on the stability of paternal depression over time and associations between paternal depression and child internalizing problems in early childhood. Participants were a subsample (n = 166) of families from the Early Steps Multisite study, a longitudinal study of low-income parents and children. Interparental relationship quality (age 2) attenuated the association between paternal depressive symptoms at age 2 and paternal depressive symptoms at age 3. Both interparental relationship quality (age 3) and child inhibitory control (age 3) attenuated the association between paternal depressive symptoms (age 3) and age 4 child internalizing problems. Results suggest that high interparental relationship quality may be a protective factor in terms of lessening the stability of paternal depressive symptoms over time, as well as the association between paternal depression and later child internalizing problems. Similarly, high levels of inhibitory control may buffer children from the negative effects of paternal depression on the development of internalizing problems.

Global deficits in executive functioning are transdiagnostic mediators between severe childhood neglect and psychopathology in adolescence

BACKGROUND

Children reared in institutions experience profound deprivation that is associated with both heightened levels of psychopathology and deficits in executive functioning (EF). It is unclear whether deficits in EF among institutionally-reared children serve as a vulnerability factor that increases risk for later psychopathology. It is also unclear whether this putative association between EF and psychopathology is transdiagnostic (i.e. cuts across domains of psychopathology), or specific to a given syndrome. Thus, we examined whether global deficits in EF mediate the association between severe childhood neglect and general v. specific psychopathology in adolescence.

METHODS

The sample consisted of 188 children from the Bucharest Early Intervention Project, a longitudinal study examining the brain and behavioral development of children reared in Romanian institutions and a comparison group of never-institutionalized children. EF was assessed at age 8, 12, and 16 using a well-validated measure of neuropsychological functioning. Psychopathology was measured as general (P) and specific internalizing (INT) and externalizing (EXT) factors at age 12 and 16.

RESULTS

Institutionally-reared children had lower global EF and higher general psychopathology (P) at all ages compared to never-institutionalized children. Longitudinal path analysis revealed that the effect of institutionalization on P at age 16 operated indirectly through poorer EF from ages 8 to 12. No indirect effects involving EF were observed for INT or EXT at age 16.

CONCLUSIONS

We conclude that stable, global deficits in EF serve as a cognitive endophenotype that increases transdiagnostic vulnerability to psychopathology in adolescence among those who have experienced profound early neglect.

The effect of the 2019 novel coronavirus pandemic on college students in Wuhan

OBJECTIVE

This study explored a multiple mediation model in Wuhan's college students. Positive thinking and resilience were identified as mediators between 2019 novel coronavirus (2019-nCoV) victimization experiences and mental health.

METHOD

The sample included 384 from 4 universities in Wuhan, China. Four structured instruments were applied to the college students, including scale of the 2019-nCoV coronavirus victimization experience, scale of the positive thinking, scale of the resilience, and scale of the mental health. The responses were scored using a 5-point Likert scale. Structural equation models were used to construct measurement and structural models.

RESULTS

The findings confirmed that the 2019-nCoV victimization experience was a negative predictor of mental health; positive thinking and resilience were strong mediators between 2019-nCoV victimization experience and mental health.

CONCLUSIONS

The results indicated that a complete model was significant because positive thinking compensated for resilience. Notably, these 2 strong mediators will vastly resist the negative influences of 2019-nCoV victimization experience on mental health in Wuhan's college students until the end of the pandemic. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

COVID-19: Threat and fear in Indonesia

The purpose of this article is to provide a brief report on how the Indonesian population has experienced the COVID-19 pandemic in the first 2 months since the establishment of COVID-19 Rapid Response Task Force on March 13. The discussion will focus on the psychological trauma that the population has experienced due to the lack of preparedness, the poorly equipped health care system, and lockdown policies in dealing with the spread of the coronavirus. Four different types of psychological trauma were increasingly observed, based on digital communication with people affected and reports from the news and social media. These 4 types of psychological trauma were social withdrawal, hysteria, individual violence, and collective violence. On the basis of the described psychological consequences of the pandemic, it can be assumed that both the individual and collective reactions must be considered to reduce harm of the coronavirus pandemic. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

A psychoanalytic view of reactions to the coronavirus pandemic in China

The coronavirus pandemic, which apparently began in Wuhan in December 2019, and has persisted to the present day, has had several psychological effects in China. The real danger has produced prolonged stress. Large-group phenomena have been stimulated. Overwhelming affects generated by the real danger have led to regression in the stimulus barrier (or "filter"). The COVID-19 has also triggered unconscious defensive reactions, including obsessional cleaning, counterphobic behavior, humor, and denial. The nationally imposed home quarantine of millions of families has caused in-home conflicts and neurotic repetitions of unresolved childhood issues. Prior psychiatric illnesses have been exacerbated. Health workers, including psychiatrists, psychologists, and psychoanalysts, have experienced emotional depletion. Finally, in families where there has been infection or death, delayed mourning and post-traumatic phenomena have been observed. In each of these situations, different interventions based on psychoanalytic principles have been useful.

Emotional and behavioural symptoms, risk behaviours and academic success in Chilean Mapuche and non-Mapuche adolescents

Introduction: There is controversy over the real existence of differences in mental health and academic performance between the Mapuche ethnic minority male adolescents and the male adolescents not belonging to this ethnicity in Chile.Objective: In consequence, the aim of this study was to investigate the differences in emotional and behavioural symptoms, risky behaviours and academic success on the Chilean Mapuche and non-Mapuche adolescents.Design: The sample consisted of 233 adolescents of which 119 were Mapuche adolescents and 114 were non-Mapuche adolescents.Results: The results showed that the Mapuche adolescents do not have more anxiety problems and depression than the non-Mapuche adolescents. Furthermore, the Mapuche adolescents present less drug consumption and behavioural problems. Moreover, there were no differences in academic performance.Conclusions: This study provides social interest data of the adolescents' mental health, which can be useful for the country's socio-sanitary and political decisions. Future studies should investigate these and other variables related to the mental health of minorities in greater depth.

Warning Signs of Partner Abuse in Intimate Relationships: Gender Differences in Young Adults' Perceptions of Seriousness

In response to the high rates of intimate partner abuse (IPA) among young adults and related negative health effects, this study examined 18- to 26-year-old Australians' perceptions of unhealthy partner behaviors that may constitute early warning signs of abuse in intimate relationships. This research is the first to examine gender differences on this issue in a young adult population. A convenience sample of 49 males and 152 females (N = 201) completed an online survey, rating how seriously they viewed a list of partner warning sign behaviors (WSBs). WSBs consisted of three subscales: Dominance-Possessiveness, Denigration, and Conflict-Retaliation. Participants' perceived seriousness of WSBs was analyzed by gender and WSB type. Results revealed large and significant gender differences in perceptions of WSBs, with females likely to rate all WSBs more seriously than males. Furthermore, females' responses were negatively skewed and leptokurtotic indicating high levels of convergence in the view that such behaviors are a concern. Analysis by WSB type revealed that conflict-retaliation behaviors were perceived most seriously by both genders, with more than half of males and 67% of females rating these as very serious. In contrast, significantly lower levels of perceived seriousness were observed for denigration and dominance-possessiveness behaviors. Half to two thirds of females viewed dominance-possessiveness and denigration WSBs as very serious, respectively, whereas just one third of males endorsed both these WSB types as very serious. Findings reveal that females have a heightened awareness of the subtle warning signs of abuse in intimate relationships and that as partner WSBs become more overt, both genders are more likely to recognize them as serious. Findings also indicate that subtler WSBs, such as control and denigration, are less readily identified as unhealthy, particularly among males.

Development of externalizing symptoms across the toddler period: The critical role of older siblings

We examined child and family risk factors that were associated with the development of individual differences in externalizing problems across the toddler years. Our central hypothesis was that toddlers with more aggressive and disruptive older siblings would be at elevated risk for heightened levels of externalizing behavior. We tested this hypothesis in the context of other theoretically relevant risk factors: toddlers' inhibitory and internalized control, experiences of coercive parental discipline, and gender. Participants were 167 toddlers, their older siblings, and parents in a longitudinal study following younger siblings across the first 3 years of life. Mothers and fathers contributed ratings of externalizing symptoms between 1 and 18 months across the transition to siblinghood for older siblings and 18 to 36 months for younger siblings. Toddlers' inhibitory and internalized control were assessed using behavioral and parent report measures, and parents completed questionnaires concerning their use of coercive discipline. Individual differences in toddler externalizing symptoms were highly stable between 18 and 36 months of age for a sample of second-born children with older siblings, even though there was evidence of significant decline in externalizing symptoms from 18 to 36 months. As predicted, toddlers with elevated levels of externalizing symptoms tended to have older siblings with higher externalizing difficulties across the first 18 months of the younger sibling's life. Thus, these findings highlighted the need for further research on older siblings' contributions to the behavioral development of their toddler-age younger siblings. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Attachment orientations and loss adjustment among bereaved spouses

Stressful life events such as losing a spouse can enhance inflammation. Responses to loss may depend, in part, on individual differences in attachment anxiety and avoidance. An individual's attachment orientation (i.e., an individual's levels of attachment anxiety and avoidance) reflects how an individual relates to others-- specifically, whether they feel their trusted others will reliably be there for them, and whether they feel comfortable opening up to and depending on their relationship partners. This study investigated the association between attachment orientations and poor loss adjustment in recently bereaved individuals (N = 100). Poor loss adjustment was operationalized as greater levels of inflammation and grief symptoms, as well as poorer self-reported mental and physical health. Attachment anxiety was associated with increased stimulated monocyte IL-6 and CCL4 production, but not TNFα. Likewise, attachment anxiety was associated with greater grief symptoms as well as poorer mental and physical health. In contrast, attachment avoidance was not associated with inflammation; it was, however, associated with less grief symptoms as well as better self-reported mental and physical health. Our findings provide evidence that attachment orientations may be associated with loss adjustment and adverse health outcomes following the recent loss of a spouse.

Physical Abuse, Emotional Abuse, and Neglect and Childhood Behavior Problems: A Meta-Analysis of Studies in Mainland China

The relationship between three types of child maltreatment, including physical abuse, emotional abuse and neglect, and childhood behavior problems in Mainland China, has not been systematically examined. This meta-analysis reviewed findings from 42 studies conducted in 98,749 children in Mainland China and analyzed the pooled effect sizes of the associations between child maltreatment and childhood behavior problems, heterogeneity in study findings, and publication bias. In addition, this study explored cross-study similarities/differences by comparing the pooled estimates with findings from five existing meta-analyses. Equivalent small-to-moderate effect sizes emerged in the relationships between the three types of maltreatment and child externalizing and internalizing behaviors, except that emotional abuse related more to internalizing than externalizing behaviors. Considerable heterogeneity exists among the 42 studies. Weak evidence suggests that child gender and reporter of emotional abuse may moderate the strengths of the relationships between child maltreatment and behavior problems. No indication of publication bias emerged. Cross-study comparisons show that the pooled effect sizes in this meta-analysis are about equal to those reported in the five meta-analyses conducted in child and adult populations across the world. Findings urge relevant agencies in Mainland China to build an effective child protection system to prevent child maltreatment.

A Comparison of Neurocognitive Decline in Older Adults in Same-Sex and Opposite-Sex Relationships

BACKGROUND

Individuals from sexual minorities experience health inequalities that have detrimental impacts on their health, especially in the elderly, by exacerbating care needs and symptoms of chronic conditions such as Alzheimer's disease (AD). Neurocognitive decline due to AD in the sexual minority population remains under-investigated. However, being in a relationship may mitigate the risk of experiencing cognitive impairment.

OBJECTIVE

The aim of this study was to investigate whether cognitive decline and brain atrophy may differ in people from sexual minorities.

METHODS

Clinical data for this study were selected from the National Alzheimer's Coordinating Center's Uniform Data Set and structural MRI data collected across 14 Alzheimer's Disease Centers. Eighty participants including 20 patients with AD and 20 healthy controls (HC) in same-sex relationships were identified and matched to groups of participants (20 AD and 20 HC) in opposite-sex relationships. The effects of diagnosis and relationship were investigated on all measures.

RESULTS

No diagnosis-by-relationship interactions were found on any variable. However, post hoc analyses revealed that the opposite-sex group had grey matter atrophy mainly in medio-temporal areas. In the same-sex group, atrophy also extended to pre-frontal and cingulate areas. The severity of neuropsychiatric symptoms correlated with volume of pre-frontal and insular/temporal areas only in the same-sex group.

CONCLUSION

Neurocognitive decline due to AD may express similarly across individuals, independently of relationship type, thus suggesting a protective role of relational status. However, the same-sex group appeared to be more likely to experience at least one neuropsychiatric symptom and to have atrophy extending to fronto-limbic areas.

Family conflict observations and outcomes among adopted school-age children with lesbian, gay, and heterosexual parents

Children's externalizing problems are associated with family conflict among children and their biological parents, yet these linkages have remained unexamined among adoptive or lesbian and gay parent families. Investigating family processes facilitative of adjustment among adoptees, who face unique developmental challenges, is warranted. This multimethod study of 96 (26 lesbian, 29 gay, 41 heterosexual parent) adoptive families examined observations of adoptive family conflict and associations with child adjustment and feelings about adoption (children's M_age = 8 years). The sample was recruited from 5 private, domestic infant adoption agencies across the United States. Parents and children reported about children's externalizing problems and feelings about adoption, respectively. Observations of family conflict interaction were rated from videotaped family discussions. Family interactions were associated with children's behavioral and adoption-specific adjustment, yet analysis of variance and hierarchical linear modeling analyses revealed no differences by parental sexual orientation in family dynamics (i.e., negativity/conflict, positive affect, cohesiveness) or child outcomes. Parents generally reported children to have few externalizing behaviors. Children reported positive feelings, moderate preoccupation, and low negativity about their adoption. These findings extend the family systems literature about conflict and child development among diverse families with sexual minority parents and adopted children. Practitioners who work with adoptive and sexual minority parent families can encourage positive and cohesive family interactions in supporting children's adjustment. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Can Anything Good Ever Come From Bearing Migraine Attacks? Suggestions for a Comprehensive Concept of Gain in Migraine

PURPOSE OF REVIEW

The purpose of this review is to summarise the current state of knowledge concerning known types of gain, the reasons why patients might seek it, as well as implications for headache disorders.

RECENT FINDINGS

Even though the subject has been studied in the past, it received less attention in recent years. There is no doubt that migraine is a highly disabling disorder. However, attacks sometimes may be beneficial for the migraine brain as a time-out from the daily routine. On the other hand, patients are often stigmatised as trying to satisfy other needs through their disease. These "other needs" may be the exaggerated seeking for attention and affection or an undue official sickness certificate and were named secondary gain. Striving for secondary gain denotes a behaviour that aims at benefiting from a disease in a way that is seen as inappropriate by others. The fact that the term has persisted in doctors' vocabulary for decades probably indicates that it designates a concept considered relevant by many. However, its usage is complicated by its usually imprecise definition. We found in a literature search that the strive for secondary gain is not limited to neurosis, might both occur consciously and unconsciously, sometimes may aim at financial gain and sometimes at social gain, and can either be potentially expected or readily obtained. This behaviour mainly seems to aim at shaping one's interactions with the environment. Its causes have not been elucidated completely, though, but "unrequited demands for love, attention and affection" have been postulated. The desire for social gain can be influenced by approaches based upon behavioural psychology. Broaching the issue of secondary gain may be beneficial in the daily clinical routine.

Relations between caregiver-report of sleep and executive function problems in children with autism spectrum disorder and attention-deficit/hyperactivity disorder

BACKGROUND

Many children with autism spectrum disorder (ASD) experience comorbid symptoms of attention-deficit/hyperactivity disorder (ADHD). Additionally, children with ASD and ADHD often have sleep disturbances and deficits in executive functioning (EF). In typical development, sleep disturbances are causally linked to EF deficits and exacerbate ADHD-like symptoms.

AIM

The aim of this study was to determine whether caregiver-report sleep and EF difficulties predict ADHD symptoms in children with ASD.

METHODS

Caregiver-report of child sleep, EF, and ADHD symptom severity was collected for 101 children with ASD, 7-11 years of age. Hierarchical linear regressions tested the independent and interactive effects of sleep and EF in predicting ADHD symptoms.

RESULTS

Children with ASD were more likely to have symptoms of ADHD if they experienced both sleep and EF difficulties. Children with difficulties in working memory were particularly at risk for clinically significant symptoms of ADHD. Notably, however, sleep did not mediate or moderate the relation between working memory and ADHD symptoms in this sample, suggesting that these variables act through independent mechanisms to increase vulnerability for comorbidity.

CONCLUSIONS

These results have clinical significance as sleep and EF deficits may identify an ASD subgroup that is at increased risk for a comorbid ADHD diagnosis.

Externalizing Behaviors Buffer the Effects of Early Life Adversity on Physiologic Dysregulation

The present study examined the counterintuitive hypothesis that externalizing behaviors such as aggression, although in many respects detrimental, may be functional and protect against the detrimental health consequences of early life adversity. In particular, in line with evolutionary models of development, we argue that externalizing problems moderate the association between chronic stress exposure and allostatic load, a biological marker of chronic physiological dysregulation. Prospective interactive effects of externalizing behaviors and cumulative risk (a confluence of multiple risk factors) on children's allostatic load were assessed in 260 children (46% female, baseline age = 9). Exposure to early life adversity was assessed at baseline using a cumulative risk index. Externalizing behaviors were reported by parents at baseline. Allostatic load was measured at baseline and at ages 13 and 17, using endocrine, cardiovascular and metabolic parameters. Results of linear-mixed effects models indicated that the association between cumulative risk and allostatic load was attenuated for adolescents who scored high on externalizing behaviors. Further examination of sex differences indicated that the findings were more pronounced among males than females.

Adolescents' compulsive sexual behavior: The role of parental competence, parents' psychopathology, and quality of parent-child communication about sex

BACKGROUND AND AIMS

Compulsive sexual behavior (CSB) has implications for clinical and non-clinical adult populations. Disposition to CSB has been shown to influence adolescence sexual behaviors, but the development of adolescents' disposition toward CSB has yet to be examined in the family context. In this study, we investigated whether parent-adolescent communication mediates the links between parental characteristics and adolescents' CSB.

METHODS

The sample included 275 Israeli families [triad of mothers (age = 34-63 years, M = 45.48, SD = 5.46), fathers (age = 36-83 years, M = 48.33, SD = 6.63), and one adolescent (48.2% boys, 51.1% girls; age = 14-18 years, M = 16.23, SD = 1.18)]. Parents completed measures of psychopathology, parental self-esteem, and parental self-efficacy, and adolescents completed measures of quality of sex-related communication and CSB.

RESULTS

The results indicate that, for girls, higher maternal self-esteem and lower psychopathology were linked with better sex-related communication and so with lower CSB. For boys, only parental religiosity was linked with the quality of sex-related communication and CSB, with religious parents having better communication than secular ones.

DISCUSSION

The findings provide an opportunity for researchers to gain a better insight into the dynamics of familial factors in the development of CSB among adolescents.

Parental Depression, Overreactive Parenting, and Early Childhood Externalizing Problems: Moderation by Social Support

This study used a large (N = 519), longitudinal sample of adoptive families to test overreactive parenting as a mediator of associations between parental depressive symptoms and early childhood externalizing, and parents' social support satisfaction as a moderator. Maternal parenting (18 months) mediated the association between maternal depressive symptoms (9 months) and child externalizing problems (27 months). Paternal parenting was not a significant mediator. Unexpectedly, we found a cross-over effect for the moderating role of social support satisfaction, such that partners' social support satisfaction reduced the strength of the association between each parent's own depressive symptoms and overreactive parenting. Results point to the importance of accounting for broader family context in predicting early childhood parenting and child outcomes.

Teachers' perceptions of Restricted and Repetitive Behaviours (RRBs) in children with ASD: Attributions, confidence and emotional response

BACKGROUND

Restricted and Repetitive Behaviours (RRBs) are some of the most difficult behaviours to manage in children with Autism Spectrum Disorders (ASD). Although RRBs frequently occur in educational settings, we know little about the way in which teachers understand these behaviours.

AIMS

The study aimed to explore the attributions, emotional response and feelings of confidence held by teachers working in different educational settings when faced with RRBs.

METHODS AND PROCEDURES

A single group survey design using behavioural vignettes was adopted in order to elicit teacher beliefs and ratings.

OUTCOMES AND RESULTS

Analysis indicated that there were differences in the attributions and confidence ratings held for different types of RRBs. Significant differences were also observed between teachers working in mainstream and specialist educational settings. Emotional response and confidence scores were often predictive of one another alongside factors related to teaching experience.

CONCLUSION AND IMPLICATIONS

The findings indicate that teachers from mainstream schools potentially hold less helpful beliefs in response to RRBs and therefore are a professional group who may benefit the most from additional support and training. Further research could consider conducting a qualitative exploration of why teachers hold certain beliefs about RRBs and/or sampling those who are less experienced in working with children with ASD.

Having another child without intellectual disabilities: Comparing mothers of a single child with disability and mothers of multiple children with and without disability

To investigate how having a child without a disability is related to maternal mental health and its predictors, we compared mothers of a single child with intellectual disabilities (single-child group, n = 117) and mothers of children with and without intellectual disabilities (multiple-children group, n = 457), in Japan. Compared to the multiple-children group, the single-child group had lower hope and social capital and poorer mental health; furthermore, 42.5% of them had decided not to have another child, despite desiring one. Hope was the strongest predictor of mental health in both groups but was more positively related to mental health in the multiple-children group. The fear of the possibility of the next child having a disability and receiving inadequate support were the obstacles for mothers who had decided not to have another child. Thus, greater support and more opportunities for obtaining adequate information about the implications of having another child may be needed.

Should We Subtype ADHD According to the Context in Which Symptoms Occur? Criterion Validity of Recognising Context-Based ADHD Presentations

ADHD symptoms show considerable individual variation in the contexts in which they are expressed. It has previously been proposed that subtyping individuals according to the contexts in which symptoms are expressed may be clinically useful. We examined context-based patterns of ADHD symptoms in a longitudinal cohort study of n = 1388 children, as well as context-specific and context-general predictors of symptoms. Participants were community-ascertained and provided ADHD symptom data at ages 7, 9, and 11. Using growth mixture modelling we identified five inattention and five hyperactivity/impulsivity categories that differed in the developmental patterns of symptoms reported by parent and teacher informants. We found some evidence that context-specific predictors were related to context-specific expressions. Specifically, after controlling for other risk factors for ADHD symptoms, relationships with teachers predicted school-specific (teacher-reported) but not home-specific (parent-reported) symptom levels. However, no subtypes defined by exclusively home-based symptoms emerged, suggesting that while symptoms may sometimes be specific to the school context, they are only rarely confined to the home context. Subtyping by context could be informative; however, further work will required to uncover the nature of any etiological, functional, or outcome differences between those who show symptom expression in different contexts.

A data-driven method for identifying shorter symptom criteria sets: the case for DSM-5 alcohol use disorder

BACKGROUND

Although the DSM is a widely used diagnostic guide, lengthy criteria sets can be problematic and provide the primary motivation to identify short-forms. Using the 11 diagnostic criteria provided by the DSM-5 for alcohol use disorder (AUD), the present study develops a data-driven method to systematically identify subsets and associated cut-offs that yield diagnoses as similar as possible to use all 11 criteria.

METHOD

Relying on data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC-III), our methodology identifies diagnostic short-forms for AUD by: (1) maximizing the association between the sum scores of all 11 criteria with newly constructed subscales from subsets of criteria; (2) optimizing the similarity of AUD prevalence between the current DSM-5 rule and newly constructed diagnostic short-forms; (3) maximizing sensitivity and specificity of the short-forms against the current DSM-5 rule; and (4) minimizing differences in the accuracy of the short-form across chosen covariates. Replication is shown using NESARC-Wave 2.

RESULTS

More than 11 000 diagnostic short-forms for DSM-5 AUD can be created and our method narrows down the optimal choices to eight. Results found that 'Neglecting major roles' and 'Activities given up' could be dropped with practically no change in who is diagnosed (specificity = 100%, sensitivity ⩾ 99.6%) or the severity of those diagnosed (κ = 0.97).

CONCLUSIONS

With a continuous improvement model adopted by the APA for DSM revisions, we offer a data-driven tool (a SAS Macro) that identifies diagnostic short-forms in a systematic and reproducible way to help advance potential improvements in future DSM revisions.

Psychological pain and suicidal ideation in undergraduates: The role of pain avoidance

In the present study, the first with a Western sample, we tested the relationship between three dimensions of psychological pain and suicidal ideation in a sample of 331 Portuguese college students. When controlling for the effect of depressive symptoms, the avoidance dimension, but not the cognitive and affective dimensions of psychological pain, made a significant contribution in predicting the three indicators of suicidal ideation. According to these results, psychotherapeutic action may focus either on enabling clients to tolerate mental pain or on providing more effective and adaptive strategies to cope with this pain.

Childhood sexual abuse and attachment insecurity: Associations with child psychological difficulties

Childhood sexual abuse (CSA) is considered an important public health concern that can derail the developmental course of children. Given that children rely upon their attachment figures when they experience upsetting events, attachment organization may play a critical role in predicting victims' adaptation to CSA. To date, no studies have delineated the unique and interactive contributions of these two risk factors in the prediction of psychopathology. The aims of this study were to examine attachment in CSA victims and a comparison group and to assess the contributions of each risk factor to child psychological difficulties. Participants included 111 children aged 7-13, of whom 43 were CSA victims. Children completed an attachment interview and reported on their depressive symptoms. Their mothers reported on children's externalizing symptoms, internalizing symptoms, dissociation, and sexualized behavior. Our key findings showed that child victims of CSA were more likely to be classified as having insecure and disorganized attachment. Further, insecure attachment was the primary factor associated with higher self-reported depressive symptoms in all children and that CSA was associated with more parent-reported child externalizing problems, sexualizing problems, and dissociation. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Circulating Levels of Brain-Derived Neurotrophic Factor and History of Suicide Attempts in Women

A growing body of research examining biological factors associated with suicidal behaviors highlights the role of brain-derived neurotropic factor (BDNF), involved in neurogenesis and synaptic plasticity. There is evidence suggesting that suicide attempters have lower BDNF levels than those with no history of suicide attempts. The key question addressed in the current investigation is whether differences in circulating BDNF levels persist beyond the current suicidal episode and would be observed in those with a past history of suicide attempts (SA). Plasma levels of BDNF were assessed in 73 women from the community. We found that women with a history of SA exhibited lower levels of BDNF than women with no SA history and this difference was maintained after statistically controlling for the influence of other potential psychiatric or demographic factors. These findings support and extend existing research by suggesting that circulating BDNF levels are decreased among individuals with a history of SA compared to individuals with no history of SA. This relation appeared to be specific to women's history of SA and was not explained by other potential psychiatric or demographic factors, which further highlights the role of BDNF as a promising biomarker for suicidal behavior.

The Psychometric Properties of the Hypersexual Behavior Inventory Using a Large-Scale Nonclinical Sample

The conceptualization of hypersexuality has begun to converge as a result of proposed diagnostic criteria. However, its measurement is still diverse. The Hypersexual Behavior Inventory (HBI) is one of the most appropriate scales used to assess hypersexuality, but further examination is needed to test its psychometric properties among different clinical and nonclinical groups, including samples outside of the United States. The aim of the present study was to investigate the reliability and the generalizability of HBI and to determine a cutoff score on a large, diverse, online, nonclinical sample (N = 18,034 participants; females = 6132; 34.0%; M_age = 33.6 years, SD_age = 11.1). Confirmatory factor analysis (CFA) and reliability indices provided support for the structure of the HBI and demonstrated excellent reliability. Employing latent profile analysis (LPA), seven classes emerged, but they could not be reliably distinguished by objective sexuality-related characteristics. Moreover, it was not possible to determine an adequate cutoff score, most likely due to the low prevalence rate of hypersexuality in the population. HBI can be reliably used to measure the extent of hypersexual urges, fantasies, and behavior; however, objective indicators and a clinical interview are essential to claim that a given individual may exhibit features of problematic sexual behavior.

Predictors of Intrusive Sexual Behaviors in Preschool-Aged Children

Intrusive sexual behaviors (ISBs) are a specific type of problematic sexual behavior characterized by the invasive nature of the acts (e.g., touching others' private parts, attempting intercourse; Friedrich, 1997). The limited amount of research on ISBs has focused on sexual abuse history as the primary predictor. However, Friedrich, Davies, Feher, and Wright (2003) found that ISBs in children up to age 12 were related to four broad conceptual factors: (a) exposure to sexual content, (b) exposure to violent behavior, (c) family adversity, and (d) child vulnerabilities. The current study sought to replicate Friedrich's study using a clinical sample of 217 preschool-aged children (ages two to six). Results supported variables from within the child vulnerabilities construct (externalizing behaviors, β_EXT = 0.032, p = 0.001), post-traumatic stress disorder (PTSD) criteria met (β_PTSD = 0.177, p = 0.02), and an inverse relationship with age (β_AGE = -0.206, p = 0.024). These results highlight the importance of considering childhood behavioral patterns and reactivity to traumatic events as correlates of ISBs in young children.

Does medical students' personality have an impact on their intention to show empathic behavior?

Several studies have demonstrated a correlation between specific personal traits and empathy. However, it is not clear if persons with certain personality traits lack the intent to show empathic behavior or if other factors independent of their intent are affecting their empathic behavior. To answer this question, we asked 132 medical students to fill out questionnaires evaluating the General Intention to Show Empathic Behavior (GISEB) and the five personality traits measured by NEO Five-Factor Inventory (NEO-FFI). Additionally, we evaluated the influence of other factors, such as age, gender, curricular progress (second versus fourth year), and preferred specialization after graduation. We performed a Pearson's correlation and a regression analysis. Results indicate that the five personality traits and gender have little influence on the General Intention (GISEB), only extraversion (r = .221, 95% CI [.013-.394], p = .027), and agreeableness (r = .229, 95% CI [.021-.428], p = .022) correlated with the intention. The only predictor for General Intention (GISEB) was curricular progress (β = - .27, p < .05), showing a decrease of General Intention to Show Empathic Behavior from second to fourth year of university (U = 1203.5, p = .002). A further finding indicates that gender and personality influence the students' wish of specialization after graduation: Agreeableness (F(12, 53) = 2.376, p = .016) impacted the preferred specialization. Our study demonstrated that medical students' personality might not notably impact the intention to show empathic behavior. Further research is needed to investigate moderating effects.