SIGIS-SIAMS-SIE position statement of gender affirming hormonal treatment in transgender and non-binary people

PURPOSE

Gender Incongruence (GI) is a marked and persistent incongruence between an individual's experienced and the assigned gender at birth. In the recent years, there has been a considerable evolution and change in attitude as regards to gender nonconforming people.

METHODS

According to the Italian Society of Gender, Identity and Health (SIGIS), the Italian Society of Andrology and Sexual Medicine (SIAMS) and the Italian Society of Endocrinology (SIE) rules, a team of experts on the topic has been nominated by a SIGIS-SIAMS-SIE Guideline Board on the basis of their recognized clinical and research expertise in the field, and coordinated by a senior author, has prepared this Position statement. Later on, the present manuscript has been submitted to the Journal of Endocrinological Investigation for the normal process of international peer reviewing after a first internal revision process made by the SIGIS-SIAMS-SIE Guideline Board.

RESULTS

In the present document by the SIGIS-SIAMS-SIE group, we propose experts opinions concerning the psychological functioning, gender affirming hormonal treatment, safety concerns, emerging issues in transgender healthcare (sexual health, fertility issues, elderly trans people), and an Italian law overview aimed to improve gender non-conforming people care.

CONCLUSION

In this Position statement, we propose experts opinions concerning the psychological functioning of transgender people, the gender-affirming hormonal treatment (full/partial masculinization in assigned female at birth trans people, full/partial feminization and de-masculinization in assigned male at birth trans people), the emerging issues in transgender health care aimed to improve patient care. We have also included an overview of Italian law about gender affirming surgery and registry rectification.

Daily gender expression is associated with psychological adjustment for some people, but mainly men

To what extent does gender expression vary day-to-day? Are daily changes related to psychological adjustment in the same way for all individuals? A person-specific approach was used to answer these questions in a 75-day intensive longitudinal study. Fifty-seven cisgender adults (27 women) provided over 4000 reports of daily masculinity and femininity and of three indices of internalizing problems. Results revealed: (a) substantial daily fluctuations in gender expression, especially in women; (b) sample-level links between daily increases in femininity or reductions in masculinity and heightened anxiety, depression, and self-reproach for men, but no apparent links for women; and (c) person-specific links between gender expression and psychological adjustment, such that some women reported internalizing problems with reduced masculinity (average male pattern) and some men reported problems with heightened masculinity (opposite the average male pattern). Findings highlight how intensive longitudinal research can illuminate the uniqueness of gender-related daily experiences, and their implications for the wellbeing of individuals.

International Comparisons of Emotionally Reactive Problems in Preschoolers: CBCL/1½-5 Findings from 21 Societies

Our goal was to conduct international comparisons of emotion regulation using the 9-item Emotionally Reactive (ER) syndrome of the Child Behavior Checklist for Ages 1½-5. We analyzed parent ratings for 17,964 preschoolers from 21 societies, which were grouped into 8 GLOBE study culture clusters (e.g., Nordic, Confucian Asian). Omnicultural broad base rates for ER items ranged from 8.0% to 38.8%. Rank ordering for mean item ratings varied widely across societies (omnicultural Q = .50) but less so across culture clusters (M Q = .66). Societal similarity in mean item rank ordering varied by culture cluster, with large within-cluster similarity for Anglo (Q = .96), Latin Europe (Q = .74), Germanic (Q = .77), and Latin American (Q = .76) clusters, but smaller within-cluster similarity for Nordic, Eastern Europe, and Confucian Asian clusters (Qs = .52, .23, and .44, respectively). Confirmatory factor analyses of the ER syndrome supported configural invariance for all 21 societies. All 9 items showed full to approximate metric invariance, but only 3 items showed approximate scalar invariance. The ER syndrome correlated . 65 with the Anxious/Depressed (A/D) syndrome and .63 with the Aggressive Behavior syndrome. ER items varied in base rates and factor loadings, and societies varied in rank ordering of items as low, medium, or high in mean ratings. Item rank order similarity among societies in the same culture cluster varied widely across culture clusters, suggesting the importance of cultural factors in the assessment of emotion regulation in preschoolers.

Emotional adaptation to relationship dissolution in parents and non-parents: A new conceptual model and measure

Relationship dissolution can cause declines in emotional well-being, particularly if there are children involved. Individuals’ capacity to cope with the pragmatics of the situation, such as agreeing childcare arrangements, can be impaired. Before now, there has been no psychometric test to evaluate individuals’ emotional readiness to cope with these demands. This paper presents a model of emotional adaptation in the context of relationship dissolution and its key assumptions, and validates the Emotional Adaptation to Relationship Dissolution Assessment (EARDA). In Study 1 (Sample 1, n = 573 separated parents, Sample 2, n = 199 mix of parents and non-parents), factor analyses support the EARDA as a unidimensional scale with good reliability. In Study 2 (using Sample 1, and Sample 3, n = 156 separated parents) the convergent, discriminant, concurrent criterion-related, and incremental validity of the EARDA were supported by tests of association with stress, distress, attachment style, and co-parenting communication and conflict. In Study 3, the nomological network of emotional adaptation to relationship dissolution was explored in Sample 2 using cluster analysis and multi-dimensional scaling (MDS). Emotional adaptation clustered with positive traits and an outward focus, and was negatively associated with negative traits and an inward focus. Emotional adaptation was conceptually located in close proximity to active and adaptive coping, and furthest away from maladaptive coping. In Study 4 (n = 30 separated parents embarking on mediation), high, medium, and low emotional adaptation to relationship dissolution categories correlated highly with mediators’ professional judgement, offering triangulated face validity. Finally, in Study 5, EARDA scores were found to mediate between separation characteristics (time since break up, whether it was a shock, and who initiated the break up) and co-parenting conflict in Sample 1, supporting the proposed model. The theoretical innovation of this work is the introduction of a new construct that bridges the gap between relationship dissolution and co-parenting. Practical implications include the use of the measure proposed to triage levels of support in a family law setting.

A 2-year longitudinal study of neuropsychological functioning, psychosocial adjustment and rehospitalisation in schizophrenia and major depression

Neuropsychological functioning turns out to be a rate-limiting factor in psychiatry. However, little is known when comparing neuropsychological and psychosocial functioning in inpatients with schizophrenia or severe depression in their treatment pathways including add-on psychoeducation or the latter combined with cognitive behavioral therapy up to 2-year follow-up. To evaluate this question, we investigated these variables in two randomised controlled trials including 196 patients with DSM-IV schizophrenia and 177 patients with major depression. Outcome measures were assessed in the hospital at pre- and posttreatment and following discharge until 2-year follow-up. We focused on neuropsychological and psychosocial functioning regarding its differences and changes over time in data of two pooled trials. There were significant time effects indicating gains in knowledge about the illness, short and medium-term memory (VLMT) and psychosocial functioning (GAF), however, the latter was the only variable showing a time x study/diagnosis interaction effect at 2-year follow-up, showing significant better outcome in depression compared to schizophrenia. Moderator analysis showed no changes in psychosocial and neuropsychological functioning in schizophrenia and in affective disorders due to age, duration of illness or sex. Looking at the rehospitalisation rates there were no significant differences between both disorders. Both groups treated with psychoeducation or a combination of psychoeducation and CBT improved in neuropsychological and psychosocial functioning as well as knowledge about the illness at 2-year follow-up, however, patients with major depression showed greater gains in psychosocial functioning compared to patients with schizophrenia. Possible implications of these findings were discussed.

The adjustment process of young Bedouin women who were child brides

Qualitative study explores the adjustment process of young Bedouin women in Israel who were minors and legally underage when they married. Child brides have always existed in Bedouin society, which sees marriage as a social and religious framework that protects the girl. This study's participants, 30 young women who were 13-17 when they married, shed light on the long and continuing process of adjustment, the sharp transitions in their lives, and their cognitive assimilation of married life. Their stories allow a glimpse of how a generation of young women within a traditional, strongly patriarchal society is starting to challenge accepted traditional practices. The case of Bedouin society may be relevant to other traditional societies, to indigenous peoples, and in general to the issue of child marriage that is so widespread globally. Child brides, a worldwide phenomenon, have always existed in Bedouin society, which sees marriage as a social and religious framework that protects the girl and her family from dishonor. Such marriages continue despite legal prohibition. This qualitative study in the phenomenological tradition explores the adjustment process of young Bedouin women in Israel who were legally underage when they married. The participants, 30 young women who married at ages 13-17, were recruited from the case loads of social workers in southern Israel. Data were obtained through in-depth semistructured interviews. The data shed light on the women's long and continuing process of adjustment, the sharp transitions in their lives, and their cognitive assimilation of married life and motherhood. Optimism that everything will work out and individual and family resilience are important factors, but the adjustment process is different for each of two groups of the participants: In one group, the girl met her prospective husband before marriage, was engaged for at least 6 months, and was prepared by her family for marriage and intimate relations. In the second group, the girl did not know the prospective husband, was engaged very briefly (up to 1 month), was not prepared for marriage, and was not asked for her opinion or consent. For the second group, the adjustment process was longer and more difficult. The stories of both groups reveal how a generation of young women within a traditional, strongly patriarchal society is starting to challenge traditional practices, including the husband's dependence on his family and the mother-in-law's interference, although ultimately they conform to their society's norms. Social services need to be aware of the processes these young women are undergoing and to build suitable intervention programs for them, their spouses, and their families. Also needed is a program that will explain to girls and their families the implications of marriage at a young age. The case of Bedouin society may be relevant to other traditional societies, to indigenous peoples, and to the global issue of child marriage. This article contributes to global knowledge by presenting the world of these young women, members of a society that is undergoing powerful changes that have weakened the traditional establishment but that still clings to such values as honor and male supremacy.

Illness Perception Mediates the Relationship Between the Severity of Symptoms and Perceived Health Status in Patients With Behçet Disease

OBJECTIVE

The aim of this study was to investigate the relationship between psychological representations of illness, perceived health status, and self-assessment of symptom severity in patients with Behçet disease, a rare long-term incurable condition with unclear etiology.

METHODS

Using cross-sectional survey design, data on self-administered questionnaires on illness perception, health status, symptoms severity, and demographic characteristics were collected from 273 patients with Behçet disease (age range, 18-65 years). The data were subjected to mediation analysis to test whether cognitive and emotional components of illness perception mediate the relationship between the severity of symptoms and heath status.

RESULTS

The results support our hypotheses that cognitive components of illness perception (perceived consequences and identity of the illness) mediate the link between symptom activity and pain, whereas emotional components of the illness (emotional representations about the illness) mediate the relationship between disease activity and perceived energy level.

CONCLUSIONS

The robustness of these mediation effects suggests potential directions for clinical psychologists and health care practitioners in developing support programs. We supplement our study with Open Access database containing information about type of medication, comorbid mood disorder, and detailed measurement of the severity of BD symptoms for sharing and accumulating multidisciplinary knowledge aiming to support the development of interventions. Addressing psychological aspects of BD will help to manage complex patients effectively.

Dynamic patterns of marital conflict: Relations to trajectories of adolescent adjustment

The deleterious effects of marital conflict on youth outcomes are well-documented in both cross-sectional and longitudinal studies. To date, longitudinal studies have focused on repeated measures of youths' outcomes and the temporal dynamics of marital conflict have largely been ignored. Marital conflict changes over time as contextual and relationship characteristics change, and these patterns of change may provide unique predictive power in accounting for differences in youth outcomes. This study provides a novel exploration of an old idea by focusing on dynamic patterns of marital conflict in predicting trajectories of adolescents' adjustment. All variables were measured at ages 16, 17, and 18 with 252 adolescents (53% female) enrolled in the longitudinal Family Stress and Youth Development Study. Latent growth curve models with latent variable interactions were used to determine whether marital conflict at age 16 (intercept), change over time in marital conflict (slope), and the intercept-slope interaction predicted change over time in adolescent internalizing and externalizing symptoms and levels of internalizing and externalizing symptoms at age 18. Youth exposed to high and increasing levels of marital conflict reported high and stable levels of internalizing and externalizing symptoms across adolescence. Adolescents exposed to low and decreasing levels of marital conflict had consistently fewer symptoms. Furthermore, exposure to initially low but increasing levels of marital conflict was associated with increases in problems across adolescence, which contrasted with findings for youth with initially high marital conflict exposure that decreased over time. Findings are discussed in relation to both conceptual and methodological advances. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Comparison of Institutionally Reared and Maltreated Children on Socioemotional and Biological Functioning

The current study compared behavioral and adrenocortical functioning of maltreated (N = 91) and comparably aged (1.5-3 years) institutionally-reared children soon after (1.5-2.5 months) placement in foster care or adoptive homes, respectively. Foster and adoptive parents reported on the children's socioemotional competence and behavior problems, experimenters scored fear and positive affect to laboratory tasks, and diurnal cortisol measures were obtained. We sought to address whether these early contexts, characterized by different types of neglect and deprivation, have differential effects on young children's development. We found little support for the argument that either context results in uniformly poorer functioning soon after removal from adversity. Maltreated children were less fearful and more positive when exposed to both positive and novel events than institutionally-reared children. However, maltreated children were reported to have more behavior problems than did institutionally-reared children, and institutionally-reared children showed more typical declines in cortisol throughout the day than the maltreated children. These findings increase our ability to construct more targeted and effective interventions for these populations.

Acculturation and adjustment of migrants reporting trauma: The contextual effects of perceived ethnic density

Little is known about the relation between acculturation and socioecological contexts of migrants with a personal trauma history living in the community. This study represents an extension of our previous work and aimed to unpack the perceived neighborhood ethnic density (ED) effect and examine the moderating role of ED on the acculturation-adjustment relation in a community sample of migrants with trauma (N = 99) from developing countries residing in Montreal, Canada. ED was protective against general psychological distress but did not predict posttraumatic symptoms. The ED effect was mediated via degree of acculturation to the French-Canadian mainstream cultural context, rather than heritage acculturation, social support, or discrimination. Moreover, protective effects of French-Canadian mainstream acculturation for depressive symptoms and life satisfaction were found under high but not low ED conditions. Similarities and differences with our previous research as well as theoretical and prevention implications are discussed from a person-environment interaction perspective.

Premorbid adjustment trajectories in schizophrenia and bipolar disorder: A transdiagnostic cluster analysis

Despite the overlap between schizophrenia and bipolar disorder, neurodevelopmental abnormalities are thought to be associated primarily with schizophrenia. Transdiagnostic and empirical identification of subgroups based on premorbid adjustment (PMA) may enhance understanding of illness trajectories. 160 patients with bipolar I or II disorder (BD; n = 104) or schizophrenia or schizoaffective disorder (SZ; n = 56) were assessed on PMA course from childhood to late adolescence and current symptoms and functioning. A hierarchical cluster analysis was performed using social and academic PMA scores, resulting in three optimal clusters. Cluster 1 (n = 28 SZ, 65 BD) had normal social and academic PMA, the most education, and mildest current symptoms. Cluster 2 (n = 15 SZ, 24 BD) had normal social PMA but an impaired-declining academic course and had a greater proportion of males than Cluster 1. Cluster 3 (n = 13 SZ, 15 BD) had an impaired-stable social PMA and an impaired-declining academic course and the most severe current negative symptoms and childhood trauma. The proportions of SZ and BD diagnoses, current neurocognition, and functioning did not differ between clusters. These findings suggest shared neurodevelopmental abnormalities between SZ and BD, with subgroups exhibiting distinct PMA trajectories that cut across disorders.

Ventral prefrontal cortex and emotion regulation in aging: A case for utilizing transcranial magnetic stimulation

OBJECTIVES

The ventrolateral prefrontal cortex (vlPFC) has been speculated to play an important role in complex processes that allow emotional factors to influence human cognition. Accumulating evidence from human neuroimaging studies, in conjunction with studies of patients with lesions and animal models, shed light on the role of the vlPFC in emotion regulation (ER). This review aims to discuss and integrate recent findings related to vlPFC's role in ER in the context of aging, drawing from diverse sources, and suggest future directions for research utilizing transcranial magnetic stimulation (TMS).

METHODS/DESIGN

We summarize findings from the existing literature investigating the neural basis of frontal-lobe mediated ER and then highlight major findings from recent studies directly comparing healthy younger and older adult groups. We conclude by pointing to unaddressed questions worth pursuing in future research.

RESULTS AND DISCUSSION

We propose future research directions utilizing TMS to answer key unaddressed questions. Moreover, we discuss the potential advantages, challenges, and limitations of using TMS as a complement to the existing neuroimaging methods in ER.

Posttraumatic Growth in Patients with Malignant Bone Tumor: Relationships with Psychological Adjustment

Aim: Owing to the inadequate data to support the valid instrument for assessing the positive changes among patients with malignant bone tumor, the present study was designed to provide such valid evidence through examining the psychometric properties of a Chinese version of the Posttraumatic Growth Inventory (PTGI-C) among these patients, and to evaluate the effects of posttraumatic growth on positive and negative symptoms in malignant bone tumor patients. Methods: Potential patients with malignant bone tumor from five tertiary hospitals were admitted to the hospital during the period from January 2013 to October 2017. At the baseline assessment (T1), all patients completed a demographic form, PTGI-C, and Positive and Negative Affect Scale (PANAS). After 4 weeks later (T2), all the patients finished PANAS and PTGI-C again, and the PTGI-C was re-administered to patients who were simple randomly selected from the total sample. Results: The PTGI-C exhibited moderate reliability and validity. The Cronbach’s α coefficient of the total scale was 0.91. Confirmatory factor analysis supported the five-factor model and the convergent validity results obtained were distinct but correlated. The multiple linear regression analyses showed that posttraumatic growth had a significant prediction on positive affect (F=16.445, p<0.001), accounting for 69.4 % of the variance and as well as the negative affect (F=8.707, p<0.001), accounting for 48.3 % of the variance. Personal strength at T1 was positively associated with positive affect at T2, and more personal strength and spiritual change at T1 were associated with less negative affect at T2. Conclusions: PTGI-C has demonstrated sufficient psychometric properties which indicate that it is appropriate to measure posttraumatic growth in patients with malignant bone tumor. Relating to others, spiritual growth, personal strength and appreciate to life are important factors which contribute to predicting positive affect and negative affect.

A Model-Based Cluster Analysis of Maternal Emotion Regulation and Relations to Parenting Behavior

In a diverse community sample of mothers (N = 108) and their preschool-aged children (M_age  = 3.50 years), this study conducted person-oriented analyses of maternal emotion regulation (ER) based on a multimethod assessment incorporating physiological, observational, and self-report indicators. A model-based cluster analysis was applied to five indicators of maternal ER: maternal self-report, observed negative affect in a parent-child interaction, baseline respiratory sinus arrhythmia (RSA), and RSA suppression across two laboratory tasks. Model-based cluster analyses revealed four maternal ER profiles, including a group of mothers with average ER functioning, characterized by socioeconomic advantage and more positive parenting behavior. A dysregulated cluster demonstrated the greatest challenges with parenting and dyadic interactions. Two clusters of intermediate dysregulation were also identified. Implications for assessment and applications to parenting interventions are discussed.

Trajectories of child and caregiver psychological adjustment in families of children with cancer

OBJECTIVE

To describe the trajectory of patient and caregiver mental health from diagnosis through the first year of treatment for pediatric cancer and assess whether rates of clinically relevant symptoms were elevated compared with norms. We examined mean levels of internalizing and externalizing symptoms and posttraumatic stress symptoms (PTSS) in children with cancer, and depression, anxiety, and PTSS in caregivers during the first year of treatment; the proportion of patients and caregivers that scored in the clinical range at each time point; and the typical trajectory of symptoms in patients and caregivers and whether trajectories differed between individuals.

METHOD

Families (N = 159) of children newly diagnosed with cancer (Mage = 5.6 years; range = 2-18 years) participated in a short-term prospective study. Primary caregivers provided monthly reports of their own and their children's psychological adjustment.

RESULTS

On average, children were well-adjusted. However, compared with norms, there was a higher than expected proportion of children with clinically relevant internalizing symptoms around the time of diagnosis. On average children's symptoms declined over time, though variability was observed. Caregivers were less well-adjusted on average, with a high proportion reporting clinically relevant symptoms over time for depression and anxiety. Caregiver symptoms also declined over time, though considerable variability was observed.

CONCLUSION

Although most children remain well-adjusted during the first year of treatment, many caregivers experience clinically relevant symptoms of psychological distress. Implications for development of interventions targeting at-risk patients and caregivers are discussed. Identifying processes that predict between-family variability in trajectories of psychopathology is an important next step. (PsycINFO Database Record

Victims of Fukushima Daiichi nuclear power plant accident in long-lasting disillusionment phase

This study describes the existence of the long-lasting disillusionment phase for the victims after the accident at the Fukushima Daiichi Nuclear Power Plant following the Great East Japan Earthquake in March 2011. Through analyzing the mental situation of the victims, the situations were categorized into 2 groups for forced evacuees: "in the disillusionment phase" and "in the reconstruction phase," Other 2 groups are for host Iwaki residents: "with negative feelings against evacuees" and "leading their life constructively." The negative feeling enhances the vicious psychological cycle for the evacuees in the long-lasting disillusionment phase and repeating emotion of survivor's guilt in the reconstruction phase. We propose that people who were getting back to a normal life while leading their life constructively should raise their voices in favor of living together with evacuees.

Stressful life events, relationship stressors, and cortisol reactivity: The moderating role of suppression

Stressful life events (SLEs) are exceedingly common and have been associated with a range of psychological disorders, perhaps through dysregulation in the hypothalamic-pituitary-adrenal (HPA) axis. The use of certain emotion regulation strategies in response to stress, such as expressive suppression and cognitive reappraisal, has additionally been linked to heightened HPA axis reactivity to acute stress. However, it is unclear how emotion regulation may interact with SLEs to affect HPA axis reactivity, particularly concerning relationship stressors (RSs). Using cross-sectional data from 117 men and 85 women aged 18-55 years old (M = 39.9 ± 10.7), we investigated whether trait use of suppression or reappraisal interacted with recent negatively perceived SLEs and relationship stressors to impact HPA axis response to an acute stressor. Separate area under the curve and linear mixed models revealed that trait suppression interacted with SLEs and RSs to predict cortisol response to stress, while reappraisal did not. Findings indicate higher trait expressive suppression may influence the cortisol response to acute stress after exposure to more recent stressful events, particularly when those stressful events include relationship stress.

Is reappraisal always effective in modifying emotional reactions in females? The role of regulatory timing and goals

Introduction

Numerous studies have explored the effect of cognitive reappraisal before or after emotion-inducing events. However, only a few studies have examined the influence of regulatory timing on the effectiveness of reappraisal. Thus, the aim of this study was to investigate the role of regulatory timing and goals in reappraisal regulation, which would help promote the specific application of cognitive reappraisal in emotion regulation. We hypothesized that decrease reappraisal would be more effective when initiated early rather than late, but increase reappraisal would be more effective when initiated in the emotional high-activation phase.

Methods

This study, via event-related potential (ERP) technique, probed the influence of the timing and regulatory goal on negative emotion when reappraisal was introduced, respectively 500 ms before (anticipatory), 2,000 ms after (online 2,000 ms) picture onset (in Experiment 1), 500 ms after (online 500 ms) picture onset, and 1,500 ms after (online 1,500 ms) picture onset (in Experiment 2).

Results

Based on the ERP results, under the anticipatory regulation condition, the LPP amplitude in the parietal area was significantly reduced by decrease reappraisal during 700-2,100 ms after picture onset, and under the online 500 ms regulation condition, the LPP in central and parietal areas was significantly enhanced by increase reappraisal during 450-750 ms after regulatory cue onset. Moreover, our results showed that increase reappraisal evoked a larger prefrontal or frontal LPP than decrease reappraisal beginning at about 700 ms after picture onset under the anticipatory regulation condition and beginning at 450 ms after regulatory cue onset under the online 500 ms regulation condition, which may reflect increased cognitive effort and mental conflict associated with increase reappraisal.

Conclusion

The anticipatory reappraisal successfully decreased negative emotion, and online 500 ms reappraisal successfully increased negative emotion. Our results support the hypothesis.

Electrophysiological evidence for detrimental impact of a reappraisal emotion regulation strategy on subsequent cognitive control in schizophrenia

In healthy individuals, there is evidence that effective implementation of an emotion regulation strategy has beneficial effects on temporally proximal cognitive control task performance. This effect occurs because both of these processes rely heavily on the prefrontal cortex. Individuals with schizophrenia (SZ) have impairments in both emotion regulation and cognitive control that are driven by structural and functional abnormalities of the prefrontal cortex; however, it is unknown whether emotion regulation attempts fail to benefit subsequently performed cognitive control tasks in people with SZ. The present study examined whether attempts to increase or decrease negative emotion via reappraisal have differential effects on subsequent cognitive control in a sample of outpatients diagnosed with SZ (n = 30) and demographically matched healthy controls (CN; n = 29). Participants completed a combined emotion regulation and cognitive control task in which numerical Stroop trials were presented immediately after unpleasant or neutral images that were either increased via reappraisal, decreased via reappraisal, or passively viewed. The electroencephalogram was recorded while participants performed the reappraisal-Stroop task and event related potentials (ERPs) were used to index emotion regulation effectiveness (late positive potential: LPP) and cognitive control (sustained potential: SP). Both CN and SZ evidenced higher LPP amplitude for unpleasant than neutral stimuli consistent with robust neural response to unpleasant stimuli. Although CN demonstrated neurophysiological evidence of effective use of reappraisal to increase and decrease negative emotion, SZ only showed an effective ability to increase negative emotion via reappraisal. CN displayed enhanced cognitive control following increase trials and impaired cognitive control following decrease trials, as indicated by modulation of SP amplitude. In SZ, increase instructions impaired cognitive control and decrease instructions had no effect on cognitive control. Findings suggest that emotion regulation abnormalities may play an underrecognized role in general cognitive control deficits that occur in SZ. (PsycINFO Database Record

When opposites lead to the same: a direct comparison of explicit and implicit disgust regulation via fMRI

Cognitive reappraisal and placebo administration constitute two different approaches for modulating one’s own emotional state. Whereas reappraisal is an explicit (effortful) type of self-regulation, placebo treatment initiates implicit processes of affective control. The brain mechanisms underlying these processes have not been directly compared with each other up until now; doing this enables the identification of distinct and shared neuronal features. We conducted a functional magnetic resonance imaging study with 45 women, who were presented with disgusting and neutral images in a block design, at three experimental sessions, over 3 consecutive days. They were asked to passively view the images in one session, engage in reappraisal in another, and in another session they received a placebo pill: a disgust-reducing ‘anti-nausea drug’. Relative to passive viewing, both reappraisal and placebo treatment effectively reduced the experienced disgust intensity. In the placebo condition, this reduction was associated with decreased activation of the insula and the dorsolateral prefrontal cortex (DLPFC). In contrast, reappraisal induced increased activation in both regions. Furthermore, both regulation strategies were associated with opposite patterns of connectivity in a network encompassing the amygdala, the insula and the DLPFC. Only placebo administration led to a reduced coupling in this network.

Difficulties with emotion regulation moderate the association between childhood history of maltreatment and cortisol reactivity to psychosocial challenge in postpartum women

Exposure to child maltreatment can lead to long-term emotional difficulties and dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis. However, no prior work has examined emotion regulation as a moderator of the association between childhood history of maltreatment and cortisol response to psychosocial challenge. Amongst a sample of 140 postpartum women, associations between childhood maltreatment, emotion regulation, and cortisol response to a computerized Emotional Stroop paradigm were examined using structural equation modeling. Three saliva samples (baseline, 20- and 40-min post-challenge) were collected and later assayed for cortisol. Stepwise regression analyses revealed that difficulties with emotion regulation significantly moderated the association between maternal history of child maltreatment and cortisol reactivity (β=-0.17, CI_.95=-0.31, -0.04, t=-2.51, p=0.01). Specifically, women with higher child maltreatment scores and greater difficulties with emotion regulation displayed reduced cortisol reactivity. This finding suggests that diminished emotion regulation capacity may uniquely contribute to blunted physiological reactivity in postpartum women exposed to higher levels of child maltreatment. As the postpartum period has significant implications for maternal well-being and infant development, these findings are discussed in terms of adaptive responsivity, maternal behaviour, and clinical practice.

Factors influencing psychological, social and health outcomes after major burn injuries in adults: cohort study protocol

INTRODUCTION

The goal of burn care is that 'the quality of the outcome must be worth the pain of survival'. More research is needed to understand how best to deliver care for patients with burns to achieve this aim. Loss of independence, function as well as loss of income for patients with burns and carers cause a significant burden at both individual and societal levels. Much is being done to advance knowledge in the clinical care field; however, there has been a paucity of research exploring psychosocial outcomes. This paper describes the study background and methods, as implemented in an Australian cohort study of psychosocial outcomes after major burn injuries.

METHODS AND ANALYSIS

In this inception cohort study, a target sample of 230 participants, aged 18 years or over, admitted to a single statewide burns centre with a burn injury are identified by hospital staff for inclusion. Baseline survey data are collected either in person or by telephone within 28 days of the injury and participants then followed up with telephone interviews at 3, 6 and 12 months postburn. Injury and burns treatment information is collected from medical records. Social support is measured as a predictor variable using the Multidimensional Scale of Perceived Social Support. Outcome data are collected via standardised measures in the domains of Quality of Life (SF-12, EQ-5D, BSHS-B), depression (PHQ-9), post-traumatic stress disorder (PCL-C, PAS), community integration (CIQ-R) and Quality-Adjusted Life Years (EQ-5D). Additional survey questions measure life satisfaction, return to work and public services utilisation at 12 months postinjury. Data analysis methods will include analysis of variance, Pearson correlation and hierarchical multiple regression analyses.

ETHICS AND DISSEMINATION

Hospital-based and University of Queensland Human Research Ethics Committees have approved the protocol. Results from the study will be disseminated at national and international conferences, in peer-reviewed journals and in a doctoral thesis.

TRIAL REGISTRATION NUMBER

Australia New Zealand Clinical Trials Registry (ACTRN12616000828426). Retrospectively registered on 23 June 2016; pre-results.

Perceived discrimination and youths' adjustment: sleep as a moderator

Adolescents' sleep duration was examined as a moderator of the association between perceived discrimination and internalizing (anxiety, depression) and externalizing symptoms. Participants were 252 adolescents (mean: 15.79 years; 66% European American, 34% African American) who reported on their perceived discrimination (racial and general) and adjustment. Sleep duration was measured using actigraphy. Moderation effects were evident. The lowest levels of internalizing symptoms were observed for adolescents with longer sleep duration in conjunction with lower levels of perceived racial discrimination. Further, general perceived discrimination was associated more strongly with externalizing behaviours for youth with shorter versus longer sleep. Findings highlight the importance of sleep as a bioregulatory system that can ameliorate or exacerbate the effects of discrimination on youths' adjustment.

Perceived parental psychological control, familism values, and Mexican American college students' adjustment

OBJECTIVES

Drawing from cultural ecological and risk and resilience perspectives, we investigated associations among Mexican American college students' perceptions of mothers' and fathers' psychological control and familism values, and college students' adjustment (i.e., depressive symptoms and self-esteem). Additionally, we examined how familism values moderated the relations between perceived psychological control and college students' adjustment.

METHODS

Participants were 186 Mexican American college students (78.5% women; Mage = 21.56 years), and data were collected using self-report online surveys.

RESULTS

Using path analyses, we found that perceived maternal psychological control was positively associated and familism values were negatively associated with college students' depressive symptoms. Additionally, perceived paternal psychological control was negatively associated with college students' self-esteem when college students reported low, but not high, familism values.

CONCLUSION

Findings highlight the importance of family relationships for Mexican American college students and the significance of examining these relationships within this cultural context. (PsycINFO Database Record

Transactional Links Between Teacher-Student Relationships and Adolescent Rule-Breaking Behavior and Behavioral School Engagement: Moderating Role of a Dopaminergic Genetic Profile Score

Throughout adolescence, there is an increase in rule-breaking behavior and a decrease in behavioral school engagement. The role of teacher-student relationship quality in the development of these adjustment problems remains understudied. This study examined how adolescent-reported teacher-student affiliation and dissatisfaction and parent-reported rule-breaking behavior and behavioral engagement impact one another throughout adolescence. In addition, we examined the moderating effect of genes by means of a Biologically Informed Multilocus genetic Profile Score (BIMPS), a composite score reflecting the cumulative effect of multiple dopaminergic genes, with a higher score indicating higher dopamine signaling in the adolescent brain. We used three-year longitudinal data from 1111 adolescents (51 % boys; M age = 13.79), and their parents. Cross-lagged analyses revealed a transactional process in which adolescents who display more rule-breaking behavior and less behavioral engagement experienced increased subsequent dissatisfaction with their teachers, which in turn further increased their adjustment problems. Also, adolescents with more adjustment problems experienced decreased subsequent affiliation with their teachers. The other way around, adolescents' behavioral engagement also benefitted from positive relationships with teachers. Multi-group analyses revealed genetic moderation for behavioral engagement, but not for rule-breaking. Specifically, adolescents who had a BIMPS score coding for moderate levels of dopamine signaling (instead of high or low signaling) were most affected in their behavioral engagement when they experienced dissatisfaction with their teachers. Our study findings may guide schools in implementing interventions to create a supportive class and school environment including positive, supportive teacher-student relationships and indicate that providing a such a supportive school environment is important for all adolescents.

Revealing a latent variable: individual differences in affective response to repeated injections

[Correction Notice: An Erratum for this article was reported in Vol 129(5) of Behavioral Neuroscience (see record 2015-43762-001). In the article, there was an error in the abstract. The sentence "However, injections significantly increased time spent immobile in the forced swim test in LRs, while the identical regimen significantly decreased the same measure in HRs, compared with handled-controls." should be "However, injections significantly increased time spent immobile in the forced swim test in HRs, while the identical regimen significantly decreased the same measure in LRs, compared with handled-controls."] Latent variables may exist in experimental designs and may interfere with reproducibility of findings. The present study reveals 1 such variable, the individual differences in affective response to chronic injection stress, by using the novelty-seeking phenotype as a model of differential emotional reactivity. The phenotype is identified by exposing a population of experimentally naïve outbred rats to the mild stress of a novel environment and classifying them as high responders (HR; upper 1/3) and low responders (LR; lower 1/3) based on their locomotor reactivity. Research has shown that HR/LR animals differ in their basal levels of anxiety- and depressive-like behavior, as well as in their response to environmental and pharmacological challenges; suggesting validity of this model in studying individual differences in stress reactivity. The present data showed that 14 daily, intraperitoneal saline injections did not alter the phenotypic differences in social behavior observed basally in HR/LR rats. However, injections significantly increased time spent immobile in the forced swim test in HRs, [corrected] while the identical regimen significantly decreased the same measure in LRs, [corrected] compared with handled-controls. These data indicate that individual differences in stress reactivity can have a significant impact on the depressive-like responses to repeated intraperitoneal injections in rats. Given that such underlying emotional variability exists within standard, outbred rat populations, this study highlights the importance of accounting for such variability in any study investigating the effects of repeated drug administration on depressive-like behavior for reliability and replicability of findings. Thus, we recommend including an uninjected control group in all studies.

A Longitudinal Study of Post-Traumatic Growth and Psychological Distress in Colorectal Cancer Survivors

The stability of post-traumatic growth over time and the relationship between post-traumatic growth and traditional distress outcomes remains unclear. We tracked post-traumatic growth in a population-based sample of colorectal cancer patients from soon after diagnosis to five years subsequently to assess the heterogeneity of a post-traumatic growth response to cancer over time and describe the simultaneous and longitudinal relationships between post-traumatic growth and psychological distress. 1966 colorectal patients who were five months post diagnosis were assessed six times over a five year period. There was considerable heterogeneity associated with both psychological distress and benefit finding scores over time. However, both for benefit finding and psychological distress, the variation in individual scores suggested an underlying positive linear trend and both lagged and lagged change components. Specifically, benefit finding and psychological distress are mutual leading indicators of each other. First, benefit finding served as a leading indicator of distress, in that increases in reported benefit finding from year to year predicted higher future increases in psychological distress. As well, in an inverse relationship, psychological distress served as a leading indicator of benefit finding, such that increases in reported distress from year to year predicted lower future increases in benefit finding. Post-traumatic growth may reflect patients coping efforts to enhance perceptions of wellbeing in response to escalating cancer–related threats, acting as harbinger of increasing trajectories of psychological distress. This explanation is consistent with a cognitive dissonance response in which threats to the integrity of the self then lead to a tendency to accentuate positive aspects of the self.