A systematic review of the psychosocial factors associated with pain in children with juvenile idiopathic arthritis

BACKGROUND

Pain is one of the most frequently reported experiences amongst children with Juvenile Idiopathic Arthritis (JIA); however, the management of JIA pain remains challenging. As pain is a multidimensional experience that is influenced by biological, psychological, and social factors, the key to effective pain management lies in understanding these complex relationships. The objective of this study is to systematically review the literature on psychosocial factors of children with JIA and their caregivers 1) associated with and 2) predictive of later JIA pain intensity, frequency, and sensitivity in children 0-17 years of age.

METHODS

The Joanna Briggs Institute methodology for etiology and risk and Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement guided the conduct and reporting of this review. Terms related to pain and JIA were searched in English without date restrictions across various databases (PubMed, CINAHL, PsycINFO, Embase, Scopus, and the Cochrane Central Register of Controlled Trials) in September 2021. Two independent reviewers identified, extracted data from, and critically appraised the included studies. Conflicts were resolved via consensus.

RESULTS

Of the 9,929 unique studies identified, 61 were included in this review and reported on 516 associations. Results were heterogeneous, likely due to methodological differences and moderate study quality. Results identified predominantly significant associations between pain and primary and secondary appraisals (e.g., more child pain beliefs, lower parent/child self-efficacy, lower child social functioning), parent/child internalizing symptoms, and lower child well-being and health-related quality of life. Prognostically, studies had 1-to-60-month follow-up periods. Fewer beliefs of harm, disability, and no control were associated with lower pain at follow-up, whereas internalizing symptoms and lower well-being were predictive of higher pain at follow-up (bidirectional relationships were also identified).

CONCLUSIONS

Despite the heterogeneous results, this review highlights important associations between psychosocial factors and JIA pain. Clinically, this information supports an interdisciplinary approach to pain management, informs the role of psychosocial supports, and provides information to better optimize JIA pain assessments and interventions. It also identifies a need for high quality studies with larger samples and more complex and longitudinal analyses to understand factors that impact the pain experience in children with JIA.

TRIAL REGISTRATION

PROSPERO CRD42021266716.

Links Between Romantic Relationship Dysfunction and Drinking Behaviors Are Moderated by Gender and Age

OBJECTIVE

Romantic relationship dysfunction is a risk for subsequent alcohol use, with some research suggesting gender differences in this link. We evaluated how different aspects of relationship dysfunction are related to different drinking behaviors and whether these associations vary by gender. We further examined the role of age as a potential moderator of this gender difference.

METHOD

Qualtrics Panelists (N = 1,470; 50% women) who were in a romantic relationship and regularly consumed alcohol completed an online survey. The sample was wide-ranging in age (range: 18-85 years old; M = 46.64, SD = 11.95). Participants reported drinking about 10 drinks per week, on average (SD = 11.01).

RESULTS

Five factor scores were constructed from relationship predictors (relationship distress, intrusion/jealousy, and disagreements) and drinking outcomes (consumption and coping motives). Moderation analyses indicated several significant two-way interactions between relationship dysfunction, gender, and age when predicting alcohol outcomes. Of note, the positive associations between relationship distress and both consumption and coping motives were stronger among younger than older individuals and among men than women (consistent with an externalizing stress perspective). A significant three-way interaction suggested that, for women, associations between intrusion/jealousy and coping motives were strongest at younger ages, consistent with an interpersonal sensitivity perspective. Conversely, for men, these associations were stronger at older ages, consistent with an externalizing stress perspective.

CONCLUSIONS

Men and younger individuals should be of particular focus when designing and testing interventions for drinking in response to relationship distress and disagreements. Younger women and older men may benefit from interventions focused on drinking to cope with relationship jealousy and electronic intrusions.

Few Differences in Sexual Talk by Gender/Sex and Dyad Type: A Retrospective and Daily Diary Study with Couples

Sexual talk is a type of verbal communication that occurs exclusively during sexual activity and that is specific to the sexual activity itself. Previous research has identified two types of sexual talk: individualistic (i.e., self-focused) and mutualistic (i.e., sharing/partner-focused), which have generally been linked to greater sexual and relationship well-being. Whether sexual talk use varies by gender/sex (i.e., men, women, gender/sex diverse individuals; GSD) or dyad type (i.e., same- vs. mixed-gender/sex) has not been examined. Given initial evidence that the types of sexual talk may contribute differently to sexual and relationship well-being, it is important to identify factors (e.g., gender/sex) that may be associated with the amount of sexual talk used. We examined differences by gender/sex and dyad type in the average sexual talk use among long-term couples (N = 229; 69 same-gender/sex) using retrospective cross-sectional dyadic data. We also examined these differences in the same sample (N = 217) using a 35-day dyadic daily diary study. Retrospectively, but not daily, women reported using more mutualistic talk than men, especially when partnered with a woman. There were no significant gender/sex or dyad type differences in use of individualistic talk retrospectively or daily. Exploratory analyses with the GSD couples suggested that there may be gender/sex and dyad type differences retrospectively and daily, for individualistic and not mutualistic talk; however, these analyses must be interpreted with caution due to the small subsample size of GSD couples.

Friendship Conflict, Drinking to Cope, and Alcohol-Related Problems: A Longitudinal Actor-Partner Interdependence Model

Drinking to cope with negative affect is a strong predictor of alcohol-related problems. We hypothesized that the association between friendship conflict and alcohol-related problems would be mediated by coping-with-depression motives in emerging adults' close friendships. We used a 4-wave, 4-month longitudinal self-report survey design measuring friendship conflict, coping motives, and alcohol-related problems from 174 same-sex friendship dyads. Participants were recruited from Nova Scotia, Canada between September 2016 and February 2019. Participants had a mean age of 18.66 (SD = 1.17) and were 66.1% female. Data were analyzed using multilevel structural equation modeling. Coping-with-depression motives mediated the link between conflict and alcohol-related problems at the between- and within-subject levels. Unexpectedly, coping-with-anxiety motives was an additional mediator at the within-subjects level. Interventions for emerging adults' problem drinking should consider the influence of friendship conflict and its impact on emerging adults' tendencies to drink to cope with both depression and anxiety. Materials/Syntax: https://osf.io/krs3v/.

Socially prescribed perfectionism predicts next-day binge eating behaviors over 20-days

Existing research on perfectionism and binge eating suggests that socially prescribed, self-oriented, and other-oriented perfectionism (Socially Prescribed Perfectionism, SPP; Self-Oriented Perfectionism, SOP; and Other-Oriented Perfectionism, OOP) are differentially related to binge eating. However, previous studies have largely utilized cross-sectional methodology. The present study used a 20-day daily diary methodology to examine associations between daily levels of perfectionistic dimensions and next-day binge eating behaviors with a nonclinical sample of emerging adults (N = 263). Zero-inflated negative binomial regression models indicated that daily SPP (but not SOP or OOP) predicted a greater intensity of next-day binge eating behaviors in the count portion of the model; however, daily levels of perfectionistic dimensions did not predict the presence/absence of next-day binge eating behaviors in the zero-inflated portion of the model. Additionally, analyses examining the reverse causal direction (i.e., binge eating behaviors predicting higher next-day perfectionism) failed to provide evidence that the occurrence or intensity of binge eating behaviors predicts next-day levels of SPP, SOP, or OOP. Overall, at a daily level, SPP appears to be a vulnerability factor for binge eating behaviors. It may be helpful for clinicians to target state-levels of SPP to reduce harmful binge eating behaviors. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Reactivity to Daily Self-Monitoring of Cannabis Use in Biological Females

Assessment reactivity involves changes to behaviours from self-monitoring those behaviours (Nelson & Hayes, 1981). In the substance use field, reactivity has been identified both as a potential confound in daily diary research (Cohn et al., 2015) and as a possible intervention tool in clinical practice (Cohn et al., 2018). Reactivity to daily self-monitoring of alcohol and tobacco use has been inconsistent in prior research. Reactivity to daily self-monitoring of cannabis use quantity has received far less study. This study involved secondary analyses of data from N = 88 females who self-monitored their cannabis use for 32 days. We examined objective reactivity of cannabis use to daily self-monitoring by assessing changes in daily cannabis use over 32 days. We also explored participants' perceptions of the impact daily self-monitoring had on their cannabis use at study completion (i.e., subjective reactivity). In hurdle models testing objective reactivity, neither probability of cannabis use, nor quantity of cannabis use, changed significantly over the study period. Many respondents (45%) reported no subjective reactivity, though a slight majority (55%) reported some subjective reactivity. Subjective reactivity did not moderate objective reactivity over time; however, higher subjective reactivity was significantly associated with increased variability (interquartile range [IQR]) in cannabis use across the self-monitoring period. Overall, reactivity appears unlikely to confound research utilizing daily diary cannabis measures, and daily self-monitoring of cannabis use may be unlikely to serve as a useful stand-alone intervention for reducing cannabis use in non-treatment-seeking individuals. Potential clinical implications of the novel finding of a link between subjective reactivity and objective cannabis use variability are discussed.

The association between labour epidural analgesia and postpartum depressive symptoms: a longitudinal cohort study

BACKGROUND

Pain is a risk factor for postpartum depression (PPD) and labour epidural analgesia (LEA) may lower the incidence of PPD. We evaluated depressive symptoms risk at three, six, and 12 months postpartum in women with LEA compared with women without LEA.

METHODS

With ethics approval, hypotheses were tested using data from a longitudinal prospective observational cohort study between January 2015 and January 2019 in nulliparous women aged ≥ 18 yr with uncomplicated, singleton pregnancies. Email surveys were completed at baseline (18-20 weeks' gestation) and at three-, six- and 12 months postpartum, including the Edinburgh Postpartum Depression Scale (EPDS). Maternal, infant, and anesthesia characteristics were abstracted from electronic databases. The EPDS scores at three, six, and 12 months postpartum were analyzed using generalized estimating equations with and without covariates.

RESULTS

Of the 909 women who consented to participate, 709 women were included in the study. Antenatal EPDS scores, not LEA, predicted postpartum depressive symptom risk (P < 0.001). The adjusted 95% confidence intervals suggest mean EPDS scores differ from 1.0 point lower in the LEA group at 12 months to 1.5 points higher in the no LEA group at three months on its 0-30 scale. All the confidence intervals included zero at three, six, and 12 months, so were considered non-significant (P > 0.05).

CONCLUSION

This study did not identify an association between LEA and risk of depressive symptoms postpartum, although small mean differences between groups cannot be ruled out. Future studies should focus on other modifiable variables that influence the development of PPD.

The Influence of Drinking Buddies: A Longitudinal Investigation of Drinking Motivations and Drinking Behaviors in Emerging Adults

Background: Heavy alcohol consumption and frequent alcohol use are associated with many adverse social and physical consequences. The different motivations underlying why people drink predict different patterns of alcohol consumption. A drinking buddy (i.e. a friend with whom a person drinks alcohol) influences a person's drinking via social learning, leading to escalations in drinking over time. Purpose: Few studies have investigated drinking motives among peers and none have studied whether the drinking motives of a drinking buddy can influence another person's drinking behavior; we sought to fill that gap. Method: Same-sex drinking buddies (N = 174; 66.1% female) were assessed once monthly for four months using self-report questionnaires. Participants were on average 18.66 years-old (SD = 1.17). Results: Indistinguishable actor-partner interdependence models using multilevel path analysis were conducted, with each drinking motive predicting drinking frequency and quantity, respectively. There were significant actor effects for social, enhancement, conformity, and coping motives; moreover, the enhancement, social, and coping-anxiety motives of the drinking buddy influenced the individual's drinking frequency across the four months of the study. Conversely, only the enhancement motives of the buddy predicted drinking quantity in the individual when averaged across time. Sex was not a significant moderator of these effects. Importance: When targeting risky drinking behavior in a therapeutic context, assessing and addressing a person's reasons for drinking, as well as their drinking buddy's reasons for drinking, may reduce the risk of escalations in either friend's drinking frequency over time.

The videoscopic view may not be significantly superior to the directly sighted peroral view during Macintosh-style videolaryngoscopy: a randomized equivalence cadaver trial

PURPOSE

Videolaryngoscopy is widely believed to give a superior view to that obtained by direct laryngoscopy. Published literature suggests this benefit extends to both hyper-angulated and Macintosh-style videolaryngoscopes. Notwithstanding, our clinical experience shows that the videoscopic view with a Macintosh-style videolaryngoscope is often no different or only marginally better than the directly sighted peroral view.

METHODS

A human cadaver equivalence study was performed in which four experienced laryngoscopists obtained pre-assigned laryngeal views by direct sighting using the single-use Macintosh blades of the GlideScope® Spectrum™ (GS) DirectView Macintosh (DVM) and C-MAC®S videolaryngoscopes. Blinded to the laryngoscopist's view, two independent observers rated the videoscopic view presented on the proximal video monitor at the same time. Directly sighted and videoscopic views obtained by the laryngoscopist and video scorers were recorded on a visual analogue scale (VAS) for each device as the primary outcome measures and compared.

RESULTS

On the VAS, the C-MAC®S videoscopic view revealed only approximately 0.9% more (99% confidence interval [CI], -2.5% to 4.3%) of the laryngeal inlet than the directly sighted view. Using GS DVM, the videoscopic view revealed 6.7% (99% CI, 2.3% to 11.0%) more of the laryngeal inlet than the directly sighted view. Although results for the GS DVM achieved statistical significance, neither device gave a clinically significantly improved videoscopic view compared with the directly sighted peroral view.

CONCLUSION

This study failed to corroborate previously published findings of a clinically significantly improved videoscopic view compared with direct peroral sighting using Macintosh-style videolaryngoscopes. Further study of this class of device is warranted in human subjects.

Association of obesity with failure of ultrasound-guided axillary brachial plexus block: a two-centre, prospective, observational, cohort study

The objective of this study was to evaluate whether the failure rate of ultrasound-guided axillary brachial plexus block is similar in obese patients compared with non-obese patients when performed as the primary anaesthetic technique. We recruited 105 obese (body mass index ≥ 30 kg.m-2 ) and 144 non-obese patients to this prospective, observational, cohort study conducted at two Canadian centres. A perineural technique of axillary brachial plexus block was performed using 30 ml ropivacaine 0.5% under real-time ultrasound guidance. Sensory and motor block assessment was carried out every 5 min until 30 min after block completion in all four terminal nerve distributions (radial, median, ulnar and musculocutaneous nerve). A composite score consisting of three sensory points and three motor points was used for assessment in each nerve distribution. A failed block was defined as a score of less than 14 points out of a possible 16 points, or a sensory block score less than 7 out of 8 points 30 min after block completion. Thirty minutes after block completion, obese patients had a higher failure rate of 33.7% (34/101) compared with 17.8% (24/135) for non-obese patients, with a failure rate difference (95%CI) of 15.9% (6.4-27.1%) between the groups. The median (IQR [range]) time to achieve a successful block in obese patients was 25 (20-30 [5-30]) min, compared with non-obese patients at 20 (15-30 [5-30]) min (p = 0.003). Despite a higher sensory-motor failure rate as per the composite score, the axillary brachial plexus block provided adequate surgical anaesthesia as indicated by a low need for conversion to general anaesthetic in obese (8.6%) and non-obese patients (7.0%; p = 0.656). This study showed that despite ultrasound guidance, obese patients had a slower onset time and higher axillary brachial plexus block failure rate at 30 min compared with non-obese patients.

Investigating the Relationship Between Perfectionistic Self-Presentation and Social Anxiety Using Daily Diary Methods: A Replication

Worrying about the negative consequences of appearing imperfect to others (i.e., perfectionistic self-presentation) is conceptually related to social anxiety. Mackinnon, Battista, Sherry and Stewart (2014) tested whether perfectionistic self-presentation could predict social anxiety beyond several important covariates using a 21-day daily measurement approach. We sought to replicate Mackinnon et al.’s (2014) findings using the same daily diary methodology. Participants included 263 young adults (79.9% women;M age = 21.4) who completed a series of questionnaires once per day for 21 days. Participants completed measures of perfectionistic self-presentation, perfectionism cognitions, social anxiety, depressed mood and socially prescribed perfectionism. Intraclass correlations suggested measures had both within-subjects and between-subjects variability. Confirmatory factor analyses supported the a-priori factor structures at both levels. Using multilevel structural equation modeling, we showed that perfectionistic self-presentation predicted social anxiety even when controlling for socially prescribed perfectionism, depressed mood and perfectionism cognitions at both levels, replicating Mackinnon et al (2014). Our replication suggests that perfectionistic self-presentation is an important predictor of daily social anxiety. Intervention efforts may wish to target perfectionistic self-presentation in order to better help treat those with social anxiety. Open data/methods: https://osf.io/ty2aj/.

Drinking motives and drinking behaviors in romantic couples: A longitudinal actor-partner interdependence model

Excessive alcohol consumption is related to adverse physical and social consequences. Research shows an individual's own drinking motives (reasons for drinking alcohol) are linked to his or her specific drinking outcomes in a theoretically expected manner. Romantic couples often engage in a "drinking partnership," where partners reciprocally influence each other's drinking. Though alcohol consumption partner effects have been studied, partner effects of drinking motives on an individual's alcohol consumption have not been investigated in romantic couples. We investigated this topic. Romantic couples (N = 203) were assessed once weekly for four weeks using self-report questionnaires. Participants were on average 22.7 years old (SD = 5.5) and were in their relationship an average of 2.3 years (SD = 2.4). Actor-partner interdependence models using multilevel path-analysis with indistinguishable dyads were conducted, with each motive predicting drinking quantity and frequency. There were significant actor effects for social and enhancement motives; moreover, changes in a partner's enhancement and social motives predicted change in the individual's drinking quantity during any given week, but only averaged partners' enhancement motives predicted the individual's drinking frequency. Coping-with-anxiety motives had significant actor effects when predicting averaged quantity and frequency; moreover, changes in partners' coping-with-anxiety motives predicted changes in drinking quantity. Enhancement and social motives of the partner influenced the drinking quantity and frequency of the actor by way of influencing the actor's enhancement and social motives. Intervention efforts targeting both members of a romantic dyad on their reasons for drinking should be tested for preventing escalations in either member's drinking behavior. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

"It Was the Best of Times, It Was the Worst of Times": A Qualitative Investigation of Perfectionism and Drinking Narratives in Undergraduate Students

Perfectionism is a transdiagnostic risk factor for mental health and interpersonal difficulties, but research on perfectionism and alcohol use in emerging adults remains equivocal. Qualitative research methods are underutilized in this area, and inductive analysis of drinking narratives in undergraduate perfectionists may help clarify conflicting results and support novel approaches to quantitative inquiry in this area. We interviewed 20 undergraduates high in perfectionism (6 adaptive perfectionists and 14 maladaptive perfectionists) using a narrative interview, with analyses focusing on a situation involving alcohol use. We coded interviews for emergent themes using thematic analysis. Five themes emerged as follows: (1) drinking as a social experience, (2) suffering consequences, (3) learning from alcohol, (4) alcohol use as escapism, and (5) reluctance and moderation. Our results add to existing literature by highlighting the interpersonal conflict in perfectionistic people's experience in relation to alcohol use during emerging adulthood. Results also suggest perfectionistic people may use alcohol and intoxication as a way to facilitate a "release" from unpleasant situations or emotions. Perfectionists reported both positive and negative experiences, which lends support for using a narrative perspective to help overcome preexisting assumptions about adaptive and maladaptive qualities of perfectionism.

Maintaining Affection Despite Pain: Daily Associations Between Physical Affection and Sexual and Relationship Well-Being in Women with Genito-Pelvic Pain

Provoked vestibulodynia (PVD) is a recurrent, genito-pelvic pain condition that affects 8-12 % of women and has negative implications for sexual and relationship functioning. Many women with PVD report avoiding physical affection because they are concerned that affectionate behavior will lead to painful sexual activity. In community samples, physical affection is associated with improved sexual and relational well-being; however, no research has assessed the influence of physical affection on well-being in women with PVD. The current study examined day-to-day, within-person associations between affectionate behavior (hugging/kissing, cuddling) and sexual satisfaction, relationship satisfaction, sexual functioning, and pain intensity in women with PVD. Seventy women diagnosed with PVD completed an 8-week daily survey. Data were analyzed using multilevel modeling. All outcomes were assessed on days involving sexual activity (n = 401 days). Physical affection was assessed on days with and without sexual activity. Hugging/kissing was positively associated with sexual satisfaction, relationship satisfaction, and sexual functioning within any given day and when predicting the next day. Hugging/kissing was unrelated to pain intensity. Cuddling was not associated with any outcomes. Results persisted for affection that occurred on days with and without sexual activity. Findings suggest physical affection is beneficial for the sexual and relationship well-being of women with PVD. These results may inform interventions that encourage women coping with PVD to engage in more daily physical affection with their partners.

Relations of Five-Factor Personality Domains to Gambling Motives in Emerging Adult Gamblers: A Longitudinal Study

At least three types of gambling motives have been proposed: coping motives (gambling to reduce negative affect), enhancement motives (gambling to enhance positive affect), and social motives (gambling to increase social affiliation). Few studies have examined the underlying personality traits that give rise to these different motivations. The present study tests the longitudinal link between changes in five-factor model personality domains and gambling motives among emerging adults. A sample of 679 emerging adults (Mage = 18.90 years; 51.8% female) was recruited as part of the Manitoba Longitudinal Study of Young Adults (MLSYA). Participants completed self-report questionnaires across four measurement occasions, with each measurement 12–18 months apart. The NEO Five Factor Inventory was administered at waves 1 and 3, and the Gambling Motives Questionnaire was administered at wave 4. Data were analyzed using longitudinal structural equation modeling. Emerging adults who experienced increases in neuroticism had higher coping motives at a subsequent wave. Those who experienced increases in extraversion had higher enhancement and social motives. Those who experienced increases in agreeableness had lower social and coping motives. Changes in conscientiousness and openness were unrelated to any of the motives after controlling for all other variables. Extraversion and agreeableness predicting social motives were the most robust findings. A multigroup analysis showed the measurement and structural models did not differ by sex. Longitudinal changes in five-factor model personality domains were linked to specific motives for gambling in a theoretically-expected fashion. Results have implications for personality-targeted interventions for problem gamblers.Au moins trois types de motivations au jeu ont été proposées : l’adaptation (jouer pour atténuer une émotion négative), la stimulation (jouer pour stimuler une émotion positive) et les rapports sociaux (jouer pour accroître ses liens sociaux). Peu d’études ont examiné les traits de personnalité associés à ces différentes motivations. La présente étude met à l’épreuve le lien longitudinal entre des changements touchant les domaines de la personnalité (selon un modèle à cinq facteurs NEO Pi-R) et les motivations au jeu chez les jeunes adultes. Un échantillon de 679 jeunes adultes (Mâge = 18,9 ans; 51,8 % de femmes) a été recruté dans le cadre d’une étude longitudinale sur les jeunes adultes du Manitoba (Manitoba Longitudinal Study of Young Adults [MLSYA]). Les participants ont rempli des questionnaires d’autoévaluation lors de quatre séances de mesure espacées d’un intervalle de 12 à 18 mois entre chacune. Le test de personnalité à cinq facteurs NEO Pi-R a été administré aux participants pendant les séances 1 et 3, et ceux-ci ont répondu au questionnaire sur les motivations au jeu lors de la séance 4. Les données ont été analysées au moyen d’une modélisation par équation structurelle longitudinale. Chez les jeunes adultes dont la personnalité a connu un accroissement du domaine du névrosisme, les motivations relevant de l’adaptation étaient également plus élevées. Ceux chez qui le domaine de l’extraversion s’est accru, les motivations étaient de l’ordre de la stimulation et de la recherche de rapports sociaux, alors que ceux pour qui le domaine de l’agréabilité a augmenté, les motivations relevant de l’adaptation et de la recherche de rapports sociaux étaient moins importantes. Des changements dans les domaines de la conscience et de l’ouverture n’étaient associés à aucun type de motivation, après un rajustement pour toutes les autres variables. La constatation la plus robuste de l’étude consiste dans le fait que les domaines de l’extraversion et de l’agréabilité sont des variables explicatives des motivations d’ordre social. Une analyse de groupes multiples a montré que les mesures et les modèles structuraux ne donnaient lieu à aucune différence quant au sexe. Il existe un lien entre les changements longitudinaux touchant les domaines de la personnalité du modèle à cinq facteurs NEO Pi-R et les motivations propres au jeu, conformément à ce que prévoyait la théorie. Ces résultats ont une incidence sur les interventions auprès des joueurs à problèmes axées sur la personnalité.

Cross-cultural comparisons of drinking motives in 10 countries: Data from the DRINC project

INTRODUCTION AND AIMS

This study tested the measurement invariance of the Drinking Motives Questionnaire-Revised Short Form (DMQ-R-SF) in undergraduates across 10 countries. We expected the four-factor structure to hold across countries, and for social motives to emerge as the most commonly endorsed motive, followed by enhancement, coping and conformity motives. We also compared individualistic and collectivistic countries to examine potential differences in the endorsement of drinking motives when countries were divided according to this broad cultural value.

DESIGN AND METHODS

A sample of 8478 undergraduate drinkers from collectivistic (Portugal, Mexico, Brazil, Spain; n = 1567) and individualistic (Switzerland, Hungary, Canada, the Netherlands, the UK and Ireland, and the USA; n = 6911) countries completed the DMQ-R-SF. Countries were classified as individualistic or collectivistic based on world-wide norms.

RESULTS

Using multigroup confirmatory factor analysis, the 4-factor model of the DMQ-R-SF showed configural and metric invariance across all 10 countries. As predicted, the rank order of undergraduates' drinking motive endorsement was identical across countries (social > enhancement > coping > conformity), although a mixed model analysis of variance revealed a significant interaction where undergraduates from individualistic countries more strongly endorsed social and enhancement motives relative to undergraduates from collectivistic countries.

DISCUSSION AND CONCLUSIONS

There was broad cross-cultural consistency in the factor structure and mean patterns of drinking motives. Undergraduate students appear to drink mainly for positive reinforcement (i.e. for social and enhancement reasons), although this tendency is particularly pronounced among those from more individualistic countries. [Mackinnon SP, Couture M-E, Cooper ML, Kuntsche E, O'Connor RM, Stewart SH, and the DRINC Team. Cross-cultural comparisons of drinking motives in 10 countries: Data from the DRINC project.

Validation of the Gambling Motives Questionnaire in Emerging Adults

People engage in gambling behaviour for a variety of different reasons, some of which are riskier than others in terms of associations with heavy and problem gambling. Stewart and Zack (Addiction 103:1110-1117, 2008) developed a measure called the Gambling Motives Questionnaire (GMQ) that assesses levels of three distinct gambling motives: enhancement (to increase positive emotions), coping (to decrease negative emotions), and social (to increase affiliation). While this measure has been validated in a community-recruited sample of middle-aged gamblers, the GMQ has yet to be validated in emerging adulthood (ages 18-25 years)—a developmental period associated with increased risk for heavy and problematic gambling. The current project tested the psychometric properties of the GMQ in a community sample of emerging adult gamblers using archival data from the Manitoba Longitudinal Study of Young Adults. Participants (N = 487; 73.9% Caucasian; 52.6% female; mean age 22.23 years) completed the GMQ and questionnaire measures of gambling behaviour and problems. Exploratory factor analysis revealed that a three-factor model adequately fit the data; however, problematic items were identified. A modified 9-item version of the GMQ with the problem items removed fit the data well. Both the original 15-item and the 9-item versions had acceptable subscale alpha reliabilities (αs >.78). While all three subscales (from both the 9-item and 15-item versions) were positively correlated with problem gambling, only enhancement motives emerged as a significant independent predictor when the other motives and gambling behaviours were entered as simultaneous predictors. These results suggest the GMQ is a valid measure for tapping motives in emerging adults, and that high enhancement motives are particularly predictive of gambling problems in this developmental period. Future intervention efforts might specifically target enhancement motives in emerging adults.

Investigating Possible Reciprocal Relations Between Depressive and Problem Gambling Symptoms in Emerging Adults

OBJECTIVE

Previous cross-sectional research has shown that depression and problem gambling co-occur. Longitudinal research, however, allows for a better determination of directionality, as behavioural changes in gambling involvement can be more reliably studied over time. Our study assesses symptoms of depression and problem gambling across 4 waves and addresses whether their relation is directional (with one reliably preceding the other), bidirectional, or pathoplastic.

METHOD

As part of the Manitoba Longitudinal Study of Young Adults, prospective data were collected on Canadian young adults' (Wave 1: n = 679, 51.8% female, aged 18 to 20 years) depressive symptoms, involvement in gambling, and risky gambling behaviour. Recruitment and the first cycle of data collection (Wave 1) took place in fall 2007. Three additional waves of data collection then occurred in 12- to 18-month intervals: fall 2008, spring 2010, and spring 2011. The Problem Gambling Severity Index and the Composite International Diagnostic Interview-Short Form were administered through telephone interview at each wave.

RESULTS

Bivariate growth curves showed that depressive and problem gambling symptoms were positively correlated at Wave 1, Wave 2, and Wave 4. Neither disorder was found to be a risk factor for the other, and depression and problem gambling were not pathoplastically related (that is, increases in one did not result in increases in the other over time, and vice versa).

CONCLUSIONS

While depression and problem gambling are related, their co-occurrence may be better explained not by depressive- or gambling-related risk, but by the presence of a common underlying factor (such as substance abuse).

Perfectionistic Concerns, Social Negativity, and Subjective Well-Being: A Test of the Social Disconnection Model

Partner-specific perfectionistic concerns (PC) include concern over mistakes, self-criticism, and socially prescribed perfectionism as it pertains to one's partner. The social disconnection model proposes that PC influences well-being indirectly through interpersonal problems. Thus, we hypothesized that social negativity (expressed anger, hostility, and rejection) would mediate the relationship between dyadic PC and subjective well-being. Data from 203 romantic dyads (92.1% heterosexual) were collected using self-report surveys and a four-wave, 4-week longitudinal design. Participants were predominantly female (53.1%), young (M = 22.69 years), and Caucasian (82.3%). Data were analyzed using an actor-partner interdependence model with multilevel structural equation modeling. There were significant actor effects at the between-subjects and within-subjects levels, and significant partner effects for the relationship between PC and social negativity at the within-subject level. Social negativity mediated the relationships between PC and both negative affect and life satisfaction. However, positive affect was more weakly related to PC and social negativity. The social disconnection model was supported. PC was positively associated with one's own social negativity and evoked hostile behaviors from one's partner. Hostile, rejecting behaviors reduced the well-being of the actor, but not the partner. Results suggest perfectionism may be best understood within an interpersonal context.

Dyadic conflict, drinking to cope, and alcohol-related problems: A psychometric study and longitudinal actor-partner interdependence model

The motivational model of alcohol use posits that individuals may consume alcohol to cope with negative affect. Conflict with others is a strong predictor of coping motives, which in turn predict alcohol-related problems. Two studies examined links between conflict, coping motives, and alcohol-related problems in emerging adult romantic dyads. It was hypothesized that the association between conflict and alcohol-related problems would be mediated by coping-depression and coping-anxiety motives. It was also hypothesized that this would be true for actor (i.e., how individual factors influence individual behaviors) and partner effects (i.e., how partner factors influence individual behaviors) and at the between- (i.e., does not vary over the study period) and within-subjects (i.e., varies over the study period) levels. Both studies examined participants currently in a romantic relationship who consumed ≥12 alcoholic drinks in the past year. Study 1 was cross-sectional using university students (N = 130 students; 86.9% female; M = 21.02 years old, SD = 3.43). Study 2 used a 4-wave, 4-week longitudinal design with romantic dyads (N = 100 dyads; 89% heterosexual; M = 22.13 years old, SD = 5.67). In Study 2, coping-depression motives emerged as the strongest mediator of the conflict-alcohol-related problems association, and findings held for actor effects but not partner effects. Supplemental analyses revealed that this mediational pathway only held among women. Within any given week, alcohol-related problems changed systematically in the same direction between romantic partners. Interventions may wish to target coping-depression drinking motives within couples in response to conflict to reduce alcohol-related problems.

CBT for high anxiety sensitivity: alcohol outcomes

INTRODUCTION

High anxiety sensitivity (AS) has been associated with greater alcohol consumption and alcohol-related problems as well as greater sensitivity to the anxiety-reducing effects of alcohol and greater risky negative reinforcement motives for drinking. The present study reported on the alcohol-related outcomes of a telephone-delivered cognitive behavioral treatment (CBT) designed to reduce high AS.

METHODS

Eighty individuals with high AS (M age=36 years; 79% women; 76% Caucasian) seeking treatment for their AS-related concerns participated in the study and were randomly assigned to an eight week telephone CBT program or a waiting list control. Participants completed measures of drinking motives and problem drinking at pre- and post-treatment.

RESULTS

Multilevel modeling showed that the treatment was successful in reducing AS. The treatment also resulted in specific reductions in drinking to cope with anxiety motives as well as physical alcohol-related problems. Mediated moderation analyses showed treatment-related changes in AS mediated changes in drinking to cope with anxiety motives. Changes in drinking to cope with anxiety motives mediated changes in physical alcohol-related problems.

CONCLUSIONS

Results of the present study suggest that an AS-targeted intervention may have implications for reducing risky alcohol use cognitions and behaviors. Further research is needed in a sample of problem drinkers.

Testing the Feasibility and Psychometric Properties of a Mobile Diary (myWHI) in Adolescents and Young Adults With Headaches

BACKGROUND

Headaches are prevalent among teens and young adults. Self-monitoring is essential for managing headaches and can be accomplished with the help of electronic headache diaries. An increasing number of electronic headache diaries exist, yet the absence of quality standards compromises their use for research and clinical purposes.

OBJECTIVE

Our goal was to develop and test the usability, feasibility, and psychometric properties of an electronic diary iPhone application for self-monitoring by adolescents and young adults with headaches.

METHODS

We used an iterative participatory design to develop and test our electronic headache diary. Participants aged 14-28 years old with recurrent headaches were recruited internationally. Screening and consent were conducted online. Following completion of an online pre-questionnaire, participants downloaded the diary to use in their natural environment for 14 days. An online post-questionnaire was completed following testing. The diary's usability and feasibility were tested first and determined to be complete when improvements to the diary did not result in a statistically significant impact on indicators of feasibility and adherence. Interviews were conducted with participants of usability and feasibility testing. The psychometric properties of the diary were then tested, and a case study analysis of one participant was completed.

RESULTS

Three cycles to test the usability and feasibility were conducted. Each cycle included 11-19 unique participants ranging in age from 16 to 28 years. Following the testing period for each cycle, 15% to 25% of participants took part in the post-cycle interview. Participants perceived the final version of the diary as useful, easy to learn, and efficient to use. Psychometric properties were then tested with a sample of 65 participants (6 aged 14-17 years old; 59 aged 18-28 years old). All items in the diary had substantial between- and within-subjects variability (percent of variance for the two participant groups ranged from 20.64 to 75.60 and 23.74 to 79.21, respectively). Moreover, the Migraine Disability Assessment (MIDAS) included in the diary had adequate between-subjects reliability (R1F=0.66, RKF=0.98), but low within-subjects reliability (RC=0.51). Critical elements of the diary demonstrated adequate convergent and concurrent validity, particularly in the older age group (18-28 years). The validity of some critical elements of the diary could not be explored in the younger age group due to the small subgroup size. The case study provides an example of the potential utility of the diary.

CONCLUSIONS

Our electronic headache diary was shown to be a usable and feasible self-monitoring tool when used by adolescents and young adults with headaches for 14 days. This study provides preliminary support of its psychometric properties. Our diary has the potential for helping users to better understand their headaches and, consequently, to change behaviors to improve self-management of their headaches. Its effectiveness as a component of an intervention will be the focus of future research.

Testing the four-factor model of personality vulnerability to alcohol misuse: a three-wave, one-year longitudinal study

The 4-factor model of personality vulnerability identifies 4 personality risk factors for alcohol misuse: hopelessness, anxiety sensitivity, impulsivity, and sensation seeking. These personality traits are associated with distinct mechanisms and motivations for alcohol misuse. Individuals high in hopelessness drink to regulate dysphoric affect, while those high in anxiety sensitivity drink to reduce anxiety and to conform to peer expectations. Individuals high in sensation seeking are highly sensitive to the rewarding properties of alcohol, and misuse alcohol to maximize enjoyment. Impulsivity is a broad risk factor contributing to all drinking motives. We hypothesized that personality vulnerabilities would indirectly predict alcohol quantity and problems through specific drinking motives theorized by the 4-factor model. The present study tested hypotheses using a 3-wave, 1-year longitudinal study of undergraduate drinkers (N = 302). Data were analyzed using multilevel path analysis. Hopelessness and impulsivity were positively related to drinking motives in the expected fashion. Anxiety sensitivity was related to coping-anxiety and conformity motives only in the between-subjects model (partially supporting hypotheses), while sensation seeking was generally unrelated to all drinking motives and alcohol outcomes (failing to support hypotheses). Enhancement motives predicted alcohol quantity and problems at both levels, coping-depression motives predicted alcohol problems at the between-subjects level only, and coping-anxiety, conformity, and social motives failed to predict alcohol outcomes beyond other motives. Overall, this study partially supports the 4-factor model, with the strongest support emerging for impulsivity and hopelessness. This study suggests that personality traits such as impulsivity and hopelessness may be important targets in prevention and treatment with undergraduate drinkers.

Telephone-delivered cognitive behavioral therapy for high anxiety sensitivity: a randomized controlled trial

OBJECTIVE

High anxiety sensitivity (AS) is associated with the development and maintenance of anxiety and depressive symptoms and is theorized to be a mediator of treatment outcomes for anxiety and depression. The present study tested the efficacy of a telephone-delivered cognitive behavioral therapy (CBT) intervention in reducing high AS and its associated anxiety and depressive symptoms.

METHOD

Treatment-seeking participants with high AS were recruited from the community (N = 80; M age = 36 years; 79% women; 76% Caucasian) and were randomly assigned to an 8-week telephone-delivered CBT program or a waiting list control. Participants completed anxiety and depression symptom and diagnostic measures at pre- and posttreatment, after a subsequent 4 weeks of continued interoceptive exposure, and 8 weeks later.

RESULTS

Multilevel modeling showed the treatment was successful in reducing AS, as well as panic, social phobia, posttraumatic stress symptoms, and number of Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) diagnoses per participant when compared to a waiting list control. These gains were maintained at follow-up. Generalized anxiety and depressive symptoms, however, did not improve as a result of treatment. Mediated moderation analyses suggested that treatment-related changes in AS may mediate anxiety symptom changes.

CONCLUSION

RESULTS of the present study provide promising evidence for this transdiagnostic treatment approach. Reductions in anxiety symptoms across diagnostic categories stemming from this AS-targeted intervention may have implications for helping a broad array of clients with various anxiety disorders that share AS as a common risk or maintenance factor.

Discrepancies confer vulnerability to depressive symptoms: a three-wave longitudinal study

Discrepancies (i.e., a subjective sense of falling short of one's own standards) are a key part of the perfectionism construct. Theory suggests discrepancies confer vulnerability to depressive symptoms. Since most research in this area is cross-sectional, longitudinal research is needed to disentangle directionality of relationships and to permit stronger causal inferences. Determining whether discrepancies are an antecedent of depressive symptoms, a consequence of depressive symptoms, or both is critical to understanding the discrepancies-depressive symptoms relationship. Knowledge about the temporal stability of discrepancies is also only starting to emerge, and it is unclear whether discrepancies predict incremental variance in depressive symptoms above and beyond neuroticism (i.e., a dispositional tendency to experience negative emotional states). The present study tested relationships among discrepancies, neuroticism, and depressive symptoms in 127 1st-year undergraduates using a 3-wave longitudinal design. Results suggest discrepancies may be understood as a trait-state where people are both highly consistent in their rank order on discrepancies and fluctuate somewhat in the level of discrepancies they experience at a particular point in time. As hypothesized, discrepancies predicted increases in depressive symptoms, even after controlling for neuroticism. Contrary to hypotheses, depressive symptoms did not predict changes in discrepancies. This study extends a long tradition of theory noting the depressing consequences of believing that one has fallen short of one's own standards. Harsh self-criticism and unobtainable self-expectations involving a strong sense of imperfection may be part of the premorbid personality of people vulnerable to depressive symptoms.

Caught in a bad romance: perfectionism, conflict, and depression in romantic relationships

According to the social disconnection model, perfectionistic concerns (i.e., harsh self-scrutiny, extreme concern over mistakes and others' evaluations, and excessive reactions to perceived failures) confer vulnerability to depressive symptoms indirectly through interpersonal problems. This study tested the social disconnection model in 226 heterosexual romantic dyads using a mixed longitudinal and experience sampling design. Perfectionistic concerns were measured using three partner-specific self-report questionnaires. Conflict was measured as a dyadic variable, incorporating reports from both partners. Depressive symptoms were measured using a self-report questionnaire. Perfectionistic concerns and depressive symptoms were measured at Day 1 and Day 28. Aggregated dyadic conflict was measured with daily online questionnaires from Days 2 to 15. Data were analyzed using structural equation modeling. There were four primary findings: (a) Dyadic conflict mediated the link between perfectionistic concerns and depressive symptoms, even when controlling for baseline depressive symptoms; (b) depressive symptoms were both an antecedent and a consequence of dyadic conflict; (c) perfectionistic concerns incrementally predicted dyadic conflict and depressive symptoms beyond neuroticism (i.e., a tendency to experience negative emotions) and other-oriented perfectionism (i.e., rigidly demanding perfection from one's partner); and (d) the relationships among variables did not differ based on gender. As the most rigorous test of the social disconnection model to date, this study provides strong support for this emerging model. Results also clarify the characterological and the interpersonal context within which depressive symptoms are likely to occur.

Reformulating and testing the perfectionism model of binge eating among undergraduate women: a short-term, three-wave longitudinal study

The perfectionism model of binge eating (PMOBE) is an integrative model explaining why perfectionism is related to binge eating. This study reformulates and tests the PMOBE, with a focus on addressing limitations observed in the perfectionism and binge-eating literature. In the reformulated PMOBE, concern over mistakes is seen as a destructive aspect of perfectionism contributing to a cycle of binge eating via 4 binge-eating maintenance variables: interpersonal discrepancies, low interpersonal esteem, depressive affect, and dietary restraint. This test of the reformulated PMOBE involved 200 undergraduate women studied using a 3-wave longitudinal design. As hypothesized, concern over mistakes appears to represent a vulnerability factor for binge eating. Bootstrapped tests of mediation suggested concern over mistakes contributes to binge eating through binge-eating maintenance variables, and results supported the incremental validity of the reformulated PMOBE beyond perfectionistic strivings and neuroticism. The reformulated PMOBE also predicted binge eating, but not binge drinking, supporting the specificity of this model. The reformulated PMOBE offers a framework for understanding how key contributors to binge eating work together to generate and to maintain binge eating.

Intimacy in young adults' narratives of romance and friendship predicts Eriksonian generativity: a mixed method analysis

A quantitative and qualitative study tested Erikson's ego developmental hypotheses regarding the positive relationship between generativity and intimacy. At age 26, participants (N = 100) told 2 stories about "relationship-defining moments," one about a romantic partner, and another about a same-sex friend. Levels of relationship intimacy were coded from these narratives. "True love" and "true friendship" themes arose as the most prototypical, highly intimate stories. Romantic intimacy and friendship intimacy as coded from narratives each contributed uniquely to the prediction of generative concern; as intimacy in each domain increased, so did generative concern. This relationship remained statistically significant, even when controlling for gender, current romantic relationship status, subjective well-being, optimism, and depressive symptoms. Results suggest that our "relationship-defining moment" narrative task is a useful tool for examining development in emerging adulthood and that intimacy may be an important precursor to generative concern in early adulthood, consistent with Erikson's model.

Birds of a Feather Sit Together: Physical Similarity Predicts Seating Choice

Across four studies, people sat (or reported they would sit) closer to physically similar others. Study 1 revealed significant aggregation in seating patterns on two easily observed characteristics: glasses wearing and sex. Study 2 replicated this finding with a wider variety of physical traits: race, sex, glasses wearing, hair length, and hair color. The overall tendency for people to sit beside physically similar others remained significant when controlling for sex and race, suggesting people aggregate on physical dimensions other than broad social categories. Study 3 conceptually replicated these results in a laboratory setting. The more physically similar participants were to a confederate, the closer they sat before an anticipated interaction when controlling for sex, race, and attractiveness similarity. In Study 4, overall physical similarity and glasses wearing similarity predicted self-reported seating distance. These effects were mediated by perceived attitudinal similarity. Liking and inferred acceptance also received support as mediators for glasses wearing similarity.