Family and child influences on early academic and emotion regulatory behaviors

Research on child and family factors in early childhood has shown that both are associated with social and instrumental functioning at school entry. The present study sought to examine the direct and indirect effects of child negative emotionality, maternal education, depression, IQ, and quality of maternal instruction on children's academic and emotion regulatory behaviors from the toddler period to school entry using a sample of 174 boys from low-SES backgrounds. Results revealed direct effects of maternal IQ on academic outcomes at school entry that were mediated by maternal instruction. Further, maternal instruction predicted the child's academic and emotion regulation (ER) outcomes even after accounting for other maternal and child variables. The effects of both instruction variables moderated the impact of maternal education. The results suggest that maternal instruction plays an important role in early school success, particularly for children at risk for school problems.     

Meditation buffers medical student compassion from the deleterious effects of depression

Increasing data suggest that for medical school students the stress of academic and psychological demands can impair social emotions that are a core aspect of compassion and ultimately physician competence. Few interventions have proven successful for enhancing physician compassion in ways that persist in the face of suffering and that enable sustained caretaker well-being. To address this issue, the current study was designed to (1) investigate the feasibility of cognitively-based compassion training (CBCT) for second-year medical students, and (2) test whether CBCT decreases depression, enhances compassion, and improves daily functioning in medical students. Compared to the wait-list group, students randomized to CBCT reported increased compassion, and decreased loneliness and depression. Changes in compassion were most robust in individuals reporting high levels of depression at baseline, suggesting that CBCT may benefit those most in need by breaking the link between personal suffering and a concomitant drop in compassion.     

An Assessment of Medical School Stressors on Preclinical Students’ Levels of Clinical Empathy

This study examines the impact of medical school-specific stressors on potential changes in medical students’ levels of clinical empathy. A total of 352 students at a U.S. medical school completed questionnaires at the beginning and the end of the 2007–2008 academic year. Subjects were found to decrease significantly in levels of empathy, although these changes were minimal. The negative impact of medical school-specific stressors was found to not significantly affect students’ changes in clinical empathy, yet correlation analyses showed that students high in clinical empathy were more likely to report that significant medical school stressors had more negative impact on their lives. Whereas medical school stress may not be a direct cause of the decline in empathy, students may be adapting to their environment by shedding empathy in order to become less vulnerable to the negative impact of the stressors.     

Somatization, psychiatric disorder, and stress in utilization of ambulatory medical services

Examined the prediction from Mechanic's (1972) attribution theory of somatization that somatizers who are under stress will overuse ambulatory medical services. Two hundred fourteen volunteer patients from university ambulatory care clinics completed the Diagnostic Interview Schedule and the Life Experiences Inventory. We examined somatization, psychiatric diagnoses, and life stress-and the interaction of these factors-in predicting frequency of medical visits during the preceding year, after controlling for need (active medical problems) and predisposing factors. As hypothesized, life stress interacted with somatization in predicting number of medical visits; somatizers who were under stress made more visits to the clinics than did nonsomatizers or somatizers who were not under stress. Although stress affected somatizers most, stress was predictive of increased medical utilization for all patients. These results suggest that psychological services intended to reduce overutilization of outpatient medical services might best focus on stress reduction and be most beneficial to somatizers.     

Age and gender differences in adolescents' homework experiences

Extant data collected through the Experience Sampling Method were analyzed to describe adolescents' subjective experiences of homework. Analyses explored age and gender differences in the time adolescents spend doing homework, and the situational variations (location and companions) in adolescents' reported concentration, effort, interest, positive affect and stress while doing homework. Regarding age differences, middle school students reported more positive experiences when homework was done with companions and in locations other than home, whereas high school students reported more positive experiences when homework was done alone and at home. Regarding gender differences, girls, regardless of age, reported greater stress than boys when doing homework alone, and lower stress when doing homework with friends. High school girls reported lower interest than middle school boys when doing homework alone. Findings provide an understanding of age and gender differences in adolescents' perceptions of homework, which might help educators and parents structure engaging homework environments.     

The behaviour style observation system for young children predicts teacher‐reported externalizing behaviour in middle childhood

The Behaviour Style Observation System for Young Children (BSOS) was used to predict preschool‐aged children's externalizing and internalizing behaviour problems in middle childhood, 3–5 years after the initial assessment. This observational measurement tool was designed to sample and assess young children's disruptive, non‐compliant, and unresponsive behaviour, during a brief (11 min) observation in the child's home. In the current study, the BSOS was used to predict parent and teacher ratings of child behaviour problems after school entry in a longitudinal sample (N=81) of at‐risk children at time 2. The BSOS predicted teacher‐reported externalizing problems at time 2. In contrast, parent reports of behaviour problems, although correlated with repeated parent reports at time 2, were not significantly predictive of teacher‐reported behaviour problems at school age. The BSOS was not associated with either parent or teacher reports of internalizing problems. These findings emphasize the importance and utility of using observational measures when examining the continuity of behaviour problems in young children over time. Copyright © 2009 John Wiley & Sons, Ltd.     

Medical school oath-taking: the moral controversy

Professions typically formulate codes of ethics. Medical students are exposed to various codes and often are expected to recite some code or oath at their graduation. This article reports the findings of a study of one large medical class, asked upon entry to medical school and again at the beginning of their fourth term, which of 13 specified professional, religious, and secular codes of ethics they would turn to for moral guidance in their practice of medicine. The study finds great diversity in the students' choices and no clear pattern of change by their fourth term. Very few students chose the oath they would be asked to recite at their graduation. The article probes the problems this creates for school administrators and professors as well as students. It asks the implications for professional oath-taking at graduation and in the practice of the profession.     

Beginning Medical School: Determinants of Male and Female Emotional Reactions1

With the knowledge that medical students experience a variety of academic pressures as well as interpersonal stress during medical school, an assessment was made of emotional reactions among male and female students during the initial months of medical training. Questionnaires were completed at the start of school and 4 months later for the incidence of positive and negative emotions and tension-related symptoms. Students also estimated their midterm grade point average (GPA) and rated the friendliness of their peers and their experience of sex discrimination. By midterm, all students experienced negative emotions and symptoms more frequently and positive emotions less frequently than at the beginning of the school year. Additionally, women students reported more negative affect and physical symptoms at both time points than men. Women also reported a greater decrease in positive emotions and perceived peer friendliness than men. Higher anticipated GPA was associated with more frequent experience of positive emotions and less frequent negative emotions and physical symptoms in both sexes, but this pattern was stronger for women than for men. The implications of these findings are discussed.     

Developmental trajectories of disruptive behavior problems among sons of alcoholics: effects of parent psychopathology,family conflict,and child undercontrol

This study examined trajectories of disruptive behavior problems from preschool to early adolescence in 302 boys from a community-recruited sample of high-risk families. Growth modeling showed that paternal alcoholism was associated with elevated levels of sons' disruptive behavior problems. Family conflict predicted more disruptive behaviors at school entry and a slower rate of decline in such problems. Parent antisocial personality disorder (ASPD) exacerbated the effects of high preschool levels of sons' undercontrol on level of disruptive behaviors at school entry; this effect became progressively stronger across time. Low levels of undercontrol protected sons of ASPD parents from experiencing heightened levels of disruptive behaviors both at school entry and increasingly as sons grew older. Implications for subsequent maladjustment are discussed.     

Implementation trial of a cognitive behavioural therapy programme for reducing student stress in the final year of secondary school

The final year of secondary school has been shown to be associated with heightened student stress. Psychological interventions have been shown to be effective in reducing and preventing distress in students during this school period, although the widespread adoption of these interventions into school settings is limited. There have been recent calls for research to examine the implementation success of evidence-based programmes when used by schools in school settings. The present study aimed to evaluate the implementation success of an evidence-based cognitive-behavioural therapy programme (Study without Stress) using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. At one Australian high school, all tutor group teachers were trained by the school counsellor to deliver the programme in standard school classes to students in the lead up to their final year of secondary school. Students (n = 80) and teachers (n = 11) reported on programme success against the RE-AIM framework at pre-intervention, post-intervention, and three-month follow-up. The findings indicated that SWOS was implemented successfully by the school. SWOS was associated with maintaining student stress levels at normal levels over time, as well as reducing the severity of stress for initially highly distressed students. The findings provide evidence from implementation science that SWOS can be adapted and delivered effectively by school staff to manage stress in final year secondary school students.     

Proactive Socialization and Behavioral Self-Management

The purpose of this study was to examine behavioral self-management as a form of newcomer proactive socialization behavior. A longitudinal field study was conducted with a sample of 153 entry-level professionals who completed questionnaires during their first month of entry and 6 months after entry. The results indicated that self-management behavior was related to newcomers’ general anxiety and stress at entry, and to internal motivation, ability to cope, and task-specific anxiety 6 months later. In addition, anxiety and stress at entry were found to mediate the relationships between self-management and ability to cope and task-specific anxiety. The research and practical implications of these findings are discussed. It is recommended that future research integrate the self-management and information seeking perspectives to provide a more complete theory of proactive socialization.     

Job change: A study of an acute job stressor

This paper studies the relationship between job entry and job stress. Skill uncertainty, defined as having inadequately developed job skills, was thought to be associated with the stress reaction. In a longitudinal study of 62 transferred employees, skill uncertainty was associated with both negative emotional arousal 1 month after job entry and with positive emotional arousal 3 months after job entry.     

Perceived sources and levels of stress,general self-efficacy and coping strategies in clinical dental students

The aims of this study were to identify sources of stress among clinical students and to evaluate the students’ perceived levels of stress, general self-efficacy and effective coping strategies in a private dental school environment. The study group consisted of 130 undergraduate clinical dental students in a Turkish private dental school, during the academic year 2014–2015. The students were surveyed using modified version of the dental environment stress (DES) survey, the perceived stress scale, the general self-efficacy scale (G-SES) and the brief coping scale. Age, sex, year of study, history of psychiatric treatment and factors that affected the choice of dentistry were also recorded. Final year and female clinical dental students, who were found to be the most stressful students, had moderate to high perceived stress scores. Total and ‘Faculty and administration’ related DES scores increased with the year of study. Stressors related to ‘Workload’ and ‘Clinical training’ affected females more than males. G-SES scores were higher in male students and students, who had no history of psychiatric treatment. The most and the least common coping strategies were ‘Planning’ and ‘Substance abuse’, respectively. ‘Religion’ was found to be one of the main coping strategies. Stress factors affecting Turkish clinical dental students studying at private dental school differed from the previously reported stress factors affecting students studying at a governmental dental school. Advanced year and female students experienced more stress than the other students.     

Home-based family intervention for low-income children with asthma: a randomized controlled pilot study

Low-income African American children have disproportionately higher asthma morbidity and mortality. Education alone may not address barriers to asthma management due to psychosocial stress. This study evaluated the efficacy of a home-based family intervention integrating asthma education and strategies to address stress using a community-based participatory research model. Children age 8 to 13 with poorly controlled asthma and their caregivers were recruited from an urban hospital and an asthma camp. Caregivers with elevated scores on a stress measure were enrolled. Forty-three families were randomized to the 4- to 6-session Home Based Family Intervention (HBFI) or the single session of Enhanced Treatment as Usual (ETAU). All families received an asthma action plan and dust mite covers; children performed spirometry and demonstrated MDI/spacer technique at each home visit. The HBFI addressed family-selected goals targeting asthma management and stressors. Asthma management, morbidity, family functioning, and caregiver stress were assessed at baseline, postintervention, and 6 months after the intervention. ED visits and hospitalizations were ascertained by medical record review for a year after intervention completion. Only one child (5%) in HBFI had an asthma-related hospitalization compared to 7 patients (35%) in ETAU in the year following intervention. Participants in both groups demonstrated improved asthma management and family functioning, and reduced ED visits, symptom days, missed school days, and caregiver stress, but there were no differential treatment effects. The results suggest that a home-based intervention addressing medical and psychosocial needs may prevent hospitalizations for children with poorly controlled asthma and caregivers under stress.     

The prevalence and correlations of medical student burnout in the pre-clinical years: a cross-sectional study

Burnout is a psychological syndrome of emotional exhaustion, depersonalization, and impaired personal accomplishment induced by repeated workplace stressors. Current research suggests that physician burnout may have its origins in medical school. The consequences of medical student burnout include both personal and professional distress, loss of empathy, and poor health. We hypothesized that burnout occurs prior to the initiation of the clinical years of medical education. This was a cross-sectional survey administered to third-year medical students at the Mount Sinai School of Medicine (MSSM) in New York, New York (a traditional-style medical school with a marked division between pre-clinical and clinical training occurring at the beginning of the third year). Survey included an instrument used to measure job burnout, a sleep deprivation screen, and questions related to demographic information, current rotation, psychiatric history, time spent working/studying, participation in extracurricular activities, social support network, autonomy and isolation. Of the 86 medical students who participated, 71% met criteria for burnout. Burnt out students were significantly more likely to suffer from sleep deprivation (p?=?0.0359). They were also more likely to disagree with the following statements: "I have control over my daily schedule" (p?=?0.0286) and "I am confident that I will have the knowledge and skills necessary to become an intern when I graduate" (p?=?0.0263). Our findings show that burnout is present at the beginning of the third year of medical school, prior to the initiation of the clinical years of medical training. Medical student burnout is quite common, and early efforts should be made to empower medical students to both build the knowledge and skills necessary to become capable physicians, as well as withstand the emotional, mental, and physical challenges inherent to medical school.     

Entering Prostitution in Adolescence: History of Youth Homelessness Predicts Earlier Entry

The effect of youth homelessness on age of entry into prostitution was tested, controlling for other known covariates using a multivariate model. Women (N = 96) who self-identified as having engaged in prostitution completed cross-sectional standardized questionnaires (M_age = 42.6, SD = 9.18; 62% African American). Women with a history of youth homelessness entered prostitution nearly 8 years earlier than their peers without this history (at 18 vs. 25 years old). Lack of a high school degree or equivalent also predicted an earlier age of entry (at 20 vs. 28 years old). Findings highlight the poverty dynamics that underlie the relationship between early entry into prostitution and homelessness. Young women, living on the street or in shelters, with limited education and employment opportunities, are at high risk of entering prostitution when they are barely out of adolescence. Future research will be better able to design age-specific prevention strategies.     

社会支持、主动反刍与创伤后应激障碍的关系:来自地震后青少年的追踪研究

以追踪研究的方式,在汶川地震后3.5年、4.5年和5.5年三个时间点,采用社会支持问卷、反刍问卷和创伤后应激障碍量表对汶川地震后245名中学生进行调查。通过建立交叉滞后模型,考察社会支持、主动反刍与创伤后应激障碍(PTSD)的相互作用关系。结果发现,震后3.5年至5.5年间,社会支持与主动反刍之间的跨时间点预测作用不显著,PTSD对社会支持的跨时间点预测作用不显著,但对主动反刍具有显著的跨时间点正向预测作用。震后3.5年至4.5年间,社会支持对PTSD的跨时间点负向预测作用、主动反刍对PTSD的跨时间点正向预测作用均显著,但是这些作用在震后4.5年至5.5年间变得不再显著。     

Coping as a personality process: a prospective study

The study tested the proposition that coping is personality in action under stress. Using a stressful medical school entrance examination, the study examined (a) whether neuroticism emerged in coping patterns over time and (b) whether the influence of neuroticism on coping accounted for changes in anxiety and examination performance. Fifty premedical students reported their coping efforts at 35 days before, 10 days before, and 17 days after the examination. They provided daily reports of anxiety for 35 days surrounding the examination. Neuroticism influenced coping efforts and increases in daily anxiety under stress. Two types of coping, wishful thinking and self-blame, explained over half the relationship between neuroticism and increases in preexamination anxiety. Consistent with previous research, neither neuroticism nor specific coping efforts influenced examination performance.     

Physicians' values and their career stage

Professional values of 241 practicing physicians were determined from factor analyzing their responses to 25 questionnaire items dealing with an ideal medical school in their vicinity. The seven factors (values)—(1) Academic, (2) Professional Separatism, (3) Support, (4) Social Welfare, (5) Research/Specialization, (6) Status/ Prestige, and (7) Convenience—were examined for their relationship to background characteristics (e.g., training) and practice (e.g., specialty). Few differences were found. However, when values were analyzed by age and career stage, significant fluctuations were found. Levinson's adult development theory was able to account for a sizeable portion of the observed variations. Practical and theoretical consequences are discussed in connection with physician stress at critical career stages.     

Academic achievement of low birthweight children at age 11: the role of cognitive abilities at school entry

We examine the extent to which deficits in academic achievement in low birthweight (LBW) children at age 11 are explained by deficits in cognitive abilities at school entry. Data come from a longitudinal study of a stratified sample of LBW and normal birthweight (NBW) children from an innercity and middle class suburbs in the Detroit area. Woodcock-Johnson Psychoeducational Battery-Revised was used to measure reading and math at age 11. WISC-R and specific neuropsychologic tests were administered at age 6. On reading, the LBW-NBW difference was -3.6 points (SE = 1.2). The difference was explained almost entirely by IQ at age 6. On math, the LBW-NBW difference was -6.1 points (SE = 1.1). The difference on math was trivial and not significant, when IQ and neuropsychological tests at age 6 were controlled. Level of LBW was unrelated to reading, but it had a gradient relationship with math, with birthweight < or = 1,500 g associated with a greater deficit than heavier LBW. The results imply that most of the LBW-NBW gap in academic achievement at age 11 could be eliminated by eliminating differences in cognitive abilities at age 6. Interventions to improve academic performance of LBW children should focus on the preschool years.