Age-Related Differences in Identity Style: A Cross-Sectional Analysis

The Identity Style Inventory–Revised for a Sixth-Grade Reading Level (ISI-6G) was administered to samples of community college students (N = 99) and middle school and high school students (N = 320). Tests of between-groups differences indicated that the college sample had a significantly lower mean diffuse-avoidant score on the ISI-6G than the middle and high school sample. In terms of actual assignment to identity styles, college students were significantly more likely to be classified as informational or normative, while the younger students were more likely to be diffuse-avoidant. The mean ages of participants for each of the three identity styles were compared, and it was found that diffuse-avoidant participants had the lowest mean age (15.54 years), while individuals with an informational orientation had the highest mean age (17.20 years). Results suggest that, in general, identity style evolves with age and maturity and the general trajectory or progression involves movement away from a diffuse-avoidant orientation. Findings are discussed in terms of current knowledge of neurocognitive development during adolescence and early adulthood.     

Health Related Quality of Life After Percutaneous Coronary Revascularisation in Patients with Previous Coronary Artery Bypass Grafts: A Two-Year Follow Up Study

Percutaneous coronary revascularisation [PCR] improves angina and health related quality of life [HRQOL] compared to standard medical therapy. It is unknown whether PCR has the same benefits for patients with a history of CABG. Over a period of 5 years, we assessed HRQOL of patients undergoing PCR using Part 1 of the Nottingham Health Profile [NHP] at baseline 3, 12 and 24 months. We compared HRQOL after PCR in 255 patients with CABG to 2680 without. There were more males [81.1% v 69.6% p = 0.002] and older patients [mean age 60.1 years v. 58.0 p = 0.03] in CABG group. Perceived HRQOL improved at 24 months for pain, energy and emotional reaction but the improvement was less in the CABG group. However, mean NHP scores at 24 months for those with CABG had returned to baseline levels for sleep [34.9] and for physical function was worse than at baseline [22.0 vs 30.7]. This relationship persisted after adjustment for male sex, history of previous MI and coronary stent usage. Patients with previous CABG had less improvement in HRQOL after PCR. Further work is needed to assess the benefits and cost effectiveness of PCR in these patients.     

The Effects of Weight Loss Attempts, Exercise Initiation, and Dietary Practices on Health Related Quality of Life

This study (N = 98) randomly placed participants in either a higher protein or American Heart Association diet group with each group initiating an aerobic exercise program. Body composition (BC) was measured using four different methodologies (DEXA, BIA, skinfold, BMI) along with height and weight, while Health-Related Quality of Life (HRQOL) changes were measured using the Medical Outcomes Short Form 36 (SF-36). There were no significant time/diet interactions in HRQOL scores, body fat measures, and weight with the exception of Role-Physical scores (p = .006) with posttest scores higher in participants in Diet 1. Role-Physical scores changed significantly in participants in Diet 1 (p = .0001) and Diet 2 (p = .026) with higher posttest scores in each group. Social functioning had a significant main effect for time in both groups with pretest scores in both diet groups lower than their respective posttest scores (p = .015). HRQOL pretest scores were not significantly different between groups at baseline (p = .56). ANOVA revealed no significant differences in average calories between groups (p = .88). Analysis revealed no differences in exercise in minutes (p = .66) nor statistically significant changes in BC or weight (p = .65). Conclusions: Improvements in HRQOL were demonstrated in two subscales related to physiological and psychological functioning. These novel findings add to literature suggesting that HRQOL, at least concerning social functioning, work and other daily activities (Role-Physical) may improve by initiating an exercise and dietary program even when weight loss or BC improvements have been unsuccessful.     

Post Traumatic Stress,Context, and the Lingering Effects of the Hurricane Katrina Disaster among Ethnic Minority Youth

This study examined the stability of post traumatic stress disorder (PTSD) symptoms in a predominantly ethnic minority sample of youth exposed to Hurricane Katrina. Youth (n = 191 grades 4th thru 8th) were screened for exposure to traumatic experiences and PTSD symptoms at 24 months (Time 1) and then again at 30 months (Time 2) post-disaster. PTSD symptoms did not significantly decline over time and were higher than rates reported at earlier time points for more ethnically diverse samples. Younger age, female sex, and continued disrepair to the child’s home predicted stable elevated PTSD symptoms. Findings are consistent with predictions from contextual theories of disaster exposure and with epidemiological data from adult samples suggesting that the incidence of PTSD post Katrina is showing an atypical pattern of remittance. Theoretical, applied, and policy implications are discussed.     

Acculturation and Familiarity With, Attitudes Towards and Beliefs about Genetic Testing for Cancer Risk Within Latinas in East Harlem, New York City

Recent research underscores the need for increasing use of genetic testing for cancer risk in Latinos. This study examined the influence of acculturation on attitudes, beliefs about and familiarity with genetic testing for cancer risk in a community-based sample of Latinas in East Harlem, New York City (N = 103). Multivariate linear regression models analyzed the relationship of acculturation to: (1) familiarity (2) perceived benefits (3) perceived barriers and (4) concerns about abuses of genetic testing for cancer risk. Controlling for sociodemographic factors, results revealed that with increasing acculturation Latinas were more familiar with genetic testing (β = 1.62, SE = 0.72, p = 0.03), more likely to cite perceived benefits (β = 1.67, SE = 0.79, p = 0.04), and less likely to report perceived barriers related to genetic testing (β = −2.76, SE = 1.64, p = 0.10). Study results may help inform the development of culturally-appropriate health education outreach materials and programs targeted to increase awareness, knowledge and understanding about genetic testing for cancer risk within Latinas.     

Relations Among Perceived Control Over Anxiety-Related Events,Worry, and Generalized Anxiety Disorder in a Sample of Adolescents

This study examined the associations among perceived control over anxiety-related events, worry, and both symptoms and diagnoses of generalized anxiety disorder (GAD). The sample was comprised of 140 adolescents (60 girls) between the ages of 10 and 17 years (M _age  = 14.6 years; SD = 2.25) recruited from the general community. Findings were consistent with hypotheses. Self-reported perceived control over anxiety-related events related negatively to worry as well as symptoms and diagnoses of GAD even after accounting for variance associated with age, gender, and negative affectivity. Results are discussed in terms of the theoretical implications that perceived control over anxiety-related events may have for understanding GAD symptomatology among youth.     

Executive Function in Very Preterm Children at Early School Age

We examined whether very preterm (≤30 weeks gestation) children at early school age have impairments in executive function (EF) independent of IQ and processing speed, and whether demographic and neonatal risk factors were associated with EF impairments. A consecutive sample of 50 children (27 boys and 23 girls) born very preterm (mean age = 5.9 years, SD = 0.4, mean gestational age = 28.0 weeks, SD = 1.4) was compared to a sample of 50 age-matched full-term controls (23 girls and 27 boys, mean age = 6.0 years, SD = 0.6) with respect to performance on a comprehensive EF battery, assessing the domains of inhibition, working memory, switching, verbal fluency, and concept generation. The very preterm group demonstrated poor performance compared to the controls on all EF domains, even after partialing out the effects of IQ. Processing speed was marginally related to EF. Analyses with demographic and neonatal risk factors showed maternal education and gestational age to be related to EF. This study adds to the emerging body of literature showing that very preterm birth is associated with EF impairments.     

Associations of Health-Related Quality of Life with Healthcare Utilization Status in Veterans

Evidence indicates that veterans using VA healthcare services have poor health-related quality of life (HRQOL). Little is known, however, about differences in HRQOL among those who only use VA services and those who also use non-VA services. We sought to evaluate differences in HRQOL among veterans who use: (1) only non-VA services (2) only VA services and (3) both VA and non-VA services (i.e., dual users). A cross-sectional study of 39,942 US veterans who completed the CDC’s 2004 Behavioral Risk Factor Surveillance System (BRFSS) survey was analyzed. Self-rated measures of global health status and the number of days per month that veterans were limited by physical or mental problems were extracted from BRFSS survey data as outcomes. Multivariate logistic regression demonstrated that, compared to those receiving all healthcare outside of VA, veterans receiving VA care were more likely to report poorer health outcomes, including worse global health status, greater impairments in physical functioning, and increased limitations regarding routine activities (p’s ≤ .05). Both exclusive and dual users of VA services reported poorer HRQOL than individuals not using VA services. More research is needed regarding veterans’ health status, particularly in the context of dual use.     

Physical Activity, Life Satisfaction, and Self-Rated Health of Middle School Students

Little research has examined the association between life satisfaction, self-rated health (SRH), and physical activity concurrently for middle school students. A convenience sample of 245 students in grades 7 and 8 was surveyed about physical activity, life satisfaction, and SRH using the U.S. Centers for Disease Control and Prevention (CDC) 2005 Middle School Youth Risk Behavior Survey. ANOVA analyses revealed significantly reduced life satisfaction for females who reported not engaging in vigorous physical activity during the past 7 days [p < .01, effect size (ES) = .75]. Significantly reduced life satisfaction was detected for both males (p < .001, ES = .66) and females (p < .0001, ES = .80) who reported not playing on sports teams. Additionally, logistic regression analyses showed the odds of reporting fair/poor SRH increased 5.4 times for males (CI = 1.30–22.39, p < .05) and 30.9 times for females (CI = 3.74–255.43, p < .001) who reported not playing on sports teams. Preliminary findings suggest physical activity and sports participation is associated with improved life satisfaction and SRH for middle school students. In addition, although some gender differences were observed, consistent findings for sports participation suggest sports participation may carry multiple social, mental, and physical benefits for youth.     

Within-Family Differences in Internalizing Behaviors: The Role of Children’s Perspectives of the Mother-child Relationship

The goal of this exploratory, within-family, longitudinal study was to examine whether children’s perspectives of the mother-child relationship explained within-family differences in children’s responses to a shared family stressor (maternal depressive symptoms) over time. Children (ages 8 to 15 years; N = 68) residing in 34 families were drawn from a general population study in the UK. Predictor variables were assessed at Time 1 and change in internalizing behavior from Time 1 to Time 2 (2 years later) was examined. As children were nested within families, data were analyzed using multilevel modeling, controlling for previous child behavior. Child perspective of the mother-child relationship, in interaction with maternal depressive symptoms, was found to explain within-family differences in internalizing over time. Children with a negative perspective (compared to mothers’ perspectives) were the most vulnerable to the adverse effects of maternal depressive symptoms.     

The Interplay Between Post-Critical Beliefs and Anxiety: An Exploratory Study in a Polish Sample

The present research investigates the relationship between anxiety and the religiosity dimensions that Wulff (Psychology of religion: classic and contemporary views, Wiley, New York, 1991; Psychology of religion. Classic and contemporary views, Wiley, New York, 1997; Psychologia religii. Klasyczna i współczesna, Wydawnictwo Szkolne i Pedagogiczne, Warszawa, 1999) described as Exclusion vs. Inclusion of Transcendence and Literal vs. Symbolic. The researchers used the Post-Critical Belief scale (Hutsebaut in J Empir Theol 9(2):48–66, 1996; J Empir Theol 10(1):39–54, 1997) to measure Wulff’s religiosity dimensions and the IPAT scale (Krug et al. 1967) to measure anxiety. Results from an adult sample (N = 83) suggest that three dimensions show significant relations with anxiety. Orthodoxy correlated negatively with suspiciousness (L) and positively with guilt proneness (O) factor—in the whole sample. Among women, Historical Relativism negatively correlated with suspiciousness (L), lack of integration (Q3), general anxiety and covert anxiety. Among men, Historical Relativism positively correlated with tension (Q4) and emotional instability (C), general anxiety, covert anxiety and overt anxiety. External Critique was correlated with suspiciousness (L) by men.     

Hyperactivity in Boys with Attention-Deficit/Hyperactivity Disorder (ADHD): A Ubiquitous Core Symptom or Manifestation of Working Memory Deficits?

Hyperactivity is currently considered a core and ubiquitous feature of attention-deficit/hyperactivity disorder (ADHD); however, an alternative model challenges this premise and hypothesizes a functional relationship between working memory (WM) and activity level. The current study investigated whether children’s activity level is functionally related to WM demands associated with the domain-general central executive and subsidiary storage/rehearsal components using tasks based on Baddeley’s (Working memory, thought, and action. New York: Oxford University Press 2007) WM model. Activity level was objectively measured 16 times per second using wrist- and ankle-worn actigraphs while 23 boys between 8 and 12 years of age completed control tasks and visuospatial/phonological WM tasks of increasing memory demands. All children exhibited significantly higher activity rates under all WM relative to control conditions, and children with ADHD (n = 12) moved significantly more than typically developing children (n = 11) under all conditions. Activity level in all children was associated with central executive but not storage/rehearsal functioning, and higher activity rates exhibited by children with ADHD under control conditions were fully attenuated by removing variance directly related to central executive processes.

Further Evidence of the Reliability and Validity of the Multidimensional Anxiety

The psychometric properties of the Multidimensional Anxiety Scale for Children (MASC) were examined in adolescent psychiatric inpatient samples. In Study 1 (n = 287), confirmatory factor analyses provided satisfactory fit for the four-factor (comparative fit index; CFI = 0.856) and higher-order (CFI = 0.854) solutions. Using parcels as items, the fit of the four-factor model was improved substantially (CFI = 0.935). Next, in the bifactor analyses, support was attained for a model that included a general factor and four domain specific subfactors. In Study 2 (n = 195 inpatient youths), the MASC showed good scale reliability and concurrent validity. Results of the receiver operating characteristic curve and binary logistic regression analyses provided adequate evidence for discriminative validity. In Study 3 (n = 40), test–retest reliability of scores on the MASC-10 scale over a 3-week period was adequate (r _tt = 0.83, p < 0.001) for children ages 8 to 11 years.     

Predicting Health-related Quality of Life: Testing the Contextual Model Using Structural Equation Modeling

This study aims to investigate the utility of the Contextual Model of Health-Related Quality of Life (HRQOL) to explain the relationship among the domains of HRQOL with a diverse, population-based sample of breast cancer survivors (BCS). We employed a cross-sectional design to investigate HRQOL among 703 multiethnic, population-based BCS. The study methodology was guided by the Contextual Model of HRQOL. Structural Equation Modeling (SEM) was conducted to assess the hypothesized model. SEM identified significant relationships among the bio-psychological domain (general health status, cancer-related factors, and psychological factors), the cultural-socio-ecological domain (health care satisfaction, socio-ecological factor, and socio-economic status), and HRQOL. The best fitting model indicates direct pathways from ‘general health status’, ‘years since diagnosis’, ‘health care satisfaction’ and ‘socio-ecological factor’ to ‘HRQOL’ variables. Additionally, ‘socio-ecological factor’ and ‘socio-economic status’ variables were indirectly associated with HRQOL through ‘general health status’. Findings suggest that the Contextual Model of HRQOL adds valid factors to explain overall HRQOL and increases our understanding of the socio-ecological dimensions predicting HRQOL outcomes. The revelation of inter-relations among the dimensions of HRQOL may inform the translational and clinical utility of the HRQOL construct.

Test of a Factor Mixture-Based Taxonic-Dimensional Model of Anxiety Sensitivity and Panic Attack Vulnerability among University and Clinical Samples in Mexico City

The aim of the present study was to evaluate a factor mixture-based taxonic-dimensional model of anxiety sensitivity (AS) (Bernstein et al. Behavior Therapy 41:515-521, 2010), as measured by the ASI-3 (Taylor et al. Psychological Assessment 19:176-188, 2007), in regard to panic attacks, anxiety symptoms, and behavioral impairment among a university sample (N = 150, n _females  = 107, M _age = 21.3 years, SD = 4.3) and a clinical sample (N = 150, n _females  = 102, M _age = 39.0 years, SD = 12.0) from Mexico City, Mexico. Findings demonstrated cross-national support for the conceptual and operational utility of the AS taxonic-dimensional hypothesis (Bernstein et al. Journal of Anxiety Disorders 20:1-22, 2007b). Specifically, (1) the FMM-based AS taxon class base rate was significantly greater among the clinical relative to the university sample; (2) risk for panic attacks was significantly greater among the AS taxon class relative to the AS normative class; and (3) continuous individual differences in AS physical and psychological concerns, within the AS taxon class, were associated with level of risk for panic attacks, as well as panic attack severity and anxiety symptom levels. Similar AS taxonic-dimensional effects were observed in relation to degree of behavioral impairment across domains of functioning. The study results are discussed with respect to their implications for better understanding the nature of AS-related cognitive vulnerability for panic and related anxiety psychopathology.     

Changes in Cognitive Function During Substance Use Disorder Treatment

This study investigated the pattern of acute cognitive function of an ecologically valid sample of 58 consecutively admitted adults completing a 24 day residential/day substance use disorder treatment program at a Veterans Affairs Medical Center and its change over the 24 days of monitored abstinence. Participants were assessed at entry with the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) Form A and at treatment conclusion with the RBANS Form B and with the Similarities subtest of the Wechsler Adult Intelligence Scale-III (WAIS-III) and the Trail Making A and B tests at both time points. There were significant (p < 0.002) improvements in the RBANS Immediate Memory, Attention, and Total Index scores over the course of treatment and on the Similarities subtest and the Trail Making A and B tests with effect sizes ranging between 0.37 and 0.56. There was greater cognitive performance increase for participants in the lower versus upper quantiles at treatment entry on all cognitive measures.     

Predictors of Heart-Focused Anxiety in Patients Undergoing Genetic Investigation and Counseling of Long QT Syndrome or Hypertrophic Cardiomyopathy: A One Year Follow-up

Since Long QT syndrome and Hypertrophic cardiomyopathy are inherited cardiac disorders that may cause syncope, palpitations, serious arrhythmias, and sudden cardiac death, at-risk individuals may experience heart-focused anxiety. In a prospective multi-site study, 126 Norwegian patients attending genetic counseling were followed 1 year with multiple administration of questionnaires, including the Cardiac Anxiety Questionnaire, measuring three distinct symptoms of heart-focused anxiety- avoidance, attention, and fear—in mixed linear analyses. Overall, at 1-year follow-up, patients with clinical diagnosis as compared to patients at genetic risk had significantly higher scores of avoidance (p < .002), attention (p < .005), and fear (p < .007). Sudden cardiac death in close relatives, uncertainty whether other relatives previously had undergone genetic testing, patients’ perceived general health, self-efficacy expectations and procedural satisfaction with genetic counseling were influential in predicting the different symptoms of heart-focused anxiety over time.     

Behavioral and Socio-emotional Functioning in Children with Selective Mutism: A Comparison with Anxious and Typically Developing Children Across Multiple Informants

We examined differences among 158 children, 44 with selective mutism (SM; M = 8.2 years, SD = 3.4 years), 65 with mixed anxiety (MA; M = 8.9 years, SD = 3.2 years), and 49 community controls (M = 7.7 years, SD = 2.6 years) on primary caregiver, teacher, and child reports of behavioral and socio-emotional functioning. Children with SM were rated lower than controls on a range of social skills, but the SM and MA groups did not significantly differ on many of the social skills and anxiety measures. However, children with SM were rated higher than children with MA and controls on social anxiety. Findings suggest that SM may be conceptualized as an anxiety disorder, with primary deficits in social functioning and social anxiety. This interpretation supports a more specific classification of SM as an anxiety disorder for future diagnostic manuals than is currently described in the literature. The present findings also have implications for clinical practice, whereby social skills training merits inclusion in intervention for children with anxiety disorders as well as children with SM.     

Health Related Quality of Life After Gastric Bypass Surgery

The majority of studies which have evaluated health related quality of life are limited in the duration of follow up. The objective of this study was to prospectively conduct an evaluation using a repeated cross sectional analysis of separate patient cohorts who were up to four years after gastric bypass surgery. Adult Roux-en-Y gastric bypass patients were recruited to the study. All patients were requested to complete a general health status questionnaire, the Short Form-36 (SF-36), before surgery or at their post operative out patient follow up visits. Patient weight was documented at each follow up visit. A cross sectional analysis was performed to evaluate SF-36 scores in each annual cohort. Data are reported as mean +/− S.D. Three-hundred-eight patients completed at least one SF-36 assessment [Initial assessment at the time of surgery, time 1, n = 245, 1y n = 149, 2y n = 70, 3y n = 59, 4y n = 61]. The SF-36 scores were greater (p < 0.05) in each of the separate post surgery cohorts for physical functioning, role limitations due to physical health, social functioning, pain, vitality, general health and the physical component summary (PCS) scores. While not comparing changes in scores within individuals over time, these data suggest early improvement especially in the physical dimension of health related quality of life. In this analysis, this finding was also observed in each of the separate cohorts up to 4 years after gastric bypass surgery.