Detection of Feigned ADHD across Two Domains: The MMPI-2-RF and CAARS for Faked Symptoms and TOVA for Simulated Attention Deficits

Psychological assessments of Attention Deficit/Hyperactivity Disorder (ADHD) must consider possible feigning of ADHD symptoms and simulated deficits on attentional measures. Studies have consistently found that motivated examinees can easily feign ADHD with little research focused on its detection. Via a between-subjects simulation design, the current study investigated the MMPI-2-RF and the Conners Infrequency Index (CII) in a university sample by comparing four groups: feigned ADHD, feigned mental disorders, genuine ADHD, and non-ADHD controls. Encouragingly, the CII evidenced moderate discriminability between feigned ADHD and (a) genuine ADHD (d?=?0.97) as well as (b) feigned mental disorders (d?=?0.96). Because the MMPI-2-RF F-family scores did not differentiate ADHD feigners from other feigners or genuine ADHD, a Dissimulation (Ds) ADHD (Ds-ADHD) scale was developed by utilizing erroneous stereotypes as the detection strategy. While requiring cross-validation, the initial data demonstrated good discriminant validity in distinguishing feigned ADHD from both genuine ADHD and general feigning. As noted in the Discussion, ADHD assessments must systematically take into account examinees’ level of effort and actively evaluate the possibility of feigned ADHD.     

Effectiveness of the MMPI-2-RF Validity Scales for Feigned Mental Disorders and Cognitive Impairment: A Known-Groups Study

The MMPI and MMPI-2 validity scales have long been accepted as standard tools in the assessment of feigned mental disorders (FMD) based on their extensive empirical validation. Studies are now examining MMPI-2-RF with modified validity scales plus the new Infrequent Somatic Responses Scale (F_S) and the recently-adapted Response Bias Scale (RBS). The current investigation used a known-groups design to examine the effectiveness of the MMPI-2-RF for differentiating FMD and feigned cognitive impairment (FCI) from patients with genuine disorders for a large civil forensic sample. Criterion measures included the Structured Interview of Reported Symptoms-2 (SIRS-2) for the FMD group, and below-chance performances on the Victoria Symptom Validity Test (VSVT) and the Test of Memory Malingering (TOMM) for the FCI group. For FMD, both F-r and F_P-r produced very large effect sizes (ds > 2.00). Moreover, the absence of severe elevations (≥80 T) on F-r proved effective at ruling-out most FMD. For the current study, a F_P-r cut score ≥90 T for FMD produced virtually no false-positives (0.01) and only a moderate level of false-alarms. As predicted by its detection strategies, most MMPI-2-RF validity scales have limited effectiveness with the FCI group. However, FBS-r and RBS may be useful in conjunction with other clinical data for ruling out FCI for genuine neuropsychological consults. An entirely separate concern is whether certain diagnostic groups, such as major depression, will have marked elevations on MMPI-2-RF scales thereby increasing the likelihood of false-positives. On this point, F_P-r performed exceptionally well with unelevated scores (Ms < 55 T) consistently across diagnostic categories.     

A Positive Psychology Intervention for Patients with an Acute Coronary Syndrome: Treatment Development and Proof-of-Concept Trial

Positive psychological constructs are associated with superior outcomes in cardiac patients, but there has been minimal study of positive psychology (PP) interventions in this population. Our objective was to describe the intervention development and pilot testing of an 8-week phone-based PP intervention for patients following an acute coronary syndrome (ACS). Initial intervention development and single-arm proof-of-concept trial, plus comparison of the PP intervention to a subsequently-recruited treatment as usual (TAU) cohort. PP development utilized existing literature, expert input, and qualitative interview data in ACS patients. In the proof-of-concept trial, the primary outcomes were feasibility and acceptability, measured by rates of exercise completion and participant ratings of exercise ease/utility. Secondary outcomes were pre-post changes in psychological outcomes and TAU comparisons, measured using effect sizes (Cohen’s d). The PP intervention and treatment manual were successfully created. In the proof-of-concept trial, 17/23 PP participants (74 %) completed at least 5 of 8 exercises. Participants rated the ease (M = 7.4/10; SD = 2.1) and utility (M = 8.1/10, SD = 1.6) of PP exercises highly. There were moderate pre-post improvements (ds = .46–.69) in positive affect, anxiety, and depression, but minimal effects on dispositional optimism (d = .08). Compared to TAU participants (n = 22), PP participants demonstrated greater improvements in positive affect, anxiety, and depression (ds = . 47–.71), but not optimism. A PP intervention was feasible, well-accepted, and associated with improvements in most psychological measures among cardiac patients. These results provide support for a larger trial focusing on behavioral outcomes.     

Does Group CBT for Depression Do What It Says on the Tin? A Systemic Review and Meta-analysis of Group CBT for Depressed Adults (2000–2016)

The present study aimed to update previous meta-analyses of gCBT, and focus specifically on recent studies in which the Beck Depression Inventory (BDI) was used to assess outcome. PsycINFO, PubMed, EMBASE, and Cochrane were searched for eligible studies. Both randomized controlled trials (RTC, k = 9) and non-RTCs (k = 1) published since 2000 were included. On the BDI large significant effect sizes were found for gCBT compared with treatment as usual (TAU, d = 4.64), wailing list controls (WLC, d = 1.20), and both of these comparison conditions combined with studies of well-defined alternative treatments (ALT, d = 1.61). On the BDI a moderate effect size (d = 0.53) was found for comparisons of gCBT and ALT groups. gCBT also had large and significant effects on depressive cognition assessed with the Automatic Thoughts Questionnaire and the Dysfunctional Attitudes Scale compared with WLC and ALT comparison groups (d = 2.66). This meta-analysis shows that gCBT is a robust intervention for depression in adults.     

Inattentive Behavior in Boys with ADHD during Classroom Instruction: the Mediating Role of Working Memory Processes

Children with ADHD exhibit clinically impairing inattentive behavior during classroom instruction and in other cognitively demanding contexts. However, there have been surprisingly few attempts to validate anecdotal parent/teacher reports of intact sustained attention during ‘preferred’ activities such as watching movies. The current investigation addresses this omission, and provides an initial test of how ADHD-related working memory deficits contribute to inattentive behavior during classroom instruction. Boys ages 8–12 (M = 9.62, SD = 1.22) with ADHD (n = 32) and typically developing boys (TD; n = 30) completed a counterbalanced series of working memory tests and watched two videos on separate assessment days: an analogue math instructional video, and a non-instructional video selected to match the content and cognitive demands of parent/teacher-described ‘preferred’ activities. Objective, reliable observations of attentive behavior revealed no between-group differences during the non-instructional video (d = ?0.02), and attentive behavior during the non-instructional video was unrelated to all working memory variables (r = ?0.11 to 0.19, ns). In contrast, the ADHD group showed disproportionate attentive behavior decrements during analogue classroom instruction (d = ?0.71). Bias-corrected, bootstrapped, serial mediation revealed that 59% of this between-group difference was attributable to ADHD-related impairments in central executive working memory, both directly (ER = 41%) and indirectly via its role in coordinating phonological short-term memory (ER = 15%). Between-group attentive behavior differences were no longer detectable after accounting for ADHD-related working memory impairments (d = ?0.29, ns). Results confirm anecdotal reports of intact sustained attention during activities that place minimal demands on working memory, and indicate that ADHD children’s inattention during analogue classroom instruction is related, in large part, to their underdeveloped working memory abilities.     

Identifying Beneficial Physical Activity During School Recess: Utility and Feasibility of the Fitbit

The purpose of the current study was to assess the utility, feasibility, and reliability of Fitbit accelerometers to measure physical activity (via steps) of 15 young children simultaneously during recess. Fitbit-recorded steps per minute (SPM) were used as the primary measure to assess levels of activity in children playing in various structured (i.e., instructed) and unstructured (i.e., free play) recess activities. The results suggested that the number of steps measured by two Fitbits resulted in high levels of agreement, and the Fitbits were successful at identifying differential levels of activity across multiple types of play activities. Across all children, running or walking was associated with the most SPM (M = 89) and highest percentage of moderate-to-vigorous physical activity (MVPA; M = 47%), followed by soccer (M = 58 SPM; M = 12% MVPA), free play (M = 53 SPM; 3% MVPA), and tag (M = 43 SPM; 7% MVPA). The utility of the Fitbit’s minute-by-minute data records was demonstrated, with the use of additional third-party software by Python, as differential levels of physical activity associated with various play behaviors were detected, and all 15 participants were assessed simultaneously with very few observers.     

Decisional Procrastination: Assessing Characterological and Contextual Variables around Indecision

University students (n = 75; M age = 21.4 years old) and community adults (n = 55: M age = 36.6 years old) completed self-reported measures of decisional procrastination (indecision), character (life satisfaction, meaningful life, and need for cognition), context (place attachment, sense of community, and psychological home) and “cross-over” factors relating character and context (self-identity with possessions, people/thing orientation, and clutter), to provide an ecological understanding of persons who claim indecision. Controlling for social desirability tendencies, indecision was negatively related to all character but none of the context variables. Indecision also was related to both person and thing orientation and clutter. Multiple regression analysis indicated that only need for cognition significantly predicted (negatively) indecision among character, context, and cross-over variable sets. Subjective well-being also predicted indecision with low need for cognition among cross-over variables. Taken together, decisional procrastinators reported too much clutter (stuff), interfering with a positive quality of life and related to character over context and cross-over, ecological variables.     

Eight-Year Latent Class Trajectories of Academic and Social Functioning in Children with Attention-Deficit/Hyperactivity Disorder

We examined trajectories of academic and social functioning in children with attention-deficit/hyperactivity disorder (ADHD) to identify those who might be at risk for especially severe levels of academic and social impairment over time. We estimated a series of growth mixture models using data from two subsamples of children participating in the NIMH Collaborative Multisite Multimodal Treatment Study of Children with ADHD (MTA) including those with at least baseline and 96-month data for reading and mathematics achievement (n = 392; 77.3% male; M age = 7.7; SD = 0.8) or social skills ratings from teachers (n = 259; 74.9% male; M age = 7.6; SD = 0.8). We compared latent trajectories for children with ADHD to mean observed trajectories obtained from a local normative (i.e., non-ADHD) comparison group (n = 289; 80.6% male; M age = 9.9; SD = 1.1). Results indicated six latent trajectory classes for reading and mathematics and four classes for teacher social skills ratings. There was not only a relationship between trajectories of inattention symptoms and academic impairment, but also a similarly strong association between trajectory classes of hyperactive-impulsive symptoms and achievement. Trajectory class membership correlated with socio-demographic and diagnostic characteristics, inattention and hyperactive-impulsive symptom trajectories, externalizing behavior in school, and treatment receipt and dosage. Although children with ADHD display substantial heterogeneity in their reading, math, and social skills growth trajectories, those with behavioral and socio-demographic disadvantages are especially likely to display severe levels of academic and social impairment over time. Evidence-based early screening and intervention that directly address academic and social impairments in elementary school-aged children with ADHD are warranted. The ClinicalTrials.gov identifier is NCT00000388.     

Resilience to Interpersonal Trauma and Decreased Risk for Psychopathology in an Epidemiologic Sample

Quantitative measures of psychological resilience related to discrete stressors, such as interpersonal (IP) trauma, are lacking. The current study examined whether a novel, quantitative measure of resilience was related to decreased risk for a broad range of lifetime DSM-IV axis I disorders in an epidemiologic sample. Resilience was defined as the residual resulting from the difference between the individual’s predicted and observed PTSD symptom count, based on their cumulative exposure to IP traumatic events. Participants were 6288 adults (59.5% women; M _age  = 46.9, SD = 14.5) from the National Epidemiologic Study on Alcohol and Related Conditions endorsing at least one lifetime IP traumatic event. Logistic regressions were conducted to examine the relationship between resilience and axis I diagnoses, covarying for age, sex, education level, social support, and recent stressful life events. Greater resilience scores were associated with decreased likelihood of major depression (OR = .64, p < .001), generalized anxiety disorder (OR = .65, p < .001), social anxiety disorder (OR = .74, p < .001), panic disorder (OR = .65, p <. 001), and alcohol dependence (OR = .85, p < .001). Discrepancy between expected and observed PTSD symptom severity based on IP trauma load may represent a useful, quantitative measure of resilience.     

Faking Fast and Slow: Within-Person Response Time Latencies for Measuring Faking in Personnel Testing

Purpose

Item response time (RT) latencies offer a potentially promising approach for measuring faking in personnel testing, but have been studied almost exclusively as either long or short RTs relative to group norms. As such, the ability to reliably assess faking RTs at the individual level remains a challenge. To address this issue, the present study set out to examine the usefulness of a within-person difference score index (DSI) method for measuring faking, in which “control question” (baseline) RTs were compared to “target question” RTs, within single test administrations.

Design/Methodology/Approach

Two hundred six participants were randomly selected to simulated faking or honest testing conditions, and were administered two types of integrity test items (overt and personality), whereby group classification (faking/honest) served as the main dependent variable.

Findings

Faking condition RTs were longer than honest condition RTs for both item types (overt: d = .43; personality: d = .47), and overt item RTs were slightly shorter than personality item RTs in both testing conditions (honest: d = .34; faking: d = .41). Finally, using a sample cut score, the DSI correctly classified an average of 26 % more cases of faking, and 53 % less false positives, compared to the traditional normative method.

Implications

The results suggest that the DSI can be an advantageous method for identifying faking in personnel testing scenarios.

Originality/Value

This is the one of the first studies to propose a practical method for identifying individual-level faking RTs within single test administrations.

     

Recollections of childhood bullying and multiple forms of victimization: correlates with psychological functioning among college students

This retrospective investigation examined the association among childhood bullying victimization, multiple forms of victimization, and psychological functioning in a college sample. Four hundred-and-eighty-two undergraduate students participated in the study (M = 19.98 years, SD = 1.82). The sample included 65 % women. For race/ethnicity, 66.4 % were European-American (N = 320), 16.8 % African-American (N = 81). For grade level, 21.6 % were freshmen (N = 104), followed by 38.2 % sophomores (N = 184), 16.2 % juniors (N = 78), and 23.4 % seniors (N = 113). Participants completed a survey packet of measures assessing childhood bullying victimization experiences and current levels of psychological functioning. Findings indicated that bullying victimization significantly predicted greater levels of depression, anxiety, and post-traumatic stress (PTS) after controlling for other childhood victimization experiences. PTS symptoms were predicted by exposure to community violence and child abuse with bullying victimization was found to be the strongest predictor. College-level practitioners need to assess for a wide range of childhood victimization experiences, including bullying victimization.     

Psychoeducational Psychotherapy and Omega-3 Supplementation Improve Co-Occurring Behavioral Problems in Youth with Depression: Results from a Pilot RCT

This pilot randomized controlled trial (RCT) investigated benefits of omega-3 fatty acid supplementation and Individual-Family Psychoeducational Psychotherapy (PEP; a family-focused, cognitive-behavioral therapy) for behavior problems among youth with depression. Participants aged 7–14 with DSM-IV-TR depressive disorders (N = 72; 56.9 % male) were randomized to 1 of 4 treatment conditions: PEP + omega-3, PEP monotherapy (with pill placebo), omega-3 monotherapy, or placebo (without active intervention). At screen, baseline, and 2, 4, 6, 9, and 12 weeks post-baseline, parents completed the SNAP-IV, which assesses attention-deficit/hyperactivity disorder symptoms, oppositional defiant disorder symptoms, and overall behavior problems. At screen, baseline (randomization), 6 and 12 weeks, parents completed the Eyberg Child Behavior Inventory (ECBI), which includes Intensity and Problem scales for child behavior problems. Youth who had a completed SNAP-IV or ECBI for at least two assessments during treatment (n = 48 and 38, respectively) were included in analyses of the respective outcome. ClinicalTrials.gov.:NCT01341925. Linear mixed effects models indicated a significant effect of combined PEP + omega-3 on SNAP-IV Total (p = 0.022, d = 0.80) and Hyperactivity/Impulsivity trajectories (p = 0.008, d = 0.80), such that youth in the combined group saw greater behavioral improvement than those receiving only placebo. Similarly, youth in combined treatment had more favorable ECBI Intensity trajectories than youth who received no active treatment (p = 0.012, d = 1.07). Results from this pilot RCT suggest that combined PEP + omega-3 is a promising treatment for co-occurring behavior symptoms in youth with depression.     

Distress Tolerance and Social Support in Adolescence: Predicting Risk for Internalizing and Externalizing Symptoms Following a Natural Disaster

The purpose of the multi-measure, multi-wave, longitudinal study was to examine the interactive relation between behavioral distress tolerance (DT) and perceived social support (PSS) in 352 tornado-exposed adolescents aged 12–17 years (M = 14.44; SD = 1.74). At baseline, adolescents completed a computer-based task for DT, and self-report measures of PSS, depressed mood, posttraumatic stress disorder (PTSD), substance use, and interpersonal conflict. Symptoms also were assessed 4 and 12 months after baseline. Findings showed that lower levels of DT together with lower levels of PSS conferred risk for elevated symptoms of prospective depression (t(262) = ?2.04, p = .04; r_{effect size} = 0.13) and PTSD (t(195) = ?2.08, p = .04; r_{effect size} = 0.15) following a tornado. However, only PSS was significant in substance use t(139) = 2.20, p = .03; r_{effect size=}0.18) and conflict (t(138) = ?4.05, p < .0001; r_{effect size=}0.33) in our sample. Implications regarding adolescent DT, the transdiagnostic nature of PSS, and the clinical applications of our findings in the aftermath of a natural disaster are discussed.     

Preventing Conduct Disorder and Callous Unemotional Traits: Preliminary Results of a School Based Pilot Training Program

This study investigated whether a school-based pilot prevention program is effective in reducing Conduct Disorder (CD) symptoms and callous unemotional (CU) traits (i.e., lack of empathy and guilt) in a community sample of children. A total of 304 children from three schools in Cyprus were randomly assigned at school level to either a prevention group that received a skill building training program (N = 94; M _age  = 7.91, SD = .74; 52.1% female) or a control group that received no training (N = 210; M _age  = 7.82, SD = .81; 50.5% female). To evaluate the effectiveness of the program, CD symptoms and CU traits were assessed before the implementation of the training program and at 3 and 9 months after training. Additionally, the child’s impulsivity, parental involvement and friend support were assessed pre- and post-prevention. Significant post-training reductions in CU traits were identified for the prevention, but not the control, group at both 3-month and 9-month follow-ups and in CD symptoms at the 9 month follow-up. Furthermore, children in the prevention group scored lower on impulsivity and higher on paternal involvement and friend support compared to the control group after participating in the training program. This study provides preliminary evidence that child focused training delivered in the school setting can provide lasting benefits by preventing the development of CU traits, impulsivity, and CD. The program was also successful in improving the child’s social relationships with peers and parents. These findings emphasize the importance of school based prevention efforts.     

Acute Stimulant Treatment and Reinforcement Increase the Speed of Information Accumulation in Children with ADHD

The current studies utilized drift diffusion modeling (DDM) to examine how reinforcement and stimulant medication affect cognitive task performance in children with ADHD. In Study 1, children with (n = 25; 88 % male) and without ADHD (n = 33; 82 % male) completed a 2-choice discrimination task at baseline (100 trials) and again a week later under alternating reinforcement and no-reinforcement contingencies (400 trials total). In Study 2, participants with ADHD (n = 29; 72 % male) completed a double-blind, placebo-controlled trial of 0.3 and 0.6 mg/kg methylphenidate and completed the same task utilized in Study 1 at baseline (100 trials). Children with ADHD accumulated information at a much slower rate than controls, as evidenced by a lower drift rate. Groups were similar in nondecision time and boundary separation. Both reinforcement and stimulant medication markedly improved drift rate in children with ADHD (ds = 0.70 and 0.95 for reinforcement and methylphenidate, respectively); both treatments also reduced boundary separation (ds = 0.70 and 0.39). Reinforcement, which emphasized speeded accuracy, reduced nondecision time (d = 0.37), whereas stimulant medication increased nondecision time (d = 0.38). These studies provide initial evidence that frontline treatments for ADHD primarily impact cognitive performance in youth with ADHD by improving the speed/efficiency of information accumulation. Treatment effects on other DDM parameters may vary between treatments or interact with task parameters (number of trials, task difficulty). DDM, in conjunction with other approaches, may be helpful in clarifying the specific cognitive processes that are disrupted in ADHD, as well as the basic mechanisms that underlie the efficacy of ADHD treatments.     

The Effectiveness of Psychosocial Interventions Delivered by Teachers in Schools: A Systematic Review and Meta-Analysis

The growing mental health needs of students within schools have resulted in teachers increasing their involvement in the delivery of school-based, psychosocial interventions. Current research reports mixed findings concerning the effectiveness of psychosocial interventions delivered by teachers for mental health outcomes. This article presents a systematic review and meta-analysis that examined the effectiveness of school-based psychosocial interventions delivered by teachers on internalizing and externalizing outcomes and the moderating factors that influence treatment effects on these outcomes. Nine electronic databases, major journals, and gray literature (e.g., websites, conference abstract) were searched and field experts were contacted to locate additional studies. Twenty-four studies that met the study inclusion criteria were coded into internalizing or externalizing outcomes and further analyzed using robust variance estimation in meta-regression. Both publication and risk of bias of studies were further assessed. The results showed statistically significant reductions in students’ internalizing outcomes (d = .133, 95% CI [.002, .263]) and no statistical significant effect for externalizing outcomes (d = .15, 95% CI [?.037, .066]). Moderator analysis with meta-regression revealed that gender (%male, b = ?.017, p < .05), race (% Caucasian, b = .002, p < .05), and the tier of intervention (b = .299, p = .06) affected intervention effectiveness. This study builds on existing literature that shows that teacher-delivered Tier 1 interventions are effective interventions but also adds to this literature by showing that interventions are more effective with internalizing outcomes than on the externalizing outcomes. Moderator analysis also revealed treatments were more effective with female students for internalizing outcomes and more effective with Caucasian students for externalizing outcomes.     

A Replication of the Reker and Cousins’ Study About the Complementarity Between the Purpose-In-Life Test (PIL) and the Seeking of Noetic Goals (SONG) Among Spanish Young People

The main aim of this study was to replicate the Reker and Cousins’ (1979) work about the complementarity between the the Purpose-In-Life Test (PIL), which indicates the degree to which the person has found meaning and purpose in life (presence of meaning), and the Seeking of Noetic Goals (SONG), which measures the degree to which the person is motivated to find meaning and purpose in life (search for meaning). Participants were 349 Spanish undergraduates (224 women, 64.20 %, and 125 men, 35.80 %) between 18 and 26 years old, M = 20.81, SD = 2.17. Principal Component Analysis showed eight factors: four mainly related to the presence of meaning and four mainly related to the search for meaning. The PIL contributed four factors to presence of meaning, whereas the SONG contributed four factors to the search for meaning. The results confirmed the factorial structure, internal consistency, and validity of both scales and their complementarity.     

Antisocial Process Screening Device Subscales Predict Recidivism in an Australian Juvenile Offender Sample

The present study is the first to examine the psychometric properties of the self-report Antisocial Process Screening Device (APSD-SR), and the predictive utility of its subscales for reoffending, among Australian juvenile offenders (N?= 308, M age = 17.00, SD?=?1.49). Exploratory factor analysis supported a modified three-factor structure in which four items loaded differently to prior studies. Total APSD-SR and modified subscale scores were positively associated with criminal history and mental health problems (e.g., internalizing and externalizing problems, alcohol and substance abuse/dependence). Survival analyses indicated that youth scoring high on the APSD-SR total score were faster to reoffend nonviolently (Hazard Ratio [HR]?= 1.31, p?=?.0003) and violently (HR?=?1.42, p?=?.0003) than those scoring low. Whereas the modified grandiose-manipulative subscale predicted faster time to nonviolent recidivism (HR?=?1.18, p?=?.026) as a single predictor, when all subscales were simultaneously entered into the model only callous-unemotional (CU) traits and impulsivity predicted nonviolent recidivism (HR?=?1.19, p?=?.026 and 1.22, p?=?.015, respectively), and only impulsivity predicted violent recidivism (HR?=?1.26, p?=?.014). Findings inform current understanding of the relative contribution of adolescent psychopathy dimensions to designating a particularly high-risk group of Australian youth in custody.     

Emotion Regulation in Families of Children with Behavior Problems and Nonclinical Comparisons

The current study compared parents’ emotion regulation (ER) in clinical (those with a child with externalizing behavioral problems) and low-risk comparison families. Additionally, mediation models were explored with parent ER predicting child behavior problems through child ER. Participants were 60 families with children (71.7% boys; 73% Caucasian) ages 2 through 8 years (M?=?4.62; SD?=?1.69) from a rural population in the United States: 34 clinical families referred for parent training and 26 nonclinical families. A blocking design was used to balance the two groups on key demographic characteristics. Parents’ and children’s ER was assessed using parent-report surveys and structured behavioral observations. Analyses indicated higher rates of parental emotion dysregulation (specifically, more difficulty when upset with achieving goal-directed behaviors, p?=?.01, d?=?0.67; controlling impulses, p?=?.01, d?=?0.64; limited use of ER strategies, p?=?.02, d?=?0.62; and more negative verbalizations to their child during the observed task, p?<?.01, d?=?0.73) and child emotion dysregulation (specifically, more difficulty as reported by parents, p?<?.01, d?=??2.42) in the clinical group. Mediational analyses indicated there were indirect paths from parental ER to children’s behavioral problems through child ER. Findings from this research suggest a need to measure and target ER in both parents and their children when working with families who are referred for treatment of child behavior problems.     

The Effect of Religious Belief and Forgiveness on Coping with Diabetes

We aimed to investigate the relationship of religious beliefs and forgiveness in diabetic patients with various sociodemographic characteristics, emotional problems and glycaemic control. The study comprises 100 patients diagnosed with type 2 DM. We used a data collection form, the Scale of Forgiveness and Religiosity (SFR), Problem Areas in Diabetes Scale (PAID), Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI) and the Audit of Diabetes-Dependent Quality of Life (ADDQoL). We also recorded blood glucose and HbA1c test results. A statistically significant relationship was determined only between the scores of the STAI-I and the religious belief scales (r = 0.198, p = 0.049). A statistically significant negative relationship was determined between the forgiveness scale points and the BDI (r = 0.326, p = 0.001), the STAI-II (r = 0.308, p = 0.002) and PAID (r = 0.313, p = 0.001) and a positive correlation with ADDQoL (r = 0.284, p = 0.004). To conclude, forgiveness by patient himself or others reduced the emotional problems which were experienced related to diabetes by reducing stress levels and could increase quality of life.