The Multilevel Relationships of HIV‐Related Stigma to Child and Caregiver Mental Health among HIV‐Affected Households in South Africa

HIV/AIDS‐related (HAR) stigma is still a prevalent problem in Sub‐Saharan Africa, and has been found to be related to mental health of HIV‐positive individuals. However, no studies in the Sub‐Saharan African context have yet examined the relationship between HAR stigma and mental health among HIV‐negative, HIV‐affected adults and families; nor have any studies in this context yet examined stigma as an ecological construct predicting mental health outcomes through supra‐individual (setting level) and individual levels of influence. Multilevel modeling was used to examine multilevel, ecological relationships between HAR stigma and mental health among child and caregiver pairs from a systematic, community‐representative sample of 508 HIV‐affected households nested within 24 communities in KwaZulu‐Natal, South Africa. Two distinct dimensions of HAR stigma were measured: individual stigmatizing attitudes, and perceptions of community normative stigma. Findings suggest that individual‐level HAR stigma significantly predicts individual mental health (depression and anxiety) among HIV‐affected adults; and that community‐level HAR stigma significantly predicts both individual‐level mental health outcomes (anxiety) among HIV‐affected adults, and mental health outcomes (PTSD and externalizing behavior scores) among HIV‐affected children. Differentiated patterns of relationships were found using the two different stigma measures. These findings of unique relationships identified when utilizing two conceptually distinct stigma measures, at two levels of analysis (individual and community) suggest that HAR stigma in this context should be conceptualized as a multilevel, multidimensional construct. These findings have important implications both for mental health interventions and for interventions to reduce HAR stigma in this context.     

Like mother,like child? Maternal determinants of children's early social-emotional development

Social-Emotional competencies evolve early in life. For example, early emotion regulation is learned primarily in the context of mother–child interaction, which may allow for maternal influences to shape children's social-emotional development. The aim of the current study was to longitudinally examine maternal determinants of children's early social-emotional development in a community-based sample of first-time mothers (N = 61, aged 22–39 years). Specifically, we used structural equation modeling to examine how maternal emotion regulation difficulties and subclinical depression directly and indirectly, through sensitivity and postnatal bonding, assessed at 6 to 8 months predicted child outcomes at 12 to 16 months. We found that mothers’ sensitivity predicted fewer social-emotional and behavioral problems and that stronger bonding predicted fewer problems and more social-emotional competencies. Emotion regulation difficulties were significantly associated with depressive symptoms; yet, when accounting for shared variances, both factors differentially predicted less positive child outcomes such that more difficulties indirectly, through poorer bonding, predicted greater delay in competencies, and more symptoms indirectly, through less sensitivity, predicted more problems. Current findings underline the significance of maternal factors impacting the quality of mother–child interaction for children's positive development. Potential implications for early prevention programs to support children who are otherwise at risk for negative emotional outcomes due to mothers’ emotional state postpartum are discussed.     

Influence of in utero exposure to maternal depression and natural disaster-related stress on infant temperament at 6 months: The children of Superstorm Sandy

This study examined the effects of in utero exposure to maternal depression and Superstorm Sandy, a hurricane that hit metropolitan New York in 2012, on infant temperament at 6 months. Temperament was assessed using the Infant Behavior Questionnaire-Revised. Maternal depression was measured by the Edinburgh Postnatal Depression Scale. The main effects and the interaction of maternal depression and Sandy exposure on infant temperament were examined using a multivariable generalized linear model. Results show that prenatal maternal depression was associated with lower emotion regulation and greater distress. Stratification and interaction analyses suggested that the adverse effects of prenatal maternal depression on problematic temperament were amplified by in utero Sandy exposure. This study underscores the importance of providing prenatal screening and treatment for maternal depression during pregnancy while also identifying high-risk families who may have suffered from disaster-related traumas to provide necessary services. As the frequency of natural disasters may increase due to climate change, it is important to understand the consequences of in utero stress on child development and to formulate plans for early identification.     

情绪调节自我效能感与心理健康的交叉滞后研究

摘 要：对531名青少年进行为期五个月的追踪,运用交叉滞后回归分析考察积极、沮丧、生气三种情绪调节自我效能感与心理健康（问题行为、抑郁和生活满意度）间的相互影响。结果：T1积极情绪调节自我效能感不能预测T2问题行为、抑郁和生活满意度;T1沮丧情绪调节自我效能感显著预测T2抑郁水平;T1生活满意度和抑郁显著预测T2生气情绪调节自我效能感。结论：高沮丧情绪调节自我效能感能保护青少年处于“低抑郁状态”,而生气情绪调节自我效能感更容易受到个体生活满意度和抑郁水平的影响,是青少年处于不良心理状态下的易感效能。     

青少年孤独感与抑郁症状:反应风格的中介作用以及性别的调节作用

基于反应风格理论,本研究探索反应风格在青少年孤独感与抑郁症状之间的中介效应。使用孤独感量表、儿童反应风格量表以及儿童抑郁量表对 795 名 青少年进行调查。结果发现：（1）青少年孤独感能显著预测抑郁症状。（2）青少年孤独感能通过反刍、问题解决间接预测抑郁症状。（3）反应风格整体（比率分数）中介青少年孤独感与抑郁症状之间的关系。本研究结果显示,反应风格能够解释青少年孤独感与抑郁症状之间的内在机制。     

Reliability and validity of the Basic Depression Questionnaire

Background/ObjectiveDepressive disorders have a high prevalence around the world. They present a great comorbidity with other disorders like anxiety, thereby making a differential diagnosis very difficult. The Basic Depression Questionnaire was designed to palliate this issue by isolating specific depression symptoms. Our aim is to study the reliability, factorial structure, and differential item functioning of this questionnaire. Method: The sample consisted of 1,397 adults without psychological problems (M_age = 29.76, SD = 11.25, 64.78% women) who completed the CBD. Results: We observed that none of the items presented differential functioning. A monofactorial structure was established. In this model a good fit was obtained by confirmatory factor analysis and a strict invariance by sex. The ordinal alpha was used to check the reliability and it fetched an index of .95. Conclusions: The Basic Depression Questionnaire has adequate psychometric properties. The absence of differential item functioning and the invariance by sex are guarantees of an adequate use to diagnose depression for men and women. So, its clinical use can help to differentiate between the specific diagnoses for depressive disorders and anxiety disorders.     

Coparental Affect,Children's Emotion Dysregulation,and Parent and Child Depressive Symptoms

Children's emotion dysregulation and depressive symptoms are known to be affected by a range of individual (parent, child) and systemic (parent–child, marital, and family) characteristics. The current study builds on this literature by examining the unique role of coparental affect in children's emotion dysregulation, and whether this association mediates the link between parent and child depressive symptoms. Participants were 51 mother–father–child triads with children aged 7 to 12 (M age = 9.24 years). Triads discussed a time when the child felt sad and a time when the child felt happy. Maternal and paternal displays of positive affect were coded, and sequential analyses examined the extent to which parents were congruent in their displays of positive affect during the emotion discussions. Results indicated that interparental positive affect congruity (IPAC) during the sadness discussion, but not the happiness discussion, uniquely predicted parent‐reported child emotion dysregulation, above and beyond the contributions of child negative affect and parental punitive reactions. The degree of IPAC during the sadness discussion and child emotion dysregulation mediated the association between maternal, but not paternal, depressive symptoms and child depressive symptoms. Findings highlight the unique role of coparental affect in the socialization of sadness in youth and offer initial support for low levels of IPAC as a risk factor for the transmission of depressive symptoms in youth.     

Child Characteristics,Parent Education and Depressive Symptoms,and Marital Conflict Predicting Trajectories of Parenting Behavior from Childhood Through Early Adolescence in Taiwan

The study examined how child and parent characteristics, and contextual sources of stress, such as marital conflict predict initial status and trajectories of parent involvement, support, and harsh control, over a 4‐year period in families in Taiwan (n = 4,754). Based on Belsky's (1984) ecological model of parenting, three domains predicting parenting were tested, child characteristics (age cohort and gender), father and mother characteristics (education and depressive symptoms), and contextual sources of stress (marital conflict). The study followed two cohorts of children; the younger cohort was followed from first to fourth grade and the older cohort from fourth to seventh grade. Initially, fourth graders reported more parental involvement, support, and harsh control than first graders. However, involvement, support, and harsh control decreased across the 4 years for the older cohort as they transitioned to early adolescence. In the first year, girls reported more parental involvement and support and less harsh control than boys. Across the 4 years, involvement and support increased, and harsh control decreased for boys; whereas involvement stayed the same, support slightly decreased, and harsh control slightly increased for girls. Children whose parents were more educated reported more parent involvement, support, and harsh control in the first year. Children whose fathers were chronically depressed and whose parents were experiencing marital conflict reported decreasing parent involvement and support over the years.     

Three-way interaction of neuroticism,extraversion, and conscientiousness in the internalizing disorders: Evidence of disorder specificity in a psychiatric sample

It is well-established that neuroticism, extraversion, and conscientiousness are individually associated with internalizing disorders, but research suggests that these main effects may be qualified by a three-way interaction when predicting depression. The current study was the first to examine this three-way interaction in a psychiatric sample (N = 463) with a range of internalizing symptoms as the outcomes. Using two omnibus personality inventories and a diagnostic interview, the expected three-way interaction emerged most consistently for symptoms of major depression, and there was also evidence of synergistic effects for post-traumatic stress disorder and generalized anxiety disorder. Findings indicate that, even in a clinically-distressed and currently-disordered sample, high levels of extraversion and conscientiousness protect against distress disorders for those with high levels of neuroticism.