Distress tolerance and early adolescent externalizing and internalizing symptoms: The moderating role of gender and ethnicity

A large body of research has examined the development of internalizing and externalizing symptoms in childhood and early adolescence. Notably, there is significant concomitant impairment associated with early adolescent symptomatology, as well as association of these symptoms with future development of psychopathology, poor physical health, self-destructive thoughts and behaviors, criminal behavior, and HIV risk behaviors. Drawing on negative reinforcement theory, the current study sought to examine the potential role of distress tolerance, defined as the ability to persist in goal-directed activity while experiencing emotional distress, as a potential mechanism that may underlie both internalizing and externalizing symptoms among 231 Caucasian and African American youth (M age = 10.9 years; 45.5% female; 54.5% Caucasian ethnicity). A series of regressions resulted in significant moderated relationships, such that low distress tolerance conferred increased risk for alcohol use among Caucasians, delinquent behavior among African Americans, and internalizing symptoms among females. Clinical implications, including the potential role of negative reinforcement models in early intervention with young adolescents, are discussed.     

Thought control strategies as mediators of trauma symptoms in young women with histories of child sexual abuse

The current retrospective study examined thought control strategies, or cognitive techniques individuals use to deal with unpleasant thoughts following stressful events, as potential mediators of adjustment in young women with histories of child sexual abuse (CSA). In a sample of 76 undergraduate women who self-reported on abuse experiences, thought control strategies, and current trauma symptoms, several key findings emerged: (i) Greater severity of the CSA event was associated with greater reported use of worry and punishment strategies and less use of social control strategies; (ii) Increased use of worry and punishment strategies following the CSA event was associated with greater levels of trauma symptoms, while increased use of social control strategies following the CSA event was associated with lower levels of trauma symptoms; and (iii) Worry, punishment, and social control strategies served as mediators between CSA severity and trauma symptoms. The results suggest that thought control strategies, specifically increased worry and punishment, and decreased social control, play a vital role in understanding adjustment after CSA. Future research should examine the roles of these cognitive control strategies as possible avenues of intervention following CSA.     

CBT for Anxiety and Associated Somatic Complaints in Pediatric Medical Settings: An Open Pilot Study

Objective To examine the initial feasibility and potential efficacy of a cognitive-behavioral intervention for youth with anxiety disorders and non-medical somatic symptoms. Background Based on a strong relationship between somatic complaints and anxiety disorders, screening youngsters seeking medical care due to physical symptoms with no organic basis may enhance the recognition of anxiety disorders and facilitate access to appropriate services. Method Seven boys and girls, ages 8 through 15, with medically unexplained gastrointestinal complaints and anxiety disorders received a 12-session cognitive-behavioral intervention targeting anxiety and physical symptoms. Assessments were conducted at baseline and following treatment. Results All participants were classified as treatment responders. Three of the seven participants no longer met diagnostic criteria for their principal anxiety disorder. Children’s physical discomfort decreased from a moderate to minimal level based on self- and parent-reports. Conclusions Our modified cognitive-behavioral approach has promise for reducing anxiety and somatic symptoms in children seeking medical care.     

The Cohen–Hoberman inventory of physical symptoms: Factor structure,and preliminary tests of reliability and validity in the general population

Objective: The present study aimed to investigate the factor structure and psychometric properties of the Cohen–Hoberman inventory of physical symptoms (CHIPS). Construct and discriminant validity were examined by assessing associations between factors and subjective health complaints (SHC) inventory subscales in addition to measures of pain sensitivity, perceived stress and psychological distress.

Design: A cross-sectional online survey was conducted with 535 healthy individuals from the general population (80.6% female, mean age = 29.80).

Main outcome measures: Participants completed CHIPS, SHC, perceived stress scale, pain sensitivity questionnaire, and hospital anxiety and depression scale.

Results: Principal components analysis demonstrated that CHIPS comprised 8 ‘symptoms’ factors as follows; ‘sympathetic/cardiac’ (7 items; α = .827), ‘muscular’ (6 items; α = .752), ‘metabolic’ (5 items; α = .736), ‘gastrointestinal’ (5 items; α = .714), ‘vasovagal’ (4 items; α = .743), ‘cold/flu’ (2 items; α = .837), ‘headache’ (2 items; α = .690) and ‘minor haemorrhagic’ (2 items; α = .309). Significant correlations were observed between factors and SHC subscales (moderate-high), pain sensitivity (negligible-low) and levels of perceived stress and anxiety (low-moderate) indicating good construct, and discriminant validity, respectively.

Conclusions: CHIPS is a multidimensional and internally consistent measurement of physical symptoms. The postulated factor structure may be used for research purposes particularly in health psychology, to consistently differentiate between clusters of self-reported symptoms.     

科技干扰与青少年智能手机成瘾的关系：情绪症状和环境敏感性的作用

本研究以问卷法对湖北省两所中学共3219名初一至初三的中学生进行调查,建立结构方程模型来考察在家庭环境中由于父母使用科技设备而产生的科技干扰对青少年智能手机成瘾的影响机制。结果发现：（1）科技干扰不仅能直接正向预测青少年智能手机成瘾,还能通过情绪症状的中介作用间接预测青少年智能手机成瘾;（2）环境敏感性在情绪症状对青少年智能手机成瘾的影响中起显著的调节作用,具体而言,较高的环境敏感性能够缓冲情绪症状对青少年智能手机成瘾的影响。     

Adapting Brief CBT-I for Depressed Adolescents: A Case Illustration of the Sleeping Better Program

Disturbed sleep is a common symptom of depression in adolescents, but this symptom is not often targeted in psychological therapies for depression. Although the causal relationship between sleep and depression is unclear, there is increasing evidence that in adults, Cognitive Behavioral Therapy for Insomnia (CBT-I) improves sleep problems and reduces symptoms of depression; however, there has been little investigation of using this approach with adolescents. This article describes the adaptation of brief CBT-I for adolescents with depression. A single case study is reported to illustrate the use of the Sleeping Better program. Adaptations for adolescents include increased emphasis on engagement of the young person and the inclusion of parents in treatment. The treatment program was acceptable to the adolescent and parent, and treatment outcome, as indicated by sleep diaries and standardized measures of depression and anxiety, was positive. Further evaluation of the Sleeping Better program is needed to establish if it is an effective low-intensity intervention for sleep problems in adolescents who have depression or anxiety.     

Relationship satisfaction determines the association between Epstein–Barr virus latency and somatic symptoms after the loss of a spouse

The loss of a spouse is associated with a host of negative health outcomes. While bereaved individuals commonly report somatic symptoms, no investigations exist of the association between reactivation of latent Epstein–Barr virus (EBV) and somatic symptoms among this population. Further, how an individual perceives the quality of their lost relationship in retrospect may impact loss outcomes. Among 99 bereaved spouses, elevated EBV antibody titers were associated with somatic symptoms for those who retrospectively reported high or mean levels of relationship satisfaction (RS), but not among those less satisfied. Further, higher RS was associated with greater grief symptoms. This study identifies higher retrospective RS as a possible risk factor for negative physical and mental health outcomes during bereavement.     

The interface of identity distress and psychological problems in students’ adjustment to University

Identity distress, psychological symptoms, and adjustment to university (academic, social, and person-emotional) were examined among students in Spain (N = 241; M_age = 19.0 (1.6), Md = 19; 84% female) and Canada (N = 531; M_age = 19.8 (2.2), Md = 19; 82% female). The expected positive relationships were found between these variables. Similarly, increased identity distress of Spanish students and greater maladjustment at university for those in Canada were associated with contextual differences in the respective environments. Psychological problems mediated the linkages between identity distress with academic, social, and person-emotional functioning at university, respectively. Also, psychological problems and context/country were independent predictors of students’ identity distress. Findings underscore the importance of examining contextual factors that influence student adjustment to university in relation to identity development and mental health and they offer suggestions for further research and counseling services.     

震后儿童创伤后应激障碍的症状网络演化

本研究借助网络分析方法,探讨儿童创伤后应激障碍(PTSD)症状的演化规律。以经历汶川地震的197名儿童为研究对象,在灾后4、29、40和52个月对其PTSD症状进行了历时4年的追踪测量。网络分析结果显示,闪回的中心性一直较高,而其他高中心性的症状随时间的推移发生了变化：侵入性想法和创伤线索引发生理性反应的中心性随时间推移呈上升趋势,线索引发情感反应和未来无望的中心性随时间推移呈下降趋势。本研究拓宽了学界对儿童PTSD症状学的认识, 并为建立灾后阶段性干预模式提供启示。