自我隐瞒对消防员创伤后应激反应的影响：经验回避和反刍的链式多重中介作用

人格特质和情绪调节策略是创伤后应激反应的重要影响因素。作为一种在个人感到痛苦时有意地向他人隐藏自身状况的人格特质,自我隐瞒会通过适应不良的情绪调节策略影响心理健康。然而,鲜有研究考察自我隐瞒、适应不良的情绪调节策略与创伤后应激反应的关系。对创伤后应激反应的情绪调节策略的研究发现,经验回避和反刍是两种有重要影响的适应不良的情绪调节策略。在创伤后应激反应的研究对象上,前人主要关注在创伤事件中幸存的直接受害者身上,而对频繁处理各类突发事件而成为创伤后应激反应高危人群的消防员一直缺乏研究。因此,本研究意在考察自我隐瞒对经历职业创伤的消防员创伤后应激反应的影响以及经验回避和反刍这两种适应不良的情绪调节策略的中介作用。 研究被试为215名将个人经历的职业创伤作为首要创伤事件的一线消防员。他们来自我国3个城市,均为男性,平均年龄22.90±3.38岁。使用中文修订版的埃森创伤问卷、自我隐瞒量表、反刍反应量表、接受与承诺问卷第二版和事件影响量表进行现场调查。被试均匿名填写调查问卷。使用SPSS20.0进行描述性统计和相关性分析。使用Mplus7.4进行结构方程模型的分析。采用Harman单因子检验的方法进行共同方法偏差检验。采用偏差矫正的百分位Bootstrap方法进行中介效应的显著性检验。 结果表明,自我隐瞒、经验回避、反刍和创伤后应激反应之间存在两两显著正相关;自我隐瞒对创伤后应激反应具有直接效应;自我隐瞒通过反刍对创伤后应激反应产生间接效应;自我隐瞒通过经验回避-反刍的中介链对创伤后应激反应产生间接效应;自我隐瞒影响创伤后应激反应的总效应值为0.427,其中总间接效应值为0.217,占总效应值的50.82%。本研究还发现,64名(29.77%)将个人经历的职业创伤作为首要创伤事件的一线消防员达到了严重创伤后应激反应的水平。 总之,自我隐瞒可以通过三条路径影响创伤后应激反应：直接影响、反刍的中介作用和经验回避-反刍的系列中介作用。在理论层面,这拓展了对影响创伤后应激反应的人格特质的理解和对自我隐瞒影响的心理健康状况的理解。在实践层面,这提示我们重视自我隐瞒、经验回避和反刍在预防和治疗创伤后应激反应中的潜在贡献。此外,本研究还发现,消防员确实是创伤后应激反应的高危人群。作为突发事件的第一响应人,消防员的心理健康应该得到更多关注与研究。     

Durability of Cognitive Behavioral Therapy Effects for Youth and Adolescents With Anxiety,Depression, or Traumatic Stress:A Meta-Analysis on Long-Term Follow-Ups

Cognitive behavioral therapies (CBT) for youth with anxiety, traumatic stress, and depression have demonstrated strong effects in individual studies and meta-analyses. Relatively more attention has been given to posttreatment effects, though, and assessment of follow-up effects has been limited at the meta-analytic level. The current meta-analysis aimed to (a) examine the effects of youth CBT at posttreatment, 1-month, 3-month, 6-month, 1-year, and long-term (2 + years) follow-up as well as (b) identify research-related variables (e.g., measure respondent type) that relate to effects. Using a random effects model across 110 child and adolescent CBT groups, within-group effect sizes were large at posttreatment (g = 1.24) and from 1-month through long-term follow-up (g = 1.23–1.82), and effect sizes did not significantly differ by treatment target (i.e., anxiety, traumatic stress, depression). However, availability of outcome data for effect sizes diminished across later follow-up assessments. Moreover, effect sizes were significantly associated with outcome respondent type across assessment timing, with outcome measures from caregiver and youth respondents associated with smaller effect sizes (B = -0.97, p < 0.001) relative to outcome measures that were evaluator-reported. Results provide initial support for the durability of treatment effects for youth CBTs and highlight the importance of some confounding variables. Implications for improving treatment research standards and prioritizing assessment of long-term follow-up assessment are discussed.     

Impulsivity and Behavior-Dependent Life Events Mediate the Relationship of Reward Sensitivity and Depression,but Not Hypomania,Among at-Risk Adolescents

Both reward sensitivity and impulsivity are related to the development and course of bipolar spectrum disorders (BSDs) and have been implicated in other disorders and negative functional outcomes such as substance abuse, obesity, suicidal behaviors, and risk-taking. Furthermore, according to the transactional component of the Behavioral Approach System (BAS)/reward hypersensitivity theory of BSDs, people with reward hypersensitivity should experience more BAS-relevant events, and thus, are more vulnerable to mood symptoms and episodes via stress generation. Impulsivity may exacerbate stress generation in individuals at risk for BSDs based on exhibiting reward hypersensitivity. The current study examined whether impulsivity explained the generation of stress and subsequent mood symptoms beyond what is explained by reward sensitivity alone. Participants were 131 Moderate BAS and 216 High BAS sensitivity adolescents (M = 18.43 years, SD = 1.40), who completed baseline measures of reward sensitivity and impulsivity, as well as follow-up measures of life events and mood symptoms. Results from linear regression analyses indicated that higher baseline impulsivity predicted behavior-dependent, but not behavior-independent, life events. Furthermore, path analyses suggested that the effect of BAS group on depression symptoms at next follow-up was partly explained via the indirect effect of impulsivity and negative behavior-dependent life events. We did not find these effects for behavior-independent or positive-dependent events or for prediction of hypomanic symptoms. The findings suggest that impulsivity may account for stress generation of negative events that precede depression.     

Effects of Rumination and Worry on Sleep

Recent research suggests that the stress-sleep relationship is mediated by pre-sleep arousal (PSA) and that cognitive arousal has a stronger mediating effect than somatic arousal; however, this has not been directly tested. Using multilevel moderated mediation, we compared the effects of cognitive arousal and somatic arousal within the stress-sleep relationship. We also assessed whether two forms of repetitive negative thought—rumination and worry—are similarly involved in the stress-sleep relationship. Data was collected from 178 participants across the United States via an online platform. Participants completed baseline self-report surveys examining rumination tendencies and worry tendencies. Over the course of 2 weeks, participants completed daily questionnaires assessing daily stress, PSA, and sleep quality. Results indicated that indirect effects from stress to sleep quality via PSA were statistically significant at low and high levels of rumination and worry, and people at high levels of rumination and worry had stronger relationships between stress and PSA. Across all models, cognitive arousal consistently accounted for more of the variance in the stress-sleep relationship as compared to somatic arousal. Implications for the cognitive behavioral treatment of insomnia are discussed.     

Gender‐specific factors associated with the suicidal ideation of children in Taiwan: A large‐scale cross‐sectional study

We examined the relationship between suicidal ideation (SI) and the depressed mood, life stress and parenting styles in children. A large‐scale survey was conducted including 5328 children from 65 elementary schools in Taiwan. SI was measured by asking children if any suicidal thoughts had occurred in the previous month. A series of regression models was analysed separately for male and female students. Compared with boys, girls demonstrated a higher proportion of SI. Among boys, SI was significantly associated with a high level of perceived environmental stress (adjusted odds ratio [aOR] = 2.61), a high degree of depressed mood (aOR = 2.39), authoritative (aOR = 1.72) and authoritarian (aOR = 2.53) parenting styles and two or more life‐stress events (aOR = 1.45). A high level of perceived environmental stress (aOR = 2.09), a high degree of depressed mood (aOR = 2.89) and an authoritarian parenting style (aOR = 1.76) were significantly associated with the SI in girls. Gender‐specific interventions aimed at preventing SI must enhance support systems at school and at home, particularly for students who suffer from a high degree of stress and depressed mood, and are subjected to an authoritarian parenting style.     

Measuring generalised expectancies for negative mood regulation in China: The Chinese language Negative Mood Regulation scale

Negative mood regulation expectancies (NMRE) represent people's confidence that they can alleviate their negative affect or induce a positive emotional state through thought or action. NMRE predict coping behaviour and mood outcomes for individuals under stress. Since 1990, much research documents the reliability and validity of the English language Negative Mood Regulation (NMR) scale as a measure of NMRE. The current research reports two studies developing a Chinese language translation of the NMR (NMR‐C) scale that goes beyond literal translation to be a culturally sensitive measure of NMRE in China. In Study 1, 713 college students from both a major city and a rural setting in China were surveyed. Data support the resulting 32‐item NMR‐C's reliability (alpha = .88) and validity. The NMR‐C showed both direct and indirect links to depression and anxiety; coping mediated the indirect effect. In Study 2, 331 prison police officers in three Chinese provinces participated. NMRE buffered the effect of high role pressure, moderating the relationship between prison police role stress and job engagement. Results of the two studies support the reliability and validity of the Chinese language NMR scale and parallel results found with measures of NMRE in the West and in other Asian countries.     

Organizations Behaving Badly: Antecedents and Consequences of Uncivil Workplace Environments

The present study investigated the relationship between employees’ perceptions of five characteristics emphasized in their work organization (i.e., individualism, hostile interaction styles, competition, hierarchical governance, and email reliance) and the occurrence of incivility in that context. We also examined how perceptions of uncivil environments, in turn, related to personal experiences of workplace incivility and negative outcomes for targets. The proposed model was examined in two samples of university faculty. Study 1 tested the model with three organizational characteristics (individualism, hostile interaction styles, and competition) and three outcomes (job satisfaction, turnover intentions, and physical health) in a sample of faculty from a wide range of departments at a large Southern university. The second study investigated two additional organizational characteristics (hierarchical governance and email reliance) and an additional outcome (psychological distress) in a nationwide sample of law faculty. Results demonstrated that all but one of the characteristics (email reliance) related to perceptions of an uncivil workplace environment; uncivil environment perceptions, in turn, predicted personal experiences of incivility and negative occupational and health outcomes.     

An examination of the psychometric properties of scores on the Family Strain Index (FSI) in a general community sample

Given the potentially harmful effects of parenting stress on parents, children, and their relationship, it is critical to have a reliable and valid measure of parenting stress in clinical and community samples. The Family Strain Index (FSI) is a brief questionnaire designed to measure stress and demand on parents of children with ADHD. The present study is the first to evaluate the psychometric properties of scores on the FSI in a general community sample. Parents (89% mothers) of 550 preschool children (aged 2–5 years; 50% boys) sampled through 17 kindergartens located in Danish cities and villages completed the FSI, the ADHD Rating Scale (RS)‐IV Preschool Version, and a background questionnaire. FSI scores were characterized by restricted range and floor effects. The scale's construct validity was not supported and the measurement repeatability after 1 month was low. The scale did have convergent validity as levels of parenting stress were associated with perceived ADHD behavior in off‐spring, but overall, results did not encourage the use of the FSI as a measure of parenting stress in the general population. Measures that include more normative events may be more appropriate when attempting to capture parenting stress in general community samples.     

When Treatment is Traumatic: An Empirical Review of Interventions for Pediatric Medical Traumatic Stress

Pediatric medical traumatic stress (PMTS) is common among injured/ill children and is associated with elevated distress, treatment non‐adherence, and poor health outcomes. As survivorship of life‐threatening pediatric injury and illness continues to increase alongside rapid medical advancements, rates of PMTS and negative sequelae are expected to grow; however, research on prevention and treatment of PMTS is limited. The current study sought to systematically review the literature using a developmental framework to highlight research gaps. Sixteen peer‐reviewed studies were identified via a systematic literature search. Consistent with best practices for treatment of childhood trauma, caregiver involvement and CBT principles served as the foundation for most interventions. All studies reported improvements in PMTS; however, among the most methodologically rigorous, few found statistically superior reductions in PMTS between intervention and control groups. While many studies focused on a specific developmental stage and discussed developmental considerations, others took a “one‐size‐fits” approach. Interventions that demonstrated the most promising findings were online, self‐guided, or time‐limited. Future research would benefit from expanding diversity of participants, continuing to evaluate novel delivery methods, and integrating developmental considerations along with trauma‐informed care (TIC) approaches, given their useful framework for understanding child traumatic stress responses and avenues for prevention and treatment.     

Direct and indirect associations of cognitive reappraisal and suppression with disease biomarkers

Objective: Habitual use of emotion regulation strategies may influence physical health. We examined whether the tendencies to employ cognitive reappraisal and suppression were associated with health biomarkers, and whether stress and sleep quality mediated these associations. Design & main outcome measures: Using data from the Biomarkers substudy (n?=?1255) of the national Midlife in the U.S. Study, we tested the hypothesis that there would be indirect, but not direct, associations of cognitive reappraisal and suppression to biomarker indicators of multisystem physiological dysregulation, that is, allostatic load (AL). We computed the proportion of biomarkers in the highest risk quartile within seven biological systems, and summed these scores to compute AL. Associations with the biological systems were also examined separately.Results: Neither reappraisal nor suppression was directly associated with AL or biomarker function in the seven biological systems. Suppression was indirectly associated with higher AL and greater dysregulation in the inflammatory, metabolic, and hypothalamic-pituitary-adrenal systems via its relations to stress and sleep, p?<?0.05. Reappraisal was indirectly associated with lower AL and less metabolic and inflammatory dysregulation, ps<0.05.Conclusions: Suppression and reappraisal may have different downstream health effects via stress, sleep, and biomarker expression, suggesting malleable emotion regulation strategies may be an important intervention target.