Improving Health Care Utilization, Improving Chronic Disease Utilization, Health Status, and Adjustment in Adolescents and Young Adults with Cystic Fibrosis: A Preliminary Report

We conducted a randomized clinical trial of a 3-session written self-disclosure intervention for patients with cystic fibrosis (CF). Patients (n = 39) who were at least 15 years of age and diagnosed with CF participated in the intervention. Participants in the intervention arm were asked to write in the health care setting about an important emotionally distressing issue of personal significance for a 20-min period of time and two additional 20-min writing episodes at the patient's home, which were prompted by telephone calls. Patients in the control condition received standard care alone. Findings revealed that the intervention resulted in a reduction of the number of days patients spent in the hospital over a 3-month period. The intervention did not have an impact on physiological (Forced Expiratory Volume and Body Mass Index or subjective markers of health status. These findings extend those of Pennebaker's (cf., J. Smyth, 1998) demonstrating an effect of the written-self-disclosure intervention on health care utilization. These preliminary findings are promising and justify further investigation of the modified intervention in other chronic illness populations.     

Teacher Nominations of Preschool Children at Risk for Mental Health Problems: how False Is a False Positive Nomination and What Make Teachers Concerned?

Journal of Psychopathology and Behavioral Assessment - Identification attempts in populations with a low prevalence of problems usually result in a considerable number of false positives. Thus, the...     

Bimodal assessment in a stressful social encounter: Individual differences,lead-lag relationships,and response styles

Analogue social-stress situations have assumed an important role in the assessment of social anxiety. However, psychophysiological assessment of social anxiety in these laboratory situations has produced inconsistent results. Notably, the empirical relationship between autonomic reactivity and behavioral indices of social anxiety has fluctuated widely. The present study examined the relationship between heart rate and behavioral ratings of social anxiety in a normal college-student sample utilizing a methodology which (a) addressed individual differences, (b) utilized a relatively unobtrusive heart-rate monitoring system, and (c) assessed time-lag relationships between the two measures. Cross-lagged correlations for the full sample of 25 subjects and a subset of heart-rate reactives showed large intersubject variability between the measures. The results support the lack of convergence between the two modes of measurement when subjects are considered as an aggregate.     

The importance of behavioral and cognitive factors in heterosexual-social anxiety1

Subject groups were classified on the basis of behavioral ratings for degree of anxiety exhibited and level of social skill displayed during a simulated dating interaction. Subjects were then asked to view and evaluate their own skill performance and the performance of bogus subjects during the same interaction when presented on videotapes. All subject groups were accurate in rating the performance of the bogus subjects but the high anxious/high skill subjects underestimated (in comparison to judge's ratings) their own skill while high anxious/low skill subjects accurately assessed their poor performance. Implications of the establishment of two types of heterosexual-socially anxious subjects were drawn for both clinical practice and research.     

Sexualization in U.S. Latina and White Girls’ Preferred Children’s Television Programs

Master narratives, or prevailing cultural storylines, of motherhood provide a framework for new mothers to make sense of their experiences and to develop a coherent maternal identity. The present mixed methods study developed a theory-driven methodology to systematically identify a master narrative and examined whether one is present in 32 U.S. first-time mothers’ accounts of developing feelings for, and connection to, their newborns. In coding these mothers’ 95 episodes, we found that just over half of the mothers exclusively described positive feelings/connection toward their babies that were present in pregnancy or at birth (“At First Sight”; AFS), whereas 31 % exclusively described feelings/connection that took time to develop, or were negative, questioned, and/or tentative (“It Took Time”; ITT). To identify the presence of a master narrative, we compared these groups’ accounts on several theoretical indicators; the episodes of mothers who exclusively described ITT experiences were longer, more often contained talk of expectations, and were more likely to have a mismatch between expectation and experience than those of mothers who exclusively described AFS experiences. This suggests that ITT experience accounts countered a master narrative that mothers should have overwhelming, positive, and immediate feelings for/connection to their babies (AFS). Using discursive analysis, we then examined how the master narrative was actually invoked in the accounts of two mothers, one who positioned her experiences as aligned with, and one who positioned her experiences as counter to, the master narrative. Implications for supporting mothers in making meaning of their experiences, whether by aligning with the master narrative or co-constructing an empowering counter-narrative, are discussed.     

Longitudinal Associations Between Parental SES and Adolescent Health-Related Quality of Life Using Growth Curve Modeling

We evaluate how two aspects of socioeconomic status, parental objective and subjective social status, are associated with health-related quality of life in three racial/ethnic groups during pre- to mid-adolescent development, using growth curve modeling. In a longitudinal cohort study, 4,048 Black, Latinx, or White adolescents were assessed in 5th, 7th and 10th grade. Objective social status (OSS) was based on parent-reported highest household educational attainment and total household income, and subjective social status (SSS) was measured with the MacArthur Scale, through which parents indicated their social standing in reference to community and national norms. Adolescents completed the Pediatric Quality of Life Inventory to measure their physical and psychosocial health-related quality of life. Based on growth curve modeling of the intercept, adolescents whose parents have higher OSS levels reported better health-related quality of life, whereas parental SSS was not associated with adolescent health-related quality of life in 5^th grade. These findings were largely consistent across racial/ethnic groups. Based on growth curve modeling of the developmental slopes (or growth curves), higher objective social status was associated with a slower positive growth of health-related quality of life from 5^th to 10^th grade, which was largely consistent across racial/ethnic groups. The opposite appeared for parental SSS and physical health-related quality of life, and only for Latinx, where higher parental perceived social status was associated with an acceleration of positive change. Family income and education may influence health-related quality of life at the start of adolescence, but its effect appears to diminish as youth mature. However, in Latinx youth, parents’ perceived social status may continue to influence improvement in their physical health-related quality of life as they mature.

     

The Abbreviated Dimensions of Temperament Survey: Factor Structure and Construct Validity Across Three Racial/Ethnic Groups

The factor structure, reliability, and construct validity of an abbreviated version of the Revised Dimensions of Temperament Survey (DOTS–R) were evaluated across Black, Hispanic, and White early adolescents. Primary caregivers reported on 5 dimensions of temperament for 4,701 children. Five temperament dimensions were identified via maximum likelihood exploratory factor analysis and were labeled flexibility, general activity level, positive mood, task orientation, and sleep rhythmicity. Multigroup mean and covariance structures analysis provided partial support for strong factorial invariance across these racial/ethnic groups. Mean level comparisons indicated that relative to Hispanics and Blacks, Whites had higher flexibility, greater sleep regularity, and lower activity. They also reported higher positive mood than Blacks. Blacks, relative to Hispanics, had higher flexibility and lower sleep regularity. Construct validity was supported as the 5 temperament dimensions were significantly correlated with externalizing problems and socioemotional competence. This abbreviated version of the DOTS–R could be used across racial/ethnic groups of early adolescents to assess significant dimensions of temperament risk that are associated with mental health and competent (healthy) functioning.     

Social support and adjustment in chronically ill and handicapped children

The relationship between social support and adjustment was investigated in children with a chronic physical illness or handicap. Mothers of 153 children with juvenile diabetes, juvenile rheumatoid arthritis, chronic obesity, spina bifida, or cerebral palsy reported on these children's family support, peer support, externalizing behavior problems, and internalizing behavior problems. Children reported as having high social support from both family and peers showed a significantly better adjustment than those with high social support from only one of these sources. Chronically ill or physically handicapped children without high support from both family and peers were reported to have significantly more behavior problems than children in general. Both family and peer support contributed negatively and independently to the variance in externalizing behavior problems, whereas only peer support did so for internalizing behavior problems. There were no interactions between type of support and either sex or age in predicting adjustment.