Translational Issues in Psychological Science最新文献

Background: Exposure to childhood maltreatment (CM) increases risk for psychiatric disorders and maladaptive outcomes across the lifespan, including the transition into parenthood. Mothers with histories of CM are more likely to experience poorer mental health and engage in negative parenting practices. Maternal CM influences parenting behaviors, potentially leading to adolescent maladaptive outcomes. This study examines the effects of maternal CM on adolescent emotional and behavioral difficulties, focusing on how mothers' and adolescents' perceptions of parental psychological control (PPC) mediate these relationships.

Methods: We analyzed data from 148 mother-adolescent dyads recruited for a longitudinal investigation of early life stress and psychopathology. Mothers completed the Childhood Trauma Questionnaire assessing CM, and both mothers and adolescents reported perceptions of PPC. Adolescents reported internalizing and externalizing problems 2-4 years later. Mediation analyses assessed maternal CM's effects on adolescent behavioral problems, examining adolescent- and mother-reported PPC as mediators.

Results: Maternal childhood abuse significantly predicted adolescent externalizing problems, mediated by adolescents' perceptions of PPC. Higher maternal childhood abuse correlated with increased adolescent-reported PPC, which was associated with greater externalizing problems. Mother-reported PPC did not mediate this association, highlighting adolescents' perceptions. Maternal neglect had no significant direct or indirect effects on adolescent outcomes, or on adolescent- or mother-reported PPC.

Conclusions: These findings underscore the importance of adolescents' perceptions of parenting in understanding the effects of maternal childhood abuse on externalizing problems. Lack of findings for maternal neglect highlights the need to identify alternative mechanisms by which neglect may affect adolescent functioning. Interventions promoting positive mother-adolescent relationships could improve adolescent psychosocial outcomes.

Parental burnout has detrimental consequences for both parents and children, highlighting the importance of identifying accessible resources that buffer against parental burnout. Digital media may be one tool that parents use to regulate their day-to-day emotions, but existing research that primarily relies on global estimates of typical media use limits our understanding of real-time processes. In the current study, 401 predominantly White, college-educated parents of infants 12-24 months old completed 21 daily diaries reporting on parental burnout symptoms, parenting experiences, and motivations for family media use. Temporal network analysis revealed different findings across time scales (same-day vs. next-day) and levels (within- vs. between-subjects). On days when parents reported more burnout symptoms (i.e., exhaustion, distance, overwhelm) compared to their usual levels, they also reported using more media to regulate their emotions on the same day. Exhaustion, specifically, predicted parents' regulatory media use the next day, though there were no between-person links. Using media to connect was associated with feeling less distant from children in general and on the same day. Parents who found their children more difficult to manage used more media to regulate their own emotions on the same day, but less overall. These patterns and differences across networks suggest that media use may be an adaptive short-term strategy that parents use when feeling more burned out or struggling in their parenting role. Understanding why a specific strategy might be adaptive for parents can inform targeted guidance to help parents better manage their day-to-day parenting-related emotional challenges.

This study examined antipsychotic prescribing patterns with respect to mental health diagnoses and racial/ethnic differences among privately insured youth. We leveraged 2009-2021 data from Optum's de-identified Clinformatics^® Data Mart Database, derived from a database of administrative claims for members of large commercial and Medicare Advantage healthcare insurance plans. There were 46,372 new antipsychotic users between 6-17 years old. For each antipsychotic user, we identified a non-user with the same age, sex, and year of enrollment. We first examined sociodemographic and mental health characteristics of antipsychotic users. We then compared the odds of being an antipsychotic user across different racial/ethnic groups. Comparisons were repeated in subgroups of youth diagnosed with attention-deficit/hyperactivity disorder (ADHD), depressive disorders, and disruptive behavior disorders to examine racial/ethnic differences within common, off-label diagnoses. At least 61% of antipsychotic users had no recorded FDA-approved diagnoses. Depressive disorders and ADHD appeared most frequently, in 46% and 40% of antipsychotic users, respectively. Across the full sample, racial/ethnic minority youth had approximately 25-60% lower odds of antipsychotic use compared with White youth. However, racial/ethnic differences were greatly reduced or eliminated within groups of youth with ADHD, depressive disorders, and disruptive behavior disorders. These findings suggest most privately insured antipsychotic users lack recorded diagnoses for which antipsychotic use in youth is FDA-approved or has established guidelines. Furthermore, it is possible that observed differences in antipsychotic use among racial/ethnic minoritized groups can be attributed at least in part to disparities upstream of initial diagnoses.

This commentary addresses Herman et al. (2024)'s article on applying the Knowledge-to-Action (KTA) model to the dissemination of evidence-based online mental health resources. Herman et al. (2024)'s article emphasizes the need for a decision-making tool to aid the intended audience in identifying their own problems and matching them to respective solutions. We propose the utility of audience segmentation research when designing and tailoring decision-making tools to the unique needs of heterogenous audiences. A conceptual overview of audience segmentation research is outlined, including two commonly used approaches (i.e., demographic separation, empirical clustering). In sum, audience segmentation prior to the development of a decision-making tool may aid in tailoring dissemination strategies and ultimately expanding the reach and adoption of evidence-based resources among the intended audience, which may more effectively minimize the know-do gap.

The COVID-19 pandemic disturbed the lives of adolescents during a well-established, sensitive period of development, and further disadvantaged communities already burdened with limited resources. Although there has consistently been discourse on human suffering during and since the COVID-19 pandemic, very little attention has been given to flourishing during this time of extraordinary adversity. Flourishing is a construct that describes a group of individuals who are concurrently reporting high or frequent hedonic (positive emotions) and eudaimonic (purpose, fulfilment) experiences. In the present study we modeled resilience as indexed by the association between early life adversity (ELA) and flourishing, as well as the mediating role of two indices of psychosocial resources (cumulative and compensatory) as a function of individual differences in the impact of COVID-19 in their lives. To do so, we used data collected from 223 predominantly Hispanic/Latino youth (age 11-18) assessed between April 2021 and April 2022 as part of a community-engaged partnership. Based on adolescent self-report on the Mental Health Continuum (MHC-SF), 36.3% of the sample met criteria for flourishing. Parallel moderated mediation showed that having more exposure to ELA was associated with a lower likelihood of flourishing (p < .001), and that this association was differentially explained by compensatory psychosocial resources depending on COVID-19 impact. Specifically, among adolescents experiencing high COVID-19 impact, ELA was associated with a lower likelihood of flourishing via lower compensatory psychosocial resources, indirect effect at high COVID-19 impact b = -0.01 (SE = 0.007), 95%CI[-0.03, -0.002]. These results underscore the importance of considering ELA and recent stress in conceptualizations of adolescent flourishing and demonstrate the potential advantages of identifying interventions that increase compensatory psychosocial resources among ELA-exposed youth.

Racially minoritized transgender and gender expansive (i.e., gender identities that exist beyond the cisgender binary of male or female) young adults (RMTGEYA) experience both individual-level and structural stigma that negatively impacts mental health outcomes. RMTGEYA have any array of strength resources that are tied to culture, community, and identity that are vital resources for mental health. Unfortunately, they are rarely included in the research literature. We aimed to qualitatively spotlight resilience resources as sources of standalone strength possessed by RMTGEYA as well as tools for mitigating the impact of stigma. We interviewed 16 RMTGEYA and conducted thematic analyses on their responses to questions on topics of strength, stigma, and mental health. Results of team-based thematic analysis yielded a reliable codebook (Krippendorff's α = 0.87) from which we derived 5 major themes related to: 1) internal strength; 2) collectivist strength; 3) intersectional strength; 4) macro-level strengths and privileges; and 5) strength in the absence of macro-level supports that are not always adequate in the presence of greater structural oppression. RMTGEYA's are abundant with strength, but there is opportunity for clinical science and practice to leverage these strengths to improve mental health outcomes. Our results spotlight the importance of taking a strength-based approach to research, assessment, and intervention that also promotes advocacy for better structural supports to materially improve the lives off RMTGEYA.

Lesbian, gay, bisexual, transgender, and queer (LGBTQ+) individuals face health care disparities, highlighting the need for inclusive and affirming health care environments. Critical to this issue is the willingness to disclose sexual orientation and gender identity (SOGI) in health care settings, as it can significantly influence the quality of care. Despite prior literature emphasizing affirming spaces, the link between the physical health care office environment and SOGI disclosure remains underexplored. This study investigates the impact of health care office environments on the disclosure of SOGI in a diverse sample of N = 399 participants (LGBTQ+ n = 196; cisgender and heterosexual: cishet n = 203). Findings reveal that affirming health care settings enhance willingness to disclose SOGI status, particularly among sexual minorities who identify as cisgender (LGBQ) individuals, while transgender and gender diverse individuals exhibit less willingness to disclose compared to LGBQ and cishet individuals. Individual factors (e.g., outness, internalized stigma) significantly influence willingness to disclose SOGI status. Affirming health care environments mitigated the negative impact of internalized LGBTQ+ stigma on willingness to disclose. These results highlight the need for affirming spaces, addressing both external discrimination and internalized LGBTQ+ stigma to mitigate LGBTQ+ health disparities.

Given the multiple layers of intersectional stigma and discrimination faced by gay and bisexual men and other men who have sex with men (GBMSM) in Kenya, substances may be used to cope with minority stressors. The majority of research on substance use for this population has focused on reporting rates of substance use and its association with HIV risk and mental health. This study provides an in-depth and nuanced exploration of what motivates substance use and substance use reduction, and how substance use impacts various aspects of Kenyan GBMSM's lives. Individual in-depth interviews were conducted with 60 GBMSM (ages 20-45) in Western Kenya as part of a larger study focused on developing an HIV prevention and sexual health promotion intervention. Thematic qualitative analyses were conducted by a diverse team of analysts. Substance use was perceived to have positive and negative effects within three primary thematic areas of functioning: sexual health, physical health, and economic well-being. Motivations or reasons for using substances included coping with stigma, increasing social connectedness, increasing sexual confidence, lowering sexual inhibitions, and peer pressure. Various motivations or reasons to reduce substance use were discussed, including improving sexual health, improving mental well-being, having better sex, maintaining power during sex work, and maintaining physical good looks. These data provide a more complex understanding of the role that substance use plays in Kenyan GBMSM's lives, and provide valuable information for community-based interventions to prevent negative health outcomes from substance use.

Dysregulated irritability is the most robust early childhood transdiagnostic predictor of psychopathology. However, this evidence has failed to translate to practice due to a dearth of efficient, developmentally-based screening tools. Drawing on the well-validated Multidimensional Assessment Profiles (MAPS) Temper Loss Scale, early feasibility testing of a preliminary clinical screener (MAPS-Early Assessment Screener for Irritability; MAPS-EASI 1.0) was well-received. However, large-scale clinical implementation requires enhanced precision, with age-banded norms psychometrically derived in a large representative sample. Here, we aim to optimize MAPS-EASI for routine pediatric care via psychometric validation of the MAPS-EASI 2.0 Irritability Screener and Impact Rating. Data on 2-5-year-old children (N=1,508) were utilized to derive generalizable thresholds for MAPS-EASI 2.0. Analyses were guided by timing of toddler (n=463) and preschool (n=1045) age well-child visits, generating two Irritability Screener forms: (1) 3 items for toddlers (18-33 months); and (2) 4 items for preschoolers (34-66 months). Irritability Screener severity cut-points were established with good-to-excellent classification (areas under the curve=0.84, 0.88), sensitivity (0.83, 0.82), and specificity (0.72, 0.79), for toddlers and preschoolers respectively. Over-identification was reduced by including impairment in the screening algorithm via the MAPS-EASI 2.0 Impact Rating. The clinical threshold for this integrative algorithm identified 15% and 18% of toddlers and preschoolers, respectively; these rates align with established population prevalence. Pragmatic, transdiagnostic developmental screening tools for routine care may accelerate real-world impact of irritability science for early mental health.

Deliberate Emotion Regulation (ER), the effortful regulation of emotions, is strongly linked to psychopathology. In adults, deliberate ER is often experienced as a self-narrative, such as reappraising a negatively perceived scenario. However, researchers have yet to study how young children articulate deliberate ER strategies, whether these strategies relate to real-time ER neurophysiological processes, and how these strategies are associated with psychopathology. We examined preschool-aged children's verbally articulated ER strategies prior to a frustration challenge, and related these strategies to subsequent real-time neural and physiological responses to frustration and psychopathology in a sample of 59 children. We categorized children's responses into two groups: those who articulated any emotion regulation strategy (i.e., "strategy") and those who did not articulate a strategy (i.e., "no strategy"). We found that about 70% of children in our sample were able to articulate an emotion regulation strategy. Children who articulated a strategy had lower psychophysiological stress during a frustration task compared to children who did not articulate a strategy. Children who articulated a strategy also had fewer ADHD symptoms compared to peers who did not, but also significantly smaller variability of symptoms, and when these unequal variances were taken into account the difference was outside of the traditional p < .05 threshold for significance. To our knowledge, this pilot study is the first to show that emotion regulation strategy articulation may be an emerging skill in early childhood connected to successful modulation of physiological stress and fewer symptoms of psychopathology.