What variables predict stigmatizing attitudes toward people with mental disorders and their treatment in Filipinos and Americans?

In the United States, Asian Americans express greater stigma toward those with mental disorders and report lower rates of seeking mental health treatment than do White Americans. However, research on these topics in Filipino cultural groups, especially Filipinos living in the Philippines (i.e., Filipino nationals), is sparse. To support the design of interventions to decrease stigma and improve rates of seeking treatment, we assessed attitudes toward mental disorders and help-seeking in Filipinos. U.S. national (i.e., American) and Filipino national participants completed an online survey containing the Mental Illness Stigma Scale, a Theory of Planned Behavior questionnaire measuring attitudes toward seeking treatment, and queries regarding demographic and psychosocial factors. Filipinos expressed significantly more stigma regarding relationship disruption, interpersonal anxiety, and poor hygiene, alongside increased perceived subjective norms opposing seeking treatment and decreased perceived behavioral control over getting treatment if necessary. We ran a linear mixed effects regression on each nationality separately to identify relationships between stigma and psychosocial factors. For Filipinos, increased parental education predicted decreased perceived relationship disruption and interpersonal anxiety; urbanization was associated with greater trust in mental health professionals, and having a close relative with a disorder led to decreased belief in patient recoverability. For Americans, increased participant education predicted decreased interpersonal anxiety, increased perceived recoverability, and improved perceived behavioral control over getting treatment if necessary, and having a close relative with a disorder predicted improved perceived treatability. The results guide programs for decreasing stigma and increasing treatment-seeking behavior. Limitations, future research directions, and possible interventions are discussed.

Testing similarity in longitudinal networks: The Individual Network Invariance Test.

The comparison of idiographic network structures to determine the presence of heterogeneity is a challenging endeavor in many applied settings. Previously, researchers eyeballed idiographic networks, computed correlations, and used techniques that make use of the multilevel structure of the data (e.g., group iterative multiple model estimation and multilevel vector autoregressive) to investigate individual differences. However, these methods do not allow for testing the (in)equality of idiographic network structures directly. In this article, we propose the Individual Network Invariance Test (INIT), which we implemented in the R package INIT. INIT extends common model comparison practices in structural equation modeling to idiographic network structures to test for (in)equality between idiographic networks. In a simulation study, we evaluated the performance of INIT on both saturated and pruned idiographic network structures by inspecting the rejection rate of the χ² difference test and model selection criteria, such as the Akaike information criterion (AIC) and Bayesian information criterion (BIC). Results show INIT performs adequately when t = 100 per individual. When applying INIT on saturated networks, the AIC performed best as a model selection criterion, while the BIC showed better results when applying INIT on pruned networks. In an empirical example, we highlight the possibilities of this new technique, illustrating how INIT provides researchers with a means of testing for (in)equality between idiographic network structures and within idiographic network structures over time. To conclude, recommendations for empirical researchers are provided. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Mental health markers and protective factors in students with symptoms of physical pain across WEIRD and non-WEIRD samples - a network analysis.

BACKGROUND: Studies conducted in Western societies have identified variables associated with chronic pain, but few have done so across cultures. Our study aimed to clarify the relationship between specific mental health markers (i.e., depression, anxiety, posttraumatic stress disorder [PTSD], perceived stress) as well as specific protective factors (i.e., social support and self-efficacy) related to physical pain among university students across non-WEIRD and WEIRD samples. METHOD: A total of 188 university students (131 women and 57 men) were included in the study. We used network analysis to ascertain mental health markers especially central to the experience of physical pain. RESULTS: No statistically significant difference was found between mental health markers (i.e., depression, anxiety, perceived stress, and PTSD) and protective factors (i.e., social support and self-efficacy) associated with physical pain symptoms for Swiss students versus Indian students (M = 0.325, p = .11). In addition, networks for Swiss versus Indian students did not differ in global strength (S = 0.29, p = .803). Anxiety was the most central mental health marker, and social support was the most important protective factor related to physical pain in both countries. However, for Swiss students, perceived stress, and for Indian students, PTSD symptoms were central mental health markers related to physical pain. CONCLUSION: Our results identify factors that may serve as important treatment targets for pain interventions among students of both countries before it becomes chronic.

The future of psychological treatments: The Marburg Declaration.

Although psychological treatments are broadly recognized as evidence-based interventions for various mental disorders, challenges remain. For example, a substantial proportion of patients receiving such treatments do not fully recover, and many obstacles hinder the dissemination, implementation, and training of psychological treatments. These problems require those in our field to rethink some of our basic models of mental disorders and their treatments, and question how research and practice in clinical psychology should progress. To answer these questions, a group of experts of clinical psychology convened at a Think-Tank in Marburg, Germany, in August 2022 to review the evidence and analyze barriers for current and future developments. After this event, an overview of the current state-of-the-art was drafted and suggestions for improvements and specific recommendations for research and practice were integrated. Recommendations arising from our meeting cover further improving psychological interventions through translational approaches, improving clinical research methodology, bridging the gap between more nomothetic (group-oriented) studies and idiographic (person-centered) decisions, using network approaches in addition to selecting single mechanisms to embrace the complexity of clinical reality, making use of scalable digital options for assessments and interventions, improving the training and education of future psychotherapists, and accepting the societal responsibilities that clinical psychology has in improving national and global health care. The objective of the Marburg Declaration is to stimulate a significant change regarding our understanding of mental disorders and their treatments, with the aim to trigger a new era of evidence-based psychological interventions.

Evidence of spatial clustering of childhood acute lymphoblastic leukemia cases in Greater Mexico City: report from the Mexican Inter-Institutional Group for the identification of the causes of childhood leukemia.

Background: A heterogeneous geographic distribution of childhood acute lymphoblastic leukemia (ALL) cases has been described, possibly, related to the presence of different environmental factors. The aim of the present study was to explore the geographical distribution of childhood ALL cases in Greater Mexico City (GMC). Methods: A population-based case-control study was conducted. Children <18 years old, newly diagnosed with ALL and residents of GMC were included. Controls were patients without leukemia recruited from second-level public hospitals, frequency-matched by sex, age, and health institution with the cases. The residence address where the patients lived during the last year before diagnosis (cases) or the interview (controls) was used for geolocation. Kulldorff's spatial scan statistic was used to detect spatial clusters (SCs). Relative risks (RR), associated p-value and number of cases included for each cluster were obtained. Results: A total of 1054 cases with ALL were analyzed. Of these, 408 (38.7%) were distributed across eight SCs detected. A relative risk of 1.61 (p<0.0001) was observed for the main cluster. Similar results were noted for the remaining seven ones. Additionally, a proximity between SCs, electrical installations and petrochemical facilities was observed. Conclusions: The identification of SCs in certain regions of GMC suggest the possible role of environmental factors in the etiology of childhood ALL.

A roadmap to address stress in graduate students: How to develop and disseminate a student-led single-session evidence based intervention.

Objective: This manuscript describes an evidence-based, student-led, single-session group intervention to support emotional wellbeing among graduate students. The present objective is to provide a roadmap for other universities. Participants: Key participants include clinical psychology graduate students (leader and workshop facilitators), faculty supervisor, representatives from receiving departments or schools, and institutional advocates. Methods: The two-hour workshop was based on four core transdiagnostic cognitive behavioral skills, including psychoeducation about emotions, mindful emotional awareness, cognitive flexibility, and behavior change. The workshop was designed and continues to be led by trained graduate students. Results: Key steps and lessons learned are presented for the exploration, preparation, implementation, and sustainment phases. Conclusions: This program has the potential to be flexibly replicated at other universities to assist with graduate student mental health. It provides unique supports for recipients and unique training opportunities for student facilitators.

Posttraumatic stress disorder symptoms and positive affect: Individual and multilevel dynamic networks.

OBJECTIVE: Network analysis aims to identify links between symptoms that may serve to maintain one other; the current study uses network analysis to identify relationships between posttraumatic stress disorder (PTSD) symptoms as they unfold over time within individuals. We also examine whether positive affect (PA) may buffer subsequent PTSD symptoms in daily life and compare single individual networks to the average within-person effects. METHOD: Fifty-two individuals (76.9% female; 84.6% white) who had experienced a Criterion A trauma participated in the 2-week study and reported their PA and PTSD symptom levels five times a day at 2-hr intervals (M surveys completed = 60.4). Multilevel and regularized individual-only network models were generated using vector autoregression. RESULTS: Feeling distant from others was the PTSD symptom most closely connected to lower PA; it was also the most connected to other PTSD symptoms. PA items did not predict lower PTSD at the next time point, except for one bidirectional relationship. Feeling on edge was the symptom with the largest magnitude of relationships to other symptoms in the multilevel network, but this was only reflected in 38.5% of the individual networks. Three example individual networks are described and discussed for clinical implications. CONCLUSIONS: We did not find evidence to support the hypothesis that PA buffers PTSD symptom severity on the time scale assessed (2 hr). Feeling distant from others was a bridge between lower PA and PTSD symptoms and may indicate social support as an important factor in treating trauma survivors. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Solitude can be good-If you see it as such: Reappraisal helps lonely people experience solitude more positively.

OBJECTIVE: Solitude is a common experience that can elicit both positive (e.g., relaxation) and negative (e.g., loneliness) emotions. But can changing the way we think about solitude improve its emotional effects? In a previous study, our team found that positively reframing solitude buffers against a reduction in positive affect when alone. Yet, it is unknown whether people who are lonely-and thus more likely to experience solitude negatively-benefit from modifying their beliefs about being alone. METHOD: Here, we test whether reframing solitude as a beneficial experience or de-stigmatizing loneliness helps people experiencing moderate-to-severe loneliness (N = 224) feel more positive emotion and less negative emotion during solitude. We randomly assigned participants to read about either the benefits of solitude, the high prevalence of loneliness, or a control topic. Then, participants spent 10 min alone in the laboratory. State affect was assessed before and after the solitude period. RESULTS: Across conditions, the solitude period reduced high-arousal positive (e.g., excited) and high-arousal negative (e.g., anxious) affect. Notably, people who read about the benefits of solitude experienced a significantly larger increase in low-arousal positive affect compared with the control condition. CONCLUSION: Our findings indicate that lonely individuals can more readily reap the emotional benefits of solitude when they reframe solitude as an experience that can enhance their well-being.

Type 1 diabetes in North East England and North Cumbria: patterns and time trends in 0-14-year-olds from 2012 to 2020.

Introduction: It is important to understand patterns in the epidemiology of type 1 diabetes because they may provide insight into its etiology. We examined the incidence of type 1 diabetes in children aged 0-14 years, and patient demographics and clinical parameters at presentation, over the period 2012-2020 using the North East and North Cumbria Young Persons diabetes register. Methods: Patients up to the age of 14 years with type 1 diabetes, and their families- managed in a total of 18 young persons diabetes clinics-were approached in person at the time of clinic appointments or in the days following diagnosis and they consented to their data being included in the register. Data were submitted regionally to a central unit. Descriptive statistics including crude and age-specific incidence rates were calculated. Temporal trends were analyzed using Joinpoint regression. Comparisons in incidence rates were made between age, sex and areas of higher and lower affluence as measured by the Index of Multiple Deprivation (IMD). Results: A total of 943 cases were recorded between January 2012 and December 2020. Median age at diagnosis was 8.8 years (Q1: 5.3, Q3: 11.7). There were more males than females (54% male). The median HbA1c at diagnosis was 100 mmoL/L (IQR: 39) and over one third (35%) were in ketoacidosis (pH < 7.3). Crude incidence decreased from 25.5 (95% confidence interval [CI] 20.9, 29.9) in 2012 to 16.6 (95% CI: 13.0, 20.2) per 100,000 in 2020 (5.1% per annum, 95% CI 1.1, 8.8%). During the period of the study there was no evidence of any trends in median age, HbA1c, BMI or birthweight (p = 0.18, 0.80, 0.69, 0.32) at diagnosis. Higher rates were observed in males aged 10-14 years, but similar rates were found for both sexes aged 0-9 years and there was no difference between areas of higher or lower deprivation (p = 0.22). Conclusion: The incidence of diabetes in the young may be falling in the North East of England and North Cumbria. The reasons are unclear as there were no associations identified between levels of deprivation or anthropometric measurements. Potential mechanisms include alterations in socioeconomic background or growth pattern. Further research is needed to understand the reasons behind this finding.

Crying over spilled milk? A network analysis of aversive well-being comparison, brooding rumination and depressive symptoms.

BACKGROUND: Comparative thinking about one's well-being is ubiquitous. Comparisons that threaten an individual's self-motives are aversive and interact with rumination and depression. Aversive well-being comparisons include upward social, past temporal, counterfactual, and criteria-based comparisons, as well as downward prospective temporal comparisons. Although the frequency, discrepancy, and affective impact of aversive comparison total scores have been associated with brooding rumination and depression, no study has investigated the interaction of specific comparison standards (e.g., social or counterfactual) with symptom cascades of brooding and depressive symptoms. METHODS: To examine this interaction, we conducted network analyses on the interplay between aversive well-being comparisons, brooding rumination, and depression. Specifically, we conducted a cross-sectional study in N = 500 dysphoric individuals and a longitudinal study in N = 921 participants at two timepoints, three months apart. Participants completed measures of depression, brooding, and the Comparison Standards Scale for Well-being, which assessed the frequency, perceived discrepancy, and affective impact of aversive well-being comparisons. RESULTS: Feelings of worthlessness emerged as the most central attribute in the networks of the dysphoric sample. Longitudinally, brooding and depressive symptoms predicted aversive comparisons, but not the other way around, which accounted for social and other-referent counterfactual comparisons to a greater degree than for other comparison types. LIMITATIONS: We used nonclinical samples. CONCLUSIONS: The findings highlight the critical role of comparison standards in depression. Further research is warranted to detect potential intervention targets for mitigating negative effects of negative self-evaluation.

How do mindfulness and compassion programs improve mental health and well-being? The role of attentional processing of emotional information.

BACKGROUND AND OBJECTIVES: Although the benefits of Meditation-Based Programs are well documented, the mechanisms underlying these benefits have not been fully elucidated. Therefore, we examined whether: (1) formal training in mindfulness and compassion meditation modifies the distribution of attentional resources towards emotional information; and (2) whether changes in attentional processing of emotional information after the meditation programs mediate the improvements in psychological distress, emotion regulation, and well-being. METHODS: A sample of 103 participants enrolled in the study: 36 in the mindfulness program (MBSR), 30 in the compassion program (CCT), and 37 in the no-intervention comparison group (CG). The assessment before and after the programs included the completion of an emotional Attentional Blink task (AB) together with self-report measures of psychological distress, emotion regulation, and well-being. RESULTS: MBSR and CCT reduced similarly the AB deficit, whereas no changes occurred in the CG. This AB reduction was found for the different emotional and non-emotional stimuli (i.e., negative, positive, and neutral), showing a significant disengagement from first-target emotions and significant accessibility of second-target emotions to consciousness. The effects of both meditation programs on the psychological measures were mediated by changes in the AB and emotion regulation skills. LIMITATIONS: Due to our naturalistic design in a real-world community setting, random assignment of participants was not feasible. CONCLUSIONS: Meditation may promote more flexible and balanced attention to emotional information, which may be a key transdiagnostic mechanism underlying its benefits on emotional distress and well-being.

Managing Fear During Pandemics: Risks and Opportunities.

Fear is an emotion triggered by the perception of danger and motivates safety behaviors. Within the context of the COVID-19 pandemic, there were ample danger cues (e.g., images of patients on ventilators) and a high need for people to use appropriate safety behaviors (e.g., social distancing). Given this central role of fear within the context of a pandemic, it is important to review some of the emerging findings and lessons learned during the COVID-19 pandemic and their implications for managing fear. We highlight factors that determine fear (i.e., proximity, predictability, and controllability) and review several adaptive and maladaptive consequences of fear of COVID-19 (e.g., following governmental health policies and panic buying). Finally, we provide directions for future research and make policy recommendations that can promote adequate health behaviors and limit the negative consequences of fear during pandemics.

The Return of Repression? Evidence From Cognitive Psychology.

The controversy over alleged repressed and recovered memories of childhood sexual abuse (CSA) was among the most contentious ever to embroil psychology and psychiatry. Adapting paradigms from cognitive psychology, my research group tested hypotheses pertinent to repressed memory and false memory interpretations of recovered memories. We tested adults who: (1) report recovering memories of CSA after not having thought about their abuse for years; (2) report never having forgotten their CSA; (3) believe they harbor "repressed" memories of CSA; and (4) deny having been sexually abused. We tested hypotheses about mechanisms that might figure in the inability to recall memories of one's abuse and those that might render one susceptible to developing false memories of abuse. The purpose of this article is to summarize this work. Finally, I draw on the work of Lionel Penrose to speculate about why the popularity of the concept of repressed memories of trauma-or its synonym, dissociative amnesia for trauma-may be rising today.

Oversimplifications and Misrepresentations in the Repressed Memory Debate: A Reply to Ross.

Ross argued that false memory researchers misunderstand the concepts of repression and dissociation, as well as the writings of Freud. In this commentary, we show that Ross is wrong. He oversimplifies and misrepresents the literature on repressed and false memory. We rebut Ross by showing the fallacies underlying his arguments. For example, we adduce evidence showing that the notions of dissociation or repression are unnecessary to explain how people may forget and then remember childhood sexual abuse, stressing that abuse survivors may reinterpret childhood events later in life. Also, Ross overlooks previous critiques concerning dissociation. Finally, we will demonstrate that Ross misrepresents work by Freud and Loftus in the area of repressed and false memory. His article confuses, not clarifies, an already heated debate on the existence of repressed memory.

Is avoidance the only issue? A case study of "self-triggering" in combat-related posttraumatic stress disorder.

OBJECTIVE: We explore the emerging concept of "self-triggering" through a case illustration of a Vietnam veteran with posttraumatic stress disorder (PTSD) who engaged in self-triggering for 50 years after his index trauma. He reduced the frequency of self-triggering upon receiving a combination of cognitive processing therapy and behavioral exposure treatment. METHOD: This article provides a brief overview of the emerging literature on self-triggering, proposes theory for its function, and discusses how self-triggering affected the treatment of this veteran's chronic PTSD. RESULTS: Through clinical intervention that focused on what to approach (i.e., real-world experiences) and what to avoid (i.e., online triggering videos), the veteran stopped one kind of self-triggering but not another. The veteran attributed much of his positive behavior change to desire to honor the life of a young boy whose likely death he witnessed in Vietnam. CONCLUSIONS: Though people with PTSD often go to great lengths to avoid reminders of their trauma, there is a subset who seek reminders that trigger distressing reexperiencing symptoms. Such puzzling self-triggering behavior in those with PTSD is seldom studied and poorly understood. The details of this veteran's experience present a compelling case for self-triggering as an attempt to search for meaning in one's trauma, gain control of symptoms, and punish oneself. Implications for research and clinical practice are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

A tutorial on bayesian networks for psychopathology researchers.

Bayesian Networks are probabilistic graphical models that represent conditional independence relationships among variables as a directed acyclic graph (DAG), where edges can be interpreted as causal effects connecting one causal symptom to an effect symptom. These models can help overcome one of the key limitations of partial correlation networks whose edges are undirected. This tutorial aims to introduce Bayesian Networks to identify admissible causal relationships in cross-sectional data, as well as how to estimate these models in R through three algorithm families with an empirical example data set of depressive symptoms. In addition, we discuss common problems and questions related to Bayesian networks. We recommend Bayesian networks be investigated to gain causal insight in psychological data. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Exposure to descriptions of traumatic events narrows one's concept of trauma.

The concept of "trauma" was originally used by psychiatrists to describe horrific events such as rape and torture that characteristically provoke extreme emotional distress. Both colloquially and clinically, the concept of psychological trauma has broadened considerably. Although many clinical scientists have expressed concern about the broadening of the concept of trauma, it remains unclear how this concept expansion occurs. We present two experiments in which American adults (N = 276 and N = 267) sequentially classified descriptions of events (e.g., "broke a leg in a bicycle accident") as either "trauma" or "not trauma." In the first experiment, we manipulated the frequency of severe events (i.e., severe events became less and less common). In the second experiment, we manipulated the range of events (i.e., participants viewed only severe or only nonsevere events). Together, the findings suggest that an individual's frame of reference for the severity of events plays a role in narrowing or broadening the concept of trauma. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Self-triggering: Does function determine pathogenesis?

OBJECTIVE: Research suggests six motives for exposing oneself to painful reminders of a trauma outside of a therapeutic context (self-triggering). These include provoking arousal, escaping emotional numbness, self-punishment, controlling symptoms of posttraumatic stress disorder (PTSD), making meaning of one's trauma, and generating an experience that matches one's emotions. The goal of the current study is to examine if these motives subserve broader functions of self-triggering behavior that differentially relate to PTSD symptoms. METHOD: We conducted an exploratory factor analysis on the self-reported reasons for self-triggering collected from 360 adults who endorsed lifetime self-triggering. We then theorized higher-order factors and tested both their fit to the data with a confirmatory factor analysis and whether they moderated the relationship between self-triggering and PTSD symptoms. RESULTS: We found that five factors best described the reasons for self-triggering. We theorized one higher-order factor (function) of "emotional modification" that encompasses sensation-seeking, antinumbing, self-punishment, and affect-matching. The "meaning-making" function consists of efforts to make meaning of one's trauma. This structure fit the data well in a confirmatory factor analysis. Self-triggering frequency no longer predicted symptom severity when meaning-making was highly endorsed as a function of self-triggering. Emotional modification did not affect this relationship. CONCLUSIONS: Generalizability may be limited by the sample's high symptom levels, limited demographic diversity, and high proportion of interpersonal trauma. These findings suggest that the degree to which individuals self-trigger to make meaning of trauma may affect how pathogenic the behavior is, underscoring the clinical importance of identifying the function of patients' self-triggering. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

A network approach to climate change anxiety and its key related features.

Research has pointed to startling worldwide rates of people reporting considerable anxiety vis-à-vis climate change. Yet, uncertainties remain regarding how climate anxiety's cognitive-emotional features and daily life functional impairments interact with one another and with climate change experience, pro-environmental behaviors, and general worry. In this study, we apply network analyses to examine the associations among these variables in an international community sample (n = 874). We computed two network models, a graphical Gaussian model to explore network structure, potential communities, and influential nodes, and a directed acyclic graph to examine the probabilistic dependencies among the variables. Both network models pointed to the cognitive-emotional features of climate anxiety as a potential hub bridging general worry, the experience of climate change, pro-environmental behaviors, and the functional impairments associated with climate anxiety. Our findings offer data-driven clues for the field's larger quest to establish the foundations of climate anxiety.