Sexual Health Education Experiences and Recommendations from the Perspective of LGBTQ+ Youth.

Despite the well-known benefits of comprehensive sexual health education, the majority of school sexual health education curricula in the United States (U.S.) is non-comprehensive and excludes LGBTQ+ students. This exclusion may contribute to poor health outcomes in LGBTQ+ youth, with some research beginning to document these experiences and provide recommendations for curricula changes. Using a sample of LGBTQ+ youth across the U.S. (ages 13-17; N = 809), this study characterizes youths' sexual health education experiences and provides curricula recommendations using a mixed methods approach. Quantitative analyses revealed that LGBTQ+ content is often excluded from sexual health education, particularly topics surrounding sexual orientation and gender identity, which youth wanted to learn more about. Furthermore, participants identified several extracurricular sources of sexual health education, including online spaces, friends, and personal experiences, which were often preferred. Qualitative analyses suggested that LGBTQ+ youth described their sexual health education as exclusive of LGBTQ+ content, often being based in abstinence, religious principles, or described as oppressive (e.g. hearing LGBTQ+ negative remarks) or suppressive (e.g. skipping required LGBTQ+ content). LGBTQ+ youth also provided recommendations for future curricula. Findings can inform curricula development and implementation, as well as policy change, to ascertain that all youth have access to inclusive and comprehensive sexual health education.

Serving the Underserved? Uptake, Effectiveness, and Acceptability of Digital SSIs for Rural American Adolescents.

OBJECTIVE: Rural teens are less likely to access care for depression than urban teens. Evidence-based digital single-session interventions (SSIs), offered via social media advertisements, may be well suited to narrowing this gap in treatment access and increasing access to support for adolescents living in rural areas. We evaluated the viability of using social media-based advertisements to equitably recruit adolescents living in rural areas with elevated depression symptoms to digital SSIs; we sought to characterize and assess whether SSI completion rates and acceptability differed for adolescents living in rural versus more urban areas, across three intervention conditions (two active, evidence-based SSIs; one placebo control); and we tested whether digital SSIs differentially reduced depressive symptoms. METHOD: We used pre-intervention and three-month follow up data from 13- to 16-year-old adolescents (N = 2,322; 88% female; 55% non-Hispanic White) within a web-based randomized control trial of three free, digital SSIs (ClinicalTrials.gov identifier: NCT04634903) collected eight months into the COVID-19 pandemic in the United States. RESULTS: Digital SSIs reached adolescents at population-congruent rates; however, social media ads resulted in relative underrepresentation of youths from rural areas who hold minoritized racial/ethnic identities. Adolescents living in rural areas also completed digital SSIs at similar rates to their urban peers, found SSIs equivalently as acceptable, and reported comparable depression symptom reductions as youth living in urban areas. CONCLUSION: Digital SSIs and their dissemination through social media may offer a promising means of narrowing the gap between access to evidence-based mental health support between adolescents living in rural and urban areas; however, targeted efforts are warranted to reach racially minoritized youths in rural U.S. counties.

The differential impact of COVID-19 across health service psychology students of color: An embedded mixed-methods study.

OBJECTIVES: Communities of color in the United States systematically experience inequities in physical and mental health care compared to individuals who identify as non-Hispanic White. The coronavirus disease 2019 (COVID-19) pandemic exacerbated these structural drivers of inequity to disproportionate and devastating effects for persons of color. In addition to managing the direct effects of COVID-19 risk, persons of color were also navigating increased racial prejudice and discrimination. For mental health professionals and trainees of color, the effects of COVID-19 racial health disparities and the increase in acts of racism may have been compounded by their work responsibilities. The current study used an embedded mixed-methods approach to examine the differential impact of COVID-19 on health service psychology (HSP) students of color as compared to their non-Hispanic White peers. METHOD: Using quantitative and qualitative data from the Epidemic-Pandemic Impacts Inventory, measures of perceived support and of discrimination, and open-ended questions about students' experiences with racism and microaggressions, we examined the extent to which different racial/ethnic HSP student groups experienced COVID-19-related discrimination, the impacts of COVID-19 felt by students of color, and how these experiences differed from those of their non-Hispanic White peers. RESULTS: HSP students of color endorsed greater impacts of the pandemic on both self and others in the home, perceived themselves as less supported by others, and reported more experiences of racial discrimination than non-Hispanic White HSP students. CONCLUSION: Throughout the graduate experience, HSP students of color and their experiences of discrimination need to be addressed. We provided recommendations to HSP training program directors and students both during and after the COVID-19 pandemic.

Interpersonal Competence: A Mediator Between ODD Problems and Parent-Child Relationship Discord.

A central requirement of Oppositional Defiant Disorder (ODD) consists of difficulties with interpersonal relationships. As emerging adults' transition into adulthood and seek more autonomy from parents, it is important to examine how ODD problems and parent-child discord are indirectly associated through interpersonal competencies. The current study examined the indirect effects between ODD problems in emerging adults and parent-child discord through multiple interpersonal competencies as well as the additional differences among parent-child gender dyads. Emerging adults (N = 599 individuals aged 18 to 25 years; M = 19.60, SD = 1.40; 68% females) were recruited via an online research platform and completed online survey measures of ODD problems, parent-child relationship discord, and interpersonal competence. Indirect effects were significant for the mother-daughter dyad only. Additional results, limitations, and implications are discussed.

Parental Discipline During Emerging Adulthood: A Person-Centered Approach.

Although most parental discipline research examines the effects of discipline in children and adolescents, recent research has demonstrated that emerging adults continue to receive parental discipline. Importantly, a newly validated instrument for assessing discipline specifically during emerging adulthood has been created. Scales from this instrument include maternal and paternal approval, disappointment, and abuse, and these scales were associated with other parenting behaviors and psychological outcomes during emerging adulthood. However, a person-centered approach has not been conducted with this instrument. Given that discipline occurs at an idiographic level and that group norms inform such behaviors, a person-centered approach would identify highly informative emerging adult profiles based on patterns of discipline they receive from their parents. Thus, the current study utilized latent profile analysis (LPA) of 1110 participants attending a Southern United States university to identify emerging adult discipline profiles. These groups were then associated with parental and emerging adult psychological problems to gain an understanding of how these factors relate to different patterns of discipline across gender. Results best supported four profiles labeled as approving, distant, disappointed, and abusive. These groups reported increasingly higher parental and personal psychological problems across approving, distant, disappointed, and abusive profiles. Gender moderated some of these effects. Implications and future directions are discussed.

Financial stress and debt in clinical psychology doctoral students.

INTRODUTION: Few studies examine the financial burden of clinical psychology doctoral programs and its impact on achievements, stress, and mental health. OBJECTIVES: The current study sought to better understand students' financial stress and debt, and how financial stress may impact their mental health and the attainment of personal and professional milestones. METHOD: Students (N = 912) completed an online survey assessing demographics, sources of income and expenditures, mental health, and milestones. RESULTS: After accounting for yearly inflation, stipends have not kept pace with the average cost of living in the United States. Over one-third of students indicated that they had no expendable pretax income after paying for their education and typical living expenses. Additionally, over 80% reported acquiring additional debt in graduate school to offset their living expenses. Financial concerns were associated with delays in major life milestones (e.g., buying a car/house, getting married/starting a family, having children), as well as avoiding medical (34.2%) or mental (41.4%) health care, with 17.5% of participants experiencing a health crisis they could not afford while in graduate school. Financial stress was associated with an increase in time spent thinking about finances, higher rates of depression and anxiety symptoms, and decreased sleep. CONCLUSION: Many clinical psychology doctoral students experience financial stress and are often unable to afford basic educational, personal living, and health care expenses, likely worsening mental health. Academic programs and leadership are encouraged to increase student stipends, improve financial transparency, provide access to health care, and alleviate financial stress and debt.

Characterizing changes in mental health-related outcomes for health service psychology graduate students during the first year of the COVID-19 pandemic.

OBJECTIVES: Health service psychology (HSP) graduate students experienced adverse mental health outcomes during COVID-19. However, little is known about how mental health outcomes changed in this population after the onset of COVID-19. METHODS: N = 496 HSP graduate students reported onset or worsening of mental health outcomes, inability to access mental health care, worry about COVID-19, and stress at two different timepoints during the first year of the COVID-19 outbreak (timepoint 1: May 1 to June 25, 2020; timepoint 2: September 2 to October 17, 2020). This study tested whether mental health outcomes improved, worsened, or stayed stable during this timeframe. The study also examined whether rising COVID-19 case rates in the state where a participant lived moderated changes in mental health outcomes. RESULTS: Overall, HSP graduate students endorsed adverse mental health outcomes at a higher rate during the first survey relative to the second survey. Even still, 62.68% of students reported worsened mental health symptoms, 49.84% reported worsened sleep, and 23.92% reported increased alcohol and substance use in the 2 months leading up to the second survey. CONCLUSION: HSP programs should monitor graduate students' evolving mental health, provide wellness resources, and adopt flexible approaches to support graduate students navigating training during periods of immense disruption.

Evaluating comforting messages with the sentiment analysis and social cognition engine.

The current study extended the literature on social support by examining the differences in the word content of supportive messages using a free online linguistic tool called sentiment analysis and social cognition engine (SEANCE) across multiple levels. Participants created supportive messages in response to vignettes of distressed individuals, which were evaluated with SEANCE for word content and coded by researchers for person-centeredness. Word content was significantly different by level of person-centeredness, biological sex of support provider, and the recipient of support. The results suggest that tools such as SEANCE may help to identify levels of person-centeredness beyond that of a trained coder and that future research should examine the individual differences of support provider and recipient when evaluating message content.

Emerging Adult Report of Childhood Maltreatment and Related Facets of Impulsivity.

Childhood maltreatment is related to a host of outcomes, many of which may be partially explained by the transdiagnostic factor of impulsivity. The research linking maltreatment to impulsivity is well supported. However, research differentiating between emotional and physical maltreatment and impulsivity is lacking, particularly with regard to facets of trait impulsivity. Thus, the current study examined the links between childhood emotional and physical maltreatment and current impulsivity traits of positive and negative urgency, lack of perseverance, lack of premeditation, and sensation seeking in emerging adults. Furthermore, effects of maltreatment are known to differ by the gender of the parent and the gender of the child. Thus, differences between parent-emerging adult child gender dyads were also examined. Results suggested both physical and emotional maltreatment were associated with negative urgency across the parent-child gender dyads. Emotional maltreatment and physical maltreatment differed in relation to impulsivity facet across parent and child gender. Results contribute to a knowledge base to use in future exploration of emotional and physical maltreatment outcomes and targets of intervention.

Mental health concerns and barriers to care among future clinical psychologists.

Few studies have examined the mental health of clinical psychology doctoral students, a unique group given their education and training in psychopathology, assessment, and intervention. Students (N = 912) completed an online survey assessing demographics, mental health, mental healthcare utilization, and barriers to care during graduate school. Nearly 25% of participants reported moderate to severe symptoms of anxiety, 20% reported moderate to severe symptoms of depression or suicidal intent (SI), and more than 10% reported a high risk of alcohol abuse or moderate to severe drug use during graduate school. In comparison to peers, ethnic minority and lesbian, gay, bisexual, transgender, and queer (LGBTQ+) participants reported more symptoms of depression and SI. LGBTQ+ participants reported more nonsuicidal self-injury and drug use. Participants also experienced significant barriers to receiving mental healthcare (e.g., financial difficulties, limited availability, insufficient time). Leadership is encouraged to prioritize the mental health of clinical psychology doctoral students, which may have implications on their service provision.

Stress-Buffering Role of Social Support during COVID-19.

In order to reduce the high infection rate of COVID-19, individuals began to engage in self-isolation amid a time of uncertainty and worry. Given that social support can be protective against the negative effects of distress on mental and physical health, the lack of support may negatively impact individuals during their self-isolation. Thus, the current study examined the role of self-isolation on feelings of stress, the perception and reception of social support, and mental health problems during the COVID-19 pandemic. A sample of 405 college students were asked to report on the amount of self-isolation in which they were engaging, worry about COVID-19, psychological health, and received and perceived social support. Results indicated that when the length of time in self-isolation was taken into account, perceived social support buffered the connection between worry about COVID-19 and psychological health. These results indicate that social support, worry about COVID-19, and self-isolation may influence individuals' psychological health during times of stress.

Con el fin de disminuir el alto índice de contagio de la COVID-19, las personas comenzaron a autoaislarse en medio de un momento de incertidumbre y preocupación. Teniendo en cuenta que el apoyo social puede ser protector contra los efectos negativos del distrés en la salud mental y física, la falta de apoyo puede afectar negativamente a las personas durante su autoaislamiento. Por lo tanto, el presente estudio analizó el papel que desempeña el autoaislamiento en los sentimientos de estrés, la percepción y la recepción de apoyo social y los problemas de salud mental durante la pandemia de la COVID-19. Se solicitó a una muestra de 405 estudiantes universitarios que informen sobre la cantidad de autoaislamiento que estaban haciendo, las preocupaciones acerca de la COVID-19, la salud psicológica y el apoyo social recibido y percibido. Los resultados indicaron que cuando se tuvo en cuenta el periodo de tiempo en autoaislamiento, el apoyo social percibido amortiguó la conexión entre la preocupación acerca de la COVID-19 y la salud psicológica. Estos resultados indican que el apoyo social, la preocupación acerca de la COVID-19 y el autoaislamiento pueden influir en la salud psicológica de las personas durante momentos de estrés.

Maltreatment and Affective and Behavioral Problems in Emerging Adults With and Without Oppositional Defiant Disorder Symptoms: Mediation by Parent-Child Relationship Quality.

The current study examined the indirect effect of maternal and paternal emotional and physical maltreatment on affective and behavioral symptoms of oppositional defiant disorder (ODD) through parent-child relationship quality; gender and overall ODD symptoms were examined as moderators. Participants included 2,362 emerging adults who completed questionnaires about parental emotional and physical maltreatment, parent-child relationship quality, and affective and behavioral ODD symptoms. These characteristics were compared across parent and child gender (i.e., maternal and paternal effects as well as male and female differences) as well as participants reporting high and low ODD symptoms. In the low ODD group, indirect effects of emotional maltreatment occurred in all parent-child dyads except the mother-son dyad, whereas in the high ODD group, indirect effects occurred only in the father-son dyad. Indirect effects of physical maltreatment occurred only in the father-son dyad in the low ODD group, and only in the mother-daughter dyad on behavioral ODD symptoms in the high ODD group. The results suggest that specific parent-child gender dyads respond differently, warranting further investigation of gender effects. Moreover, emerging adults in the low ODD symptoms group demonstrated a positive association between parental maltreatment and ODD symptoms and a negative association between parent-child relationship quality and ODD symptoms, whereas those high in the high ODD symptoms group did not demonstrate these associations. That is, emerging adults reporting high ODD symptoms demonstrated no relationship between their ODD symptoms and harsh parenting, suggesting an ineffective coercive process.

Appraisal and social support as moderators between stress and physical and psychological quality of life.

One proposed mechanism of social support is the facilitation of primary and secondary reappraisal of stressful situations. The current study examined the expansion of the original stress-buffering hypothesis to include primary or secondary appraisal in an emerging adult population (N = 854) on physical and psychological health outcomes. The additional moderating effects of gender also were examined. Perceived social support (by the Multidimensional Survey of Perceived Social Support) significantly buffered the effects of stress from negative events (by the Risky Behaviour and Stressful Events Scale) on physical and psychological health (by the World Health Organizations Quality of Life Instrument) for females only. Neither primary nor secondary appraisal (by the Stress Appraisal Measure) acted as additional buffers for male or females. Social support may be a more salient buffer for females. Reappraisal mechanisms may have another role in the buffering pathways. Further implications and limitations were discussed.

Temperament and Affective and Behavioral ODD Problems in Emerging Adults: Moderation by Gender and Perceived Parental Psychopathology.

Recent research has indicated that ODD problems persist into emerging adulthood, although mechanisms influencing ODD during emerging adulthood remain relatively unknown. Additionally, temperament and parental psychopathology both are implicated in the development of childhood ODD. Thus, the current study examined how perceived parental (i.e., maternal and paternal) psychopathology (i.e., anxiety, depressive, and antisocial problems) moderated the relationship between temperament (i.e., effortful control, negative affect, and surgency) and ODD problems (i.e., affective and behavioral) in a sample of 599 emerging adults who were instructed to complete questionnaires based on their current perceptions. Results indicated that perceived parental anxiety and antisocial problems moderated the relationship between two of the temperament variables (i.e., negative affect and effortful control) and both types of ODD problems. Moreover, these results were further moderated by participant gender. Finally, perceived parental depressive problems served as a moderator for affective problems only. Overall, results suggest that similar associations found regarding childhood ODD may be implicated when examining emerging adults, and gender moderates these associations.

Links between parental socialization of coping on affect: Mediation by emotion regulation and social exclusion.

INTRODUCTION: Parental socialization of coping strategies is associated with various emotion regulation difficulties and continues to impact individuals during emerging adulthood. As emerging adults' transition into adulthood, they experience social stressors that put their emotion regulation skills to the test. METHODS: The current study examined the associations of the parental socialization of coping strategies and emotion regulation difficulties with emerging adult positive and negative affect in response to social exclusion. Emerging adults (N = 402, 206 males and 196 females) from a large Southern university in the United States were recruited for the study. Participants completed survey measures of parental socialization of coping, positive and negative affect, and emotion regulation difficulties before engaging in a social exclusion task called Cyberball. After the task, participants completed a measure of positive and negative affect again. RESULTS: Primary parental socialization of coping was associated with emotion regulation difficulties, both of which were associated with affect after the exclusion task, thus supporting the indirect effect of parental coping socialization on affect through a preexisting variable (i.e., emotion regulation) and a causal manipulation (i.e., exclusion task). CONCLUSIONS: The impact of parental suggestions of coping strategies and emotion regulation difficulties during emerging adulthood indicate that parents continue to be an important point of intervention as individuals' transition to adulthood.

Risky sexual behavior: the indirect effects between parent-child relationship quality and quality of life in emerging adults.

PURPOSE: Parent-child relationship quality is an important factor when examining adolescent's risk for problem behaviors. For this reason, many researchers have explored the impacts of parent-child relationship quality on adolescent and child behavior, yet the parent-child relationship has lasting consequences into adulthood. METHODS: The current study examined the mediating role of risky sexual behavior (as measured by the Youth Risk Behavior Survey) on the relationship between parent-child relationship quality (as measured by the Parental Environment Questionnaire) and quality of life (as measured by the World Health Organizations Quality of Life Questionnaire) beyond adolescence, during emerging adulthood. The additional moderating effects of gender were examined. Participants consisted of 507 undergraduate students (173 males, 334 females) recruited from a large university in the Southern United States between 18 and 25 years of age. RESULTS: Parent-child relationship quality was positively related to quality of life among both males and females. The indirect pathway from parent-child relationship quality to quality of life, through risky sexual behavior, was significant in females but not in males. CONCLUSIONS: Results suggest that the parent-child relationship, specifically for females, may be a target for intervention in the prevention of risky sexual behavior in Emerging Adulthood. Further results, implications, and limitations were discussed.