Pubertal stress recalibration and later social and emotional adjustment among adolescents: The role of early life stress.

The current study investigated whether recalibration of the hypothalamic-pituitary -adrenocortical (HPA) axis stress response in youth who had previously experienced early life stress (ELS) would predict socioemotional adjustment in a follow-up assessment approximately 2-4 years later when youth were 12- to 21-years old. The sample consisted of previously institutionalized (PI) (N = 96) youth and a comparison non-adopted (NA) group (N = 117). Youth were 16 years old on average at the time of the follow-up assessment. Parent and youth-reported measures were used to assess youth's internalizing symptoms and emotion regulation. Parent-reported measures were used to assess youth's externalizing symptoms. We tested whether showing cortisol increases (vs. not) across the peripubertal period was associated with later social and emotional adjustment differently for PI and NA youth. Significant interactions emerged showing that for PI youth only, increases in cortisol reactivity across the peripubertal period was associated with poorer subsequent socioemotional functioning.

SIGIS-SIAMS-SIE position statement of gender affirming hormonal treatment in transgender and non-binary people.

PURPOSE: Gender Incongruence (GI) is a marked and persistent incongruence between an individual's experienced and the assigned gender at birth. In the recent years, there has been a considerable evolution and change in attitude as regards to gender nonconforming people. METHODS: According to the Italian Society of Gender, Identity and Health (SIGIS), the Italian Society of Andrology and Sexual Medicine (SIAMS) and the Italian Society of Endocrinology (SIE) rules, a team of experts on the topic has been nominated by a SIGIS-SIAMS-SIE Guideline Board on the basis of their recognized clinical and research expertise in the field, and coordinated by a senior author, has prepared this Position statement. Later on, the present manuscript has been submitted to the Journal of Endocrinological Investigation for the normal process of international peer reviewing after a first internal revision process made by the SIGIS-SIAMS-SIE Guideline Board. RESULTS: In the present document by the SIGIS-SIAMS-SIE group, we propose experts opinions concerning the psychological functioning, gender affirming hormonal treatment, safety concerns, emerging issues in transgender healthcare (sexual health, fertility issues, elderly trans people), and an Italian law overview aimed to improve gender non-conforming people care. CONCLUSION: In this Position statement, we propose experts opinions concerning the psychological functioning of transgender people, the gender-affirming hormonal treatment (full/partial masculinization in assigned female at birth trans people, full/partial feminization and de-masculinization in assigned male at birth trans people), the emerging issues in transgender health care aimed to improve patient care. We have also included an overview of Italian law about gender affirming surgery and registry rectification.

Psychological adjustment of Spanish adolescents and their parents during COVID-19 lockdown: A mixed method approach.

Previous literature on the psychological impact of COVID-19 has shown a direct relationship between family conflicts and psychological distress among parents and their children during the domestic lockdown and social isolation; but there are also opportunities to enhance family bonding, encourage collective problem-solving and improve personal relationships. This study aimed to explore psychological adjustment processes of Spanish adolescents and their parents during the first month of lockdown by analyzing their narratives, perceived outcomes, protection and risk factors. A total of 142 people agreed to participate in this study. Of all participants, 61 were adolescents (M = 13.57; SD = 1.74; 57% women) and 81 were parents (M = 46.09; SD = 4.72; 91% mothers). All were Spanish residents and completed an online survey during the domestic lockdown in March 2020. From a qualitative design, methodology followed a mixed approach to analyze data. The results showed three different types of adaptation to lockdown and social isolation in both adolescents and their parents: 1) positive adjustment, 2) moderate adjustment, and 3) maladjustment. Most participants reported a good adjustment and only a 20% of parents and a 16% of adolescents stated that they had not been able to achieve a positive psychological adjustment. There are few significant quantitative differences between adolescents and their parents. The qualitative analysis of data showed that adolescents reported less psychological distress than their parents. The two most important protective factors were social support and keeping busy during lockdown. The most significant risk factors were loss of mobility and social isolation. The conclusions stressed that regarding psychological maladjustment, parents experienced feelings of uncertainty whereas adolescents experienced a kind of mourning process. These findings can be used to design and implement effective intervention measures for mental health and psychological well-being in such a difficult situation as domestic lockdown.

Ethnic-Racial discrimination experiences predict Latinx adolescents' physiological stress processes across college transition.

Consistent with conceptual frameworks of ethnic-race-based stress responses, and empirical evidence for the detrimental effects of ethnic-racial discrimination, the current study hypothesized that experiencing more frequent ethnic-racial discrimination during adolescence would predict differences in physiological responses to psychosocial stress across the college transition. U.S. Latinx adolescents (N = 84; Mage = 18.56; SD = 0.35; 63.1% female; 85.7% Mexican descent) completed survey measures of ethnic-racial discrimination during their final year of high school and first college semester (~5 months later), as well as a standard psychosocial stressor task during their first college semester. Repeated blood pressure and salivary cortisol measures were recorded to assess cardiovascular and neuroendocrine activity at baseline and stress reactivity and recovery. Data were analyzed using multilevel growth models. Experiencing more frequent ethnic-racial discrimination in high school, specifically from adults, predicted higher baseline physiological stress levels and lower reactivity to psychosocial stress during the first college semester, evidenced by both blood pressure and cortisol measures. Experiencing ethnic-racial discrimination from peers in high school also predicted higher baseline blood pressure in college, but not stress reactivity indices. Results were consistent when controlling for concurrent reports of ethnic-racial discrimination, gender, parents' education level, body mass index, oral contraceptive use, time between longitudinal assessments, depressive symptoms, and general perceived stress. Experiencing frequent ethnic-racial discrimination during adolescence may lead to overburdening stress response systems, indexed by lower cardiovascular and neuroendocrine stress reactivity. Multiple physiological stress systems are sensitive to the consequences of ethnic-racial discrimination among Latinx adolescents transitioning to college.

Daily gender expression is associated with psychological adjustment for some people, but mainly men.

To what extent does gender expression vary day-to-day? Are daily changes related to psychological adjustment in the same way for all individuals? A person-specific approach was used to answer these questions in a 75-day intensive longitudinal study. Fifty-seven cisgender adults (27 women) provided over 4000 reports of daily masculinity and femininity and of three indices of internalizing problems. Results revealed: (a) substantial daily fluctuations in gender expression, especially in women; (b) sample-level links between daily increases in femininity or reductions in masculinity and heightened anxiety, depression, and self-reproach for men, but no apparent links for women; and (c) person-specific links between gender expression and psychological adjustment, such that some women reported internalizing problems with reduced masculinity (average male pattern) and some men reported problems with heightened masculinity (opposite the average male pattern). Findings highlight how intensive longitudinal research can illuminate the uniqueness of gender-related daily experiences, and their implications for the wellbeing of individuals.

The stability of psychological adjustment among donor-conceived offspring in the U.S. National Longitudinal Lesbian Family Study from childhood to adulthood: differences by donor type.

OBJECTIVE: To study differences by sperm donor type in the psychological adjustment of the U.S. National Longitudinal Lesbian Family Study (NLLFS) offspring across three time periods from childhood to adulthood. DESIGN: U.S.-based prospective cohort study. SETTING: Paper-and-pencil questionnaires and protected online surveys. PATIENT(S): A cohort of 74 offspring conceived by lesbian parents using an anonymous (n = 26), a known (n = 26), or an open-identity (n = 22) sperm donor. Data were reported when offspring were ages 10 (wave 4), 17 (wave 5), and 25 (wave 6). INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Achenbach Child Behavior Checklist administered to lesbian parents when offspring were ages 10 and 17 and the Achenbach Adult Self-Report administered to offspring at age 25. RESULT(S): In both relative and absolute stability, no differences were found in internalizing, externalizing, and total problem behaviors by donor type over 15 years. However, both externalizing and total problem behaviors significantly declined from age 10 to 17 and then increased from age 17 to 25. Irrespective of donor type, among the 74 offspring, the large majority scored continuously within the normal range on internalizing (n = 62, 83.8%), externalizing (n = 62, 83.8%), and total problem behaviors (n = 60, 81.1%). CONCLUSION(S): The results reassure prospective lesbian parents and provide policy makers and reproductive medicine practitioners with empirical evidence that psychological adjustment in offspring raised by lesbian parents is unrelated to donor type in the long term.

Emotional adaptation to relationship dissolution in parents and non-parents: A new conceptual model and measure.

Relationship dissolution can cause declines in emotional well-being, particularly if there are children involved. Individuals' capacity to cope with the pragmatics of the situation, such as agreeing childcare arrangements, can be impaired. Before now, there has been no psychometric test to evaluate individuals' emotional readiness to cope with these demands. This paper presents a model of emotional adaptation in the context of relationship dissolution and its key assumptions, and validates the Emotional Adaptation to Relationship Dissolution Assessment (EARDA). In Study 1 (Sample 1, n = 573 separated parents, Sample 2, n = 199 mix of parents and non-parents), factor analyses support the EARDA as a unidimensional scale with good reliability. In Study 2 (using Sample 1, and Sample 3, n = 156 separated parents) the convergent, discriminant, concurrent criterion-related, and incremental validity of the EARDA were supported by tests of association with stress, distress, attachment style, and co-parenting communication and conflict. In Study 3, the nomological network of emotional adaptation to relationship dissolution was explored in Sample 2 using cluster analysis and multi-dimensional scaling (MDS). Emotional adaptation clustered with positive traits and an outward focus, and was negatively associated with negative traits and an inward focus. Emotional adaptation was conceptually located in close proximity to active and adaptive coping, and furthest away from maladaptive coping. In Study 4 (n = 30 separated parents embarking on mediation), high, medium, and low emotional adaptation to relationship dissolution categories correlated highly with mediators' professional judgement, offering triangulated face validity. Finally, in Study 5, EARDA scores were found to mediate between separation characteristics (time since break up, whether it was a shock, and who initiated the break up) and co-parenting conflict in Sample 1, supporting the proposed model. The theoretical innovation of this work is the introduction of a new construct that bridges the gap between relationship dissolution and co-parenting. Practical implications include the use of the measure proposed to triage levels of support in a family law setting.

Psychological adjustment outcomes among pediatric brain tumor survivors: A meta-analysis.

BACKGROUND: Pediatric brain tumor survivors (PBTS) are at significant risk for psychological adjustment difficulties, including greater depressive and anxious symptomology. Systematic reviews have identified this heightened risk among youth with medical conditions, but these reviews have not been specific to PBTS. Therefore, the current study aimed to directly examine the psychological adjustment of PBTS as compared to healthy peers. PROCEDURE: A systematic review and meta-analysis was conducted using PubMed, PsychInfo, and Academic Search Premier databases. The search yielded 2833 articles, with 22 articles meeting inclusion criteria. RESULTS: A statistically significant overall medium effect size (Hedge's g = 0.32) indicated that PBTS exhibited poorer overall psychological adjustment relative to healthy comparison groups. Studies that included younger children were associated with larger between-group differences. When evaluating specific outcomes, PBTS had relatively higher levels of depressive symptoms (Hedge's g = 0.36), anxious symptoms (Hedge's g = 0.11), and general distress (Hedge's g = 0.22), but not more externalizing problems. CONCLUSIONS: The present study confirmed that PBTS are indeed at greater risk for psychological adjustment difficulties relative to healthy comparison groups. These findings highlight the importance of psychosocial screening among this population. Given that depressive symptoms were the most elevated relative to healthy peers, investigation of such symptomatology among PBTS is particularly important.

The adjustment process of young Bedouin women who were child brides.

Qualitative study explores the adjustment process of young Bedouin women in Israel who were minors and legally underage when they married. Child brides have always existed in Bedouin society, which sees marriage as a social and religious framework that protects the girl. This study's participants, 30 young women who were 13-17 when they married, shed light on the long and continuing process of adjustment, the sharp transitions in their lives, and their cognitive assimilation of married life. Their stories allow a glimpse of how a generation of young women within a traditional, strongly patriarchal society is starting to challenge accepted traditional practices. The case of Bedouin society may be relevant to other traditional societies, to indigenous peoples, and in general to the issue of child marriage that is so widespread globally. Child brides, a worldwide phenomenon, have always existed in Bedouin society, which sees marriage as a social and religious framework that protects the girl and her family from dishonor. Such marriages continue despite legal prohibition. This qualitative study in the phenomenological tradition explores the adjustment process of young Bedouin women in Israel who were legally underage when they married. The participants, 30 young women who married at ages 13-17, were recruited from the case loads of social workers in southern Israel. Data were obtained through in-depth semistructured interviews. The data shed light on the women's long and continuing process of adjustment, the sharp transitions in their lives, and their cognitive assimilation of married life and motherhood. Optimism that everything will work out and individual and family resilience are important factors, but the adjustment process is different for each of two groups of the participants: In one group, the girl met her prospective husband before marriage, was engaged for at least 6 months, and was prepared by her family for marriage and intimate relations. In the second group, the girl did not know the prospective husband, was engaged very briefly (up to 1 month), was not prepared for marriage, and was not asked for her opinion or consent. For the second group, the adjustment process was longer and more difficult. The stories of both groups reveal how a generation of young women within a traditional, strongly patriarchal society is starting to challenge traditional practices, including the husband's dependence on his family and the mother-in-law's interference, although ultimately they conform to their society's norms. Social services need to be aware of the processes these young women are undergoing and to build suitable intervention programs for them, their spouses, and their families. Also needed is a program that will explain to girls and their families the implications of marriage at a young age. The case of Bedouin society may be relevant to other traditional societies, to indigenous peoples, and to the global issue of child marriage. This article contributes to global knowledge by presenting the world of these young women, members of a society that is undergoing powerful changes that have weakened the traditional establishment but that still clings to such values as honor and male supremacy.

Characterization of 5-HT1A receptor and transport protein KIF13A expression in the hippocampus of stress-adaptive and -maladaptive mice.

The ability to adapt to stress is an essential defensive function of a living body, and disturbance of this ability in the brain may contribute to the development of affective illness including major depression and anxiety disorders. A growing body of evidence suggests that brain serotonin (5-HT)1A receptors may be involved, at least in part, in the development of adaptation to stress. 5-HT1A receptor was reported to be transported by KIF13A, a motor protein and a member of the kinesin superfamily, from the golgi apparatus to the plasma membrane. The aim of the present study was to characterize the expression pattern of 5-HT1A receptor and KIF13A in the hippocampus of stress-adaptive and -maladaptive mice. Mice were either exposed to repeated adaptable (1 h/day) or unadaptable (4 h/day) restraint stress, or left in their home cage for 14 days. The levels of 5-HT1A receptor and KIF13A expression were assessed by western blot analysis. To confirm the formation of a 5-HT1A receptor and KIF13A complex, we performed blue native-sodium dodecyl sulfate-polyacrylamide gel electrophoresis (BN-SDS-PAGE). Western blotting showed that neither 5-HT1A receptor nor KIF13A expression changed significantly in the hippocampal total extract of stress-adaptive and -maladaptive mice. In contrast, expression of 5 H T1A receptor and KIF13A in the hippocampal membrane fraction was increased in stress-adaptive mice, but not in stress-maladaptive mice. BN-SDS-PAGE analysis revealed that the bands of 5-HT1A receptor and KIF13A were both observed at a molecular weight of approximately 70 kDa, which indicated that 5-HT1A receptor and KIF13A form a complex. The present findings suggest that translocation of 5-HT1A receptor in complex with KIF13A to the plasma membrane of the hippocampus may play an important role in the formation of stress adaptation.

A 2-year longitudinal study of neuropsychological functioning, psychosocial adjustment and rehospitalisation in schizophrenia and major depression.

Neuropsychological functioning turns out to be a rate-limiting factor in psychiatry. However, little is known when comparing neuropsychological and psychosocial functioning in inpatients with schizophrenia or severe depression in their treatment pathways including add-on psychoeducation or the latter combined with cognitive behavioral therapy up to 2-year follow-up. To evaluate this question, we investigated these variables in two randomised controlled trials including 196 patients with DSM-IV schizophrenia and 177 patients with major depression. Outcome measures were assessed in the hospital at pre- and posttreatment and following discharge until 2-year follow-up. We focused on neuropsychological and psychosocial functioning regarding its differences and changes over time in data of two pooled trials. There were significant time effects indicating gains in knowledge about the illness, short and medium-term memory (VLMT) and psychosocial functioning (GAF), however, the latter was the only variable showing a time x study/diagnosis interaction effect at 2-year follow-up, showing significant better outcome in depression compared to schizophrenia. Moderator analysis showed no changes in psychosocial and neuropsychological functioning in schizophrenia and in affective disorders due to age, duration of illness or sex. Looking at the rehospitalisation rates there were no significant differences between both disorders. Both groups treated with psychoeducation or a combination of psychoeducation and CBT improved in neuropsychological and psychosocial functioning as well as knowledge about the illness at 2-year follow-up, however, patients with major depression showed greater gains in psychosocial functioning compared to patients with schizophrenia. Possible implications of these findings were discussed.

Trajectories of Observed Shyness and Psychosocial Adjustment in Children.

Shyness can manifest as inhibition, fear, and avoidance in the context of social novelty and situations of perceived social evaluation. In the present study, 130 children (Mage = 7.6 years, SD = 1.8) participated in a videotaped self-presentation task across three separate visits spanning approximately 3 years in early and middle childhood. Children's observed shyness was best characterized by two trajectories, including a high-stable class (19%) and a low-stable class (81%). Girls were more likely than boys to follow a pattern of high-stable observed shyness. Further, children in the high-stable observed shyness class were rated by parents and teachers as more socially anxious relative to children in the low-stable class, and boys in the high-stable observed shyness class were rated by their teachers as displaying more depressive symptoms relative to girls. These findings suggest that a subset of children display stable behavioral shyness, and this is correlated with psychosocial functioning.

Examining the Adjustment Patterns of Adults With Multiple Chronic Pain Conditions and Multiple Pain Sites: More Pain, No Gain.

The present study examined how multiple chronic pain conditions and pain sites are associated with sociodemographics, chronic pain adjustment profiles, and emotional distress. A total of 2,407 individuals who reported at least 6 months of having consistent pain severity, pain interference, and/or emotional burden due to pain were recruited through random digit dialing across the United States. Participants' chronic pain adjustment profiles (ie, pain intensity, pain interference, emotional burden, pain catastrophizing, pain coping, pain attitudes, and social resources) were assessed. Anxiety and depressive symptoms were also measured using a subsample of 181 participants who provided 3-month follow-up data. More than 60% of individuals with chronic pain reported having multiple pain conditions. Middle-aged single women with fibromyalgia, disability and of low socioeconomic status reported a greater number of pain conditions and pain sites. Structural equation modeling revealed that a higher number of pain conditions and sites were associated with more dysfunctional chronic pain adjustment profiles. The subsample analyses showed that reporting a greater number of pain conditions predicted a higher level of depression and anxiety 3 months later, controlling for pain-related anxiety and depressive symptoms, pain severity and interference at baseline. Having multiple pain conditions and sites may represent a psychosocial barrier to successful adjustment to chronic pain. PERSPECTIVE: This article argues for the importance of assessing the number of co-occurring chronic pain conditions and bodily areas that are affected by pain in both pain research and clinical settings. Measuring and incorporating such information could potentially enhance our nascent understanding of the adjustment processes of chronic pain.

International Comparisons of Emotionally Reactive Problems in Preschoolers: CBCL/1½-5 Findings from 21 Societies.

Our goal was to conduct international comparisons of emotion regulation using the 9-item Emotionally Reactive (ER) syndrome of the Child Behavior Checklist for Ages 1½-5. We analyzed parent ratings for 17,964 preschoolers from 21 societies, which were grouped into 8 GLOBE study culture clusters (e.g., Nordic, Confucian Asian). Omnicultural broad base rates for ER items ranged from 8.0% to 38.8%. Rank ordering for mean item ratings varied widely across societies (omnicultural Q = .50) but less so across culture clusters (M Q = .66). Societal similarity in mean item rank ordering varied by culture cluster, with large within-cluster similarity for Anglo (Q = .96), Latin Europe (Q = .74), Germanic (Q = .77), and Latin American (Q = .76) clusters, but smaller within-cluster similarity for Nordic, Eastern Europe, and Confucian Asian clusters (Qs = .52, .23, and .44, respectively). Confirmatory factor analyses of the ER syndrome supported configural invariance for all 21 societies. All 9 items showed full to approximate metric invariance, but only 3 items showed approximate scalar invariance. The ER syndrome correlated . 65 with the Anxious/Depressed (A/D) syndrome and .63 with the Aggressive Behavior syndrome. ER items varied in base rates and factor loadings, and societies varied in rank ordering of items as low, medium, or high in mean ratings. Item rank order similarity among societies in the same culture cluster varied widely across culture clusters, suggesting the importance of cultural factors in the assessment of emotion regulation in preschoolers.

A predictive model of resilience among family caregivers supporting relatives with traumatic brain injury (TBI): A structural equation modelling approach.

Constructs from positive psychology were employed to create an explicit model of caregiver resilience. Predictive and mediating relationships among resilience and related variables (personality, coping, self-efficacy, hope, social support) were then tested for their association with burden and psychological adjustment among family members caring for relatives with severe TBI. Family participants (n = 131) from six rehabilitation units from New South Wales and Queensland completed assessments which elicited explanatory (Eysenck Personality Questionnaire, Ways of Coping Questionnaire), mediating (Connor-Davidson Resilience Scale, General Self-Efficacy Scale, Herth Hope Scale, Medical Outcome Study Social Support Survey), and caregiver outcome (Caregiver Burden Scale, Mental Health sub-Scale-SF36, General Health Questionnaire, and Positive and Negative Affect Scale) variables. Structural Equation Modeling (SEM) showed that resilience had a direct effect on positive affect in caregivers. Resilience also played a protective role in relation to two variables associated with caregiver vulnerability: an indirect association with caregiver burden mediated through social support; a direct effect on hope, which, in turn, was associated with positive mental health. Positive mental health then played a buffering role in relation to psychological distress and negative affect. Resilience, in combination with other psychological attributes, was associated with reduced morbidity among family caregivers after severe TBI.

A round peg in a square hole: strategy-situation fit of intra- and interpersonal emotion regulation strategies and controllability.

Although the importance of contextual factors is often recognised, research on emotion regulation strategies (ERS) has mainly focused so far on the effectiveness of ERS across situations. In the present research, we tested the strategy-situation fit hypothesis, which does not assume general effectiveness of ERS but instead stresses the importance of the congruency between ERS and the contexts in which they are used. Using a longitudinal Ambulatory Assessment dataset (N = 138), we found that controllability of a situation positively moderated the effectiveness of interpersonal ERS, such that, e.g. providing feedback to others was significantly associated with less positive feelings but only in less controllable situations. Intrapersonal ERS were negatively moderated by controllability, such that downplaying a negative situation was associated with less negative feelings in less controllable situations. Finally, favouring interpersonal over intrapersonal ERS was also positively moderated by controllability, demonstrating the situational fit of ERS in daily life.

Illness Perception Mediates the Relationship Between the Severity of Symptoms and Perceived Health Status in Patients With Behçet Disease.

OBJECTIVE: The aim of this study was to investigate the relationship between psychological representations of illness, perceived health status, and self-assessment of symptom severity in patients with Behçet disease, a rare long-term incurable condition with unclear etiology. METHODS: Using cross-sectional survey design, data on self-administered questionnaires on illness perception, health status, symptoms severity, and demographic characteristics were collected from 273 patients with Behçet disease (age range, 18-65 years). The data were subjected to mediation analysis to test whether cognitive and emotional components of illness perception mediate the relationship between the severity of symptoms and heath status. RESULTS: The results support our hypotheses that cognitive components of illness perception (perceived consequences and identity of the illness) mediate the link between symptom activity and pain, whereas emotional components of the illness (emotional representations about the illness) mediate the relationship between disease activity and perceived energy level. CONCLUSIONS: The robustness of these mediation effects suggests potential directions for clinical psychologists and health care practitioners in developing support programs. We supplement our study with Open Access database containing information about type of medication, comorbid mood disorder, and detailed measurement of the severity of BD symptoms for sharing and accumulating multidisciplinary knowledge aiming to support the development of interventions. Addressing psychological aspects of BD will help to manage complex patients effectively.