Social problem solving moderates emotion reactivity in predicting suicide ideation among college students.

Objective: To evaluate the hypothesis that social problem solving (SPS) moderates strong emotion reactivity (ER) to stressful events in predicting suicide ideation (SI). Participants: 200 college students: mean age = 20.33; 75% women; 58% white. Methods: Participants completed the following self-report inventories: Beck Scale for Suicide Ideation, Emotion Reactivity Scale, and Social Problem-Solving Inventory-Revised. Results: Regression and slope analyses found SPS to moderate the association between ER and SI. Specifically, (a) as ER increased, SI increased significantly less for average problem solvers as compared to ineffective problem solvers, and (b) SI increased only slightly for effective problem solvers as ER increased. A secondary exploratory analysis found 20 college students who previously attempted suicide reported more negative ER, less effective SPS, and higher SI, as compared to a group of 20 sex-and age-matched peers. Conclusions: Effective social problem solving serves to decrease the likelihood that college students will experience higher levels of suicide ideation even when their negative emotion reactivity is high. Clinical implications for treatment and prevention are discussed.

Beyond maintaining safety: Examining the benefit of emotion-centered problem solving therapy added to safety planning for reducing late life suicide risk.

Few clinical trials have examined brief non-pharmacological treatments for reducing suicide risk in older Veterans, a high-risk group. Problem Solving Therapy (PST) is a promising psychosocial intervention for reducing late life suicide risk by increasing adaptive coping to problems through effective problem solving and related coping skills. The current randomized clinical trial will compare the efficacy of six telephone-delivered sessions of Safety Planning (enhanced usual care; EUC) only or an updated version of PST (emotion-centered PST [EC-PST]) + EUC to determine the added clinical benefit of EC-PST for reducing severity of suicidal ideation and for increasing reasons for living, a critical protective factor. Participants randomized to EC-PST + EUC or EUC only will be 150 Veterans (75 each) with active suicidal ideation who are aged 60 or older; have a current DSM-5 anxiety, depressive, and/or trauma-related disorder; and without significant cognitive impairment. Primary outcomes (Geriatric Suicide Ideation Scale and Reasons for Living-Older Adults scale) will be assessed at 11 timepoints: baseline, after each of 6 treatment sessions, posttreatment, and at follow-up at 1, 3, and 6 months posttreatment, and analyzed using mixed effects modeling. Additionally, moderators and mediators of primary outcomes will be examined-functional disability, executive dysfunction, and problem-solving ability. Qualitative feedback from participants will identify potential Veteran-centric changes to the EC-PST protocol and to EUC. Ultimately, the goal of this study is to inform the evidence-based clinical practice guidelines for treatments to reduce suicide risk in older Veterans and specifically to inform clinical decision-making regarding the merit of adding EC-PST to EUC.

Social problem solving as a mediator of stress and chronic prostatitis symptomology.

Social problem solving (SPS), the process by which individuals attempt to cope with stressful life problems, has previously been found to mediate the relationship between stress and disorder-related symptomatology among several medical patient populations. The present study sought to identify a similar relationship among a sample of 63 men diagnosed with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). Results found that SPS mediated the relationship between two different measures of stress and CP/CPPS symptoms. These results suggest that attempts to foster patients' SPS efficacy may help reduce CP/CPPS-related negative symptoms.

Problem-solving training for Veterans in home based primary care: an evaluation of intervention effectiveness.

BACKGROUND: Veterans enrolled in Veterans Health Administration (VHA) Home Based Primary Care (HBPC), a program providing in-home medical and mental health care by an interdisciplinary care team, often face substantial physical, cognitive, and mental health challenges. This program evaluation examined the impact of a brief problem-solving intervention on depressive symptoms, quality of life, and problem-solving abilities for Veterans enrolled in HBPC. DESIGN: Pre- and post-intervention outcomes for Veterans, and qualitative feedback from Veterans and clinicians regarding program satisfaction. PARTICIPANTS AND SETTING: A total of 230 HBPC patients (mean age in years = 72.1, SD = 11.6) within the U.S. national VHA health care system. INTERVENTION: Six-session, individual Problem-Solving Training (PST-HBPC). METHOD: Licensed psychologists and social workers (n = 115) completed training and administered the treatment with HBPC Veterans between 2014 and 2017. MEASUREMENTS AND RESULTS: From baseline to post-intervention, Veterans completing five or more PST-HBPC sessions (n = 199) reported significant reductions in depressive symptoms on the Patient Health Questionnaire 9-item (PHQ-9), in difficulty functioning due to depressive symptoms (PHQ-9 item 10), and in thoughts of death (PHQ-9 item 9). They also reported more effective problem-solving on the Social Problem-Solving Inventory - Revised: Short form (total score and subscales), and improved quality of life across life domains on the World Health Organization Quality of Life-BREF (WHOQOL-BREF) scale. Both clinicians and Veterans also reported satisfaction with the program. CONCLUSIONS: Preliminary findings support the continued dissemination and implementation of this brief PST intervention for HBPC Veterans, and its potential for use with non-VA home care populations with complex comorbidities.

Reducing mental health disparities by increasing the personal relevance of interventions.

One of the most persistent health disparities is the underutilization of mental health services by people of color. Neither evidence-based treatments (universal focus) nor culturally adapted treatments (group focus) have reduced these disparities. We propose the personal relevance of psychotherapy (PROP) model, which integrates universal, group, and individual dimensions to determine the personal relevance of interventions. A cultural example of personal relevance among people of East Asian ancestry involves "face" (i.e., one's prestige and position in society), which may moderate treatment outcomes. Pragmatic intervention approaches focused on helping individuals cope with specific external problems, compared to managing a "personal" disease, can effectively "restore" face. Thus, social problem-solving interventions may be more personally relevant to many people of East Asian ancestry than are approaches that are internally focused. In addition, we posit that social neuroscience can offer unique opportunities above and beyond self-report measures when assessing the impact of PROP and the personal relevance of interventions for diverse populations. Our preliminary evidence upon testing this hypothesis indicated that among Asian Americans, exposure to problem-solving therapy content elicited significantly greater neural activity in brain areas associated with personal relevance compared to exposure to cognitive-behavioral therapy content. Identifying personally relevant interventions has the potential to reduce mental health disparities by increasing engagement with mental health services for diverse groups. The increased client engagement produced by personally relevant interventions also has the potential to make mental health services more effective for diverse groups. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Acculturative Stress, Social Problem Solving, and Depressive Symptoms among Korean American Immigrants.

The present study examined the relationship among acculturative stress, social problem solving, and depressive symptoms among 107 Korean American immigrants. Hierarchical regression analysis showed that acculturative stress significantly predicted depressive symptoms controlling for different domains of acculturation. With regard to the role of social problem solving, among the five dimensions of social problem solving (i.e., positive problem orientation, negative problem orientation, rational problem solving, impulsive/careless style, and avoidant style), negative problem orientation and impulsive/careless style significantly predicted depressive symptoms. Avoidant style significantly interacted with acculturative stress, indicating that avoidant style is associated with depressive symptoms when acculturative stress is high. The study underscores the impact of culture as well as severity of stress on the relationship among acculturative stress, coping, and depressive symptoms among Korean American immigrants.

Case formulation and the therapeutic alliance in contemporary problem-solving therapy (PST).

In addition to providing psychoeducation and sharing clinical explanations and treatment goals, case formulation serves as a potential mechanism by which therapists may facilitate an alliance with their patients. This article illustrates how a case formulation shared with a patient early in the process of contemporary problem-solving therapy (PST) may yield both a road map to treatment and a means to build and adapt a therapeutic alliance based on patient attributes. We provide a description of a clinical case in which PST was carried out with a woman who, in the midst of alcohol recovery, experienced symptoms of anxiety, depression, and binge eating.

Positive and negative religious coping, depressive symptoms, and quality of life in people with HIV.

The present study examined the relationships of positive and negative types of religious coping with depression and quality of life, and the mediating role of benefit finding in the link between religious coping and psychological outcomes among 198 individuals with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS). The results of multiple hierarchical analyses revealed that negative religious coping was significantly associated with a high level of depressive symptoms and a low level of quality of life, controlling for demographic and clinical variables. On the other hand, positive religious coping was significantly associated with positive domains of outcome measures such as positive affect and life satisfaction, but not with overall depressive symptoms or quality of life. Tests of mediation analyses showed that benefit finding fully mediated the relationship between positive religious coping and the positive sub-domains of psychological outcomes. The importance of investigating both positive and negative types of religious coping in their relationships with psychological adaptation in people with HIV was discussed, as well as the significance of benefit finding in understanding the link between religious coping and psychological outcomes.

Social problem solving and depression in couples coping with cancer.

OBJECTIVE: When one person in a couple has cancer, both members may experience depressive symptoms and may react as an emotional system. However, the variables that influence this depressive system have not been identified. This study examined whether social problem solving, an important moderator of individual cancer-related depression, is related to depression in the couple system. METHODS: Sixty-three couples with one partner diagnosed with cancer completed self-report questionnaires regarding depressive symptoms, social problem solving, and relationship satisfaction. RESULTS: Multiple regression correlations supported the hypothesis that depression occurs in an emotional system (patient depression predicted partner depression and partner depression predicted patient depression). When examining how partner social problem solving impacts transmission from patient to partner, hierarchical multiple regression demonstrated that one social problem-solving component (positive problem orientation) eliminated the prediction of partner depression by patient depression. No other component of partner social problem solving eliminated the prediction of partner depression by patient depression. Partner social problem solving had no effect on whether partner depression predicted patient depression. CONCLUSIONS: Partners with more positive beliefs about solving problems were less likely to experience depression together with the patients. Further investigation into the role of social problem solving in the interpersonal depression system is warranted.

Social problem solving as a mediator of the stress-pain relationship among individuals with noncardiac chest pain.

OBJECTIVE: The present study tested the hypothesis that social problem solving (SPS) served to mediate the relationship between preceived stress and noncardiac chest pain (NCCP). DESIGN: Adults undergoing stress myocardial perfusion imaging (MPI) to determine the presence of underlying cardiovascular disease related to the experience of chest pain were recruited prior to stress testing to complete a series of self-report inventories. MAIN OUTCOME MEASURES: MPI results were used to identify individuals with NCCP (N = 166; 91 men, 75 women; mean age = 53.92 years, SD = 11.98). Measures included perceived stress, SPS, and chest pain frequency and intensity. RESULTS: In direct tests of the mediational effects of SPS, it was found that two problem-solving dimensions, negative problem orientation and rational problem solving, each served as significant mediators of the effects of stress on both NCCP intensity and frequency. CONCLUSION: These results support a mediational analysis of NCCP that includes stress and SPS. As such, it identifies SPS as a potentially important clinical target to consider when developing future psychosocial-based therapy protocols for treating individuals with NCCP.

Social problem solving and noncardiac chest pain.

OBJECTIVE: To investigate differences in social problem solving (SPS) between individuals with noncardiac chest pain (NCCP) and persons with chest pain who tested positive for underlying cardiac disease. METHODS: The major design involved a matched case-control methodology and compared a group of patients with NCCP (n = 53) with a group of patients with cardiac disease-related chest pain (n = 53) with regard to a battery of psychological distress, stress, and pain measures as well as a multidimensional measure of SPS. RESULTS: Initial analyses found no differences between the groups regarding reported levels of chest pain intensity or frequency. However, patients with NCCP, as compared with their matched counterparts, reported significantly higher levels of depression, anxiety, perceived stress, and anger. In the analysis that addressed SPS differences between groups, general negative affectivity and prior history of cardiac disease served as covariates and revealed that individuals with NCCP were characterized by less effective problem solving on three of five dimensions assessed as compared with their matched counterparts. Moreover, the relationship between SPS and pain among patients with NCCP was found to be above and beyond that related to general negative affectivity. CONCLUSIONS: These findings both support and add to the literature regarding psychosocial correlates of NCCP and identify SPS as a potentially important factor in its pathogenesis.

Aggression-related hostility bias and social problem-solving deficits in adult males with mental retardation.

Attributional bias and social problem-solving deficits in two groups of adult males (aggressive vs. nonaggressive) with mild mental retardation were investigated. When presented with vignettes depicting various problem situations, aggressive participants were less accurate in correctly identifying interpersonal intent, characterized by more problem-solving deficits, and generated higher numbers of aggressive solutions to resolve problems as compared to their nonaggressive counterparts. The present results support the applicability of contemporary models of social information processing and adjustment with regard to reactive aggression to men with mental retardation.

Project Genesis: assessing the efficacy of problem-solving therapy for distressed adult cancer patients.

The efficacy of problem-solving therapy (PST) to reduce psychological distress was assessed among a sample of 132 adult cancer patients. A second condition provided PST for both the patient and a significant other. At posttreatment, all participants receiving PST fared significantly better than waiting list control patients. Further, improvements in problem solving were found to correlate significantly with improvements in psychological distress and overall quality of life. No differences in symptom reduction were identified between the 2 treatment protocols. At a 6-month follow-up, however, patients who received PST along with their significant other reported lower levels of psychological distress as compared with members of the PST-alone condition on approximately half of the outcome measures. These effects were further maintained 1-year posttreatment.

A problem-solving approach to stress reduction among younger women with breast carcinoma: a randomized controlled trial.

BACKGROUND: Previous research indicates that younger women (i.e., 50) and that coping style is significantly related to the psychosocial adjustment of women with this disease. The purpose of this study was to evaluate through a randomized controlled trial the effectiveness of a problem-solving training intervention designed to empower women with breast carcinoma to cope with a range of difficulties when diagnosed in mid-life. METHODS: The study population consisted of women aged 50 years or younger who had no prior history of breast carcinoma, were diagnosed with Stage I-IIIA tumors, and for whom a first course of chemotherapy had been initiated recently. The intervention consisted of two in-person and four telephone sessions with an oncology nurse who provided problem-solving skills training and informational materials to the women over a 12-week period. All subjects were assessed for physical and psychosocial adjustment through telephone and mailed surveys at baseline, at 4 -months, and at 8 months. RESULTS: Of 183 eligible women, 164 participated (a 90% participation rate), 149 of whom completed the study (a 91% completion rate). The subjects had significantly lower unmet needs and better mental health at the 4-month assessment. The intervention significantly decreased the number and severity of difficulties experienced by women with average or good problem-solving skills at 8 months, but was not effective in alleviating or resolving the problems encountered by women with poor problem-solving skills, relative to the control group. CONCLUSIONS: We conclude that this problem-solving therapy-based home care training intervention is an effective method of helping the majority of women with breast carcinoma to reduce the stresses associated with the diagnosis and treatment of cancer in mid-life.