Understanding How Perfectionism Impacts Intensive Interdisciplinary Pain Treatment Outcomes: A Nonrandomized Trial.

OBJECTIVE: Several factors are known to impact response to the intensive interdisciplinary pain treatment (IIPT) program described in this study, yet no research has explored the role of perfectionism. This secondary data analysis explored direct and indirect relations between perfectionism and functional disability (primary outcome) and pain severity (secondary outcome) after IIPT, with pain catastrophizing and fear of pain as mediators. METHODS: Youth (N = 253) aged 8-21 with chronic pain and associated disability completed pre- and post-IIPT measures of self-oriented perfectionism (SOP), socially prescribed perfectionism (SPP), pain catastrophizing, fear of pain, functional disability, and pain characteristics for routine clinical care and this nonrandomized trial. Eight mediated models were run for the two predictors, two mediators, and two outcomes. RESULTS: Pretreatment perfectionism (SOP and SPP) led to greater reductions in pain catastrophizing over the course of IIPT, which resulted in lower pain severity (ß = -.02 [CI = -0.07, -0.01] for SOP and ß = -.02 [CI = -0.06, -0.003] for SPP) and less functional disability (ß = -.06 [CI = -0.13, -0.01] for SOP and ß = -.06 [CI = -0.14, -0.01] for SPP). Independent of pain catastrophizing, pretreatment SPP was directly associated with more posttreatment functional disability (ß = .16 [CI = 0.05, 0.27]). Fear of pain was not a mediator. CONCLUSIONS: Findings suggest perfectionism has the potential to negatively impact IIPT outcomes. However, when perfectionistic youth with chronic pain learn to manage pain-related distress, they benefit. Results highlight the importance of assessing for and treating perfectionism and pain-related distress in youth with chronic pain.

Protective Role of Religious Involvement Against Depression and Suicidal Ideation Among Youth with Interpersonal Problems.

This study examined religious involvement-private religious practices (PRP), organizational religiousness (OR), and religious support (RS)-in relation to depressive symptoms and suicidal ideation (SI) and its protective role, considering youths' school and parent-family connectedness. Youth, ages 12-15 (n = 161), were screened for peer victimization, bullying perpetration, and low social connectedness, and assessed for depressive symptoms, SI, school connectedness, parent-family connectedness, and religious involvement. Results indicated PRP and RS were associated with lower levels of depressive symptoms; PRP and OR were associated with less SI. Controlling for connectedness, PRP remained associated with less SI only. Results suggest the importance of considering religious involvement as a target of youth depression and suicide prevention interventions.

Religious Social Support, Discrimination, and Psychiatric Disorders among Black Adolescents.

Discrimination is a common experience for Black youth that can jeopardize their mental health. However, research suggests that various dimensions of religion have positive effects on youths' mental health and well-being. Additionally, exposure to discrimination may vary by youths' socio-demographic factors, such as gender and ethnicity. Numerous studies identify the protective effects of emotional and tangible religious social support on the mental health of Black adults reporting discrimination. Conversely, fewer studies address the influence of emotional and tangible religious social support on mental health for Black adolescents experiencing discrimination, while also accounting for socio-demographic heterogeneity among Black adolescents. Historically, religion has played an instrumental role in the diverse narratives of the Black Diaspora in the United States. It is important to account for its potential protective effects for Black youth. Examining these factors using a compensatory risk and resilience model, our study finds that Black adolescents who experience discrimination are also more likely to meet criteria for a psychiatric disorder. Additionally, those who report experiencing religious social support are less likely to meet criteria for a psychiatric disorder. These findings were not moderated by the sociodemographic factors of race or ethnicity. To date, this investigation is one of the first to examine the effect of different types of religious social support in the presence of discrimination on psychiatric illness among African American and Caribbean Black adolescents.

What Would I Know About Mercy? Faith and Optimistic Expectancies Among African Americans.

A small body of research has begun to explore the association between faith and optimism among African Americans. However, missing from the extant work is an examination of the extent to which traditional indices of religious commitment work together with beliefs about God to shape optimism. The present study examines the utility of indices of social location, religious commitment (i.e., early and current religious service attendance, subjective religiosity), belief about the quality of one's relationship with God (i.e., a belief that one is connected to a loving God), and beliefs about being the recipient of divine forgiveness for predicting dispositional optimism among a sample of community residing African American adults (N = 241). Age, subjective religiosity, and organizational religiosity were positively related to optimism in bivariate analyses. Hierarchical regression analyses demonstrated a significant association between age, subjective religiosity, and optimism; however, those associations were eliminated once relationship with God and belief in one's forgiveness by God were entered into the model. Only belief in God's love predicted optimism in multivariate analyses. Serial mediation analyses revealed that beliefs about the quality of one's relationship with God and belief in divine forgiveness fully mediated the relationship between subjective religiosity and optimism, but that the relationship is driven largely by relationship with God. Implications of these findings are discussed.