"Something Born of the Heart": Culturally Affiliated Illnesses of Older Adults in Oaxaca.

This qualitative research identifies and analyzes emotions and interventions linked to affective experiences and cultural aspects of health/illness/care processes in 219 older adults of eight Indigenous groups in Oaxaca, Mexico. Life stories are examined from perspectives of cultural gerontology, anthropology of emotions and critical medical anthropology with a gender perspective. Significance and healing of two illnesses of cultural affiliation: tiricia (sadness of the soul) and envidia (rancor against the successful) are examined. Conditions other than diabetes and hypertension are healed by traditional remedies or spiritual cleansings. Examining tiricia and envidia permit improved knowledge and understanding of the emotional culture and the community.

A systematic review of the psychosocial impact of emotional numbing in US combat veterans.

CONTEXT: Previous studies have linked posttraumatic emotional numbing symptoms in US combat veterans with an adverse impact in multiple important life domains. OBJECTIVES: We updated and evaluated the evidence examining the psychosocial impact of combat-related emotional numbing, including ethnoracial and gender differences. METHOD: We reviewed 1,209 articles published betwen January 2012 and 2018 and selected 24 studies for inclusion. We assessed the overall study quality as fair using a national quality assessment tool. RESULTS: Studies found emotional numbing to wield adverse effects in the areas of symptom nonimprovement, mental health difficulties, increased service utilization, poor relationship functioning, reduced quality of life, substance use disorders, suicidality, and aggression/violence. We also found evidence of ethnoracial and gender differences in veterans' posttraumatic stress disorder-related emotional numbing symptoms. CONCLUSION: Clinicians should incorporate findings on emotional numbing into assessment, treatment planning, and monitoring, to improve treatment retention and psychosocial outcomes. Implications for ethnoracial and gender differences require further exploration.

Acculturative stress, emotion regulation, and affective symptomology among Latino/a college students.

Although recent work has highlighted the relation of acculturative stress with depression and anxiety symptoms specifically among Latino/a university students, the potential mechanisms underlying these associations remain relatively unknown. The present study aims to examine difficulties in emotion regulation as an explanatory factor in the relation of acculturative stress with symptoms of depression, suicidality, social anxiety, and anxious arousal. A sample of 448 Latino/a college students (Mage = 20.67 years, SD = 1.96; 78.3% female) were recruited from a southwestern public university through an online, self-report survey. Indirect effects of acculturative stress via difficulties in emotion regulation on all outcomes were observed among males and females. Follow-up analyses showed the indirect effect on all dependent variables among Latino men occurred exclusively through lack of access to emotion regulation strategies, whereas the indirect effects among Latina women occurred through a different subfactor of difficulties in emotion regulation for each dependent variable. These findings suggest the potential clinical utility of assessing and targeting acculturative stress and difficulties in emotion regulation in the treatment of depression and anxiety problems among Latino/a college students. (PsycINFO Database Record

The moderation effect of personality on healthcare utilization in Chinese people living with HIV.

There is evidence that Type D personality can predict impaired quality of life and health status in various chronic conditions. The evidence is conflicting as to whether Type D is associated with increased healthcare services, and no study has reported on the healthcare utilization of people living with HIV (PLWH) who have a Type D personality. This study investigated the impact of Type D personality on healthcare utilization in a sample of Chinese PLWH and examined physical and emotional symptoms as possible mechanisms of healthcare utilization. This was a cross-sectional study of 199 PLWH in rural China. Participants completed a survey on physical symptoms, emotional symptoms, healthcare utilization, and Type D personality. Those PLWH with a Type D personality reported more physical and emotional symptoms and healthcare utilization than patients without this personality. Among PLWH who had a Type D personality, physical symptoms had a direct effect on healthcare utilization, and emotional symptoms did not significantly mediate this association. However, among PLWH without a Type D personality, emotional symptoms significantly mediated the effects of physical symptoms on healthcare utilization. PLWH with a Type D personality reported more healthcare utilization, which was attributed to their high physical symptoms rather than their emotional symptoms. These findings suggest that PLWH with a Type D personality might be bothered by intensified emotional symptoms, which might be too severe to be associated with physical symptoms and healthcare utilization. New prospective studies should focus on the pattern of healthcare utilization among patients with a Type D personality and their intensified physical and emotional symptoms.

Emotion dysregulation as a mechanism linking anxiety and hazardous drinking among Latinos in primary care.

BACKGROUND AND OBJECTIVES: Research suggests that Latinos experience significantly more mental health and alcohol use problems than non-Latino whites. However, relatively little is known about the mechanisms underlying alcohol use in this population. One factor associated with excessive alcohol use in Latinos is anxiety. A potential explanatory mechanism for this relationship is emotion dysregulation, as emotion dysregulation in the context of anxiety may lead to alcohol use problems/disorders. The aim of the current study was to examine the indirect effect of anxiety, through emotion dysregulation, on drinking severity and probable hazardous drinking in Latinos. METHODS: Latino adults (N = 264) were recruited from a primary care health clinic as part of a larger ongoing study examining mental health among Latinos in primary care. Participants were interviewed using the MINI and then completed various self-report assessments (in Spanish). Structural equation modeling was used to evaluate model fit. RESULTS: Structural models fit the data well. Additionally, there were statistically significant indirect effects of anxiety via emotion dysregulation on drinking severity and probable screen for hazardous drinking. DISCUSSION AND CONCLUSIONS: Anxiety may contribute to alcohol use problems due to an overall tendency to engage in maladaptive attempts to regulate emotions. SCIENTIFIC SIGNIFICANCE: Targeting emotion dysregulation in the context of anxiety and hazardous alcohol use among Latinos may be one therapeutic strategy to reduce severity of alcohol use (and hazardous drinking). (Am J Addict 2017;26:615-622).

Mental Health Effects of Premigration Trauma and Postmigration Discrimination on Refugee Youth in Canada.

This report examines the role of pre- and post-migration trauma in explaining differences in refugee and immigrant mental health. Data were derived from mother-youth refugee and immigrant dyads from six countries of origin who were living in Canada at the time of the study. Youth reports of emotional problems (EP) and aggressive behavior (AB) were the mental health outcomes. EP and AB were regressed on predictor blocks: a) status (refugee versus immigrant), visible minority, and gender; b) premigration trauma and postmigration discrimination; c) parent and youth human and social capital; d) poverty, neighborhood, and schools. Refugees suffered higher levels of EP and AB, premigration traumas, and discrimination. Postmigration perception of discrimination predicted both EP and AB and explained immigrant versus refugee differences in EP. Antirefugee discrimination net of discrimination based on immigrant or visible minority status has deleterious mental health consequences.

The association between ethnicity and care pathway for children with emotional problems in routinely collected child and adolescent mental health services data.

Adults from black and minority ethnic (BAME) backgrounds are less likely to access mental health services through voluntary care pathways and are more likely to access through compulsory ones. The aim of the present research was to explore the association between ethnicity and care pathway through child and adolescent mental health services (CAMHS), in terms of reason for referral and case closure, in children presenting with emotional problems. A sample of N = 11,592 children from 26 CAMHS was taken from a national routinely collected dataset (56 % female; 7 % aged 0-5 years, 40 % 6-12 years, 53 % 13-18 years, and <1 % 19-25 years). Multinomial logistic regressions showed that BAME children were consistently more likely to be referred to CAMHS through education, social, and other services than primary care, compared to White British children (odds ratio (OR) = 1.52-9.96, p < .001) and they were less likely to end treatment due to child and family non-attendance (OR = 0.59-0.79, p < .05). Similar to adults, children from BAME groups may be more likely to access CAMHS through compulsory than voluntary care pathways.

Dating violence in teenage girls: parental emotion regulation and racial differences.

BACKGROUND: Teen dating violence (TDV) is a common phenomenon of great public concern. TDV may lead to severe long-term consequences for victims and offenders, and even more so for females than for males. AIM: The aim of this paper is to investigate possible underlying factors for involvement in TDV either as a perpetrator or a victim. Social learning theory is commonly used to explain internalisation of parents' behaviour on children's behavioural expressions, but less so on parents' emotion regulation as a direct link to later TDV. METHOD: We used longitudinal data from the Pittsburgh Girls Study (N = 2450) to investigate if and how parents' positive and negative emotion regulation is related to TDV, controlling for early aggression and race. RESULTS: Results show a moderately strong association between parents' negative emotion regulation and their daughters' involvement in serious dating violence. We also found that many more African American girls were involved in TDV compared to Caucasian girls, both as a perpetrator and victim. CONCLUSIONS AND PRACTICAL IMPLICATIONS: We discuss directions for future research focusing on emotion regulation and dating violence. Copyright © 2016 John Wiley & Sons, Ltd.

Associations of somatic symptom attribution in Turkish patients with major depression.

BACKGROUND: There are differences across ethno-cultural groups in the degree of somatization among patients with major depressive disorder (MDD). Studies showed that the attribution style of somatic symptoms is an important predictor of health outcome in depressed patients. AIMS: The aims of this study were to investigate associations of psychologizing, normalizing and somatizing attribution styles as measured by the Symptom Interpretation Questionnaire (SIQ) in Turkish patients with MDD. METHODS: Ninety patients who were diagnosed with a major depressive episode using a semi-structured interview were administered the SIQ to assess attribution styles, each of which was regressed on age, gender, educational level, depressive symptom severity, tendency for somatosensory amplification, current somatic symptoms and alexithymia. RESULTS: Scores on somatizing, psychologizing and normalizing attribution subscales of the SIQ were strongly correlated with each other. Somatosensory amplification and alexithymia were independent correlates of somatizing attributions. Higher levels of psychologizing and normalizing attributions were both related to more severe symptoms of depression and to somatosensory amplification. CONCLUSIONS: These results suggested that patients with higher levels of depressive symptoms were more likely to engage in a greater diversity of attribution styles as measured by the SIQ in our sample. Independent correlates of somatic symptom attribution in patients with MDD were found to be different from Western countries, suggestive of disparate cultural characteristics and help-seeking pathways and behaviour in Turkey.

Increased parental history of bipolar disorder in the United States: association with early age of onset.

OBJECTIVE: Early-onset bipolar (BP) disorder and other poor prognosis characteristics are more prevalent in patients from the United States than from the Netherlands and Germany (abbreviated as Europe). We explored the impact of parental loading for affective illness on onset and other characteristics of BP disorder. METHOD: Parental history for unipolar (UP) and bipolar (BP) depression and course of illness characteristics were obtained from self-report in adults (average age 42) with BP disorder. Illness characteristics were examined by χ2 and multinomial logistic regression in relationship to the degree of parental loading: i) both parents negative; ii) one UP disorder; iii) one with BP disorder; and iv) both affected. RESULTS: After controlling for many poor prognosis factors, compared with those from Europe, patients from the United States had more iii) one parent with BP disorder and iv) both parents affected. An early age of onset of BP disorder was independently associated with this increased parental loading for affective disorder. CONCLUSION: Parental history of BP disorder and both parents with a mood disorder were more common in the United States than Europe and were associated with an early onset of bipolar disorder and other poor prognosis characteristics. These findings deserve replication and exploration of the potential mechanisms involved and their therapeutic implications.

The protective role of group identity: sectarian antisocial behavior and adolescent emotion problems.

The protective role of strength of group identity was examined for youth in a context of protracted political conflict. Participants included 814 adolescents (Mage = 13.61, SD = 1.99 at Time 1) participating in a longitudinal study in Belfast, Northern Ireland. Utilizing hierarchical linear modeling, the results show that the effect of exposure to sectarian antisocial behaviors has a stronger effect on youth emotion problems for older adolescents. The results also show that youth with higher strength of group identity reported fewer emotion problems in the face of sectarian antisocial behavior but that this buffering effect is stronger for Protestants compared to Catholics. Implications are discussed for understanding the role of social identity in postaccord societies.

Shifting the odds of lifelong mental illness through an understanding of the profiles of adolescents and young adults with serious mental health conditions.

Every day families and mental health providers are called upon to make tough decisions in determining the best quality of care for adolescents and young adults with serious mental health conditions. This study profiles the behavioral and emotional needs and risk behaviors of adolescents and young adults seeking mental health services based on assessment of strengths and needs at program entry.

Functions of nonsuicidal self-injury among Chinese community adolescents.

This study examined functions of nonsuicidal self-injury (NSSI) among a large sample of Chinese high school students over a six-month period. Among Chinese adolescents, we identified three factors of NSSI functions, namely, Affect Regulation, Social Influence, and Social Avoidance. Affect Regulation was the most frequently endorsed function of NSSI, followed by Social Influence and Social Avoidance. Adolescent male self-injurers were more likely to endorse the Social Influence function than their female counterparts. Moderate/Severe Self-injurers did not differ from Minor Self-injurers on the endorsement of various NSSI functions. All functions of NSSI exhibited small to moderate stability over the six-month assessment period. Findings suggest that Chinese adolescents engaged in NSSI for multiple reasons. These reasons also varied considerably over time within individuals. Assessment of NSSI should thus regularly assess functions of the behavior.

Racial microaggressions and daily well-being among Asian Americans.

Although epidemiological studies and community surveys of Asian Americans have found that lifetime occurrences of racial discrimination are associated with increased risk for psychological morbidity, little is known about how exposure to racial discrimination is patterned in everyday life. Extrapolating from previous qualitative research (Sue, Bucceri, Lin, Nadal, & Torino, 2007), this study presents data on the prevalence and psychological correlates of everyday racial microaggressions that reflect the Asian American experience. Measures of positive affect, negative affect, somatic symptoms, and racial microaggressions were completed by 152 Asian Americans each day for up to 14 consecutive days. Approximately 78% of participants reported some form of racial microaggression within the 2-week study period. Multilevel analyses indicated that elevations in daily microaggressions, as well as greater microaggressions on average, predicted increases in somatic symptoms and negative affect. Implications of these findings for racial microaggression research and clinical practice are discussed.

Race/ethnicity and mental health in the first decade of the 21st century.

Recent empirical studies on mental health generally report racial/ ethnic differences in depression rates but typically do not control for potential confounding by sample contextual variations in historical epoch, geographical location, and social demography. An empirical study of race/ethnicity differences in psychological distress is reported as an attempt to control these contexts by using a sample that is homogeneous in age, historical epoch, geography, and social demography (954 youth ages 18-19 living in a single, large urban community). No mean differences in psychological distress were observed among four racial/ethnic groups: Asians, African Americans, Latinos, and non-Hispanic Whites. A second analysis compared 17 different racial/ethnic groups defined in terms of family national origin. No differences in psychological distress were found among these groups. The findings are consistent with the view that race/ethnicity itself is not related to disparities in mental health.

Shared Reading and Risk of Social-Emotional Problems.

BACKGROUND AND OBJECTIVES: The American Academy of Pediatrics recommends literacy promotion as well as routine developmental surveillance during well-child visits to improve academic, relational, and health outcomes. In this study, we examined the possible association between shared reading and social-emotional problems among young children. METHODS: We conducted a retrospective review of longitudinal records for children aged 30 to 66 months presenting for visits to an academic pediatric primary care center between July 1, 2013, and February 1, 2019. The outcome was evidence of social-emotional problems, defined by an Ages and Stages: Social Emotional Questionnaire (ASQ:SE) score above the established cutoff. The predictor was caregiver-reported frequency of shared reading (most = 5-7 days per week, some = 2-4 days per week, rarely = 0-1 days per week) at a previous visit. Generalized linear models with generalized estimating equations were used to assess the association between the longitudinal outcome and predictor, adjusting for child demographics and needs reported on routine social history questionnaires. RESULTS: Analyses included 5693 children who completed at least 1 ASQ:SE (total of 7302 assessments) and had shared reading frequency documented before each ASQ:SE assessment. Children were predominantly Black (75%) and publicly insured (80%). Sixteen percent of ASQ:SE scores were suggestive of social-emotional concerns; 6% of caregivers reported sharing reading rarely. Children with rare shared reading had a higher risk of an ASQ:SE above cutoff compared with those with shared reading on most days (adjusted risk ratio, 1.62; 95% confidence interval, 1.35-1.92). CONCLUSIONS: Less-frequent caregiver-reported shared reading was associated with higher risk of social-emotional problems in young children presenting for primary care. This highlights potential relational and social-emotional benefits of shared reading.

Psychological and school functioning of Latino siblings of children with intellectual disability.

BACKGROUND: Siblings of children with disabilities are at risk for internalizing psychological disorders; however, little is known about how culture influences this effect. This study examined the psychological and school functioning of Latino siblings of children with intellectual disability (ID). METHODS: Participants were 100 Latino (L) and nonLatino (NL) siblings (8-15 years) of children with ID (50 LID, 50 NLID) and 100 Latino and nonLatino control siblings (50 LC, 50 NLC). Siblings, parents, and teachers completed standard questionnaires regarding sibling emotional and behavioral functioning; sibling school report cards were obtained. Analyses of variance were conducted, controlling for parent age and family income; planned contrasts compared LID siblings to the other sibling groups. RESULTS: LID siblings reported significantly more internalizing (t(1) = 2.41, p < .05) and emotional t(1) = 3.06, p < .05) symptoms, poorer awareness of (t(1) = 2.26, p < .01) and greater reluctance to express (t(1) = 3.12, p < .01) their emotions, and more problems in personal adjustment and relationships with parents (t(1) = -2.50, p < .05). Significantly higher percentages of LID siblings scored in the at-risk or clinical range for internalizing and emotional symptoms, and were more likely to score above the clinical cut-off for separation anxiety disorder and to endorse global impairment. LID siblings experienced more school absences and lower academic performance. There were no group differences in externalizing behavior problems, somatic symptoms, or teacher-reported internalizing symptoms. CONCLUSIONS: Latino siblings of children with ID are at greater risk for internalizing psychological disorders and greater impairment in personal and school functioning. Results are discussed in terms of their sociocultural significance and clinical implications.

The features of adolescent irritable bowel syndrome in Japan.

OBJECTIVE AND BACKGROUND: The onset of IBS is in adolescence in many cases. However, the features of adolescent IBS were generally lacking. The objective of this research was to know the features of adolescent IBS in Japan. METHODOLOGY: In 2004 and 2009, we randomly selected Junior high school students in Miyagi prefecture, Japan, according to population of each area. Eight hundred thirty-three boys and 888 girls (age: 15 years old) in 2004 and 256 boys and 335 girls (age: 14 years old) in 2009 participated in this study. They fulfilled self-reported questionnaires those include Rome-II Modular Questionnaire, Self-reported IBS Questionnaire, Generalized Self-Efficacy Scale, Short Form-36 ver.2, other questions on their lives and Toronto Alexithymia Scale-20. RESULTS: The prevalence of adolescent IBS was 14.6% in 2004 and 19% in 2009. Compare with students without abdominal symptoms, IBS showed lower health-related QOL and self-efficacy and complained more sleep disturbance, traumatic episodes and perceived stress in both researches. IBS girls were worse in both physical and psychological aspects. They also have alexithymic tendency and it influenced on severity of IBS symptoms. CONCLUSIONS: Adolescent IBS had almost the same prevalence as adult IBS, however the rate of IBS subtypes was different. They also had psychological problems in addition to physical conditions even though most of them were non-consulters. Improvement of self-efficacy and alxithymia may help to prevent and treat IBS.

International comparisons of behavioral and emotional problems in preschool children: parents' reports from 24 societies.

International comparisons were conducted of preschool children's behavioral and emotional problems as reported on the Child Behavior Checklist for Ages 1½-5 by parents in 24 societies (N = 19,850). Item ratings were aggregated into scores on syndromes; Diagnostic and Statistical Manual of Mental Disorders-oriented scales; a Stress Problems scale; and Internalizing, Externalizing, and Total Problems scales. Effect sizes for scale score differences among the 24 societies ranged from small to medium (3-12%). Although societies differed greatly in language, culture, and other characteristics, Total Problems scores for 18 of the 24 societies were within 7.1 points of the omnicultural mean of 33.3 (on a scale of 0-198). Gender and age differences, as well as gender and age interactions with society, were all very small (effect sizes < 1%). Across all pairs of societies, correlations between mean item ratings averaged .78, and correlations between internal consistency alphas for the scales averaged .92, indicating that the rank orders of mean item ratings and internal consistencies of scales were very similar across diverse societies.

Agreement between parent- and self-reports of Algerian adolescents' behavioral and emotional problems.

The present study examined agreement between scores obtained from self-reports of behavioral and emotional problems obtained from 513 Algerian adolescents on the Youth Self-Report (YSR) with scores obtained from reports provided by their parents on the Child Behavior Checklist (CBCL). The correlations between self- and parent-report were larger than those observed in many other cultures (e.g., intraclass correlation coefficient=0.60 and Pearson r=0.65 for Total Problems). On the whole, cross-informant agreement did not vary significantly as a function of problem type, identity of the parental informant, gender and age of the adolescent. Similar to all studied cultures, adolescents on average reported more problems than their parents reported about them, but the discrepancies were smaller than in all previous societies. Mean YSR/CBCL score discrepancies indicated higher YSR scores for several scales, but variability across dyads was large, and many dyads showed the opposite pattern.