The impact of emotion regulation and dyadic coping within posttraumatic stress symptoms and risky drinking patterns on relationship distress among trauma-exposed individuals.

Individuals with posttraumatic stress symptoms (PTSS) often consume alcohol to manage PTSS-related discomfort, which can negatively impact individual and interpersonal functioning. Processes including emotion regulation and dyadic coping may influence the effects of PTSS and drinking patterns on relationship functioning. The present study examined how PTSS and risky drinking may function through the associations between maladaptive individual and interpersonal coping strategies and relationship distress among trauma-exposed individuals. Participants were 237 adults in a romantic relationship who endorsed lifetime trauma exposure and alcohol consumption within the past year and completed an online battery of self-report measures. Path analyses showed mixed support for the hypothesized theoretical causal model. PTSS was associated with maladaptive emotion regulation, ß = .537, p = .010, and negative dyadic coping, ß = .264, p = .009, whereas risky drinking was only related to negative dyadic coping, ß = .193, p = .024. Negative dyadic coping was significant in the pathways between PTSS and relationship distress, ß = .021, p = .009, and risky drinking and relationship distress, ß = .030, p = .014. Exploratory analyses based on trauma type did not significantly change the overall model; however, a direct path suggested PTSS may have a stronger negative impact on relationship distress among individuals who experienced assault trauma (e.g., physical or sexual assault), ß = .340, p = .012. Findings highlight the interrelations among intra- and interpersonal regulation and provide clinical targets of maladaptive emotion regulation and dyadic coping strategies for individuals with PTSS and harmful drinking.

The Moderating Role of Stress Mindset on the Relationship between Drinking to Cope and Alcohol Consumption among Undergraduate College Student Drinkers.

OBJECTIVE: Previous research suggests drinking alcohol to cope with negative affect, including stress, is a risk for increased alcohol consumption and alcohol-related problems. Stress mindset, the individually held belief that stress can lead to either enhancing or debilitating outcomes, has yet to be studied within the context of alcohol use. Studying stress mindset among college students as it relates to alcohol consumption may provide important insight into heavy alcohol use in this population. METHOD: A sample of 320 undergraduates (Mage = 19.06 (SD = 0.06); 63.44% female; 65.49% White) who endorsed past-year alcohol use completed self-report measures of drinking motives, stress mindset, alcohol consumption, and alcohol-related consequences. Zero-inflated negative binomial regressions were utilized to examine the moderating effect of stress mindset on the relationship between drinking to cope and alcohol consumption. RESULTS: Stress mindset significantly moderated the relationship between drinking to cope and alcohol consumption (IRR = 0.98, se = 0.01, p < 0.05, CI = 0.96, 1.00), such that the relationship was stronger among those with a debilitating stress mindset compared to those with an enhancing stress mindset. Stress mindset did not significantly moderate the relationship between drinking to cope and alcohol-related consequences. CONCLUSIONS: Individuals with high drinking to cope scores and who hold a debilitating stress mindset may be at a particular vulnerability for heavy alcohol consumption. The present study furthers our understanding of predictors of alcohol use in a college sample and suggests the importance of future research focused on stress mindset among college student drinkers.

Does No Mean No? Situational and Dispositional Factors Influence Emerging Adult Men's Intentions to Use Assault Tactics in Response to Women's Sexual Refusal During Hookups.

Hookups can result in sexual assault when men do not listen to requests from women to stop. It is thus important to identify factors that influence men's decisions to override direct refusals in these situations. Presently, we administered first-person vignettes depicting a prototypical hookup wherein the woman refuses the man's attempt to escalate intimacy. Using a national sample of emerging adult men (N = 420), we found that they on average did not completely rule out coercive or forcible tactics, but those elevated on rape myth acceptance, hypermasculinity, and psychopathy were uniquely at risk of assault when controlling for several other traits known to correlate with rape. Participants also reported being likelier to use coercive sexual practices when refusals occurred at higher levels of sexual intimacy already attained. Notably, diagnostic analyses revealed that a subset of men had a disproportionate influence on the regression estimates, and that these men were not only elevated across a range of assault-relevant traits, but also endorsed higher likelihoods of using coercion and force in the face of female sexual refusal. Although removal of these cases did not substantively alter the results, exploratory analyses revealed that these individuals responded differently to situational factors in ways that suggested sexual opportunism. Theoretical and practical implications of these findings are discussed.

A novel ego dissolution scale: A construct validation study.

Ego dissolution (i.e., ego loss, ego disintegration, ego death, or self-loss) is a conscious state marked by a loss or diminution of one's sense of self and a lack of first-person experience. We developed a novel, valid, and internally consistent ego dissolution scale to both (a) assess trait-like aspects of ego dissolution, which have received scant attention to date, and (b) facilitate future research in a variety of contexts (e.g., personality, psychopathology, substance use/psychedelics, contemplative practices). We determined that the 10-item Ego Dissolution Scale (EDS; Cronbach's α = 0.80) and its identified subfactors of Ego-Loss (Cronbach's α = 0.84) and Unity (Cronbach's α = 0.75) were internally consistent, possessed strong convergent (e.g., depersonalization/derealization, mysticism, unusual experiences) and discriminant validity (e.g., neuroticism, social desirability). We found ego dissolution and dissociation to be empirically related yet discriminable on a statistical basis.

Just Say Yes? A Cluster Analytic Approach to Evaluating College Students' Understandings of Affirmative Consent.

Affirmative consent policies on college campuses establish more stringent standards for inferring consent to sex. Although these policies often permit nonverbal communication of consent, they rarely outline finer-grained distinctions about which specific behaviors can stand-in for verbal affirmation. It thus remains possible that students hold different understandings of this policy vis-à-vis the nonverbals used to convey and infer consent, which could undermine the purported utility of affirmative consent initiatives. We presently sampled 442 college undergraduates and asked them to rate whether specific behaviors often present during sexual interaction constitute affirmative indicators of consent. We hypothesized that students would separate into one of three groups depending on how restrictive (e.g., verbal communication only), inclusive (e.g., verbal and clear nonverbals) or potentially non-diagnostic (e.g., sexual arousal, passivity) their behavioral definitions were of affirmative consent. Using cluster analysis, we ultimately identified two groups adhering to a restrictive versus more inclusive operationalization. The former cluster understood affirmative consent as comprising verbal affirmation with variable endorsements of specific nonverbals, whereas the latter consistently endorsed a broader set of nonverbals along with variable ascription to behaviors that do not strongly imply consent. Students in the more inclusive group were more sexually experienced, less likely to use condoms, and viewed casual sex more favorably; as well as were likelier to have received sexual assault education from their parents before and during college, as well as from social media. These findings suggest that subgroups of college students construe affirmative consent policy differently and that these understandings may relate broadly to an individual's sexual experiences, attitudes, and/or education.

Surgical outcome in adolescents with mesial temporal sclerosis: Is it different?

There are extensive studies evaluating mesial temporal sclerosis (MTS) in adults and limited studies in children, with adolescents being included within both patient populations. Our aim was to evaluate predictors of surgical outcome solely in adolescent patients with MRI- and pathology -proven MTS. The Yale Epilepsy Surgery Database was reviewed from 1987 to 2012 for adolescent patients with confirmed MTS on MRI and pathology who underwent temporal lobectomy and had greater than two-year postsurgical follow-up. Clinical and electrographic data were reviewed. Eighteen patients were identified. Eleven patients (61%) were seizure-free. All seven patients (39%) who were not seizure-free free were found to have lateralized ictal onset within one hemisphere involving two or more lobes on scalp EEG (p<0.001). Of the 7 patients who were not seizure-free, 4 had a history of status epilepticus (compared to 1/11 seizure-free patients; p=0.047), and 4 had lateralized hypometabolism involving two or more lobes within a hemisphere seen on PET (compared to 0/8 seizure-free patients; p=0.002). A novel finding in our study was that lateralized (rather than localized) ictal onset on scalp EEG, lateralized hypometabolism on PET, and history of status epilepticus were risk factors for not attaining seizure freedom in adolescents with MTS who underwent temporal lobectomy.

Regretful liaisons: exploring the role of partner regret in the association between sexual and relationship satisfaction.

Regrets over partner selection can negatively influence romantic relationship functioning. It may even undermine stability in otherwise satisfied unions. The present study extends research on partner regret by exploring its several possible links with sexual satisfaction and satisfaction with the relationship as a whole. The authors analyzed data provided by 351 individuals using path analysis. Primary findings indicate that partner regret reduces sexual satisfaction by first depreciating satisfaction with the relationship as a whole. This effect was especially pronounced for parents and women. Implications for assessment and targeted interventions for partner regret are discussed.

Updated ILAE evidence review of antiepileptic drug efficacy and effectiveness as initial monotherapy for epileptic seizures and syndromes.

The purpose of this report was to update the 2006 International League Against Epilepsy (ILAE) report and identify the level of evidence for long-term efficacy or effectiveness for antiepileptic drugs (AEDs) as initial monotherapy for patients with newly diagnosed or untreated epilepsy. All applicable articles from July 2005 until March 2012 were identified, evaluated, and combined with the previous analysis (Glauser et al., 2006) to provide a comprehensive update. The prior analysis methodology was utilized with three modifications: (1) the detectable noninferiority boundary approach was dropped and both failed superiority studies and prespecified noninferiority studies were analyzed using a noninferiority approach, (2) the definition of an adequate comparator was clarified and now includes an absolute minimum point estimate for efficacy/effectiveness, and (3) the relationship table between clinical trial ratings, level of evidence, and conclusions no longer includes a recommendation column to reinforce that this review of efficacy/evidence for specific seizure types does not imply treatment recommendations. This evidence review contains one clarification: The commission has determined that class I superiority studies can be designed to detect up to a 20% absolute (rather than relative) difference in the point estimate of efficacy/effectiveness between study treatment and comparator using an intent-to-treat analysis. Since July, 2005, three class I randomized controlled trials (RCT) and 11 class III RCTs have been published. The combined analysis (1940-2012) now includes a total of 64 RCTs (7 with class I evidence, 2 with class II evidence) and 11 meta-analyses. New efficacy/effectiveness findings include the following: levetiracetam and zonisamide have level A evidence in adults with partial onset seizures and both ethosuximide and valproic acid have level A evidence in children with childhood absence epilepsy. There are no major changes in the level of evidence for any other subgroup. Levetiracetam and zonisamide join carbamazepine and phenytoin with level A efficacy/effectiveness evidence as initial monotherapy for adults with partial onset seizures. Although ethosuximide and valproic acid now have level A efficacy/effectiveness evidence as initial monotherapy for children with absence seizures, there continues to be an alarming lack of well designed, properly conducted epilepsy RCTs for patients with generalized seizures/epilepsies and in children in general. These findings reinforce the need for multicenter, multinational efforts to design, conduct, and analyze future clinically relevant adequately designed RCTs. When selecting a patient's AED, all relevant variables and not just efficacy and effectiveness should be considered.

Cross-validation of the ego dissolution scale: implications for studying psychedelics.

Introduction: Ego dissolution, variously called Ego-Loss, self-loss, and ego disintegration, is a hallmark of psychedelic drug use. We cross-validated the 10-item Ego Dissolution Scale, which we developed to assess ego dissolution in everyday life, and we included comparator variables that expanded our original assessment of construct validity. Methods: Undergraduate college student volunteers (N = 527) completed the measures online. Results: We replicated the original two factor structure (i.e., subfactors: Ego-Loss and Unity/connectedness with others, the world, universe), and we determined that the total score (Cronbach's α = 0.79) and subfactors (Ego-Loss = 78; Unity = 0.83) possessed adequate-to-good reliability and strong convergent validity (e.g., mindfulness, hallucination-predisposition, sleep variables, personality variables, positive/negative affect transliminality, dissociation/depersonalization), while neuroticism, social desirability did not correlate highly with ego dissolution. We identified distinct patterns of relations of measures associated with the Ego-Loss vs. Unity subfactors. Discussion: We discuss the implications of the use of the EDS for studying everyday aspects of ego dissolution, the long-term effects of psychedelic use, and the value of using the scale in conjunction with measures of the acute effects of psychedelics.

Experimental Approaches for Improving the Assessment of Partner Violence.

Intimate partner violence (IPV) is a serious and widespread problem. Unfortunately, like many other private behaviors, self-report is one of the few practical means of assessing IPV. Despite its known limitations, few studies have examined methods for improving the assessment of IPV through self-report, particularly in research contexts. The current study examined implicit goal priming (IGP) and restricted response latencies (RRL), which have previously been used successfully to improve reporting of other types of sensitive information. Participants in the IGP condition engaged in a word-matching task intended to subliminally prime an honesty goal immediately before completing the IPV self-report measure. In the RRL condition, the amount of time participants were allotted to answer each question was restricted to 3 s. Using a pilot sample of 71 cohabiting/married couples, we currently provide experimental support for the utility of the IGP task for increasing the frequency of reported IPV, as well as agreement between self-reports and partner reports, particularly when used in conjunction with the RRL method. We found the strongest and most consistent effects for women's reports of severe IPV perpetration and victimization, which is important given the extreme nature of these forms of IPV and because they are frequently underreported by women. We also found evidence to support the use of these methods to enhance reporting of other forms of IPV and provide additional directions for future research.

Situational and Dispositional Determinants of College Men's Perception of Women's Sexual Desire and Consent to Sex: A Factorial Vignette Analysis.

Sexual victimization of women by men on college campuses is a growing societal concern, with research identifying a host of situational and characterological factors that may predict men's likelihood to engage in sexual misconduct. In the present study, we examined the relative contribution and potential interplay of these various determinants on college men's perceptions of women's sexual desire and consent in hypothetical dating scenarios depicting a sexual interaction. We found that the men (N = 145) in this sample (a) conflated sexual desire with consent, (b) varied their appraisals of consent and desire depending on whether and how the woman in the vignette communicated consent or refusal, (c) perceived higher levels of consent if the man in the vignette had intercourse with the woman previously and as a function of escalating sexual intimacy in the ongoing interaction, (d) endorsed higher levels of perceived desire and consent across situations if they more strongly held rape-supportive attitudes, and (e) moderated their association between situational factors and perceptions of a woman's sexual intentions based on their endorsement of rape myths and a hypermasculine ideology. We conclude that efforts to prevent sexual violence among college students may benefit from being modeled on our findings that some men are likelier to infer consent regardless of the situation, that specific situational factors can foster misperceptions of consent across men in general, and that certain individuals in particular situations may pose the greatest risk for sexual misconduct.

Person- and Incident-Level Predictors of Blame, Disclosure, and Reporting to Authorities in Rape Scenarios.

Rapes perpetrated during college are both common and underreported. Research highlights that several person- and incident-level factors relating to gender and sexuality may diminish reporting, by themselves and as they pertain to attributions of blame for the assault. In this study, male and female college students (N = 916) read vignettes describing a rape perpetrated by a man against a woman, a man against a man, or a woman against a man. Participants rated the blameworthiness of both perpetrator and victim and rated the likelihood that they would disclose the rape to social ties or health services or report it to authorities if they were in the victim's position. We found that male gender and heterosexual orientation predicted higher victim blame, lower perpetrator blame, and lower likelihood of disclosure, although relative endorsement of masculine gender ideology seemed to be driving these associations, as well as predicted lower likelihood of reporting to authorities. Controlling for other factors, vignettes portraying a woman raping a man led to a lower likelihood of disclosing or reporting the assault, compared with a male-on-female rape. We also found that the effects of female-on-male rape and traditional masculine ideologies tied to rape disclosure partially by decreasing blame to the perpetrator, which itself carried a unique influence on decisions to report. Our findings overall indicate that factors related to gender, sexuality, and blame have myriad influences and may contribute to low rates of disclosing rape to important outlets.

Should enzyme-inducing antiepileptic drugs be considered first-line agents?

Despite the introduction of a host of new antiepileptic drugs (AEDs) over the last 20 years, the older agents, which are potent inducers of the cytochrome P450 (CYP450) system, remain the AEDs most commonly prescribed throughout the world. At the same time, data have gradually and continuously emerged regarding the possible adverse consequences of CYP450 induction, such that it is now appropriate to pose the question of whether the inducing drugs should still be considered first-line agents for the treatment of focal epilepsy. In this article we review the evidence suggesting that these drugs may have many detrimental metabolic effects, along with the data concerning their relative efficacy compared to the newer, noninducing AEDs. We conclude that longer and better-powered studies are needed to truly establish whether the newer AEDs are equivalent in efficacy to the older, inducing agents. Pending this, however, the extant data are sufficiently concerning to suggest that it may be prudent to start with noninducing AEDs unless there is a clear indication for one of the inducing drugs.

Conceptualizing bullying in children with autism spectrum disorder: Using a mixed model to differentiate behavior types and identify predictors.

Children with autism spectrum disorder experience bullying more frequently than their typical peers. Inconsistent definitions for and imprecise measurement of bullying in the literature impede a better understanding of this difference, and multiple types of bullying topographies create additional dimensions for analysis. In this study, participants rated the severity of bullying depicted in written vignettes of child-dyadic interactions. The vignettes varied across child age (4-15 years old) and described either one of four different types of bullying or non-bullying behavior. Participants included teachers and parents of children with autism spectrum disorder and community members without an autism spectrum disorder child. Participants' severity ratings of vignettes that described bullying differed by bullying type (i.e. verbal, physical, cyber, and interpersonal). Multilevel modeling revealed that bullying severity ratings are impacted by the age of children in the vignette, being a community member without children, and other demographic variables. These findings have implications for research methodology, assessment, and conceptualization of bullying in typical children as well as those with autism spectrum disorder.

Oxytocin receptor gene (OXTR) links to marital quality via social support behavior and perceived partner responsiveness.

Research exploring the mechanisms by which specific genes contribute to overall marital quality is still in its beginning stages; however, one mechanism may be the link between the oxytocin receptor gene (OXTR) and behavioral deficits relevant to social support-a critical determinant of marital quality. Using 79 different-sex married couples (N = 158), we found that genotypic variation in single nucleotide polymorphisms (SNPs) on wives' and husbands' OXTR variously associated with husbands' and wives' support provision and receipt behaviors in social support discussions. We also found significant indirect effects of husbands' TT genotype for OXTR SNP rs1042778 on lower marital quality for husbands and wives by way of the husband's more negative evaluation of his wife's responsiveness when he was the target for support. However, exploratory analyses also revealed that this genotype conferred benefits to marital quality through another path, altogether supporting the notion that genotypic variation on OXTR may have broad and potentially context-dependent influences on social behavior, which may play out in complex ways when examined in a marital context. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

The increased construct validity and clinical utility of assessing relationship quality using separate positive and negative dimensions.

The Positive and Negative Quality in Marriage Scale (F. D. Fincham & K. J. Linfield, 1997) is a self-report measure that separately assesses positive and negative dimensions of relationship quality. Fincham and Linfield found that ratings of positive and negative marital quality accounted for unique variance in maladaptive attributions and self-reports of dyadic behavior beyond that accounted for by the Marital Adjustment Test (H. J. Locke & K. M. Wallace, 1959), a widely used measure of marital quality that combines these dimensions. The current study expanded on these findings using a different measure of relationship quality and observed dyadic behavior with a sample of engaged couples (N=43). The results indicate that a two-dimensional approach to measuring self-evaluations of relationship quality is more informative than a one-dimensional approach during the engagement period.

Eslicarbazepine Acetate: A New Improvement on a Classic Drug Family for the Treatment of Partial-Onset Seizures.

Eslicarbazepine acetate is a new anti-epileptic drug belonging to the dibenzazepine carboxamide family that is currently approved as adjunctive therapy and monotherapy for partial-onset (focal) seizures. The drug enhances slow inactivation of voltage-gated sodium channels and subsequently reduces the activity of rapidly firing neurons. Eslicarbazepine acetate has few, but some, drug-drug interactions. It is a weak enzyme inducer and it inhibits cytochrome P450 2C19, but it affects a smaller assortment of enzymes than carbamazepine. Clinical studies using eslicarbazepine acetate as adjunctive treatment or monotherapy have demonstrated its efficacy in patients with refractory or newly diagnosed focal seizures. The drug is generally well tolerated, and the most common side effects include dizziness, headache, and diplopia. One of the greatest strengths of eslicarbazepine acetate is its ability to be administered only once per day. Eslicarbazepine acetate has many advantages over older anti-epileptic drugs, and it should be strongly considered when treating patients with partial-onset epilepsy.

A novel inherited SCN1A mutation associated with GEFS+ in benign and encephalopathic epilepsy.

Generalized epilepsy with febrile seizures plus (GEFS+) is an autosomal dominant condition often caused by mutations in SCN1A that usually first manifests as childhood simple febrile seizures but may progress to a variety of afebrile generalized seizure types. Here, we describe the case of an 8-year-old boy with a novel SCN1A mutation who developed febrile seizures at 10months of age which eventually advanced to frequent afebrile tonic-clonic seizures. His condition was unresponsive to several antiepileptic drugs and the ketogenic diet, and he experienced gradual cognitive decline. The patient's father carries the same novel mutation, but he only experienced childhood simple febrile seizures. SCN1A mutations display incomplete penetrance and variable expressivity, and the resulting severity may depend on the location and type of mutation, whether the mutation was spontaneous or inherited, and the effect of modifying alleles. The identification of novel pathogenic SCN1A mutations may eventually advance therapeutic development and prognostic capabilities.