Cumulative Trauma and Trauma Symptoms: A Three-Way Interaction.

The purpose of this study was to test if perceived social support and self-compassion will interact to reduce the magnitude of the bivariate relationship (buffering effect) between cumulative trauma and trauma symptoms after controlling for gender and age among college students. As part of a broader research project conducted between 2018 and 2019, we collected data via online surveys from a sample of 551 undergraduate students at a public university in the southern region of the US. After data cleaning, the study included 538 participants (representing 97.6% of the original dataset), ensuring a diverse representation across various ethnicities and genders. The three-way interaction model accounted for 38.61% of the variance in PTSD symptoms. In detail, with high levels of perceived social support, there was a significant difference in the buffering effects of perceived social support on the trauma-PTSD association between high and low self-compassion. Conversely, at high levels of self-compassion, perceived social support did not significantly influence the buffering effect of self-compassion. This study underscores the critical role of self-compassion in enhancing the protective effect of high-level perceived social support against PTSD symptoms following cumulative trauma.

The Impact of COVID-19 Traumatic Stressors on Mental Health: Is COVID-19 a New Trauma Type.

COVID-19 is a new type of trauma that has never been conceptually or empirically analyzed in our discipline. This study aimed to investigate the impact of COVID-19 as traumatic stress on mental health after controlling for individuals' previous stressors and traumas. We utilized a sample of (N = 1374) adults from seven Arab countries. We used an anonymous online questionnaire that included measures for COVID-19 traumatic stress, posttraumatic stress disorder, anxiety, depression, and cumulative stressors and traumas. We conducted hierarchical multiple regression, with posttraumatic stress disorder, depression, and anxiety as dependent variables. In the first step, in each analysis, we entered the country, gender, age, religion, education, and income as independent variables (Kira, Traumatology 7(2):73-86, 2001; Kira, Torture, 14:38-44, 2004; Kira, Traumatology, 2021, https://doi.org/10.1037/trm0000305). In the second step, we entered cumulative stressors and traumas as an independent variable. In the third step, we entered either COVID-19 traumatic stressors or one of its subtypes (fears of infection, economic, and lockdown) as an independent variable. Finally, we conducted structural equation modeling with PTSD, depression, and anxiety as predictors of the latent variable mental health and COVID-19 as the independent variable. Results indicated that COVID-19 traumatic stressors, and each of its three subtypes, were unique predictors of PTSD, anxiety, and depression. Thus, COVID-19 is a new type of traumatic stress that has serious mental health effects. Supplementary Information: The online version contains supplementary material available at 10.1007/s11469-021-00577-0.

The association of WTELS as a master motivator with higher executive functioning and better mental health.

The goal is to test the validity of the "Will to exist-live and survive (WTELS) as a master motivator that activates executive functions. A sample of 262 adults administered different measures that included WTELS and executive functions. We conducted hierarchical regressions with working memory deficits (WMD) and inhibition deficits (ID) as dependent variables. We entered in the last steps resilience and WTELS as independent variables. We conducted path analysis with WTELS as independent variables and WMD and ID as outcome variables and resilience and social support as mediating variables. WTELS accounted for the high effect size for lower working memory deficits and medium effect size for lower inhibition deficits. In path analysis, the effects of WTELS on decreased WMD were direct, while its effects on the ID were indirect. PROCESS analysis indicated that WTELS was directly associated with lower depression, anxiety, PTSD, and COVID-19 traumatic stress, and its indirect effects were mediated by lower executive function deficits (Kira et al., Psych 12:992-1024 2021c, Kira et al., in press). The path model discussed was generally superior to the alternative models and was strictly invariant across genders (male/ female). Supplementary Information: The online version contains supplementary material available at 10.1007/s12144-021-02078-8.

Sociodemographic factors as moderators of COVID-19 stress on depression.

BACKGROUND AND OBJECTIVES: The COVID-19 pandemic has disrupted many aspects of daily life, but relatively little is known about COVID-19-related stress for subgroups in the population. We examined differences in COVID-stress and depression as a function of gender, race, ethnicity, and subjective social status. We tested these factors as moderators of the association between COVID-stress and depression. DESIGN: We used a cross-sectional design to test associations between sociodemographic factors, COVID-stress, and depression. Analyses were based on confirmatory factor analytic and structural equations models. METHODS: A convenience sample of 1,058 U.S. MTurk workers and college students (54.5% cisgender women; 55.1% racial/ethnic minoritized individuals) was recruited. Participants completed self-report measures of COVID-stress and depression. RESULTS: COVID-stress was positively associated with depression. Overall, neither gender nor racial minoritized status moderated COVID-stress effects on depression. However, intersectional analyses revealed COVID-stress was a significant risk factor for depression among Black women compared to other participants. COVID-stress was more strongly linked to depression for Hispanic individuals and participants with higher social status. CONCLUSIONS: Future studies may benefit from the COVID-stress scale evaluated in this study and by considering the differential effects of sociodemographic factors on psychological functioning during the pandemic.

Can a school climate survey accurately and equitably measure school quality? Examining the multilevel structure and invariance of the Georgia School Climate Scale.

School climate measures are increasingly utilized as one indicator of school quality within educational accountability systems. However, concerns have been raised about the accuracy of these indicators given that school climate surveys are often not validated using multilevel methods. Further, cross-school comparisons in climate may not be trustworthy because the school-level invariance of climate surveys has not been investigated. There is a need to examine the validity of school-level climate constructs and to determine if surveys measure climate equitably for schools that serve underrepresented populations. The aim of the current study was to examine the multilevel factor structure of a statewide school climate survey to determine whether it measured climate equitably for students of different races/ethnicities and across schools with varying racial/ethnic and socioeconomic compositions. Participants included 259,778 students from 427 middle schools throughout a southeastern U.S. state. Cross-level invariance analyses revealed that the climate constructs were measured differently across levels of analysis, and school-level climate could not be interpreted as merely the aggregate of individual-level climate. Student- and school-level factorial invariance was tested using multilevel modeling procedures. Results revealed item bias with respect to student and school characteristics, and the relationships between school climate and student and school demographics changed after accounting for identified bias. As more educational agencies consider including school climate surveys in their accountability systems, these findings suggest that multilevel validation procedures and school-level invariance analyses are necessary to ensure accurate and equitable measurement.

Intersected discrimination through the lens of COVID-19: The case example of Christian minority in Iraq.

Compelling evidence proved that coronavirus disease (COVID-19) disproportionately affects minorities. The goal of the present study was to explore the effects of intersected discrimination and discrimination types on COVID-19, mental health, and cognition. A sample of 542 Iraqis, 55.7% females, age ranged from 18 to 73, with (M = 31.16, SD = 9.77). 48.7% were Muslims, and 51.3% were Christians (N = 278). We used measures for COVID-19 stressors, executive functions, intersected discrimination (gender discrimination, social groups-based discrimination, sexual orientation discrimination, and genocidal discrimination), posttraumatic stress disorder (PTSD), depression, anxiety, status and death, existential anxieties, and health. We conducted independent samples t test between Muslims and Christians. We conducted hierarchical regression analyses using the Christian minority subsample to see if intersected discrimination is predictive of COVID-19 hospitalization. We conducted two-path analyses, one with intersected discrimination as an independent variable and the second with the different discrimination types as independent variables. Intersected discrimination predicted COVID-19 hospitalization. The primary discrimination type for Christians was genocidal discrimination. Christians had higher existential anxiety about status and death than Muslims. Intersected discrimination and discrimination types had a significant association with mental health, health, and cognition variables, with intersected discrimination, had a higher impact than each. Existential anxiety about the person's social and economic status was the critical outcome of intersected discrimination that trickles down to other variables. COVID-19 stressors had significant effects on depression, PTSD, generalized anxiety, and Status existential annihilation anxiety (EAA). COVID-19 hospitalization and stressors are associated with inhibition and working memory deficits. We discussed the conceptual and clinical implications of the results. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Coping with COVID-19 Prolonged and Cumulative Stressors: the Case Example of Egypt.

The current study aimed to explore how COVID-19-traumatized populations cope using a coping model based on wills to exist, live, and survive (WTELS) that leads to positive coping and posttraumatic growth (PTG). We used data from 11 Arab countries (N = 2732), including Egypt (N = 831), and included measures for COVID-19 stressors (COVID-fear, economic, lockdown, and grief stressors), WTELS, resilience, religiosity, spirituality, social support, and PTG. We conducted ANOVA on the main sample to explore the differences between Arab countries, hierarchical regressions, and path analysis on the Egyptian subsample to test a model of the effects on WTELS. In the path model, WTELS was the independent variable. Other coping strategies were mediating variables, and COVID-19 stressor types were outcome variables. ANOVA on the main sample indicated that Egypt was the highest on COVID-19 stressors (infection fears, economic, lockdown, and grief stressors), actual infection, and WTELS. Hierarchical regression indicated that social support, resilience, and WTELS were positive predictors of PTG, with WTELS had the highest effect size (ß = .41) and WTELS being a negative predictor of COVID-19 stressors, while resilience and social support were not. Path analysis indicated that WTELS predicted higher religiosity, spirituality, social support, resilience, and lower COVID-19 stressors. Religiosity predicted higher spirituality, social support, and resilience and lower COVID-19 stressors. Interfaith spirituality predicted higher resilience and lower COVID-19 grief stressors. The results validated the central role of WTELS. Results helped to identify potentially effective interventions with COVID-19 victims that focus on WTELS, spirituality, and religiosity. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11469-021-00712-x.

The differential mental health impact of COVID-19 in Arab countries.

COVID-19 pandemic's mental health impact on Arab countries is under-researched. The goal of this investigation was to study the differential impact of COVID-19 on the mental health of Arab countries. A questionnaire including measures of COVID-19 traumatic stress, PTSD, depression, anxiety, and cumulative stressors and trauma was distributed anonymously online in seven Arab countries (Egypt (N = 255), Kuwait (N = 442), Jordan (N = 216), Saudi Arabia (N = 212, Algeria (N = 110), Iraq and Palestine (N = 139)). We used ANOVA and stepwise regression to analyze the data. For each country, regression, PTSD, depression, and anxiety were dependent variables; we entered in the first-step, gender, age, religion, education, and income. In the second step, we entered "cumulative stressors and traumas." In the third step, we entered COVID-19 traumatic stress. The ANOVA results indicated that the differences in COVID19 traumatic stress, PTSD, depression, and anxiety between the countries were significant. Post-hoc analysis indicated that Egypt is significantly higher than all the other Arab countries in COVID-19 traumatic stress, PTSD, anxiety, and depression. The subsample from Palestine and Iraq had a significantly higher cumulative trauma load than the other Arab countries but did not have higher levels of COVID-19 traumatic stress or PTSD. Stepwise regression indicated that COVID-19 traumatic stress accounted for significant variance above and beyond the variance accounted for by previous cumulative stressors and traumas for anxiety in all countries and PTSD and depression in all countries except for Algeria. We discussed the implications for these results for the urgent mental health needs of Arab countries.

The effects of COVID-19 continuous traumatic stressors on mental health and cognitive functioning: A case example from Turkey.

There is a need to accurately assess the specific impacts of the various traumatic stressors caused by COVID-19 on mental health. The goal was to evaluate the impact of different types of COVID-19 stressors (infection fears, lockdown, and economic stressors) on mental health and cognitive functioning. We used a sample of 262 Turkish adults. We administered an online questionnaire that included measures of COVID-19 traumatic stressors, PTSD, depression, anxiety, executive function deficits, and cumulative stressors and traumas (CST). The analyses included correlations, hierarchical regression, path analysis, and PROCESS mediation analysis. All COVID-19 traumatic stressors types and their cumulative load predicted PTSD, depression, anxiety, and executive function deficits after controlling for previous cumulative stressors and traumas and COVID-19 infection. COVID-19 lockdown's stressors were the strongest predictors, compared to COVID-19 fears and economic stressors. Path analysis and PROCESS mediation results indicated that COVID-19 traumatic stressors had direct effects on working memory deficits, direct and indirect effects on PTSD, depression, and anxiety, and indirect effects on inhibition deficits. Anxiety, depression, and inhibition deficits mediated its indirect effects on PTSD. The results have conceptual and clinical implications. COVID-19 continuous posttraumatic stress syndrome that includes comorbid PTSD, depression, anxiety, and executive function deficits is different and does not fit within the current trauma frameworks. There is a need for a paradigm shift in current stress and trauma frameworks to account for the COVID-19 continuous global stressors and for clinical innovations in intervention to help its victims. Supplementary Information: The online version contains supplementary material available at 10.1007/s12144-021-01743-2.

The relationship of COVID-19 traumatic stress, cumulative trauma, and race to posttraumatic stress disorder symptoms.

The purpose of this study was to test if coronavirus disease 2019 (COVID-19) traumatic stress predicts posttraumatic stress disorder (PTSD) symptoms after cumulative trauma and whether there is a three-way interaction between COVID-19 traumatic stress, cumulative trauma, and race in the prediction of PTSD. Using a cross-sectional design, a diverse sample of 745 participants completed measures of cumulative trauma, COVID-19 traumatic stress, and PTSD. COVID-19 traumatic stress accounted for a significant amount of the variance in PTSD above and beyond cumulative trauma. A significant interaction effect was found, indicating that the effect of COVID-19 traumatic stress in predicting PTSD varied as a function of cumulative trauma and that the effects of that interaction were different for Asians and Whites. There were generally comparable associations between COVID-19 traumatic stress and PTSD at low and high levels of cumulative trauma across most racial groups. However, for Asians, higher levels of cumulative trauma did not worsen the PTSD outcome as a function of COVID Traumatic Stress but did at low levels of cumulative trauma.

Addressing Concerns About How Perfectionistic Discrepancy Should Be Measured With the Revised Almost Perfect Scale.

We examine the conceptual and empirical merits of concerns Flett et al. recently raised about the Almost Perfect Scale-Revised (APS-R), specifically that items on the APS-R Discrepancy should be separated into a "Pure" Discrepancy factor and a Dissatisfaction factor. Limitations in the logic and findings of that critique are summarized. We replicate and extend Flett et al.'s study with results from two samples: (a) college freshmen STEM students ( N = 279) and (b) doctoral students in a national sample ( N = 529). Confirmatory factor analyses indicated that the alternative measurement models could be fit to the data, but were not practical improvements over the original APS-R factor model: Alternative discrepancy factors failed to demonstrate discriminant validity, nor did they have meaningfully different patterns of associations with numerous criterion variables (i.e., stress, emotion regulation, rumination, adult attachment, and life satisfaction). Thus, a data-based answer to the question of how perfectionistic discrepancy should be assessed is to stay the course with confidence using the original APS-R.

Trauma proliferation and stress generation (TPSG) dynamics and their implications for clinical science.

The current research and clinical focus on single traumas fails to assess numerous important trauma dynamics including trauma proliferation. In this study, 2 trauma proliferation pathways were identified that utilize a developmentally based trauma framework (DBTF). Data previously collected from 6 different cultural groups (N = 2279; 2 mental health clinics in Egypt and the United States, Native Americans, Palestinian adults in Gaza, and college students in Poland and Egypt) were reanalyzed. The 6 studies utilized DBTF-based measures of cumulative trauma and trauma types. Path analysis was used to test the trauma proliferation model and PROCESS software was used to identify mediators and their effect sizes. Results of the analyses indicated that attachment trauma and collective identity trauma independently predicted (directly and through mediators) personal identity trauma, role identity trauma, secondary trauma, and survival trauma. The pattern of proliferation was configurally invariant across the 6 groups and strictly invariant across genders. Implications for the consideration of trauma global dynamics, such as trauma proliferation, are discussed. (PsycINFO Database Record

Perfectionism in Argentina and the United States: Measurement Structure, Invariance, and Implications for Depression.

The Revised Almost Perfect Scale (APS-R; Slaney, Mobley, Trippi, Ashby, & Johnson, 1996 ) was designed to measure perfectionistic strivings (standards), perfectionistic concerns (discrepancy), and preferences for neatness and organization (order). In this study, English and Spanish (Arana, Keegan, & Rutsztein, 2009 ) versions of the APS-R were compared in samples of 283 college students in Argentina and 311 U.S. students. The results offered support for cross-national scalar invariance for discrepancy and order items but standards items, with a few exceptions, raised concerns about their cross-national comparability. Tests of latent means revealed no differences between the countries for discrepancy, but the order factor mean was higher in the U.S. SAMPLE: Age and gender had negligible effects on measurement models. Discrepancy was strongly related to depressive symptoms for both samples. Unlike in the U.S. sample, there was a significant association for the Argentina sample between standards and discrepancy. Overall, results indicated that discrepancy items performed well, order items were adequate with some measurement adjustments, and standards items should be revisited for their cross-cultural utility. Translation issues and general values in Argentina and the United States (e.g., collectivism-individualism) are discussed that might affect how perfectionism is understood and measured in different cultural contexts.

Perfectionism and longitudinal patterns of stress for STEM majors: Implications for academic performance.

Complementary hypotheses suggest that perfectionism may (a) cause later stress (stress generation) and (b) moderate the effects of stress on subsequent outcomes (stress enhancement). The present study tested these hypotheses with a sample of 432 first-time college freshmen pursuing science, technology, engineering, and math (STEM) majors. Students completed baseline perfectionism scales and repeated measures for perceived academic stress at monthly intervals 3 times in the fall semester and 3 times in the spring semester. Course grade data from institutional records were used to calculate first-year STEM grade point average (GPA) as the distal outcome in analyses. Gender, high school GPA, SAT math scores, and university were covariates. Latent profile analyses supported adaptive, maladaptive, and nonperfectionist classes and latent class growth mixture models identified distinctly low, moderate, and high patterns of academic stress over the year. Latent transition analyses indicated that maladaptive perfectionists were likely to experience moderate or high stress (none transitioned to low stress), and adaptive perfectionists were likely to have low or moderate stress (only 4% transitioned to high stress). Women were substantially more likely than male maladaptive perfectionists to experience high stress. Low-stressed adaptive perfectionists followed by moderately stressed maladaptive perfectionists had relatively higher GPAs than other groups. Subgroups of perfectionists who transitioned to the next higher stress level had substantially lower GPAs than other groups. Overall, results were consistent with stress-generation and stress-enhancement hypotheses regarding perfectionists. Findings suggested implications for prevention and intervention with perfectionistic STEM students that should be implemented early in their college experience.

Therapist effects, working alliance, and African American women substance users.

African American (AfA) women with substance use disorders experience low rates of treatment retention compared to other groups of substance abusers. This is problematic since substance abuse treatment is effective only to the extent clients are retained. A weak working alliance is a significant barrier to treatment retention for AfA women. Thus, identifying therapist characteristics that facilitate a strong working alliance among this population stands as a promising step toward reducing disparities in treatment retention for this group. Therapist characteristics were explored as predictors of working alliance with AfA women substance users (N = 102). Two hypotheses were tested: (1) Population Sensitive Therapist Characteristics (PSTCs: multicultural competence, egalitarianism, and empowerment) will explain a significant amount of variance in working alliance beyond that explained by general therapist characteristics (GTCs: empathy, regard, and genuineness) and (2) GTCs will partially mediate the effect of each individual PSTC on working alliance. Hierarchical multiple regression revealed that PSTCs explained 12% of the variance in working alliance after controlling for GTCs. Bootstrapping analyses demonstrated that GTCs mediated the effect of each PSTC on working alliance. Findings suggest that therapists can facilitate a stronger working alliance with AfA women substance users through demonstration of PSTCs in addition to GTCs, and that PSTCs are facilitative because they increase the likelihood the therapist is perceived as empathic, having unconditional positive regard, and genuine. Clinical and therapist training implications are discussed.

A brief measure of adolescent perceptions of school climate.

Student perceptions of school climate represent the ways students feel about the school environment. These include perceptions regarding safety, teaching and learning, and relationships within the school. It has been found that student perceptions of school climate are positively correlated with academic achievement (Brookover et al., 1978), and negatively correlated with risky behaviors (Bandyopadhyay, Cornell, & Konold, 2009; Bayar & Ucanok, 2012; Wang, Berry, & Swearer, 2013). The Georgia Brief School Climate Inventory (GaBSCI) is a measure of student perceptions of school climate. The brevity of the 9-item instrument makes it ideal as a general measure that can be used to monitor student perceptions of school climate. The survey was anonymously administered to 130,968 sixth- and eighth-grade students in the state of Georgia. Cronbach's alpha for the scale was 0.71. Exploratory and confirmatory factor analyses verified the scale's structure. Student perceptions of climate from the GaBSCI varied based on race/ethnicity, gender, and grade. Additional support for the construct validity of the GaBSCI was obtained based on its relationships with several behaviors related to bullying, and the moderating effects of grade and gender on these relationships. Implications for research and practice are discussed.

The Traumatogenic Dynamics of Internalized Stigma of Mental Illness Among Arab American, Muslim, and Refugee Clients.

Understanding the dynamics of mental health stigma through existing frameworks, especially in minorities with higher stigma, is problematic. There is a need to reconceptualize stigma, particularly in highly traumatized groups. The current study examines the validity of a new development-based trauma framework that conceptualizes stigma as a type III chronic trauma that contributes to negative mental health effects. This framework proposes that public stigma is a unique chronic traumatic stress that mediates the effects of similar trauma types in mental health patients. To test this proposition, this study explores the relationships between internalized stigma of mental illness (ISMI), different trauma types, and posttrauma spectrum disorders. ISMI, posttraumatic stress disorder, other posttrauma spectrum disorders, and cumulative trauma measures were administered to a sample of 399 mental health patients that included Arab (82%), Muslim (84%), and refugee (31%), as well as American patients (18%). Age in the sample ranged from 18 to 76 years (M = 39.66, SD = 11.45), with 53.5% males. Hierarchical multiple regression, t tests, and path analyses were conducted. Results indicated that ISMI predicted posttraumatic stress disorder and other posttrauma spectrum disorders after controlling for cumulative trauma. ISMI was associated with other chronic collective identity traumas. While Arab Americans, Muslims, and refugees had higher ISMI scores than other Americans, the elevated chronic trauma levels of these groups were significant predictors of these differences. The results provide evidence to support ISMI traumatology model. Implications of the results for treating victims of ISMI, especially Arab Americans, Muslims and refugees are discussed.

An examination of bullying in georgia schools: demographic and school climate factors associated with willingness to intervene in bullying situations.

INTRODUCTION: Research dedicated to identification of precursors to cases of aggravated bullying in schools has led to enhanced knowledge of risk factors for both victimization and perpetration. However, characteristics among those who are more likely to intervene in such situations are less understood. The purpose of this study is to examine the associations between demographic characteristics, school climate and psychosocial factors, and willingness to intervene in a bullying situation among middle and high school students in Georgia. METHODS: We computed analyses using cross-sectional data from the Georgia Student Health Survey II (GSHS 2006) administered to public school students in grades 6, 8, 10, and 12 (n=175,311). We used logistic regression analyses to determine the demographic, school climate and psychosocial factors associated with a willingness to intervene in a bullying situation. RESULTS: Students who were white and who were girls were most likely to report willingness to intervene in bullying situations. Several school-climate factors, such as feeling safe at school, liking school, feeling successful at school and perceiving clear rules at school, were associated with willingness to intervene, while youth who reported binge drinking were less willing to intervene. CONCLUSION: These findings, while preliminary, indicate that girls, students who are white, and students who experience a relatively positive school climate and adaptive psychosocial factors are more likely to report that they would intervene in bullying situations. These findings may guide how bullying is addressed in schools and underscore the importance of safe school climates.

Pre-Teen Alcohol Use as a Risk Factor for Victimization and Perpetration of Bullying among Middle and High School Students in Georgia.

OBJECTIVE: We examined the association between pre-teen alcohol use initiation and the victimization and perpetration of bullying among middle and high school students in Georgia. METHODS: We computed analyses using data from the 2006 Georgia Student Health Survey (N=175,311) of students in grades 6, 8, 10 and 12. The current analyses were limited to students in grades 8, 10 and 12 (n=122,434). We used multilogistic regression analyses to determine the associations between early alcohol use and reports of both victimization and perpetration of bullying, perpetration only, victimization only, and neither victimization or perpetration, while controlling for demographic characteristics, other substance use, peer drinking and weapon carrying. RESULTS: Pre-teen alcohol use initiation was significantly associated with both bullying perpetration and victimization relative to non drinkers in bivariate analyses (OR=3.20 95%CI:3.03-3.39). The association was also significant between pre-teen alcohol use initiation and perpetration and victimization of bullying in analyses adjusted for confounders (Adj.OR=1.74; 95%CI:1.61-1.89). Overall, findings were similar for boys and girls. CONCLUSION: Pre-teen alcohol use initiation is an important risk factor for both the perpetration and victimization of bullying among boys and girls in Georgia. Increased efforts to delay and reduce early alcohol use through clinical interventions, education and policies may also positively impact other health risk behaviors, including bullying.

Classifying adolescent perfectionists.

A large school-based sample of 9th-grade adolescents (N = 875) completed the Almost Perfect Scale-Revised (APS-R; Slaney, Mobley, Trippi, Ashby, & Johnson, 1996). Decision rules and cut-scores were developed and replicated that classify adolescents as one of two kinds of perfectionists (adaptive or maladaptive) or as nonperfectionists. A four-cluster solution further differentiating nonperfectionists was also evaluated. Criterion-related validity of the cluster solutions was supported by perfectionist and nonperfectionist group differences on select subscales of the Multidimensional Students' Life Satisfaction Scale (MSLSS; Huebner, 1994) and the Behavior Assessment System for Children, Second Edition: Self-Report-Adolescent (BASC-2: SRP-A; Reynolds & Kamphaus, 2004). Adaptive and maladaptive perfectionists were supported in both cluster solutions and validity analyses. In addition to the two types of perfectionists, the four-cluster solution differentiated two types of nonperfectionists from one that seemed similar to maladaptive perfectionists in terms of BASC-2: SRP-A scores. Although the four-cluster solution may have potential value, the three-cluster solution was recommended as more parsimonious for studies attempting to differentiate perfectionists. The findings and straightforward decision rules were generally consistent in principle with other studies attempting to classify perfectionists, although the final APS-R cut-scores differed from those of other studies of adults. The results provided additional descriptive inferences for perfectionistic and nonperfectionistic adolescents. Among other issues, the findings raised the question of whether the label of maladaptive for a subgroup of perfectionists was too broad given that the criterion-related validity scores revealed that the group's problems in adjustment were conspicuous only in the areas of anxiety and social stress.