Exploring Pain Adaptation in Youth With Juvenile Idiopathic Arthritis: Identifying Youth and Parent Resilience Resources and Mechanisms.

OBJECTIVE: Although juvenile idiopathic arthritis (JIA) is often associated with pain, this experience does not necessitate negative outcomes (eg, depression, functional impairment). Little research has explored youth and parent resilience resources (ie, stable traits) and mechanisms (ie, dynamic processes) in this context, and studies have focused on their contributions independently rather than collectively. This study, informed by the Ecological Resilience-Risk Model in Pediatric Chronic Pain, sought to (1) explore the relationships among youth and parent resilience resources and mechanisms and (2) identify the relative importance (RI; ie, independent contributions when entered simultaneously) of evidence-based youth and parent resources and mechanisms in contributing to youth-reported recovery, sustainability, and growth outcomes. METHODS: Youth (13-18 years) with JIA and their parents (156 dyads) completed a battery of online questionnaires assessing resilience resources (optimism, resilience), mechanisms (psychological flexibility, pain acceptance, self-efficacy), recovery and sustainability (pain intensity, functional disability, health-related quality of life), and growth (benefit finding) outcomes. RESULTS: Analyses demonstrated significant positive correlations across within-person resources and mechanisms and weaker correlations across within-dyad resources and mechanisms. Although the RI of predictors varied by outcome, youth pain acceptance was the most robust predictor across models (RI = 0.03-0.15). Some predictors (eg, parent psychological flexibility and pain acceptance) were generally categorized as "Not Important," whereas others (eg, youth resilience) had "Inconclusive" results, suggesting construct overlap. CONCLUSION: Although additional research is needed to further understand resilience, results highlight the importance of fostering pain acceptance in youth and incorporating parents in psychosocial interventions to optimize living with JIA.

A systematic review of the psychosocial factors associated with pain in children with juvenile idiopathic arthritis.

BACKGROUND: Pain is one of the most frequently reported experiences amongst children with Juvenile Idiopathic Arthritis (JIA); however, the management of JIA pain remains challenging. As pain is a multidimensional experience that is influenced by biological, psychological, and social factors, the key to effective pain management lies in understanding these complex relationships. The objective of this study is to systematically review the literature on psychosocial factors of children with JIA and their caregivers 1) associated with and 2) predictive of later JIA pain intensity, frequency, and sensitivity in children 0-17 years of age. METHODS: The Joanna Briggs Institute methodology for etiology and risk and Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement guided the conduct and reporting of this review. Terms related to pain and JIA were searched in English without date restrictions across various databases (PubMed, CINAHL, PsycINFO, Embase, Scopus, and the Cochrane Central Register of Controlled Trials) in September 2021. Two independent reviewers identified, extracted data from, and critically appraised the included studies. Conflicts were resolved via consensus. RESULTS: Of the 9,929 unique studies identified, 61 were included in this review and reported on 516 associations. Results were heterogeneous, likely due to methodological differences and moderate study quality. Results identified predominantly significant associations between pain and primary and secondary appraisals (e.g., more child pain beliefs, lower parent/child self-efficacy, lower child social functioning), parent/child internalizing symptoms, and lower child well-being and health-related quality of life. Prognostically, studies had 1-to-60-month follow-up periods. Fewer beliefs of harm, disability, and no control were associated with lower pain at follow-up, whereas internalizing symptoms and lower well-being were predictive of higher pain at follow-up (bidirectional relationships were also identified). CONCLUSIONS: Despite the heterogeneous results, this review highlights important associations between psychosocial factors and JIA pain. Clinically, this information supports an interdisciplinary approach to pain management, informs the role of psychosocial supports, and provides information to better optimize JIA pain assessments and interventions. It also identifies a need for high quality studies with larger samples and more complex and longitudinal analyses to understand factors that impact the pain experience in children with JIA. TRIAL REGISTRATION: PROSPERO CRD42021266716.

Links Between Romantic Relationship Dysfunction and Drinking Behaviors Are Moderated by Gender and Age.

OBJECTIVE: Romantic relationship dysfunction is a risk for subsequent alcohol use, with some research suggesting gender differences in this link. We evaluated how different aspects of relationship dysfunction are related to different drinking behaviors and whether these associations vary by gender. We further examined the role of age as a potential moderator of this gender difference. METHOD: Qualtrics Panelists (N = 1,470; 50% women) who were in a romantic relationship and regularly consumed alcohol completed an online survey. The sample was wide-ranging in age (range: 18-85 years old; M = 46.64, SD = 11.95). Participants reported drinking about 10 drinks per week, on average (SD = 11.01). RESULTS: Five factor scores were constructed from relationship predictors (relationship distress, intrusion/jealousy, and disagreements) and drinking outcomes (consumption and coping motives). Moderation analyses indicated several significant two-way interactions between relationship dysfunction, gender, and age when predicting alcohol outcomes. Of note, the positive associations between relationship distress and both consumption and coping motives were stronger among younger than older individuals and among men than women (consistent with an externalizing stress perspective). A significant three-way interaction suggested that, for women, associations between intrusion/jealousy and coping motives were strongest at younger ages, consistent with an interpersonal sensitivity perspective. Conversely, for men, these associations were stronger at older ages, consistent with an externalizing stress perspective. CONCLUSIONS: Men and younger individuals should be of particular focus when designing and testing interventions for drinking in response to relationship distress and disagreements. Younger women and older men may benefit from interventions focused on drinking to cope with relationship jealousy and electronic intrusions.

Few Differences in Sexual Talk by Gender/Sex and Dyad Type: A Retrospective and Daily Diary Study with Couples.

Sexual talk is a type of verbal communication that occurs exclusively during sexual activity and that is specific to the sexual activity itself. Previous research has identified two types of sexual talk: individualistic (i.e., self-focused) and mutualistic (i.e., sharing/partner-focused), which have generally been linked to greater sexual and relationship well-being. Whether sexual talk use varies by gender/sex (i.e., men, women, gender/sex diverse individuals; GSD) or dyad type (i.e., same- vs. mixed-gender/sex) has not been examined. Given initial evidence that the types of sexual talk may contribute differently to sexual and relationship well-being, it is important to identify factors (e.g., gender/sex) that may be associated with the amount of sexual talk used. We examined differences by gender/sex and dyad type in the average sexual talk use among long-term couples (N = 229; 69 same-gender/sex) using retrospective cross-sectional dyadic data. We also examined these differences in the same sample (N = 217) using a 35-day dyadic daily diary study. Retrospectively, but not daily, women reported using more mutualistic talk than men, especially when partnered with a woman. There were no significant gender/sex or dyad type differences in use of individualistic talk retrospectively or daily. Exploratory analyses with the GSD couples suggested that there may be gender/sex and dyad type differences retrospectively and daily, for individualistic and not mutualistic talk; however, these analyses must be interpreted with caution due to the small subsample size of GSD couples.

Friendship Conflict, Drinking to Cope, and Alcohol-Related Problems: A Longitudinal Actor-Partner Interdependence Model.

Drinking to cope with negative affect is a strong predictor of alcohol-related problems. We hypothesized that the association between friendship conflict and alcohol-related problems would be mediated by coping-with-depression motives in emerging adults' close friendships. We used a 4-wave, 4-month longitudinal self-report survey design measuring friendship conflict, coping motives, and alcohol-related problems from 174 same-sex friendship dyads. Participants were recruited from Nova Scotia, Canada between September 2016 and February 2019. Participants had a mean age of 18.66 (SD = 1.17) and were 66.1% female. Data were analyzed using multilevel structural equation modeling. Coping-with-depression motives mediated the link between conflict and alcohol-related problems at the between- and within-subject levels. Unexpectedly, coping-with-anxiety motives was an additional mediator at the within-subjects level. Interventions for emerging adults' problem drinking should consider the influence of friendship conflict and its impact on emerging adults' tendencies to drink to cope with both depression and anxiety. Materials/Syntax: https://osf.io/krs3v/.

Socially prescribed perfectionism predicts next-day binge eating behaviors over 20-days.

Existing research on perfectionism and binge eating suggests that socially prescribed, self-oriented, and other-oriented perfectionism (Socially Prescribed Perfectionism, SPP; Self-Oriented Perfectionism, SOP; and Other-Oriented Perfectionism, OOP) are differentially related to binge eating. However, previous studies have largely utilized cross-sectional methodology. The present study used a 20-day daily diary methodology to examine associations between daily levels of perfectionistic dimensions and next-day binge eating behaviors with a nonclinical sample of emerging adults (N = 263). Zero-inflated negative binomial regression models indicated that daily SPP (but not SOP or OOP) predicted a greater intensity of next-day binge eating behaviors in the count portion of the model; however, daily levels of perfectionistic dimensions did not predict the presence/absence of next-day binge eating behaviors in the zero-inflated portion of the model. Additionally, analyses examining the reverse causal direction (i.e., binge eating behaviors predicting higher next-day perfectionism) failed to provide evidence that the occurrence or intensity of binge eating behaviors predicts next-day levels of SPP, SOP, or OOP. Overall, at a daily level, SPP appears to be a vulnerability factor for binge eating behaviors. It may be helpful for clinicians to target state-levels of SPP to reduce harmful binge eating behaviors. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The association between labour epidural analgesia and postpartum depressive symptoms: a longitudinal cohort study.

BACKGROUND: Pain is a risk factor for postpartum depression (PPD) and labour epidural analgesia (LEA) may lower the incidence of PPD. We evaluated depressive symptoms risk at three, six, and 12 months postpartum in women with LEA compared with women without LEA. METHODS: With ethics approval, hypotheses were tested using data from a longitudinal prospective observational cohort study between January 2015 and January 2019 in nulliparous women aged ≥ 18 yr with uncomplicated, singleton pregnancies. Email surveys were completed at baseline (18-20 weeks' gestation) and at three-, six- and 12 months postpartum, including the Edinburgh Postpartum Depression Scale (EPDS). Maternal, infant, and anesthesia characteristics were abstracted from electronic databases. The EPDS scores at three, six, and 12 months postpartum were analyzed using generalized estimating equations with and without covariates. RESULTS: Of the 909 women who consented to participate, 709 women were included in the study. Antenatal EPDS scores, not LEA, predicted postpartum depressive symptom risk (P < 0.001). The adjusted 95% confidence intervals suggest mean EPDS scores differ from 1.0 point lower in the LEA group at 12 months to 1.5 points higher in the no LEA group at three months on its 0-30 scale. All the confidence intervals included zero at three, six, and 12 months, so were considered non-significant (P > 0.05). CONCLUSION: This study did not identify an association between LEA and risk of depressive symptoms postpartum, although small mean differences between groups cannot be ruled out. Future studies should focus on other modifiable variables that influence the development of PPD.

RéSUMé: CONTEXTE: La douleur constitue un facteur de risque de dépression post-partum (DPP) et l'analgésie péridurale obstétricale (APO) pourrait réduire l'incidence de DPP. Nous avons évalué le risque de symptômes de dépression à trois, six, et 12 mois post-partum chez les femmes ayant reçu une APO comparativement aux femmes sans APO. MéTHODE: Après avoir obtenu l'approbation du comité d'éthique, l'hypothèse a été testée en se fondant sur les données d'une étude de cohorte observationnelle prospective longitudinale réalisée entre janvier 2015 et janvier 2019 auprès des femmes nullipares âgées de ≥ 18 ans avec des grossesses simples et sans complication. Des sondages électroniques ont été complétés au début de l'étude (données de base, 18 à 20 semaines de grossesse), puis à trois, six et douze mois post-partum, et incluaient l'Échelle de dépression postnatale d'Édimbourg (EPDS). Les caractéristiques maternelles, infantiles et anesthésiques ont été extraites des bases de données électroniques. Les scores sur l'EPDS à trois, six, et 12 mois post-partum ont été analysés utilisant des équations d'estimation généralisées avec et sans covariables. RéSULTATS: Parmi les 909 femmes qui ont consenti à participer, 709 femmes ont été incluses dans l'étude. Les scores prénataux sur l'EPDS, et non l'APO, ont prédit le risque de symptômes de dépression post-partum (P < 0,001). Les intervalles de confiance ajustés de 95 % suggèrent que les scores moyens sur l'EPDS différaient de 1,0 point de moins dans le groupe APO à 12 mois à 1,5 point de plus dans le groupe sans APO à trois mois sur l'échelle de 0 à 30. Tous les intervalles de confiance englobaient le zéro à trois, six et 12 mois, et ont donc été considérés comme non significatifs (P > 0,05). CONCLUSION: Cette étude n'a pas identifié d'association entre l'APO et le risque de symptômes dépressifs post-partum, bien que de petites différences moyennes entre les groupes ne puissent être exclues. Les études futures devraient se concentrer sur d'autres variables modifiables qui influencent l'apparition de la DPP.

Reactivity to Daily Self-Monitoring of Cannabis Use in Biological Females.

Assessment reactivity involves changes to behaviours from self-monitoring those behaviours (Nelson & Hayes, 1981). In the substance use field, reactivity has been identified both as a potential confound in daily diary research (Cohn et al., 2015) and as a possible intervention tool in clinical practice (Cohn et al., 2018). Reactivity to daily self-monitoring of alcohol and tobacco use has been inconsistent in prior research. Reactivity to daily self-monitoring of cannabis use quantity has received far less study. This study involved secondary analyses of data from N = 88 females who self-monitored their cannabis use for 32 days. We examined objective reactivity of cannabis use to daily self-monitoring by assessing changes in daily cannabis use over 32 days. We also explored participants' perceptions of the impact daily self-monitoring had on their cannabis use at study completion (i.e., subjective reactivity). In hurdle models testing objective reactivity, neither probability of cannabis use, nor quantity of cannabis use, changed significantly over the study period. Many respondents (45%) reported no subjective reactivity, though a slight majority (55%) reported some subjective reactivity. Subjective reactivity did not moderate objective reactivity over time; however, higher subjective reactivity was significantly associated with increased variability (interquartile range [IQR]) in cannabis use across the self-monitoring period. Overall, reactivity appears unlikely to confound research utilizing daily diary cannabis measures, and daily self-monitoring of cannabis use may be unlikely to serve as a useful stand-alone intervention for reducing cannabis use in non-treatment-seeking individuals. Potential clinical implications of the novel finding of a link between subjective reactivity and objective cannabis use variability are discussed.

The Influence of Drinking Buddies: A Longitudinal Investigation of Drinking Motivations and Drinking Behaviors in Emerging Adults.

Background: Heavy alcohol consumption and frequent alcohol use are associated with many adverse social and physical consequences. The different motivations underlying why people drink predict different patterns of alcohol consumption. A drinking buddy (i.e. a friend with whom a person drinks alcohol) influences a person's drinking via social learning, leading to escalations in drinking over time. Purpose: Few studies have investigated drinking motives among peers and none have studied whether the drinking motives of a drinking buddy can influence another person's drinking behavior; we sought to fill that gap. Method: Same-sex drinking buddies (N = 174; 66.1% female) were assessed once monthly for four months using self-report questionnaires. Participants were on average 18.66 years-old (SD = 1.17). Results: Indistinguishable actor-partner interdependence models using multilevel path analysis were conducted, with each drinking motive predicting drinking frequency and quantity, respectively. There were significant actor effects for social, enhancement, conformity, and coping motives; moreover, the enhancement, social, and coping-anxiety motives of the drinking buddy influenced the individual's drinking frequency across the four months of the study. Conversely, only the enhancement motives of the buddy predicted drinking quantity in the individual when averaged across time. Sex was not a significant moderator of these effects. Importance: When targeting risky drinking behavior in a therapeutic context, assessing and addressing a person's reasons for drinking, as well as their drinking buddy's reasons for drinking, may reduce the risk of escalations in either friend's drinking frequency over time.

The videoscopic view may not be significantly superior to the directly sighted peroral view during Macintosh-style videolaryngoscopy: a randomized equivalence cadaver trial.

PURPOSE: Videolaryngoscopy is widely believed to give a superior view to that obtained by direct laryngoscopy. Published literature suggests this benefit extends to both hyper-angulated and Macintosh-style videolaryngoscopes. Notwithstanding, our clinical experience shows that the videoscopic view with a Macintosh-style videolaryngoscope is often no different or only marginally better than the directly sighted peroral view. METHODS: A human cadaver equivalence study was performed in which four experienced laryngoscopists obtained pre-assigned laryngeal views by direct sighting using the single-use Macintosh blades of the GlideScope® Spectrum™ (GS) DirectView Macintosh (DVM) and C-MAC®S videolaryngoscopes. Blinded to the laryngoscopist's view, two independent observers rated the videoscopic view presented on the proximal video monitor at the same time. Directly sighted and videoscopic views obtained by the laryngoscopist and video scorers were recorded on a visual analogue scale (VAS) for each device as the primary outcome measures and compared. RESULTS: On the VAS, the C-MAC®S videoscopic view revealed only approximately 0.9% more (99% confidence interval [CI], -2.5% to 4.3%) of the laryngeal inlet than the directly sighted view. Using GS DVM, the videoscopic view revealed 6.7% (99% CI, 2.3% to 11.0%) more of the laryngeal inlet than the directly sighted view. Although results for the GS DVM achieved statistical significance, neither device gave a clinically significantly improved videoscopic view compared with the directly sighted peroral view. CONCLUSION: This study failed to corroborate previously published findings of a clinically significantly improved videoscopic view compared with direct peroral sighting using Macintosh-style videolaryngoscopes. Further study of this class of device is warranted in human subjects.

RéSUMé: OBJECTIF: La vidéolaryngoscopie est considérée par beaucoup comme une modalité offrant une visualisation supérieure à celle obtenue par laryngoscopie directe. Selon la littérature publiée, cet avantage s'étendrait tant aux vidéolaryngoscopes hyper-angulés qu'aux vidéolaryngoscopes de style Macintosh. Ceci dit, notre expérience clinique montre que la visualisation par vidéoscopie obtenue à l'aide d'un vidéolaryngoscope de style Macintosh est souvent similaire ou seulement légèrement meilleure à une visualisation per-orale directe. MéTHODE: Une étude d'équivalence sur cadavre humain a été réalisée dans laquelle quatre opérateursexpérimentés en laryngoscopies ont obtenu des vues laryngées pré-assignées par visualisation directe à l'aide de lames de Macintosh à usage unique avec unDirectView Macintosh (DVM) GlideScope® Spectrum™ (GS) et un vidéolaryngoscope C-MAC®S. Sans avoir accès à la visualisation de l'opérateur, deux observateurs indépendants ont simultanémentévalué la visualisation vidéoscopique présentée sur le moniteur vidéo proximal. Les visualisations directes et vidéoscopiques obtenues par l'opérateur et les évaluateurs des vidéos ont été enregistrées sur une échelle visuelle analogique (EVA) pour chaque dispositif en tant que critère d'évaluation principal, puis comparées. RéSULTATS: Sur l'EVA, la visualisation vidéoscopique obtenue avec le C-MAC®S n'a montré qu'approximativement 0,9 % de plus (intervalle de confiance [IC] 99 %, -2,5 % à 4,3 %) de l'orifice laryngé que la visualisation directe. Avec le GS DVM, la visualisation vidéoscopique a révélé 6,7 % (IC 99 %, 2,3 % à 11,0 %) de plus de l'orifice laryngé que la visualisation directe. Bien que les résultats obtenus avec le GS DVM aient atteint une signification statistique, aucun dispositif n'a permis d'obtenir une visualisation vidéoscopique significativement améliorée d'un point de vue clinique par rapport à la visualisation per-orale directe. CONCLUSION: Cette étude n'est pas parvenue à corroborer les résultats précédemment publiés d'une visualisation vidéoscopique améliorée et cliniquement significative avec les vidéolaryngoscopes de style Macintosh par rapport à une visualisation per-orale directe. Des recherches supplémentaires sur cette classe de dispositifs sont nécessaires chez des sujets humains.

Sexual Intimacy in First-time Mothers: Associations with Sexual and Relationship Satisfaction Across Three Waves.

New mothers often experience significant declines in their sexual and relationship satisfaction compared to pre-pregnancy, yet there has been limited research examining protective factors. Intimacy-defined as the degree of disclosure and perceived partner responsiveness in a relationship-has been identified as contributing to the positive adjustment of individuals coping with novel life stressors, as well as to general sexual and relationship satisfaction. However, it is unknown whether sexual disclosure and/or partner responsiveness are reciprocally related to sexual and relationship satisfaction. This study examined the longitudinal associations between sexual intimacy-that is, intimacy in the context of sex-and sexual and relationship satisfaction in first-time mothers. First-time mothers (N = 171) completed online measures assessing disclosure and perceived partner responsiveness specific to their sexual relationship, sexual satisfaction, and relationship satisfaction at 3, 6, and 12 months postpartum. Analyses were conducted with path analysis using a longitudinal panel mediation model. Greater perceived partner responsiveness in relation to sex at a prior wave predicted increases in both sexual and relationship satisfaction at the subsequent wave. Sexual disclosure did not contribute to sexual or relationship satisfaction over time; the results did not support a reciprocal model of sexual disclosure and perceived partner responsiveness, nor indirect effects of these variables on outcomes. Perceived partner responsiveness in relation to sex is positively related, and temporally precedes sexual and relationship satisfaction in first-time mothers.

Promoting anaesthetisia providers' non-technical skills through the Vital Anaesthesia Simulation Training (VAST) course in a low-resource setting.

BACKGROUND: Short educational programmes are important in building global anaesthesia workforce capacity. The Vital Anaesthesia Simulation Training (VAST) course is a 3-day immersive simulation-based programme concentrating on core clinical challenges and non-technical skills required by anaesthesia providers in low-resource settings. METHODS: This mixed methods study prospectively evaluated the impact of VAST in Rwanda. Anaesthetists' Non-Technical Skills (ANTS) scores were quantitatively assessed for 30 course participants at three time points (pre-, post-, and 4 months after VAST). Qualitative data were gathered during focus groups (4 months after VAST) to learn of participants' experiences implementing new knowledge into clinical practice. RESULTS: The ANTS total scores improved from pre- (11.0 [2.3]) (mean [standard deviation]) to post-test (14.0 [1.6]), and improvements were maintained at retention (14.2 [1.7]). A similar pattern was observed when data were analysed using the four ANTS categories (all P<0.001). The key theme that emerged during focus group discussions was that the use of cognitive aids and clinical algorithms, repeated and reinforced across simulated scenarios, encouraged a systematic approach to patient care. The participants attributed the systematic approach to improving their problem-solving skills and confidence, particularly during emergencies. They found value in well-functioning teams and shared decision-making. After VAST, the participants described empowerment to advocate for better patient care and system improvement. CONCLUSIONS: VAST offers a simulation-based training to anaesthesia providers working in low-resource settings. Skills retention and self-reported application of learning into the workplace reflect the scope of impact of this training.

Drinking motives and drinking behaviors in romantic couples: A longitudinal actor-partner interdependence model.

Excessive alcohol consumption is related to adverse physical and social consequences. Research shows an individual's own drinking motives (reasons for drinking alcohol) are linked to his or her specific drinking outcomes in a theoretically expected manner. Romantic couples often engage in a "drinking partnership," where partners reciprocally influence each other's drinking. Though alcohol consumption partner effects have been studied, partner effects of drinking motives on an individual's alcohol consumption have not been investigated in romantic couples. We investigated this topic. Romantic couples (N = 203) were assessed once weekly for four weeks using self-report questionnaires. Participants were on average 22.7 years old (SD = 5.5) and were in their relationship an average of 2.3 years (SD = 2.4). Actor-partner interdependence models using multilevel path-analysis with indistinguishable dyads were conducted, with each motive predicting drinking quantity and frequency. There were significant actor effects for social and enhancement motives; moreover, changes in a partner's enhancement and social motives predicted change in the individual's drinking quantity during any given week, but only averaged partners' enhancement motives predicted the individual's drinking frequency. Coping-with-anxiety motives had significant actor effects when predicting averaged quantity and frequency; moreover, changes in partners' coping-with-anxiety motives predicted changes in drinking quantity. Enhancement and social motives of the partner influenced the drinking quantity and frequency of the actor by way of influencing the actor's enhancement and social motives. Intervention efforts targeting both members of a romantic dyad on their reasons for drinking should be tested for preventing escalations in either member's drinking behavior. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Cultural influences on parental responses to children's pain.

There is a scarcity of work examining the relationship between culture and pain-related caregiver behaviors. Moreover, no pediatric pain studies have examined the relationship between caregiver cultural values and pain-related caregiver behaviors nor discern if this process is mediated by caregiver parenting styles and moderated by ecosocial context. Based on cross-cultural developmental theories, this study hypothesized that ecosocial context would moderate the relationship between cultural values, parenting styles, and pain-related caregiver behaviors; and that parenting styles mediate the effect of cultural values on pain-related caregiver behaviors. A cross-cultural survey design was employed using a convenience sample of 547 caregivers of 6 to 12 year olds living in Canada (n = 183), Iceland (n = 184), and Thailand (n = 180). Multigroup structural equation modeling showed that ecosocial context did not affect which cultural model of parenting the caregiver adopted. Parenting styles mediated the relationship between cultural values and pain-related caregiver behavior. Vertical/horizontal individualism, collectivism, and authoritative- and authoritarian-parenting styles positively predicted solicitousness. Vertical individualism and authoritarian-parenting style positively predicted discouraging behavior, whereas other predictors did not. The findings support the sociocommunication model of children's pain by showing that cultural context does affect parents' behaviors. They also corroborate with others' claims of solicitousness universality in a pediatric pain context. However, solicitousness may have different cultural meanings among individuals and may be used in conjunction with discouraging behavior. The findings from this study have implications for the theory development about culture and pediatric pain, but do not provide specific clinical recommendations.

"It Was the Best of Times, It Was the Worst of Times": A Qualitative Investigation of Perfectionism and Drinking Narratives in Undergraduate Students.

Perfectionism is a transdiagnostic risk factor for mental health and interpersonal difficulties, but research on perfectionism and alcohol use in emerging adults remains equivocal. Qualitative research methods are underutilized in this area, and inductive analysis of drinking narratives in undergraduate perfectionists may help clarify conflicting results and support novel approaches to quantitative inquiry in this area. We interviewed 20 undergraduates high in perfectionism (6 adaptive perfectionists and 14 maladaptive perfectionists) using a narrative interview, with analyses focusing on a situation involving alcohol use. We coded interviews for emergent themes using thematic analysis. Five themes emerged as follows: (1) drinking as a social experience, (2) suffering consequences, (3) learning from alcohol, (4) alcohol use as escapism, and (5) reluctance and moderation. Our results add to existing literature by highlighting the interpersonal conflict in perfectionistic people's experience in relation to alcohol use during emerging adulthood. Results also suggest perfectionistic people may use alcohol and intoxication as a way to facilitate a "release" from unpleasant situations or emotions. Perfectionists reported both positive and negative experiences, which lends support for using a narrative perspective to help overcome preexisting assumptions about adaptive and maladaptive qualities of perfectionism.

Similarity in romantic couples' drinking motivations and drinking behaviors.

BACKGROUND: Research suggests that enhancement, conformity, social, coping-with-anxiety, and coping-with-depression drinking motives are linked to specific drinking outcomes in a theoretically expected manner. Social learning theory suggests that people who spend more time together emulate each other's behavior to acquire reinforcing outcomes. The present study sought to integrate drinking motives theory and social learning theory to investigate similarity in drinking behaviors and drinking motives in romantic couples. We hypothesized that couples would be more similar than chance in their drinking behaviors and motives. We also hypothesized that demographics reflecting time around and interactions with romantic partners (e.g., days spent drinking together) would positively correlate with similarity in drinking behaviors and motivations. METHODS: The present study tested hypotheses in 203 romantic couples. Participants completed a Timeline Follow-Back measure and the Modified Drinking Motives Questionnaire-Revised to track their alcohol use and drinking motives. Similarity profiles were calculated using McCrae's (J Pers Assess. 2008;90:105-109) coefficient of profile agreement, rpa. RESULTS: Couples were more similar in their drinking behavioral and motivational profiles than could be explained by chance. Days spent drinking together and days with face-to-face contact predicted increased similarity in drinking behavior profiles, but not similarity in drinking motives profiles. CONCLUSIONS: Results are partially consistent with social learning theory and suggest that social influences within couples could be important intervention targets to prevent escalations in drinking.

Cross-cultural comparisons of drinking motives in 10 countries: Data from the DRINC project.

INTRODUCTION AND AIMS: This study tested the measurement invariance of the Drinking Motives Questionnaire-Revised Short Form (DMQ-R-SF) in undergraduates across 10 countries. We expected the four-factor structure to hold across countries, and for social motives to emerge as the most commonly endorsed motive, followed by enhancement, coping and conformity motives. We also compared individualistic and collectivistic countries to examine potential differences in the endorsement of drinking motives when countries were divided according to this broad cultural value. DESIGN AND METHODS: A sample of 8478 undergraduate drinkers from collectivistic (Portugal, Mexico, Brazil, Spain; n = 1567) and individualistic (Switzerland, Hungary, Canada, the Netherlands, the UK and Ireland, and the USA; n = 6911) countries completed the DMQ-R-SF. Countries were classified as individualistic or collectivistic based on world-wide norms. RESULTS: Using multigroup confirmatory factor analysis, the 4-factor model of the DMQ-R-SF showed configural and metric invariance across all 10 countries. As predicted, the rank order of undergraduates' drinking motive endorsement was identical across countries (social > enhancement > coping > conformity), although a mixed model analysis of variance revealed a significant interaction where undergraduates from individualistic countries more strongly endorsed social and enhancement motives relative to undergraduates from collectivistic countries. DISCUSSION AND CONCLUSIONS: There was broad cross-cultural consistency in the factor structure and mean patterns of drinking motives. Undergraduate students appear to drink mainly for positive reinforcement (i.e. for social and enhancement reasons), although this tendency is particularly pronounced among those from more individualistic countries. [Mackinnon SP, Couture M-E, Cooper ML, Kuntsche E, O'Connor RM, Stewart SH, and the DRINC Team. Cross-cultural comparisons of drinking motives in 10 countries: Data from the DRINC project.

Perfectionistic Concerns, Social Negativity, and Subjective Well-Being: A Test of the Social Disconnection Model.

Partner-specific perfectionistic concerns (PC) include concern over mistakes, self-criticism, and socially prescribed perfectionism as it pertains to one's partner. The social disconnection model proposes that PC influences well-being indirectly through interpersonal problems. Thus, we hypothesized that social negativity (expressed anger, hostility, and rejection) would mediate the relationship between dyadic PC and subjective well-being. Data from 203 romantic dyads (92.1% heterosexual) were collected using self-report surveys and a four-wave, 4-week longitudinal design. Participants were predominantly female (53.1%), young (M = 22.69 years), and Caucasian (82.3%). Data were analyzed using an actor-partner interdependence model with multilevel structural equation modeling. There were significant actor effects at the between-subjects and within-subjects levels, and significant partner effects for the relationship between PC and social negativity at the within-subject level. Social negativity mediated the relationships between PC and both negative affect and life satisfaction. However, positive affect was more weakly related to PC and social negativity. The social disconnection model was supported. PC was positively associated with one's own social negativity and evoked hostile behaviors from one's partner. Hostile, rejecting behaviors reduced the well-being of the actor, but not the partner. Results suggest perfectionism may be best understood within an interpersonal context.

Maintaining Affection Despite Pain: Daily Associations Between Physical Affection and Sexual and Relationship Well-Being in Women with Genito-Pelvic Pain.

Provoked vestibulodynia (PVD) is a recurrent, genito-pelvic pain condition that affects 8-12 % of women and has negative implications for sexual and relationship functioning. Many women with PVD report avoiding physical affection because they are concerned that affectionate behavior will lead to painful sexual activity. In community samples, physical affection is associated with improved sexual and relational well-being; however, no research has assessed the influence of physical affection on well-being in women with PVD. The current study examined day-to-day, within-person associations between affectionate behavior (hugging/kissing, cuddling) and sexual satisfaction, relationship satisfaction, sexual functioning, and pain intensity in women with PVD. Seventy women diagnosed with PVD completed an 8-week daily survey. Data were analyzed using multilevel modeling. All outcomes were assessed on days involving sexual activity (n = 401 days). Physical affection was assessed on days with and without sexual activity. Hugging/kissing was positively associated with sexual satisfaction, relationship satisfaction, and sexual functioning within any given day and when predicting the next day. Hugging/kissing was unrelated to pain intensity. Cuddling was not associated with any outcomes. Results persisted for affection that occurred on days with and without sexual activity. Findings suggest physical affection is beneficial for the sexual and relationship well-being of women with PVD. These results may inform interventions that encourage women coping with PVD to engage in more daily physical affection with their partners.

Investigating Possible Reciprocal Relations Between Depressive and Problem Gambling Symptoms in Emerging Adults.

OBJECTIVE: Previous cross-sectional research has shown that depression and problem gambling co-occur. Longitudinal research, however, allows for a better determination of directionality, as behavioural changes in gambling involvement can be more reliably studied over time. Our study assesses symptoms of depression and problem gambling across 4 waves and addresses whether their relation is directional (with one reliably preceding the other), bidirectional, or pathoplastic. METHOD: As part of the Manitoba Longitudinal Study of Young Adults, prospective data were collected on Canadian young adults' (Wave 1: n = 679, 51.8% female, aged 18 to 20 years) depressive symptoms, involvement in gambling, and risky gambling behaviour. Recruitment and the first cycle of data collection (Wave 1) took place in fall 2007. Three additional waves of data collection then occurred in 12- to 18-month intervals: fall 2008, spring 2010, and spring 2011. The Problem Gambling Severity Index and the Composite International Diagnostic Interview-Short Form were administered through telephone interview at each wave. RESULTS: Bivariate growth curves showed that depressive and problem gambling symptoms were positively correlated at Wave 1, Wave 2, and Wave 4. Neither disorder was found to be a risk factor for the other, and depression and problem gambling were not pathoplastically related (that is, increases in one did not result in increases in the other over time, and vice versa). CONCLUSIONS: While depression and problem gambling are related, their co-occurrence may be better explained not by depressive- or gambling-related risk, but by the presence of a common underlying factor (such as substance abuse).