Do perfectionism, body image concerns, and intimacy predict genitopelvic pain in the postpartum? A prospective study of new mothers.

BACKGROUND: Genitopelvic pain following childbirth is common and likely to challenge the psychological, relational, and sexual well-being of new mothers. While genitopelvic pain generally decreases during the postpartum period, personal and interpersonal characteristics may explain why genitopelvic pain persists beyond the period of physical recovery in some mothers. Body image concerns, increased stress, and relationship challenges would be particularly salient during pregnancy and the postpartum period, which could put new mothers at greater risk of sexual difficulties. Also, mothers may display a negative appraisal regarding genitopelvic pain and doubt their ability to cope with it, which may contribute to the pain. AIM: The current study aimed to examine the role of perfectionism, body image concerns, and perceived intimacy in the occurrence and change in genitopelvic pain in new mothers in postpartum. METHODS: A total of 211 new mothers and their partners were recruited for a larger prospective dyadic study on the transition to parenthood. OUTCOMES: Mothers completed a single item assessing genitopelvic pain, in addition to brief validated questionnaires measuring perfectionism, body image concerns, and perceived couple intimacy during pregnancy and at 4, 8, and 12 months postpartum. RESULTS: Five multilevel modeling analyses revealed that adaptive perfectionism, maladaptive perfectionism, and body image concerns were associated with a higher occurrence of genitopelvic pain from 4 to 12 months postpartum. Mothers' and partners' perceived intimacy was not significantly related to new mothers' genitopelvic pain. None of the predictors modified the trajectory of genitopelvic pain over time. CLINICAL IMPLICATIONS: Raising awareness among health care professionals regarding the role of perfectionism and body image concerns in genitopelvic pain may help them identify new mothers at risk of chronic genitopelvic pain, while offering a new avenue of intervention. STRENGTHS AND LIMITATIONS: There has been little research examining the role of perfectionism, body image concerns, and intimacy in postpartum genitopelvic pain. Based on a longitudinal prospective approach, this study identified perfectionism and body image concerns as significant predictors of postpartum genitopelvic pain. However, prepregnancy genitopelvic pain, genitopelvic pain intensity, and sexual distress were not measured. CONCLUSION: Adaptive and maladaptive perfectionism and body image concerns are associated with new mothers' genitopelvic pain up to 12 months postpartum.

Attachment, Sexual Motives, and Sexual Satisfaction among Couples Expecting their First Child.

This study examined direct and indirect links among attachment insecurities (anxiety, avoidance) and sexual satisfaction through sexual motives in couples expecting their first child. A sample of 204 first-time pregnant couples completed online questionnaires. Dyadic path analyses revealed that attachment and sexual satisfaction were not directly associated, but rather indirectly associated through three sexual motives: partner approval, self-affirmation, and intimacy. For non-pregnant partners, attachment anxiety was related to higher sexual satisfaction through higher intimacy, whereas attachment avoidance was related to lower sexual satisfaction through lower intimacy. Results are discussed in light of clinical implications for expecting couples.

How Do Partner Support, Psychological Aggression, and Attachment Anxiety Contribute to Distressed Couples' Relationship Outcomes?

Few studies have simultaneously looked at the relative contribution of positive and negative behaviors to understand relationship outcomes. This study examined the relative roles of perceived partner support and psychological aggression in two relationship outcomes-relationship satisfaction and the willingness to invest in the relationship-as well as the contribution of attachment anxiety as a moderator in 307 couples seeking relationship therapy. Path analyses revealed that perceived partner support was associated with individuals' own higher relationship satisfaction and willingness to invest in the relationship. Attachment anxiety moderated these associations. Perceived partner psychological aggression was not associated with relationship outcomes.

Changes in Attachment and Commitment in Couples Transitioning to Parenthood.

This study examined whether attachment predicts changes in commitment and whether commitment predicts changes in attachment in both partners during the transition to parenthood. Both partners of 93 couples completed online questionnaires individually at the second trimester of pregnancy and at 4 months postpartum. Autoregressive cross-lagged path analyses based on the Actor-Partner Interdependence Model tested the bidirectional associations between attachment dimensions (anxiety and avoidance) and three modes of commitment (optimal, over-commitment, and under-commitment). Results revealed that for both partners, prenatal attachment avoidance was associated with a decrease in optimal commitment and an increase in under-commitment from pre- to postpartum. Fathers' attachment anxiety was associated with a decrease in mothers' under-commitment. Furthermore, prenatal optimal commitment was associated with a decrease in attachment avoidance, whereas under-commitment was associated with an increase in attachment avoidance. Fathers' prenatal over-commitment was associated with an increase in their own attachment anxiety and avoidance. These results highlight how attachment insecurities and relationship commitment interrelate during this major transition.

Profiles of Emotion Dysregulation Among University Students Who Self-Injure: Associations with Parent-Child Relationships and Non-Suicidal Self-Injury Characteristics.

More research is needed to understand the different vulnerability profiles of university students who engage in non-suicidal self-injury (NSSI). This study sought to classify university students (n = 479; 83.8% female) aged 17-25 years (M = 18.77; SD = 1.42) who had engaged in NSSI within the past year into latent profiles based on their self-perceived difficulties in regulating both positive and negative emotions. Independent samples of students who had a past history of NSSI but had not self-injured within the previous year (n = 439; 82.9% females; Mage = 19.03, SD = 1.62) and who had no history of NSSI (n = 1551; 69.9% females; Mage = 19.02, SD = 1.55) were recruited for comparison purposes. Latent cluster analyses revealed three emotion regulation profiles within the NSSI sample-the Average Difficulties (47.4%), Dysregulated (33.0%), and Low Difficulties (19.6%) profiles-each of which differed meaningfully from both comparison samples on mean emotion regulation difficulties. Students across profiles also differed in their self-reported experiences with parents, particularly with fathers (pressure, antipathy, unresolved attachment, psychological control), and in the extent to which they felt alienated from parents. Lastly, students across profiles differed in the frequency, methods, functions, and addictive properties of their NSSI. Findings highlight that university students who self-injure experience distinct patterns of difficulties with emotion regulation, which are associated with variation in parent-child relational risk factors and NSSI outcomes.

Invalidating Caregiving Environments, Specific Emotion Regulation Deficits, and Non-suicidal Self-injury.

This study examined the indirect effects of distinct aspects of invalidating caregiving environments (i.e., paternal maltreatment, maternal maltreatment, and perceived alienation) on non-suicidal self-injury (NSSI) via six specific emotion regulation difficulties. We hypothesized that specific emotion regulation deficits would mediate associations between invalidating environments and NSSI. Participants included 114 young adults (57 self-injurers; 57 age- and sex-matched comparison participants) aged 17-25 years. Three parallel mediation models tested hypotheses. Results showed that maternal maltreatment, paternal maltreatment, and perceived alienation indirectly predicted NSSI through poor emotional clarity. Maternal maltreatment uniquely predicted NSSI through limited access to regulation strategies. Lastly, maternal maltreatment and perceived alienation were both linked to greater difficulties engaging in goal-directed behavior during emotional upsets; however, contrary to hypotheses, this particular deficit was associated with decreased odds of engaging in NSSI. Findings illustrate how different aspects of invalidating environments and specific emotion regulation deficits may be implicated in NSSI engagement.

Fear of Failure Mediates the Relation Between Parental Psychological Control and Academic Outcomes: A Latent Mediated-Moderation Model of Parents' and Children's Genders.

Given the negative relations between parental psychological control and various aspects of emerging adults' social and emotional adaptation, there is a need to determine whether similar relations exist for emerging adults' academic adjustment. The current study tested an integrative model using an interactionist approach of dyadic gender composition to test whether maternal and paternal psychological control are unique and interactive predictors of four different indicators of academic adjustment (i.e., academic achievement, satisfaction of academic achievement, academic goal progress, and school satisfaction) for male and female emerging adults, using fear of failure as a mediator. The sample comprised 1792 undergraduate students aged 17-25 years old (74.2% identified as females). The results showed that maternal and paternal psychological control interacted to predict students' fear of failure, and that fear of failure negatively predicted all indicators of academic adjustment. The results revealed small indirect mediation effects. For females, fear of failure mediated the relation between the interaction of psychological control and satisfaction of academic achievement. For males, fear of failure mediated the relation between the interaction of psychological control and academic goal progress. The results show that parents continue to play an important role in their children's lives during emerging adulthood, and provide insight on the mechanisms underlying such parental influence.

Reliability and validity of the Experiences in Close Relationships Scale-12: Attachment dimensions in a clinical sample with eating disorders.

OBJECTIVE: Attachment insecurity is a potential risk factor for the development and maintenance of eating disorders (EDs). To date, there are multiple psychometrically sound questionnaires for the evaluation of attachment in both clinical and healthy populations, such as the Experience in Close Relationships (ECR) scale. Composed by two subscales (i.e., attachment anxiety and avoidance), the ECR scale was recently adapted to a shorter, 12-item version (ECR-12). However, a validation of the ECR-12 among patients with EDs is still lacking. The present study sought to investigate the psychometric properties of the ECR-12, when used in a treatment-seeking sample with EDs. METHOD: A total of 1,262 treatment-seeking patients with various ED diagnoses completed the ECR-12, together with a commonly used measure of ED psychopathology (Eating Disorder Inventory-2). Subsamples also completed the Attachment Style Questionnaire (n = 66) or underwent a Day Hospital Program (n = 128). RESULTS: A multigroup confirmatory factor analysis indicated that the ECR-12 maintained its two-factor structure across the ED diagnostic groups. In addition, the scale demonstrated good convergent validity, internal consistency, concurrent, and incremental validity. Finally, both ECR-12 subscales demonstrated adequate test-retest reliability. DISCUSSION: Our results provide preliminary evidence of the psychometric properties of ECR-12 in assessing attachment anxiety and avoidance among patients with EDs. This short scale could help clinicians tailor interventions for EDs that take into account attachment dimensions.

Preoccupied but not dismissing attachment states of mind are associated with nonsuicidal self-injury.

In this investigation the factor structure of the Adult Attachment Interview was studied in a partially at-risk sample of 120 young adults. More specifically, 60 participants had engaged in nonsuicidal self-injury (NSSI; 53 females, M age = 20.38 years), and 60 were non-self-injuring controls matched by age and sex. Theoretically anticipated differential associations between preoccupied (but not dismissing) states of mind and NSSI were then examined. Exploratory factor analyses identified evidence for two weakly correlated state of mind dimensions (i.e., dismissing and preoccupied) consistently identified in factor analyses of normative-risk samples. As hypothesized, results further showed that preoccupied (but not dismissing) states of mind were associated with NSSI behavior. Findings support existing arguments suggesting that the regulatory strategy adults adopt when discussing attachment-related experiences with primary caregivers, particularly passive, angry, or unresolved discourse patterns, is uniquely correlated with NSSI.

The Mediating Effects of Emotion Regulation and Dyadic Coping on the Relationship Between Romantic Attachment and Non-suicidal Self-injury.

Insecure attachment is believed to play a fundamental role in non-suicidal self-injury (NSSI). In fact, the quality of parent-child attachment relationships has become an emerging topic attracting a growing number of theoretical and research contributions in the field of NSSI. However, despite these considerable advances in the scientific study of NSSI, progress pertaining to investigating the quality of romantic attachment relationship is lacking. In an effort to expand current knowledge, the present study aims to not only explore the relationships between romantic attachment and NSSI, but also to explore the mechanisms by which these two variables relate by examining the mediating role that emotion regulation and dyadic coping might play in this relationship. Participants consisted of 797 (81.9 % female) university students, all of whom were involved in a romantic relationship for at least 6 months and between the ages of 17 and 25. Results revealed that although difficulties in emotion regulation mediated the relationships between romantic attachment insecurity (i.e., attachment anxiety and avoidance) and NSSI, dyadic coping was not found to be a significant mediator. These results highlight the importance of attachment security and internal processes to manage stress in the prevention of NSSI.

Family-based risk factors for non-suicidal self-injury: Considering influences of maltreatment, adverse family-life experiences, and parent-child relational risk.

The current investigation addressed the potential for unique influences of perceived childhood maltreatment, adverse family-life events, and parent-child relational trauma on the lifetime occurrence and addictive features of non-suicidal self-injury (NSSI). Participants included 957 undergraduate students (747 females; M = 20.14 years, SD = 3.88) who completed online questionnaires regarding the key variables under study. Although self-injuring youth reported more experiences with each family-based risk factor, different patterns of association were found when lifetime engagement in NSSI or its addictive features were under study. Perceived parent-child relational trauma was uniquely linked with NSSI behavior after accounting for perceived childhood maltreatment; adverse family-life events had an additional unique association. In contrast, perceived paternal maltreatment was uniquely related with NSSI's addictive features. Findings underline the importance of studying inter-related family-based risk factors of NSSI simultaneously for a comprehensive understanding of familial correlates of NSSI behavior and its underlying features.

Romantic Attachment and Physical Intimate Partner Violence Perpetration in a Chilean Sample: The Mediating Role of Emotion Regulation Difficulties.

Despite evidence that adult attachment insecurity has been linked to the perpetration of physical intimate violence, the mechanisms underlying this link need further exploration. The goal of this study was to evaluate the mediating role of emotion regulation difficulties in the association between romantic attachment and the use of physical intimate partner violence. To this end, 611 students recruited from Chilean universities completed the Experiences in Close Relationships questionnaire, the Difficulties in Emotion Regulation Scale, and the Revised Conflict Tactics Scales. Structural equation modeling (SEM) analyses revealed that emotion regulation difficulties mediated the relationship between dimensions of romantic attachment (anxiety over abandonment and avoidance of intimacy) and physical violence perpetration among both male and female participants. Implications for future research and clinical practice are presented herein.

Romantic Attachment and Physical Intimate Partner Violence Perpetration in a Chilean Sample: The Mediating Role of Emotion Regulation Difficulties.

Despite evidence that adult attachment insecurity has been linked to the perpetration of physical intimate violence, the mechanisms underlying this link need further exploration. The goal of this study was to evaluate the mediating role of emotion regulation difficulties in the association between romantic attachment and the use of physical intimate partner violence. To this end, 611 students recruited from Chilean universities completed the Experiences in Close Relationships questionnaire, the Difficulties in Emotion Regulation Scale, and the Revised Conflict Tactics Scales. Structural equation modeling (SEM) analyses revealed that emotion regulation difficulties mediated the relationship between dimensions of romantic attachment (anxiety over abandonment and avoidance of intimacy) and physical violence perpetration among both male and female participants. Implications for future research and clinical practice are presented herein.

Psychometric properties of the mother and father compulsive caregiving scales: a brief measure of current young adult caregiving behaviors toward parents.

This study assessed the psychometric properties of the Mother and Father Compulsive Caregiving Scales (MFCC). Exploratory (N = 1283, 71.5% Caucasian) and confirmatory (N = 2203, 76.6% Caucasian) factor analyses revealed two-factor structures for each parent: burden and autonomy. Correlational analyses with retrospective self-reports of parent-child relationship quality, family risk indicators, and psychological symptoms demonstrated similar convergent validity for both mother and father burden factors while, interestingly, the findings for mother and father autonomous factors showed different patterns. Results support that the MFCC is a short and convenient measure that would be clinically useful for the assessment of controlling/caregiving behaviors in young adulthood.

Romantic Attachment and Intimate Partner Violence Perpetrated by Men: The Role of Affect Dysregulation and Gender Hostility.

Intimate partner violence (IPV) is a major public health problem, associated with considerable consequences for the victims. Among the risk factors associated with the perpetration of male IPV, attachment insecurities (avoidance, anxiety) and affect dysregulation (AD) have received strong empirical support. A few studies showed that hostility toward women (HTW) is a correlate of IPV perpetration, but none have explored hostility toward men (HTM). This study's aim was to test direct and indirect associations between romantic attachment insecurities and IPV perpetration (psychological, physical, and sexual coercion) through AD in men seeking help, and to examine the moderator role of HTW and HTM in theses links. A sample of 1,845 men aged between 18 and 88 years and from a diverse population (e.g., cultural background, education, and sexual orientation) were recruited through 18 community organizations providing IPV services in a Canadian province. As part of the systematic assessment protocol of each organization, participants answered a series of online questionnaires. Results from a path analysis model showed indirect associations between attachment insecurities (avoidance and anxiety) and IPV perpetration (psychological, physical, and sexual coercion) through AD. Beyond these links, attachment avoidance was also directly associated with psychological violence, attachment anxiety with sexual coercion, and HTM with sexual coercion. The results revealed two moderation effects: higher HTW amplified the link between AD and physical IPV, whereas higher HTM amplified the link between AD and sexual coercion. Results highlight the relevance of assessing attachment, AD, and gender hostility in IPV programs. They also highlight the relevance of targeting HTM as a risk marker for IPV perpetration in men.

Anxiety and depressive symptoms in first-time parents: A dyadic longitudinal study based on attachment theory.

BACKGROUND: The aim of this study was to examine the temporal and dyadic associations between anxiety and depressive symptoms during the transition to parenthood (TTP), while exploring the antecedence of attachment insecurities in these associations. METHOD: Couples of first-time parents (N = 211) completed the State-Trait Anxiety Inventory, the Edinburgh Postnatal Depression Scale, the Experiences in Close Relationships scale, and a sociodemographic questionnaire during the second trimester of pregnancy and at four and twelve months postpartum. RESULTS: Both prenatal anxiety and depressive symptoms predicted postnatal depressive and anxiety symptoms. Prenatal attachment-related anxiety predicted higher postnatal anxiety and depressive symptoms whereas prenatal attachment-related avoidance predicted higher postnatal depressive symptoms only. Parents whose partners had a higher level of prenatal attachment-related anxiety experienced higher postnatal anxious and depressive symptoms via their own's prenatal depressive symptoms. Parents whose partners had a higher level of prenatal attachment-related avoidance experienced higher postnatal depressive symptoms via their own's prenatal anxious symptoms. No gender differences were found for these associations. LIMITATIONS: The sample was predominantly composed of educated heterosexual French-Canadian Caucasian couples and all measures were self-reported. CONCLUSIONS: Our original findings suggest that professionals should routinely screen for anxiety and depressive symptoms in both partners from pregnancy up to one year postpartum. Also, our findings suggest addressing attachment insecurities with both partners to prevent the development of future symptoms during pregnancy or after childbirth. Finally, our study supports the relevance of considering these symptoms at subclinical levels during the TTP.

How Relationship Satisfaction and Negative Communication Trajectories Change in Emerging Adults' Dating Relationships: A Group-Based Dual Trajectory Analysis.

Early romantic relationships are salient to the development of healthy future relationships. Yet, little is known about the evolution of romantic relationships of emerging adults since most of the research has been conducted on married or well-established couples. The current study aims to examine how relationship satisfaction and negative communication evolve and are interrelated during emerging adulthood. Using age as a time metric, we conducted group-based dual trajectory modeling analyses on 1566 unmarried Canadian individuals (from 17 to 24 years old) in a relationship, who could either stay with the same partner or change partner over time. A four-group model for relationship satisfaction and a four-group model for negative communication were found. Dual analyses highlighted the high concordance between specific trajectories of both constructs. These findings demonstrate that relationship satisfaction and negative communication do not evolve in the same ways for everyone and provide useful insights to existing clinical interventions.

Investigating the relationship between the five-factor model of distress tolerance, anxiety and anxiety sensitivity.

BACKGROUND: Distress tolerance (DT) has been conceptualized as a vulnerability factor for several psychopathologies. A five factor model of DT has been suggested, but its associations with anxiety and anxiety sensitivity have yet to be explored. OBJECTIVES: This study aimed to further validate the five-factor model of DT, identify the associations between its factors and elevated anxiety, and assess if anxiety sensitivity mediates the association between DT and anxiety. DESIGN AND METHODS: This observational study included 330 students and university workers (women = 82.7%; mean age = 27.7 years, SD = 9.4). They completed online questionnaires assessing DT, anxiety sensitivity and anxiety levels. RESULTS: The five-factor model was a good fit to the data (RMSEA = .04). Two factors, and the sex of the participants, contributed to the variance in anxiety (r2 = .418, p < .001). Tolerance of negative emotion was directly (ß = -1.98, 95% CI = [-2.53, -1.42]) and indirectly (ß = -1.10, 95% CI = [-1.55, -.78]) associated with lower anxiety through anxiety sensitivity. Tolerance of uncertainty was also directly (ß = -.08, 95% CI = [-.10, -.06]) and indirectly (ß = -.04, 95% CI = [-.05, -.02]) associated with lower anxiety through anxiety sensitivity. CONCLUSIONS: Tolerance of negative emotion and uncertainty were associated with anxiety independently of the other factors of DT. These associations seem partially explained by the effect of anxiety sensitivity.

A Latent Profile Analysis of Intimate Partner Violence Perpetrated by Men Seeking Help.

Past research has emphasized the need to identify profiles of men who perpetrate intimate partner violence (IPV) as a way to better understand this heterogeneous population and guide the development of tailored services. However, empirical validation for such profiles remains limited, since it still focuses on specific populations or fails to consider IPV as reported by men seeking treatment for IPV. We know little about the profiles of men who seek services for their use of IPV (with or without a justice referral). This study sought to identify profiles of men seeking treatment for IPV, based on their self-reported use of the various forms and severity of IPV perpetrated, and to compare the identified groups on key psychosocial risk markers of IPV. A total of 980 Canadian men entering treatment in community organizations specialized in IPV answered a series of questionnaires. A latent profile analysis identified four profiles: (a) "no/minor IPV" (n = 194), (b) "severe IPV with sexual coercion" (n = 122), (c) "minor IPV and control" (n = 471), and (d) "severe IPV without sexual coercion" (n = 193). Results revealed differences in psychosocial risk markers, including attachment insecurities, childhood interpersonal trauma, undesirable personality traits, affect dysregulation, and psychological distress, mostly between the "severe IPV without sexual coercion" profile and the "no/minor IPV" and "minor IPV and control" profiles. Very few differences were found, however, between the "severe IPV with sexual coercion" and "severe IPV without sexual coercion" profiles. Implications for awareness, prevention, and treatment efforts for each profile are discussed.

Lifetime and Child Sexual Violence, Risk Factors and Mental Health Correlates Among a Nationally Representative Sample of Adolescents and Young Adults in Haiti: A Public Health Emergency.

Very little is known in Haiti and the Caribbean regarding child and lifetime sexual victimization. Using a nationally representative sample of adolescents and young adults aged 15-24, this study aimed to document the prevalence, risk factors and mental health correlates of lifetime and child sexual violence in Haiti. A national cross-sectional surrvey was conducted in Haiti, using a multistage sampling frame, stratified by geographical department, urban or rural setting, gender, and age groups (15-19 and 20-24 years). The final sample included 3586 household participants (47.6% female). A weighted sample of 3945 individuals was obtained and used in the following analyses. Overall rate of lifetime and child sexual violence was, respectively, 27.44% (95% CI 25.94-28.94) and 11.27% (95% CI 10.18-12.35). Lifetime sexual violence rate was significantly higher among female participants (29.02%; 95% CI 27.5-30.55) compared to male (25.73%, 95% CI 24.26-27.2), χ2 = 4.63, p < .05, but there was no significant gender difference for child sexual victimization. Experiences of family physical violence, emotional abuse by mother and father, divorce of parents, and other physical violence were strongly associated with higher odds of sexual victimization. Participants who reported having experienced sexual violence are more at risk to meet criteria of PTSD (OR = 1.96, 95% CI 1.66-2.32; p < .0001), depression (OR = 1.73, 95% CI 1.47-2.02; p < .0001), psychological distress (OR =1.72, 95% CI 1.47-2.02; p < .0001), and substance abuse (OR = 1.33, 95% CI 1.13-1.57; p < .0001). Findings demonstrate that sexual violence is a public health emergency in Haiti. They provide evidence for the development of prevention and intervention programs.