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The pairing of tourism and shopping, and particularly the area of tourist shopping motivations, has led to a prolific output in terms of literature. However, the related studies are fundamentally descriptive and do not discuss the background variables in detail. The aim of this study is to develop and test an explanatory structural model of the influence of socio-demographics and acculturation on International Residential Tourist (IRT) shopping motivations. The results obtained confirm the influence of certain socio-demographic variables on acculturation, of the latter on shopping acculturation and in turn on shopping motivations. Likewise, the decisive role that nationality plays when defining the sense and intensity of structural relationships can also be verified. The model tested is foreseen to be of special interest to IRT destinations, as it allows shopping motivations to be predicted, meaning that the commercial offer can be strategically adapted.
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Smoking is a health and economic problem that is difficult to eradicate. Nicotine addicts also often suffer from psychological problems such as depression and anxiety. The recommended treatment according to clinical practice guidelines (CPG) is Cognitive Behavioural therapy (CBT), alone or combined with medication. Currently, health-related apps (m Health) enable wider availability and access to this treatment. The objectives of this study are to carry out a review of the smoking cessation apps that apply CBT and to describe the techniques used by them. Following the PRISMA framework, the databases EBSCOhost, Cochrane, Web of Science and Scopus were searched for publications between 2010-2019. Four hundred fifteen studies were found and, after applying the inclusion and exclusion criteria, only five articles were eligible for systematic review. Only three apps were identified as using CBT, and the techniques most commonly used were the recording of smoking history, progress visualised through graphics, psycho-educational videos, motivation, social support through social media, and elements of gamification to reinforce adherence and abstinence behaviour. The results recommend the inclusion of smoking behaviour analysis in these types of apps, as not all of them do so, as well as an interface between the health professionals and the users to provide a personalised treatment.
El tabaquismo constituye un problema sanitario y económico de difícil erradicación. Las personas más dependientes a la nicotina suelen presentar, además, problemas psicopatológicos como depresión y ansiedad. Según las Guías de Práctica Clínica (GPC), el tratamiento recomendado para abandonar el hábito es la Terapia Cognitivo Conductual (TCC), sola o combinada con medicación. Actualmente, las aplicaciones móviles (App) en salud (mHealth) permiten un acceso masivo y económico a este tratamiento. El objetivo de este trabajo consiste en llevar a cabo una revisión bibliográfica de las Apps para dejar de fumar que apliquen TCC y describir las técnicas implementadas. En el marco del protocolo PRISMA, la búsqueda se ciñó al periodo 2010-19 y se realizó en las bases de datos: EBSCOhost, Cochrane, Web of Science y Scopus. Se hallaron un total de 415 trabajos, de los cuales, tras aplicar los criterios de inclusión/exclusión, solo 5 artículos fueron objeto de revisión. Únicamente se identificaron 3 Apps (en inglés) que incluyeran TCC y, las técnicas más utilizadas fueron: el registro de cigarrillos, la visualización del progreso mediante gráficas, videos psicoeducativos, la motivación, el apoyo social mediante redes sociales y elementos de gamificación para reforzar la adherencia y la conducta de abstinencia. Los resultados sugieren incluir en este tipo de Apps el análisis de la conducta de fumar, ya que no todas lo hacen, así como una interfaz que comunique el personal sanitario con el usuario y pueda proporcionar un tratamiento personalizado.
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Terapia Cognitivo-Comportamental , Aplicativos Móveis , Abandono do Hábito de Fumar , Humanos , Motivação , NicotinaRESUMO
The purpose of this research was to analyze the development of self-concept during adolescence. Participants included 484 teenagers (226 boys and 258 girls) from middle-class families in the Basque Country region of Spain (Mage = 14.99, SD = 1.81 in Time 1 and Mage = 15.64, SD = 1.80 in Time 2). Longitudinal analysis found differences in the general school dimension. Six dimensions (math, verbal, general school, physical abilities, parent relationships and same-sex relationships) reported a linear trend with a decreasing monotonic pattern; self-esteem fit a cubic trend and physical appearance a quadratic trend line. Males showed higher means in self-esteem, math, physical abilities, physical appearance, emotional stability and parent relationships; and females had higher values in verbal and general school.
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Sucesso Acadêmico , Imagem Corporal/psicologia , Autoimagem , Adolescente , Comportamento do Adolescente/psicologia , Feminino , Humanos , Estudos Longitudinais , Masculino , Relações Pais-Filho , Espanha , Inquéritos e QuestionáriosRESUMO
AIM: To assess gender differences in the association between risk/protective factors and suicidal thoughts and behaviors (STB); and whether there is any gender-interaction with those factors and STB; among Spanish university students. METHODS: Data from baseline online survey of UNIVERSAL project, a multicenter, observational study of first-year Spanish university students (18-24 years). We assessed STB; lifetime and 12-month negative life-events and family adversities; mental disorders; personal and community factors. Gender-specific regression models and gender-interactions were also analyzed. RESULTS: We included 2,105 students, 55.4% women. Twelve-month prevalence of suicidal ideation (SI) was 10%, plans 5.7%, attempts 0.6%. Statistically significant gender-interactions were found for lifetime anxiety disorder, hopelessness, violence between parents, chronic health conditions and family support. Lifetime mood disorder was a common risk factor of SI for both genders (Females: OR= 5.5; 95%CI 3.3-9.3; Males: OR= 4.4; 95%CI 2.0-9.7). For females, exposure to violence between parents (OR= 3.5; 95%CI 1.7-7.2), anxiety disorder (OR= 2.7; 95%CI 1.6-4.6), and alcohol/substance disorder (OR= 2.1; 95%CI 1.1-4.3); and for males, physical childhood maltreatment (OR= 3.6; 95%CI 1.4-9.2), deceased parents (OR= 4.6; 95%CI 1.2-17.7), and hopelessness (OR= 7.7; 95%CI 2.8-21.2), increased SI risk. Family support (OR= 0.5; 95%CI 0.2-0.9) and peers/others support (OR= 0.4; 95%CI 0.2-0.8) were associated to a lower SI risk only among females. CONCLUSIONS: Only mood disorder was a common risk factor of SI for both genders, whereas important gender-differences were observed regarding the other factors assessed. The protective effect from family and peers/others support was observed only among females. Further research assessing underlying mechanisms and pathways of gender-differences is needed.
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Fatores de Proteção , Estudantes/psicologia , Estudantes/estatística & dados numéricos , Ideação Suicida , Universidades , Adolescente , Transtornos de Ansiedade/epidemiologia , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Transtornos do Humor/epidemiologia , Pais/psicologia , Grupo Associado , Prevalência , Fatores de Risco , Fatores Sexuais , Inquéritos e Questionários , Violência/estatística & dados numéricos , Adulto JovemRESUMO
BACKGROUND: Suicide is a leading cause of death among young people. While suicide prevention is considered a research and intervention priority, longitudinal data is needed to identify risk and protective factors associate with suicidal thoughts and behaviors. Here we describe the UNIVERSAL (University and Mental Health) project which aims are to: (1) test prevalence and 36-month incidence of suicidal thoughts and behaviors; and (2) identify relevant risk and protective factors associated with the incidence of suicidal thoughts and behaviors among university students in Spain. METHODS: An ongoing multicenter, observational, prospective cohort study of first year university students in 5 Spanish universities. Students will be assessed annually during a 36 month follow-up. The surveys will be administered through an online, secure web-based platform. A clinical reappraisal will be completed among a subsample of respondents. Suicidal thoughts and behaviors will be assess with the Self-Injurious Thoughts and Behaviors Interview (SITBI) and the Columbia-Suicide Severity Rating Scale (C-SSRS). Risk and protective factors will include: mental disorders, measured with the Composite International Diagnostic Interview version 3.0 (CIDI 3.0) and Screening Scales (CIDI-SC), and the Epi-Q Screening Survey (EPI-Q-SS), socio-demographic variables, self-perceived health status, health behaviors, well-being, substance use disorders, service use and treatment. The UNIVERSAL project is part of the International College Surveys initiative, which is a core project within the World Mental Health consortium. Lifetime and the 12-month prevalence will be calculated for suicide ideation, plans and attempts. Cumulative incidence of suicidal thoughts and behaviors, and mental disorders will be measured using the actuarial method. Risk and protective factors of suicidal thoughts and behaviors will be analyzed by Cox proportional hazard models. DISCUSSION: The study will provide valid, innovative and useful data for developing prevention programs for youth suicide and for improving early identification for high-risk students. The longitudinal design of this study will improve causal interpretation of analyzed associations, needed for generating and validating predictive models. It will represent the first results about suicidal thoughts and behaviors in the Spanish university population. The World Mental Health Survey collaboration will permit accurate cross-national comparisons.
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Saúde Mental/estatística & dados numéricos , Modelos Psicológicos , Estudantes/psicologia , Tentativa de Suicídio/psicologia , Adolescente , Feminino , Humanos , Masculino , Estudos Prospectivos , Fatores de Proteção , Espanha , Estudantes/estatística & dados numéricos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Ideação Suicida , Universidades , Adulto JovemRESUMO
BACKGROUND: Modelling academic self-concept through second-order factors or bifactor structures is an important issue with substantive and practical implications; besides, the bifactor model has not been analysed with a Chinese sample and cross-cultural studies in the academic self-concept are scarce. Likewise, latent structure validity evidence using network psychometrics has not been carried out. AIMS: The aim of this study is twofold: to analyse (1) the internal structure of ASC through the Self-Description Questionnaire II-Short (SDQII-S) in Chinese and Spanish samples using two approaches, structural equation modelling and network psychometrics conducting an exploratory graph analysis; and (2) the measurement invariance of the best model across countries and investigate the cross-cultural differences in ASC. SAMPLE: The sample was composed by 651 adolescents. Seven models of ASC were tested. RESULTS: Results supported the multi-dimensional nature of the data as well as the reliability. The best-fitted model for the two subsamples was the three-factor ESEM model, but only the configural invariance of this model was supported across countries. The graph function shows that the school dimension appears more related to the verbal factor in the Spanish subsample and to the math dimension in the Chinese subsample. Likewise, the relationship between verbal and math factors in Spanish students is non-existent, but this connection is more relevant for Chinese students. CONCLUSION: These two differences may be behind the difficulty in finding invariance using SEM models. It is a question of the construct's nature, less related to analytical phenomena, and deserves deeper discussion.
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Comparação Transcultural , Autoimagem , Adolescente , Humanos , Espanha , Reprodutibilidade dos Testes , Inquéritos e Questionários , Psicometria/métodos , ChinaRESUMO
A construction site has specific risks and organizational conditions requiring on-site safety inspections. Paperwork inspections have important limitations that can be overcome by substituting paper records with digital registers and using new information and communication technologies. Although academic literature has provided several tools to carry out on-site safety inspections adopting new technologies, most construction sites are not currently ready to adopt them. This paper covers this need of on-site control by providing an application that uses a simple technology accessible to most construction companies. The main objective and contribution of this paper is to design, develop, and implement a mobile device application (App), named "RisGES". It is based on the model of risk that grounds the Construction Site Risk Assessment Tool (CONSRAT) and on the related models that connect risk with specific organizational and safety resources. This proposed application is aimed to assess the on-site risk and organizational structure by using new technologies and considering all relevant resources and material safety conditions. The paper includes practical examples of how to use RisGES in real settings. Evidence for the discriminant validity of CONSRAT is also provided. The RisGES tool is at once preventive and predictive since it yields a specific set of criteria for interventions intended to decrease the levels of risks on-site, as well as to detect improvement needs in the site structure and resources for increasing the safety levels.
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Aplicativos Móveis , Local de Trabalho , Medição de Risco , Computadores de MãoRESUMO
It is a well-established finding that the central executive is fractionated in at least three separable component processes: Updating, Shifting, and Inhibition of information (Miyake et al., 2000). However, the fractionation of the central executive among the elderly has been less well explored, and Miyake's et al. latent structure has not yet been integrated with other models that propose additional components, such as access to long-term information. Here we administered a battery of classic and newer neuropsychological tests of executive functions to 122 healthy individuals aged between 48 and 91 years. The test scores were subjected to a latent variable analysis (LISREL), and yielded four factors. The factor structure obtained was broadly consistent with Miyake et al.'s three-factor model. However, an additional factor, which was labeled 'efficiency of access to long-term memory', and a mediator factor ('speed of processing') were apparent in our structural equation analysis. Furthermore, the best model that described executive functioning in our sample of healthy elderly adults included a two-factor solution, thus indicating a possible mechanism of dedifferentiation, which involves larger correlations and interdependence of latent variables as a consequence of cognitive ageing. These results are discussed in the light of current models of prefrontal cortex functioning.
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Envelhecimento/psicologia , Função Executiva/fisiologia , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Inibição Psicológica , Aprendizagem/fisiologia , Masculino , Memória/fisiologia , Pessoa de Meia-Idade , Testes NeuropsicológicosRESUMO
INTRODUCTION: The interplay of reactive and regulatory temperamental processes appears to be essential for a better understanding of emotional states and disorders. In this study we explored the prospective relationship between reactive temperament (negative affect), regulatory temperament (effortful control), negative emotion regulation styles (rumination and suppression) and self-recorded anxiety, worry, and avoidance in naturalistic conditions. METHOD: Thirty-two young adults were first assessed through questionnaires on negative affectivity, effortful control, and two forms of negative emotion regulation (rumination and suppression). After this they recorded anxiety, worry, and avoidance three times a day over 50 consecutive days through an on-line access electronic diary. RESULTS: High levels of negative affect and low levels of effortful control were associated with higher levels of anxiety, worry, and avoidance (p<.01). The prospective association between negative affectivity and avoidance was moderated by effortful control (Total R(2)=.49). Moreover, the brooding facet of rumination totally mediated the association between negative affect and anxiety with a significant indirect effect (Effect=.30, Boot CI95%=.09 to .69). CONCLUSIONS: Avoidance patterns are significantly determined by negative affect--effortful control interaction and rumination, especially brooding, totally mediates the relationship between negative affect and anxiety.
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Ansiedade/psicologia , Emoções , Temperamento , Afeto , Feminino , Humanos , Masculino , Estudos Prospectivos , Adulto JovemRESUMO
INTRODUCTION: This study develops an empirical test of two theoretical models using the approach of Structural Equation Model (SEM) to test the relationships between specific organizational factors of safety management system (SMS) and specific risk variables. METHOD: Two SEM models with two and four latent variables, respectively, and 10 observed risk variables were used to identify the strongest relationships that may lead to an accident on site. A random sample of 474 construction sites were visited and assessed in Spain from 2003 to 2010. Most of the samples were small and medium sized enterprises (SMEs), which is the predominant type of company in the Spanish construction industry. To assess the risk on sites and get the measurements of the variables included in the models, the validated method CONSRAT (Construction Sites Risk Assessment Tool) was used. After estimating the proposed models, an adequate fit was obtained for both of them. RESULTS: Results provide empirical evidence that: (a) the factor "Resources on site" is more determinant in explaining influences on risk variables because of their influence on all risk variables (Model 1); (b) the factor "Site structure complexity" (which includes structure and organization, and safety resources available on site) has a stronger effect on risk variables than other factors related to intrinsic characteristics of the work, site, or companies (Model 2). CONCLUSIONS: These results mean that the complexity and resource factors that depend on companies are those that have the greatest impact on risks, which makes it possible for companies to undertake the appropriate risk control measures. PRACTICAL APPLICATION: These results can help construction firms obtain earlier information about which organizational elements can affect future safety conditions on site, improve those elements for preventing risks, and consequently, avoid accidents before they occur.
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Indústria da Construção , Saúde Ocupacional , Acidentes de Trabalho/prevenção & controle , Humanos , Cultura Organizacional , Gestão da Segurança , Espanha , Local de TrabalhoRESUMO
To explore potential individual determinants of healthcare utilization in primary care (PC) using a structural equation modelling approach. Atotal of 638 patients from five PC units were randomly selected. Mental disorders, psychological distress and other psychological factors were assessed with the 28-item General Health Questionnaire (GHQ-28) and the Schedules for Clinical Assessment in Neuropsychiatry (SCAN). Medical records and ICD-10 diagnosis were used to measure somatic morbidity. There is a negative relationship between the presence of mental disorders and psychological well-being (-0.74), and a negative relationship with use of health services (-0.25). Age has a positive and significant relationship with the presence of chronic diseases (0.49), which has a positive and significant relationship with limitation of daily activities (0.18). This limitation has a positive relationship with poor perception of health (0.57) and with psychological well-being (0.03). Findings confirm the existence of specific pathways in PC health use. Health service use depends on the patient's psychological well-being and on the presence of chronic medical conditions. Healthcare professionals need to pay attention to the comorbidity of mental disorders and chronic medical conditions in order to identify frequent attenders and to decrease the inappropriate use of healthcare services.
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Serviços de Saúde/estatística & dados numéricos , Transtornos Mentais/psicologia , Saúde Mental , Adolescente , Adulto , Doença Crônica/psicologia , Feminino , Nível de Saúde , Inquéritos Epidemiológicos , Humanos , Masculino , Transtornos Mentais/terapia , Pessoa de Meia-Idade , Modelos Teóricos , Atenção Primária à Saúde/estatística & dados numéricos , Fatores Socioeconômicos , Adulto JovemRESUMO
Physicians and other health sciences professionals need continuous training, not only in technical aspects of their activity but also in nontechnical, transversal competencies with a cost-efficient impact on the proper functioning of healthcare. The objective of this paper is to analyze the behavioral change among health professionals at a large public hospital following a training intervention on a set of core nontechnical competencies: Teamwork, Adaptability-Flexibility, Commitment-Engagement, Results Orientation, and Leadership Skills for Supervisors. The 360° Multisource Feedback (MSF) model was applied using three sources of information: supervisors, co-workers, and the workers themselves (self-assessment). A quasi-experimental pretest-post-test single-group design with two points in time was utilized. The training intervention improved the scores of only one of the trained competencies-the "Results Orientation" competency-although the scores were slightly inflated. Moreover, significant discrepancies were detected between the three sources, with supervisors awarding the highest scores. The magnitude of behavioral change was related to certain sociodemographic and organizational variables. The study was not immune to the ceiling effect, despite control measures aimed at avoiding it. The empirical evidence suggests that the 360° MSF model must be maintained over time to enhance and reinforce an evaluation culture for better patient care.
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Competência Clínica , Médicos , Retroalimentação , Humanos , Liderança , Autoavaliação (Psicologia)RESUMO
Smartphone applications (apps) improve accessibility to smoking cessation treatments. The NoFumo+ app administers a cognitive behavioral therapy program for smoking cessation. This study evaluates the efficacy of NoFumo+ for quitting smoking or reducing cigarette consumption versus the usual information-based treatment. A clinical trial was conducted with 99 hospitalized smokers, 54 pseudo-randomly assigned to the app treatment and 45 to the usual treatment. The two groups had homogeneous baseline characteristics to ensure comparability. Abstinence was evaluated at post-treatment (two months) and at a six-month follow-up. The results obtained indicate that participants who receive the usual treatment are 5.40 times more likely to continue smoking than those who undergo the app treatment (95% CI = [1.35; 20.15]). Participants who do not succeed in quitting smoking with the app manage to decrease their habitual consumption. Users who successfully complete treatment with NoFumo+ access all its contents and use the chat, but without requesting professional support. There is not enough empirical evidence to attribute this success to any specific element of the app. NoFumo+ achieves better abstinence rates than the usual information-based treatments, and the goal of generalizing its use to the non-hospitalized smoking population may be achievable in the future.
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Aplicativos Móveis , Abandono do Hábito de Fumar , Telemedicina , Humanos , Fumantes , FumarRESUMO
Alcohol use is a persisting social and health problem in Spain that often takes place within the recreational context. This study aims to analyze objective and self-reported measures of alcohol use and to assess the potential role of social factors on alcohol intake in open-air public settings. A total of 1475 participants (47.4% women), including 27.8% adolescents organized into 355 natural groups of friends, were interviewed while they were socializing at night in the streets of Palma (Spain). Breath alcohol concentration (BrAC), self-reported measures of alcohol use, and social variables were assessed. Men showed statistically higher scores in BrAC than women. However, adolescents' Alcohol Use Disorders Identification Test (AUDIT) scores were not statistically different by gender. Correlation between objective and self-reported measures was low. Interestingly, BrAC of drinkers was lower when some friends in the group were sober. Moreover, especially in young adults, variables related to the social environment were statistically significant factors to predict BrAC. In conclusion, we found a high prevalence of alcohol intake in young people in open-air public settings, low relationship of objective and self-reported measures, and social factors linked to alcohol use, although differences by age and gender must be considered.
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Consumo de Bebidas Alcoólicas , Intoxicação Alcoólica , Testes Respiratórios , Adolescente , Adulto , Etanol , Feminino , Humanos , Masculino , Percepção , Espanha , Adulto JovemRESUMO
Supervisors Safety Response (SSR) has been closely linked to workplace safety, and, as perceived by workers, it is considered to be one of the most influential issues with regard to employees compliance with safety behaviours. This study defines and tests a bifactorial and a monofactorial model of the SSR. Two facets of the SSR were measured: (a) supervisors response toward workers safe or unsafe behaviour and (b) supervisors safety attitudes and behaviours applied to their own work. In three samples of injured blue-collar workers ( N(1) = 110, N(2) = 123, N(3) = 104), multisample confirmatory factor analyses, using maximum likelihood estimation, were conducted to test both the bifactorial and the monofactorial model. Both models provide an overall good fit, but parsimony and the high correlation between factors in the bifactorial model support the monofactorial model. Attention is drawn to the measurement of the SSR as a diagnostic tool useful in selecting intervention goals, specifically integrating supervisors safety behaviour.
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Emprego/organização & administração , Segurança , Adulto , Análise Fatorial , Feminino , Humanos , Masculino , Inquéritos e Questionários , Recursos HumanosRESUMO
INTRODUCTION: Our research is aimed at studying the relationship between risk level and organizational complexity and resources on constructions sites. Our general hypothesis is that site complexity increases risk, whereas more resources of the structure decrease risk. A Structural Equation Model (SEM) approach was adopted to validate our theoretical model. METHOD: To develop our study, 957 building sites in Spain were visited and assessed in 2003-2009. All needed data were obtained using a specific tool developed by the authors to assess site risk, structure and resources (Construction Sites Risk Assessment Tool, or CONSRAT). This tool operationalizes the variables to fit our model, specifically, via a site risk index (SRI) and 10 organizational variables. Our random sample is composed largely of small building sites with general high levels of risk, moderate complexity, and low resources on site. CONCLUSIONS: The model obtained adequate fit, and results showed empirical evidence that the factors of complexity and resources can be considered predictors of site risk level. PRACTICAL APPLICATIONS: Consequently, these results can help companies, managers of construction and regulators to identify which organizational aspects should be improved to prevent risks on sites and consequently accidents.
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Indústria da Construção/organização & administração , Segurança/estatística & dados numéricos , Local de Trabalho/organização & administração , Humanos , Modelos Teóricos , Medição de Risco/métodos , EspanhaRESUMO
Occupational Health and Safety in Spain has improved considerably over the last decade, most likely due to a new concept where an overall concept of safety culture is defined. Important changes in industrial safety, hygiene, and psychosocial factors present an optimistic panorama for the future of Spain. Despite this general improvement, according to the European Convergence Program, Spanish statistics still offer far from good safety results. In fact, according to 1997 official statistics, Spain had the highest incidence rate for nonfatal occupational accidents of all European Union (EU) countries, and occupied third place for fatal accidents. This paper summarizes the organizational structure of the Spanish National System of Health & Safety at Work, its effective health and safety laws, and statistics on the Spanish work environment obtained from III Spanish National Survey on Work Conditions (1997). The researchers hope that the findings of this work will have an impact on Spanish industry that will subsequently bring about improvements in work conditions and develop assessment and intervention models in occupational health and safety, from a theoretical position integrating environmental, human, and organizational factors.
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Exposição Ocupacional , Saúde Ocupacional , Gestão da Segurança/métodos , Humanos , Exposição Ocupacional/estatística & dados numéricos , Saúde Ocupacional/legislação & jurisprudência , Saúde Ocupacional/estatística & dados numéricos , Gestão da Segurança/tendências , EspanhaRESUMO
The relationship between negative affectivity (NA) and emotion regulation (ER) in determining anxiety and depressive symptomatology was examined in a large (n=1441) sample of adolescents (12-17 years old). Two models, diverging only as to inclusion or exclusion of a path from NA to negative ER, were analyzed through structural equation modeling; the goal was to explore the mediational or non-mediational role of ER in determining anxiety symptoms. The models yielded similar adequate fit to data, indicating that both NA and negative ER contribute to anxiety symptoms which, in turn, significantly determine depressive symptomatology. The mediational model better captures the relationships revealed in the data, with NA determining negative ER to a great extent. Additionally, most individuals scoring highly in NA also tend to score highly in negative ER, indicating that adolescents with heightened NA are prone to a dysfunctional style of ER.