Attentional Bias Toward Threat in Sexually Victimized Hispanic Women: A Dot Probe Study.

The current study examined attentional bias toward threat in Hispanic college women exposed to lifetime sexual victimization in childhood, adulthood, and both childhood and adulthood. Response latencies and attention bias scores were compared between victimized and non-victimized individuals. Participants were 20 women exposed to adulthood sexual victimization (AS group), 15 exposed to childhood sexual victimization (CS group), 8 exposed to both childhood and adulthood sexual assault (revictimization: RV group), and 20 not endorsing sexual victimization (NS group). They were asked to complete the dot-probe task. The CS group and RV group were combined to create the CS-RV group. Among the AS and CS-RV groups, response latencies were faster when attention was engaged to threat than when attention was engaged to non-threat. The NS group did not demonstrate such differences. When response latencies were compared among the three groups, the CS-RV group had slower response latencies than the NS group. The CS-RV and AS groups revealed similarly significantly elevated bias scores toward threat words than the NS group. Hispanic college women exposed to lifetime sexual victimization display elevated levels of attention bias compared to non-victimized women. Further, the current findings align with an integrative cognitive model for explaining maladaptive informational processing in trauma victims.

Temporal Associations Between Posttraumatic Stress Symptoms and Depression in Response to Online Expressive Writing Interventions in a Hispanic Sample.

Some expressive writing (EW) interventions targeting posttraumatic stress symptoms (PTSS) may reduce both PTSS and comorbid depression symptoms. The temporal associations between PTSS and depression symptom levels in response to EW interventions are unknown. This study examined the directionality of PTSS and depression symptom levels from baseline to 1-week, 1-month, and 3-month follow-ups of two online EW interventions in a Hispanic sample with diverse trauma experiences. Participants (n = 70) completed either emotion-focused or fact-focused writing for 3 consecutive days online. A manifest autoregressive model with cross-lagged effects and treatment condition was analyzed. All but one first-order autoregressive path were statistically significant, with later PTSS and depression scores significantly predicted by those scores at preceding time points. The cross-lagged effects findings suggest that earlier PTSS levels influenced later depression levels, but earlier depression did not influence later PTSS, demonstrating a unidirectional temporal association. Severe PTSS may hinder EW treatment gains in depression. Superior outcomes for emotion-focused writing relative to fact-focused writing were also found.

Beliefs about mental illness in a Spanish-speaking Latin American sample.

The US Hispanic population is large and rapidly growing, with serious healthcare disparities. Alarmingly, 67% of Hispanic adults with a mental illness go untreated. Attempts to increase treatment rates have had limited success, likely partly due to stigma beliefs. There is an urgent need to develop and utilize a Spanish language stigma assessment tool. The current study is the first to do so, translating the Beliefs Toward Mental Illness (BTMI; Hirai et al., 2018) scale into Spanish (S-BTMI). Our psychometric findings with English-Spanish bilingual Latinx undergraduate students suggest that the S-BTMI can be a reliable measure of mental illness stigma. The BTMI's 4-factor solution was confirmed by the S-BTMI. Language invariance tests for the S-BTMI and BTMI demonstrated metric invariance and partial scalar invariance. The S-BTMI's factors produced strong internal consistency and two-week test-retest reliability. A previous Latinx sample's BTMI scores were similar to the current S-BTMI scores, except for greater endorsement of incurability beliefs for the Spanish version. Average stigma levels were fairly low in the current sample. Use of the BTMI-S can improve our understanding of stigma, and its relationships to language, culture, acculturation, and treatment-seeking in Latinx communities.

A longitudinal investigation of the efficacy of online expressive writing interventions for Hispanic students exposed to traumatic events: competing theories of action.

Objective: Although expressive writing (EW) appears efficacious for treating a range of posttraumatic stress (PTS) symptoms including diagnosed PTSD, little is known about its efficacy when offered online and for ethnic/cultural minority populations such as Hispanic individuals. The current study examined the longitudinal effects of two online EW tasks for treating PTS symptoms in a Hispanic student sample. Design: Seventy-one participants who had experienced a traumatic event were randomly assigned to either an emotion-focused (EM) writing group or a fact-focused (FC) writing group and completed online writing sessions for three consecutive days. Participants completed online assessments at 1-week, 1-month, and 3-month follow-ups. The PTSD Checklist-DSM-5 version was used to assess PTS symptoms. Results: Both groups reported statistically significant reductions in severity of PTS symptoms at 1-week follow-up with the EM group demonstrating statistically significantly greater symptom reductions than the FC group. Differential longitudinal effects over the 3-month follow-up periods were found for some PTS domains, with the EM group showing superior improvements relative to the FC group. Conclusion: EW delivered online can be useful for Hispanic individuals with PTS symptoms following traumatic life events. Further, the current findings align with an inhibitory learning model for explaining EW's mechanism of action.

Factor Structure and Administration Measurement Invariance of the Beliefs Toward Mental Illness Scale in Latino College Samples: Paper-Pencil Versus Internet Administrations.

The psychometric properties of the paper-pencil and online versions of the Beliefs Toward Mental Illness Scale (BTMI) were examined in two studies with Latina/o individuals. In Study 1, 316 Latina/o participants completed the BTMI in a paper-pencil mode. The original three-factor model was found to be a poor fit model for the sample. Subsequent exploratory and confirmatory factor analyses identified a four-factor model as the best fitting model for the sample. The identified factors were Dangerousness, Social Dysfunction, Incurability, and Embarrassment. In Study 2, the identified best fit model was tested with 280 Latina/o participants who completed the BTMI online. The four-factor model had adequate fit. A series of measurement invariance tests on the fit model supported equal factor loadings, but rejected equivalent intercepts across paper-pencil and online administration methods, though partially equivalent intercepts and residuals were found. Consequently, modality-specific norms are recommended, depending on whether paper-pencil or online venues are utilized for administration.

A meta-analytic study of self-help interventions for anxiety problems.

The present study examined the effectiveness of self-help (SH) interventions for individuals with anxiety problems. Thirty-three studies, targeting a variety of anxiety disorders and problems, met criteria for inclusion with 1,582 clinical and subclinical participants. Self-help formats included books, audio/videotapes, and computer/Internet-based programs. The average effect sizes (Cohen's ds) comparing SH interventions to control groups for target symptoms were .62 at posttreatment and .51 at follow-up. When compared to therapist-directed interventions (TDIs), the average effect sizes (Cohen's ds) for target problems were -.42 at posttreatment and -.36 at follow-up. Format of SH materials, type of target disorder, presence of minimal therapist contact, and other study parameters were examined for their effect on treatment outcome. The results were discussed from the perspective of a stepped-care approach for anxiety problems.

Relaxation training and cognitive redirection strategies in the treatment of acute pain.

Relaxation training, relaxation instructions, and redirection of attention techniques were compared to a no-treatment control in the treatment of acute ischemic pain. Relaxation instructions were ineffective in reducing state anxiety, verbally reported pain or distress or pain measured during presentation of the stimulus by cross-modality matching. Relaxation training was effective in reducing distress during presentation of the stimulus and verbally reported pain. The attention-redirection technique reduced pain as measured by cross-modality matching. The interaction hypothesis was supported, re. the two measures of distress during presentation of the painful stimulus. As externality increased, the effectiveness of relaxation training increased. However, there was no consistent decrease in distress for subjects high on externality in the relaxation instruction group.

Psychiatric symptoms and their relationship to suicidal ideation in a high-risk adolescent community sample.

OBJECTIVE: The purpose of the current study was to investigate the importance of diagnostic factors in the prediction of adolescent suicidal ideation in a high-risk community sample. METHOD: Seventy-three high school students, aged 14 to 18 years, identified by school personnel as exhibiting emotional disturbance participated in the study. Psychiatric disorders were assessed with the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Epidemiologic Version 5, and suicidal ideation with the Modified Scale for Suicidal Ideation. RESULTS: Seventy-four percent of the sample met criteria for a psychiatric disorder. Continuous measures of psychiatric symptoms provided stronger prediction of suicidal ideation than dichotomous measures. In particular, severity of symptoms associated with mood disorders afforded the strongest prediction of suicidal ideation. Moreover, although significantly related to suicidal ideation at the bivariate level, symptoms associated with disruptive behavior, anxiety, and substance use disorders did not predict suicidal ideation over and above mood disorder symptoms. CONCLUSIONS: Adolescents presenting with emotional disturbance should be carefully screened for depression given the strong relationship between depressive symptoms and suicidal ideation. Furthermore, improved prediction of suicidal ideation may be obtained through the utilization of continuous measures of psychiatric symptoms in suicide research.

An investigation of the efficacy of online expressive writing for trauma-related psychological distress in Hispanic individuals.

This study compared the efficacy of 2 online expressive writing protocols for a traumatic/stressful life event in a Hispanic student sample. Participants who had reported a traumatic event were randomly assigned to either the emotion-focused group or the fact-focused group. The emotion-focused group focused their written accounts on emotions and feelings as well as facts about a stressful/traumatic experience, whereas the fact-focused group focused on facts of a stressful/traumatic event. Both groups completed 3 online writing sessions scheduled for 3 consecutive days, a 1-week online follow-up assessment, and a 5-week online follow-up assessment. Both groups statistically significantly reduced trauma symptoms over time with the emotion-focused group demonstrating statistically significantly greater trauma symptom reductions than the fact-focused group at the 5-week follow-up assessment.

An Internet-based self-change program for traumatic event related fear, distress, and maladaptive coping.

This study compared the efficacy of an Internet-based, 8-week self-help program for traumatic event-related consequences (SHTC) (n = 13) to a wait-list (WL) condition (n = 14). The SHTC consisted of cognitive-behavioral modules that progressed from the least anxiety-provoking component (i.e., information) to the most anxiety-provoking (i.e., exposure). Participants were those who had experienced a traumatic event and had been experiencing subclinical levels of symptoms associated with the event. Participants mastered the material in each module before proceeding to the next module. Pre- and post-treatment assessments revealed that SHTC participants decreased avoidance behavior, frequency of intrusive symptoms, state anxiety, and depressive symptoms, and increased coping skills and coping self-efficacy significantly more than WL participants. SHTC participants demonstrated more clinically significant improvement than WL individuals.

Social support and problem-solving as moderators of the relationship between childhood abuse and suicidality: applications to a delinquent population.

The purpose of the current study was to examine the relationship between childhood abuse, social support, and problem-solving appraisal within a juvenile delinquent sample. Hierarchical regression analyses were used to assess whether childhood abuse, social support, and problem-solving appraisal were independently predictive of suicidality, and further, whetherproblem-solving appraisal and social support moderated the childhood abuse-suicidality relationship. Childhood sexual abuse was found to be an independent predictor of suicidal ideation and behavior. In addition, both problem-solving confidence and social support moderated the relationship between childhood abuse and suicidal ideation. The results of this study underscore the importance of both problem-solving appraisal and social support to suicidality in adolescents with a history of abuse.

The relative contribution of diagnostic and psychosocial factors in the prediction of adolescent suicidal ideation.

Examined the relative importance of diagnostic and psychosocial factors in the prediction of adolescent suicidal ideation. Seventy-three high school students exhibiting emotional disturbance in the school setting completed a diagnostic interview and self-report measures assessing social support, family environment, negative life events, and problem solving. Using hierarchical regression analyses, only the presence of a pure internalizing disorder predicted suicidal ideation in addition to psychosocial variables. Interactions were found between psychiatric disorders and psychosocial variables. These results underscore the importance of including both diagnostic and psychosocial variables in research examining risk factors for adolescent suicidal behavior. Further, they suggest that adolescents presenting with psychiatric disorders, high levels of stress, and poor social support networks should be monitored for suicidality.