Unmet Needs, Minority Stress and Mental Health Outcomes Among Transgender Individuals: The Mediating Role of Schema Domains.

Exposure to gender-related minority stressors, the negative experiences and beliefs that stem from anti-trans stigma increases transgender and gender diverse (TGD) people's vulnerability to experiencing poor mental health outcomes. This study examined if the relationships between experiences of minority stress and mental health outcomes were mediated by early maladaptive schemas: mental representations shaping the way people view themselves, others and the world. Drawing from a schema therapy perspective, the study additionally examined if caregivers' failure to meet TGD people's core emotional needs was associated with mental health outcomes and if schemas similarly mediated these relationships. A total of 619 TGD adults completed an online survey about early maladaptive schemas, core emotional needs, gender-related minority stress and psychological distress and wellbeing. Causal mediation analyses indicated that caregivers who did not meet TGD people's core emotional needs and greater experiences of minority stress were associated with increased distress and lower wellbeing. These relationships were mediated by schema severity, particularly the disconnection and rejection and impaired autonomy domains. These findings provide empirical support for the schema therapy model's assumption that unmet core emotional needs are associated with schema formation. For TGD people, maladaptive beliefs about the self, others and world can form in response to manifestations of anti-trans stigma within the individual, their interpersonal relationships, community and broader society. Caregivers' failure to meet needs, plus experiences of minority stress throughout the individual's system, leads to greater distress and lower wellbeing; however, clinical interventions targeting schemas may improve outcomes for this at-risk group.

A bibliometric analysis of the quantitative schema therapy literature.

BACKGROUND: The evidence base for schema therapy has evolved significantly since it was first developed by Jeffrey Young in the 1990s. The aim of this bibliometric analysis was to summarize the trends and characteristics of the quantitative literature on schema therapy. METHOD: PsycINFO, PubMed and CINAHL Complete databases were last searched on 1 June 2023 following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 statement to identify peer-reviewed journal articles written in English that reported on original quantitative research on schema therapy or schema therapy constructs. NVivo was used to complete a descriptive analysis of the bibliographic, sample and study characteristics, and a coding framework was applied to capture the aspect of the schema therapy model that was the focus of each study, as well as the study context (e.g., the population or outcomes under investigation). SciVal was used to complete citations and authorship analyses. VOSviewer was used to examine co-authorship networks. RESULTS: A total of 704 quantitative studies on schema therapy were published by 483 unique first authors between 1994 and mid-2023. Studies predominantly used correlational designs with small samples (Mdn N = 153) of mostly females aged 18 years or older. The articles tended to focus on early maladaptive schemas, rather than schema domains or schema modes. Schema therapy and its concepts were most frequently studied in the context of depression and personality disorders. SciVal analyses indicated that, on average, articles were cited 27 times, with a Field Weighted Citation Impact of 1.02. CONCLUSIONS: Schema therapy research output appears to have slowed in recent years and several critical research gaps were evident. Areas of high priority for future research include schema modes and coping responses, and the use of developmental and longitudinal designs to evaluate several key causal assumptions in the theory underpinning schema therapy.

Predicting the Trajectories of Parents' Relationship Well-Being During COVID-19 Lockdowns and Beyond: a Vulnerability, Stress and Adaptation Model Perspective.

Strict lockdowns have been employed by many of the world's nations as a public health response to COVID-19. However, concerns have been expressed as to how such public health responses disturb the human ecosystem. In this paper, we report on findings from a longitudinal study of Australian parents in which we investigated how state differences in government-mandated lockdowns affect the relationship well-being (i.e., relationship satisfaction and loneliness) of parents. We situated the study of the relational effects of strict lockdowns within the Vulnerability Stress Adaptation Model (VSAM, Karney & Bradbury, 1995) that considers the role of parents' pre-existing vulnerabilities (i.e., psychological distress and attachment insecurity), life stressors (pre-pandemic and COVID-19 stressors), and adaptive relationship processes (constructive communication and perceived partner support). A total of 1942 parents completed 14 waves of assessments of relationship satisfaction and loneliness over a 13.5-month period as well as baseline assessments of personal vulnerabilities, life stressors, and adaptive relationship processes. Parents with high relationship adaptations and low vulnerabilities evidenced the highest relationship well-being (i.e., high satisfaction and low loneliness) during changes in lockdown restrictions, while parents with moderate relationship adaptations and vulnerabilities experienced the poorest well-being. Differences in state lockdown restrictions (i.e., Victoria [long and strict lockdown policy] vs all other states) were associated with differences in relationship well-being for parents with high relationship adaptations. Specifically, Victorian parents experienced significant declines in relationship well-being compared to non-Victorian parents. Our findings provide novel insights into how government-mandated social restrictions can disrupt the relational ecology of parents.

Early maladaptive schemas, emotion regulation difficulties and alexithymia: A systematic review and meta-analysis.

BACKGROUND: Emotion regulation is an integral part of the schema therapy model. The aim of this systematic review and meta-analysis was to synthesize the evidence on the associations between early maladaptive schemas (EMSs), difficulties with emotion regulation and alexithymia. METHOD: PsycINFO, PubMed and CINAHL Complete databases were searched on 28 May 2022 and 3 February 2023 in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Included studies were in English, in peer-reviewed journals and reported on the association between one or more of the 18 EMSs or five schema domains and emotion regulation difficulties or alexithymia. Methodological quality was assessed using the Appraisal Tool for Cross-Sectional Studies. Meta-analyses were conducted to examine difficulties with emotion regulation and alexithymia as correlates of each EMS and domain. RESULTS: A total of 19 studies published between 2008 and 2022 were included (Pooled N = 5957). Difficulties with emotion regulation were positively correlated with all 18 EMSs (range: entitlement r(7) = .28, 95% CI [.13, .42] to negativity pessimism r(5) = .53, 95% CI [.23, .74]) and schema domains (range: impaired limits r(5) = .34, 95% CI [.08, .56] to disconnection rejection r(5) = .44, 95% CI [.33, .73]). Alexithymia was positively correlated with the other-directedness domain (r(2) = .40, 95% CI [.09, .64]) and 16 of the 18 EMSs (range: unrelenting standards r(5) = .21, 95% CI [.12, .28] to emotional inhibition r(5) = .50, 95% CI [.34, .63]). CONCLUSIONS: The findings suggested that almost all 18 EMSs are implicated in emotion regulation difficulties and alexithymia, particularly those relating to unmet needs for attachment and autonomy.

Do relationship education programs reduce relationship aggression? A meta-analytic study.

There is an increasing focus on evaluating the effectiveness of Relationship Education (RE) programs on reducing relationship aggression. Nevertheless, there has been little by way of a systematic quantitative synthesis of research to date. The primary aim of this research was to conduct a meta-analysis into the effects of RE programs on relationship aggression and provide a comprehensive assessment as to the moderating effects of various methodological characteristics of studies. A secondary aim was to determine whether RE programs reduce negative aspects of relationship functioning that are known to exacerbate relationship aggression. Thirty-one studies (n = 25,527) were included comprising of pre-post comparison studies and control trials. Overall, RE programs were significantly associated with reductions in relationship aggression (d = 0.11, p = .001). Pre-post studies yielded a significantly larger effect size (d = 0.28, p < .001) than RCT studies (d = 0.05, p = .10). Subgroup analysis revealed that participants who reported moderate to severe relationship aggression upon RE program entry demonstrated large reductions in physical (d = 0.66, p = .01) and psychological (d = 0.85, p < .001) aggression compared to those who reported minimal to low relationship aggression on entry (physical aggression d = 0.07, p = .009; psychological aggression d = -0.04; p = .17). Amongst participants who reported moderate to severe relationship aggression, RE programs were also found to reduce controlling behavior (d = 0.20, p < .01) and conflict behavior (d = 0.40, p < .001). Findings demonstrate the emerging efficacy of RE programs for reducing relationship aggression and conflict behavior, particularly in those with a history of moderate to severe levels of relationship aggression.

The Impact of COVID-19 on Trends of Violence-Related Offences in Australia.

OBJECTIVE: To investigate the medium-term impacts of the COVID-19 pandemic on violence-related offences in Australia, and whether there was evidence of a 'dual pandemic' of family violence in addition to COVID-19. METHODS: Autoregressive Integrated Moving Average time series were conducted to analyse publicly available violent crime statistics data from January 2017 to November 2021. Population rates of homicide, sexual, domestic and non-domestic assault were assessed across each Australian state and territory, with the effects of COVID-19 being modelled using the average monthly World Health Organization COVID-19 stringency rating for each jurisdiction. FINDINGS: All jurisdictions in Australia showed increasing or stable domestic assault trends over the past decade, which were not significantly impacted by COVID-19, nor by the subsequent lockdowns. Non-domestic assaults demonstrated a significant, negative relationship with the stringency index for each jurisdiction, except Western Australia. There was no significant change in the rates of homicide or sexual assault across Australia in relation to COVID-19. CONCLUSION: Overall, there was no evidence of a 'dual pandemic' in Australia, and whilst domestic assaults continue to increase across the country, non-domestic assaults showed a notable but brief decline. However, these have returned to levels at least as high as pre-COVID-19 and some states show a continuing upward trend. The findings also suggest that alcohol availability may have played a role in continuing high violence numbers. Given the ongoing increasing and high levels of family violence in Australia, revised conceptual frameworks and interventions are indicated.

Older adults' support seeking from their adult children: The Support-Seeking Strategy Scale.

Due to the unavailability of assessment tools focused on support recipients, the aged-care literature has not been able to document the support seeking that occurs within familial support contexts. Therefore, we developed and validated a Support-Seeking Strategy Scale in a large sample of aging parents receiving care from their adult children. A pool of items was developed by an expert panel and administered to 389 older adults (over 60 years of age), all of whom were receiving support from an adult child. Participants were recruited on Amazon mTurk and Prolific. The online survey included self-report measures assessing parents' perceptions of support received from their adult children. The Support-Seeking Strategies Scale was best represented by 12 items across three factors-one factor representing the directness with which support is sought (direct) and two factors regarding the intensity with which support is sought (hyperactivated and deactivated). Direct support seeking was associated with more positive perceptions of received support from an adult child, whereas hyperactivated and deactivated support seeking were associated with more negative perceptions of received support. Older parents use three distinct support-seeking strategies: direct, hyperactivated, and deactivated with their adult child. The results suggest that direct seeking of support is a more adaptive strategy, whereas persistent and intense seeking of support (i.e., hyperactivated support seeking) or suppressing the need for support (i.e., deactivated support seeking) are more maladaptive strategies. Future research using this scale will help us better understand support seeking within the familial aged-care context and beyond. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The Development and Validation of the Pornography Use in Romantic Relationships Scale.

Recent reviews of the pornography literature have called for the development of valid and reliable measures that assess multiple facets of pornography use. Moreover, despite pornography use having important implications for romantic relationships, there are currently no self-report assessments of pornography use specifically within the context of romantic relationships. To address these limitations, the current paper reports on two studies regarding the development and psychometric evaluation of a 38-item multidimensional measure of pornography use within the context of romantic relationships: the Pornography Use in Romantic Relationships Scale (PURRS). Study 1 (n = 739) reports on an Exploratory and Confirmatory Factor Analytic approach to determine the factor structure of the PURRS. Study 2 (n = 765) reports on the cross-validation of the factor structure of the PURRS, before assessing the criterion validity of the measure. The PURRS exhibited good internal consistency, construct validity, and criterion validity. The findings suggest that the PURRS is best modeled by 13 first-order factors, though a higher-order factor structure comprising four broad factors may also be used. The PURRS significantly extends on past assessments of pornography use, and in particular, advances the assessment and study of pornography use within the context of romantic relationships.

Identifying the research priorities for schema therapy: A Delphi consensus study.

Despite the popularity of schema therapy, there exist several important gaps in research on the schema therapy model and its effectiveness. The number of gaps makes it difficult to determine the research areas of the highest strategic priority to advance schema therapy. The objective of this study was to establish consensus among schema therapy clinicians and researchers on the priority areas for future schema therapy research. A panel of experts in schema therapy (43 clinicians and 13 researchers) participated in a Delphi consensus study. The research areas rated were developed by interviewing the founder of schema therapy, Jeffrey Young, conducting a focus group with the executive board of the International Society for Schema Therapy and screening recent reviews on schema therapy for recommendations for future research. The panel rated 81 research areas in terms of priority across three rounds. Nineteen research areas were rated by 75% of the panel as 'Very high priority' or 'High priority'. These priorities reflected four broad themes: (1) schema therapy constructs and measures, (2) the theoretical assumptions underlying schema therapy, (3) schema therapy and theory in relation to different contexts and outcomes and (4) schema therapy effectiveness and mechanisms of change. The findings are important for establishing a clear research agenda for the future of schema therapy.

The roles of self-regulation and partner regulation on romantic relationship quality.

Research into self-regulation and partner regulation strategies has largely involved parallel lines of research, thus, it is difficult to determine the relative contribution of both forms of regulation when it comes to relationship outcomes. Therefore, the question remains as to which form of regulation is more strongly associated with relationship quality; is it more important to focus on adaptive self-regulation or adaptive strategies to regulate one's partner? The current research addresses this important gap by comparing the relative associations of adaptive self-regulation and adaptive partner regulation strategies on romantic relationship quality. A community sample of mixed gender couples (N = 114) who were predominantly satisfied with their current relationships - but nonetheless still experienced relationship conflict - were administered self-report assessments of various self-regulation and partner regulation strategies as well as a measure of relationship quality. Couples also participated in a videotaped discussion of an unresolved relationship issue that was scored by trained coders for verbal and nonverbal indicators of self-regulation and partner regulation strategies. Actor-partner interdependence modeling revealed that for both men and women, adaptive self-regulation strategies were positively associated with their own evaluations of relationship quality as well as their partner's relationship quality. In contrast, engaging in adaptive partner regulation strategies was not significantly associated with men's or women's own, or their partner's relationship quality. Findings highlight the importance of focusing on self-regulation in relationships, as it is these strategies, over partner regulation strategies, that have more positive implications for the relationship quality experienced by typically satisfied couples.

Unpacking the association between attachment insecurity and PTSD symptoms: The mediating role of coping strategies.

OBJECTIVE: The current study provides a proof of concept for an aspect of the trauma and attachment model outlined in Marshall and Frazier (2019), which argues that attachment insecurity is associated with PTSD symptoms via hyperactivating/deactivating coping strategies, especially in the context of high trauma severity. METHOD: 302 participants who had experienced a traumatic event(s) completed a survey. RESULTS: The results showed significant indirect effects between attachment insecurity and PTSD symptoms via hyperactivating/deactivating coping strategies, especially in the context of high trauma severity. In low trauma severity, hyperactivating strategies were not as strongly associated with PTSD symptoms and deactivating strategies not associated with PTSD symptoms. Hyperactivating and deactivating strategies were the mediators for attachment anxiety models and deactivating strategies was the mediator for attachment avoidance models. CONCLUSIONS: This proof of concept for Marshall and Frazier (2019) provides a platform for future research to better understand PTSD symptoms from an attachment framework. Interventions are likely to benefit by assisting people high on attachment avoidance and anxiety to modify their deactivating tendencies following a trauma of high severity and also assisting people high on attachment anxiety to modify their hyperactivating tendencies posttrauma, especially following a high trauma severity. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Does it Matter Who You Feel Sexually Aroused By? Associations Between Sexual Arousal, Relationship Quality, and Sexual Satisfaction.

BACKGROUND: Despite its integral role in normative sexual functioning, there is a dearth of research into the role of subjective sexual arousal within romantic relationships. AIM: The current proof-of-concept study addresses this gap by investigating the associations between partner-induced sexual arousal, sexual arousal induced by others, and sexual satisfaction and relationship quality. METHODS: One hundred and sixteen heterosexual couples who had been together for an average of three and a half years completed an online survey. An Actor-Partner Interdependence Modelling framework was applied to analyze the dyadic data. OUTCOMES: Participants completed the Perceived Relationship Quality Components (PRQC) Inventory and a single item global measure of sexual satisfaction derived for the current study. RESULTS: Feeling sexually aroused by one's romantic partner was positively associated with one's own sexual satisfaction and relationship quality. However, feeling sexually aroused by people other than one's romantic partner was negatively associated with one's own sexual satisfaction and relationship quality. These associations were found for both men and women. CLINICAL TRANSLATION: Therapists and practitioners may need to place an emphasis on using strategies and techniques that specifically facilitate or heighten partner-induced sexual arousal, whilst helping couples to move away from those behaviors and situations which typically lead to sexual arousal induced by those other than their partner. STRENGTHS & LIMITATIONS: This proof-of-concept study provides novel findings that address the absence of research investigating the associations between sexual arousal and outcomes in romantic relationships. The well-powered dyadic study design enabled a rigorous test of the hypotheses. However, the study was cross-sectional in nature, the sample was somewhat homogenous, and assessments included brief measures of sexual arousal and sexual satisfaction. CONCLUSION: The findings offer the first evidence to suggest that partner-induced sexual arousal and non-partner-induced sexual arousal have differential effects in terms of sexual satisfaction and relationship quality. This not only has a raft of clinical implications, but it provides the basis for several important avenues of future research on the role of subjective sexual arousal in romantic relationships. Lawless NJ, Karantzas GC, Mullins ER, et al. Does it Matter Who You Feel Sexually Aroused By? Associations Between Sexual Arousal, Relationship Quality, and Sexual Satisfaction. Sex Med 2022;10:100523.

The loss of humanness in close relationships: An interpersonal model of dehumanization.

To lose one's sense of what it means to be human reflects a profound form of loss. Recent research in the study of dehumanization highlights that the loss of humanness can be experienced at the hands of close others. Moreover, acts of dehumanization can take many forms in close relationships. In this paper, we review the emerging literature on the study of dehumanization within interpersonal relationships, placing a specific emphasis on adult romantic relationships. We situate our review of the literature within a newly developed model of interpersonal dehumanization. This model outlines how many destructive relationship behaviors reflect forms of dehumanization, which can result in a vast array of personal and relational losses.

One year on: What we have learned about the psychological effects of COVID-19 social restrictions: A meta-analysis.

This article reports on the first meta-analysis of studies on the association between government-imposed social restrictions and mental health outcomes published during the initial year of the COVID-19 pandemic. Thirty-three studies (N = 131,844) were included. Social restrictions were significantly associated with increased mental health symptoms overall (d = .41 [CI 95% .17-.65]), including depression (d = .83 [CI 95% .30-1.37]), stress (d = .21 [CI 95% .01-.42]) and loneliness (d = .30 [CI 95% .07-.52]), but not anxiety (d= .26 [CI 95% -.04-.56]). Subgroup analyses demonstrated that the strictness and length of restrictions had divergent effects on mental health outcomes, but there are concerns regarding study quality. The findings provide critical insights for future research on the effects of COVID-19 social restrictions.

Attachment Security Priming: A Meta-Analysis.

Attachment security priming has important theoretical and practical implications. We review security priming theory and research and the recent concerns raised regarding priming. We then report the results of a meta-analysis of 120 studies (N = 18,949) across 97 published and unpublished articles (initial pool was 1,642 articles) investigating the affective, cognitive, and behavioral effects of security priming. A large overall positive effect size (d = .51, p < .001) was found across all affective, cognitive, and behavioral domains. The largest effect was found for affect-related outcomes (d =.62, p < .001), followed by behavioral (d = .44, p < .001), and cognitive (d = .45, p < .001). Trait attachment anxiety and avoidance moderated the effects of subliminal security priming for behavioral outcomes-security priming effects were larger among people higher on attachment anxiety and avoidance. Assessment of publication bias revealed mixed evidence for the possible presence of asymmetry.

Dealing with loss in the face of disasters and crises: Integrating interpersonal theories of couple adaptation and functioning.

The COVID-19 pandemic has highlighted the significant and varied losses that couples can experience during times of global and regional disasters and crises. What factors determine how couples navigate their close relationships during times of loss? In this paper, we elaborate and extend on one of the most influential frameworks in relationship science-the Vulnerability Stress Adaptation Model (VSAM, Karney and Bradbury, 1995)-to enhance the model's power to explain relationships during loss-themed disasters/crises. We do so by elaborating on attachment theory and integrating interdependence theory (emphasizing partner similarities and differences). Our elaboration and extension to the VSAM provides a comprehensive framework to guide future research and inform practice and policy in supporting relationships during and beyond loss-themed disasters/crises.

Parent and child mental health trajectories April 2020 to May 2021: Strict lockdown versus no lockdown in Australia.

OBJECTIVE: To control a second-wave COVID-19 outbreak, the state of Victoria in Australia experienced one of the world's first long and strict lockdowns over July-October 2020, while the rest of Australia experienced 'COVID-normal' with minimal restrictions. We (1) investigate trajectories of parent/child mental health outcomes in Victoria vs non-Victoria and (2) identify baseline demographic, individual and COVID-19-related factors associated with mental health trajectories. METHODS: Online community sample of 2004 Australian parents with rapid repeated assessment over 14 time-points over April 2020 to May 2021. Measures assessed parent mental health (Depression, Anxiety and Stress Scales-21), child depression symptoms (13-item Short Mood and Feelings Questionnaire) and child anxiety symptoms (four items from Brief Spence Children's Anxiety Scale). RESULTS: Mental health trajectories shadowed COVID-19 infection rates. Victorians reported a peak in mental health symptoms at the time of the second-wave lockdown compared to other states. Key baseline predictors, including parent and child loneliness (standardized regression coefficient [ß] = 0.09-0.46), parent/child diagnoses (ß = 0.07-0.21), couple conflict (ß = 0.07-0.18) and COVID-19 stressors, such as worry/concern about COVID-19, illness and loss of job (ß = 0.12-0.15), predicted elevated trajectories. Effects of predictors on parent and child mental health trajectories are illustrated in an online interactive app for readers (https://lingtax.shinyapps.io/CPAS_trend/). CONCLUSION: Our findings provide evidence of worse trajectories of parent and child mental health symptoms at a time coinciding with a second COVID-19 outbreak involving strict lockdown in Victoria, compared to non-locked states in Australia. We identified several baseline factors that may be useful in detecting high-risk families who are likely to require additional support early on in future lockdowns.

The Association Between Relationship Events and Experiences and Partner Evaluations: An Ideal Standards Perspective.

Drawing on the Ideal Standards Model, the current study investigated whether the relationship events and experiences that occur on a given day in romantic relationships were associated with partner evaluations. Individuals in a current romantic relationship (N = 104) completed daily measures of positive and negative relationship events and experiences and partner evaluations for seven consecutive days. As hypothesized, findings demonstrated that on a given day negative relationship events and experiences were associated with evaluating partners as falling short of mate ideals, while positive relationship events and experiences were associated with evaluating partners as more closely meeting ideals. The findings demonstrate the importance of the relational context in evaluations of a partner against ideal standards.

The Dual Function Model of Attachment Security Priming: Theoretical Framework and Empirical Evidence.

According to attachment theory, security providing attachment figures fulfill two main functions: (1) safe haven-providing safety and comfort and reducing stress-helping people regain a sense of security; and (2) secure base-providing resources and a base from which people can spring into action. According to the Dual Function of Security Priming Model, security priming can result in one of two outcomes paralleling these two functions. Which outcome is likely to present itself depends on the level of stress imposed by the context. Here we describe the Dual Function Model of Security Priming (DFSP) Model and provide evidence from a study examining the effects of attachment security priming on hypothalamic-pituitary-adrenal activity. In the study, participants were exposed to security-related cues under high or low/no-stress conditions, while their salivary cortisol concentrations were measured. Cortisol is a suitable index as it is released not only in response to stress, but also more generally when energy needs to be mobilized. We found that while security priming led to significant decreases in salivary cortisol concentrations when presented after a stressor (stress reduction), it led to a significant increase in salivary cortisol concentrations when presented before the stressor (energy mobilization).