Possible improvement of social adjustment after subthalamic deep brain stimulation in people with Parkinson's disease? A systematic review and meta-analysis.

Interactions with others need social adjustment (i.e., the constant accommodation to changing social situations). Mixed evidence indicates positive as well as negative changes in social adjustment after subthalamic nucleus deep brain stimulation (STN-DBS) in people with Parkinson's Disease (PwPD). To date, however, no meta-analysis of these changes exists. Thus, the study aim was to review evidence of the effects of STN-DBS on social adjustment in PwPD. For this purpose, a systematic literature search in MEDLINE was conducted. The meta-analysis was performed using a random effects model and standardized mean differences (SMDs) with 95% confidence intervals (CIs). The MINORS tool was used to assess the methodological quality of the studies. The initial literature search identified 13,124 articles, of which 1,550 full texts were assessed for eligibility. Eight studies were finally included; for seven articles sufficient data for a meta-analysis was available. Most studies found mild impairment in social adjustment impairment pre-surgery. The meta-analysis revealed no significant changes but a statistical trend towards improvement in social adjustment up to six months (SMD = 0.25; 95%CI=-0.03,0.53; P = 0.08) and over 12 months (SMD = 0.26; 95%CI=-0.03,0.55; P = 0.07) post-surgery. Methodological quality was moderate in 87.5% of the studies and good in 12.5%. While mild impairment in social adjustment pre-surgery was reported in most studies, the data indicate that STN-DBS might yield beneficial effects toward this outcome. However, not enough data yet exists to draw firm conclusions. As a crucial skill for everyday functioning, social adjustment should be more often defined as an outcome in STN-DBS trials in PwPD and should be considered in clinical routines.

Differences in social adjustment during adulthood between adoptees with high and low risk for schizophrenia spectrum disorders - the Finnish adoptive family study of schizophrenia.

OBJECTIVE: To investigate differences in social adjustment during adulthood between adoptees with high genetic risk (HR) and low genetic risk (LR) for schizophrenia spectrum disorders. METHODS: This study is a subsample of the Finnish Adoptive Family Study of Schizophrenia. The study sample consisted of 120  adoptees whose biological mothers had DSM-III-R verified schizophrenia spectrum disorders, and 142 socio-demographically matched control adoptees. The social adjustment of the adoptees was assessed using the interview-based Adult Adjustment Scale (AAS). RESULTS: A lower proportion of the HR adoptees (61.7%) fell into the category of good adaptation compared to LR adoptees (74.6%) (p = 0.024). In addition, the median AAS score among HR adoptees was lower compared to LR adoptees (p = 0.023). Poorer results among HR adoptees were also found regarding some individual items and the social health -domain within the AAS. The psychiatric morbidity, excluding schizophrenia spectrum disorders, was higher among HR adoptees. Psychiatric morbidity was shown to mediate the association of genetic status to total AAS, and, also to the domain of social health. CONCLUSION: According to our results, genetic susceptibility to schizophrenia is associated with weakened social adjustment during adulthood. Although our results demonstrated that psychiatric morbidity has notable effect on the association of genetic status to adult adjustment scores, the impact of other determinants, like psychosocial factors or health-related behaviour, cannot be ruled out. The comparable rearing environment provided by the adoption design in conjunction with reliable diagnostics provide new information on the relation of genetic susceptibility and social adjustment.

The impact of modified Cognitive-Behavioral Group Therapy in social adjustment functions of children with attention deficit hyperactivity disorder and their parents' stress levels: A nonrandomized clinical trial.

This study aims to investigate the potential of a modified Cognitive-Behavioral Group Therapy (CBGT) intervention in promoting social adjustment and reducing their parental stress among children exhibiting symptoms of attention deficit hyperactivity disorder (ADHD). The research also highlights the mechanisms and advantages of employing modified CBGT to address negative symptoms associated with ADHD in children. The study was conducted at Fuzhou Children's Hospital of Fujian Province, with a total of 20 pairs of parents and children with ADHD participating. The assessment utilized measures including SNAP, Barratt Impulsivity, and Conners to evaluate changes in the children's social adjustment abilities and core/associated ADHD symptoms before and after CBGT intervention. Additionally, the Parental Stress Index was employed to gauge the level of stress experienced by the parents. Consequently, CBGT interventions have shown substantial improvements in children's social adjustment abilities and have proven to be a significant source of stress relief for parents.

Social cognition and adjustment in adult survivors of pediatric central nervous system tumors.

BACKGROUND: Survivors of pediatric central nervous system (CNS) tumors are at risk for neurocognitive and social difficulties throughout childhood. This study characterized social cognition (perception and reasoning from social cues) and adjustment in adulthood. METHODS: A total of 81 adult survivors of pediatric CNS tumors (51% female; mean [SD] age, 28.0 [5.8] years), were recruited across four groups: (1) no radiation therapy (RT) [n = 21], (2) infratentorial (IT) tumors + focal RT [n = 20], (3) IT tumors + craniospinal irradiation [n = 20], and (4) supratentorial tumors + focal RT [n = 20]. Prevalence of social cognitive and adjustment impairments was compared to test norms. Multivariable models examined clinical and neurocognitive predictors of social cognition and its impact on functional outcomes. RESULTS: Survivors demonstrated elevated risk of severe social cognitive impairments (social perception Morbidity Ratio [95% CI] 5.70 [3.46-9.20]), but self-reported few social adjustment problems. Survivors of IT tumors treated with craniospinal irradiation performed nearly 1 SD worse than survivors treated without RT on multiple measures of social cognition (e.g., social perception: ß = -0.89, p = .004). Impaired executive functioning and nonverbal reasoning were associated with worse social cognitive performance (e.g., social perception: ß = -0.75, p < .001; ß = -0.84, p < .001, respectively). Better social perception was associated with higher odds of attaining full-time employment (odds ratio, 1.52 [1.17-1.97]) and at least some college education (odds ratio, 1.39 [1.11-1.74]). CONCLUSIONS: Adult survivors of CNS tumors are at elevated risk of severely impaired social cognition, but do not perceive social adjustment difficulties. Better understanding of potential mechanisms underlying social cognitive deficits may inform intervention targets to promote better functional outcomes for at-risk survivors.

Are Empathic People Better Adjusted? A Test of Competing Models of Empathic Accuracy and Intrapersonal and Interpersonal Facets of Adjustment Using Self- and Peer Reports.

Are individuals adept at perceiving others' emotions optimally adjusted? We extend past research by conducting a high-powered preregistered study that comprehensively tests five theoretical models of empathic accuracy (i.e., emotion-recognition ability) and self-views and intra- and interpersonal facets of adjustment in a sample of 1,126 undergraduate students from Canada and 2,205 informants. We obtained both self-reports and peer-reports of adjustment and controlled for cognitive abilities as a potential confounding variable. Empathic accuracy (but not self-views of that ability) was positively related to relationship satisfaction as rated by both participants and informants. Self-views about empathic accuracy (but not actual empathic accuracy) were positively related to life satisfaction as rated by both participants and informants. All associations held when we controlled for cognitive abilities.

The effect of a virtual child disease management programme on burden and social adjustment of caregivers of children with coagulation factor deficiencies.

INTRODUCTION: The use of virtual interventions is of interest to patients with chronic disease and healthcare professionals. This study aimed to determine the effect of virtual child disease management programme on burden and social adjustment of caregivers of children with coagulation factor deficiencies. Moreover, the effect of this intervention on children's acute pain and bleeds was assessed. METHODS: This clinical trial was conducted on 80 caregivers of children with coagulation factor deficiencies. The subjects were randomly assigned into the intervention and control groups. A comprehensive virtual child disease management programme was conducted for 8 weeks and caregiver' burden and their social adjustment were assessed with the HEMOCAB and social adjustment subscale of Bell Adjustment Inventory, respectively. Data were analysed using ANCOVA and Wilcoxon test. RESULTS: Before the intervention, both groups were similar regarding the caregivers' burden and social adjustment and children's acute pain and bleeds. However, a significant difference was observed between groups in concern to caregivers' burden (P < .001), women's and men's social adjustment (P = .001, P = .03), and children's acute pain and bleeds (P < .001) after the virtual disease management programme. CONCLUSION: This study showed that using a virtual child disease management programme reduced burden and improved social adjustment of caregivers of children with coagulation factor deficiencies. This intervention decreased frequencies of acute pain and bleeds in children. Therefore, using this effective intervention in clinical practice is warranted to decrease the caregivers' burden as well as acute pain and bleeds in children.

More to the story than executive function: Effortful control soon after injury predicts long-term functional and social outcomes following pediatric traumatic brain injury in young children.

OBJECTIVE: To examine the impact of early traumatic brain injury (TBI) on effortful control (EC) over time and the relationship of EC and executive functioning (EF) to long-term functional and social outcomes. METHOD: Parents of children (N = 206, ages 3-7) with moderate-to-severe TBI or orthopedic injuries (OIs) rated EC using the Child Behavior Questionnaire at 1 (pre-injury), 6, 12, and 18 months post-injury. Child functioning and social competence were assessed at 7 years post-injury. Mixed models examined the effects of injury, time since injury, and their interaction on EC. General linear models examined the associations of pre-injury EC and EC at 18 months with long-term functional and social outcomes. Models controlled for EF to assess the unique contribution of EC to outcomes. RESULTS: Children with severe TBI had significantly lower EC than both the OI and moderate TBI groups at each post-injury time point. Both pre-injury and 18-month EC were associated with long-term outcomes. Among those with low EC at baseline, children with moderate and severe TBI had more functional impairment than those with OI; however, no group differences were noted at high levels of EC. EC had main effects on parent-reported social competence that did not vary by injury type. CONCLUSIONS: Findings suggest that EC is sensitive to TBI effects and is a unique predictor of functional outcomes, independent of EF. High EC could serve as a protective factor, and as such measures of EC could be used to identify children for more intensive intervention.

Validity and reliability of the Persian version of the machiavellian personality scale and its association with social adjustment and risky behaviors in Iranian college students.

OBJECTIVE: The present study aims to develop and assess the psychometric properties of the Persian version of the Machiavellian Personality Scale (P-MPS), and evaluate its relationship with social adjustment and risky behaviors in Iranian college students. METHODS: Participants were 500 healthy college students (270 females and 230 males) from medical and non-medical universities in Sanandaj, Iran. They completed the P-MPS, the social adjustment subscale of the Bell Adjustment Inventory, and the Youth Risk Behavior Surveillance System (YRBSS) questionnaire. The factor structure of the P-MPS was evaluated by exploratory factor analysis followed by confirmatory factor analysis (CFA). Cronbach's alpha coefficient was used to examine the internal consistency of the P-MPS and Pearson correlation test was used to investigate the relationship of the P-MPS score with the scores of social adjustment subscale and YRBSS. RESULTS: The P-MPS showed good content validity (Content validity ratio = 0.73, content validity index = 0.90), construct validity, and internal consistency (α = 0.802). The CFA results supported the four-factor solution of the questionnaire. The total score of P-MPS and its dimensions showed a significant negative relationship with social adjustment (p < 0.05). Moreover, its score was significantly correlated with risky behaviors (p < 0.05). CONCLUSION: The Persian version of MPS can be used for assessing Machiavellianism in the Iranian population.

Impact of virtual group-based acceptance and commitment therapy on social adjustment and work-family conflict among intern nurses: a randomized control trial.

BACKGROUND: An action-oriented approach such as acceptance and commitment therapy may help reduce the fusion of conflicting ideas, empower new intern nurses to act according to their values, and maximize their psychological flexibility. OBJECTIVE: To evaluate the impact of a virtual group-based acceptance and commitment therapy intervention on intern nurses' social adjustment and work-family conflict. DESIGN: A parallel, single-blind randomized control trial on intern nurses (n = 70) was randomly allocated to either a six-session online acceptance or commitment therapy intervention (n = 35) or a waiting list control group (n = 35), with each session lasting 90 min. MEASURES: The work-related acceptance and action questionnaire, the social adjustment scale-self report, and the work-family conflict scale before, after, and one month after the intervention. RESULTS: The psychological flexibility mean score of the study group was significantly higher than that of the control group (43.11 vs. 34.15, p < .001) immediately after the intervention, and this effect was sustained one month after the intervention (41.88 vs. 33.21, p < .001) with a more significant effect size (F = 128.457, p < .001, η2 = 0.791). The social adjustment mean score of the study group had significantly improved in all four subscales, with statistically significant differences (p < .001). One month after the intervention, the study group had significantly higher scores than the control group in total score, with statistically significant differences (p < .001) and large effect sizes (η2 = 0.932). Work-family conflict mean score of the study group was decreased immediately after the intervention, with statistically significant differences (p < .001). One month after the intervention, the study group had significantly lower scores than the control group in all three subscales of the WFCS, with statistically significant differences (p < .001) and large effect sizes (η2 = 0.943). CONCLUSION: Our findings proved that the virtual group-based ACT intervention effectively improved psychological flexibility and social adjustment, reducing work-family conflict among intern nurses. These findings suggest that the virtual group-based ACT intervention can be a practical approach to improving intern nurses' mental health and well-being, which could affect their job performance and overall quality of life. TRIAL REGISTRATION: The study was registered retrospectively as a randomized clinical trial on 10/2/2023, reference number; NCT05721339 .

Contextualizing the experiences of Black pregnant women during the COVID-19 pandemic: 'It's been a lonely ride'.

The emergence of the COVID-19 pandemic significantly changed the prenatal care experience, specifically regarding medical appointments and social opportunities. It is critical to capture this change through the narratives of pregnant people, particularly those of marginalized populations, whose voices may often be underrepresented in the literature. This mixed-methods paper summarizes the experiences of 40 pregnant Black/African American (AA) women during the COVID-19 pandemic. A cross-sectional, online survey was administered between 2020 and 2021 to assess prenatal health and the impacts of the COVID-19 pandemic on patients' pregnancy experience. Coping behaviors during the pandemic were self-reported using the COPE-IS. Univariate analyses were conducted. An additional analysis of participants (n = 4) was explored through a week-long qualitative exercise using a photo documentation procedure. Photo-Elicitation Interviews (PEI) were conducted to capture and center their pandemic pregnancy experiences. Sources of stress during the pandemic varied, with the most common being financial concerns (n = 19, 47.5%). Over half of the sample (n = 18, 54.5%) self-reported increases in their positive coping behaviors during the pandemic, such as communicating with friends and family, talking to healthcare providers, listening to music, and engaging in spiritual practices-such as prayer. The four PEI study participants reflected on the impacts of social distancing on their prenatal experience and mentioned hospital and provider-related weariness due to their race. The findings of this study suggest that during the COVID-19 pandemic, Black/AA pregnant women in Charlotte, NC used social support, mindfulness practices, self-advocacy, and health literacy to navigate challenges present during their prenatal health experience. This paper highlights the personal, social, and structural experiences of pregnant women during a public health crisis so that responsive and effective programs or policies can be planned in the future.

Developing an ACT-based intervention to address lung cancer stigma: Stakeholder recommendations and feasibility testing in two NCI-designated cancer centers.

Objective: Few psychosocial interventions have been tailored to meet the unique needs of patients diagnosed with lung cancer. This pilot study developed and tested a six-week intervention for reducing lung cancer stigma.Design and Subjects: Guided by qualitative interviews conducted with 9 lung cancer patients and 5 thoracic oncology care providers, Acceptance and Commitment Therapy was adapted for treatment of lung cancer stigma (ACT-LCS). In a subsequent single arm pilot study, 22 lung cancer patients reporting high levels of stigma completed the intervention.Setting: NCI-designated cancer centers in the Southwestern and Eastern United States.Results: Of 46 eligible patients, 22 provided consent, with 20 completing the intervention (10 in-person, 10 telehealth). Overall stigma decreased across timepoints, largely driven by reductions in internalized stigma. There were also significant reductions in social isolation, sleep disturbance, and fatigue.Conclusions: The ACT-LCS protocol demonstrates preliminary feasibility and acceptability. This intervention may be particularly suited for helping patients navigate feelings associated with internalized stigma.

The Impact of Parent Torture and Family Functioning on Youth Adjustment in War-Affected Families: A Path Analysis Describing Intergenerational Trauma and the Family System.

The direct exposure to physical or psychological trauma from torture or war leads to well-documented individual health consequences. Less understood are the inclusive and intergenerational effects of war trauma on family systems and youth adjustment. The purpose was to examine mechanisms in war-affected families that explained the significant emotional and behavioral consequences of intergenerational trauma in youth through the use of multiple methods. Quantitative assessments of maternal and paternal caregivers and youth characterized associations between parent torture, parent mental health distress, parent physical health problems, family functioning, and youth adjustment. Narrative statements further contextualized processes through which the trauma of a parent impacted youth and family systems. The research was conducted in partnership with local, refugee-serving community-based organizations. The study sample included parents and youth in 96 Karen families, originating from Burma in Southeast Asia, who had been resettled to the United States through the U.S. Refugee Admissions Program. Path analysis results indicated that parent torture (ß = -0.173) had statistically significant negative direct effects on youth adjustment. Parent torture had a negative indirect effect on youth adjustment through the mental health (ß = -0.345) and physical health problems of parents (ß = -0.305), and youth gender (ß = 0.126) and trauma exposure of youth (ß = -0.048). Family functioning type demonstrated a positive direct effect on youth adjustment (ß = 0.449). Family type had an indirect effect on youth adjustment through youth gender (ß = 0.142), youth trauma exposure (ß = -0.165), parent physical health problems (ß = -0.202), and parent mental health (ß = 0.509). The current study developed and tested the first model of intergenerational trauma's effects on the adjustment of Karen refugee youth. Results emphasize that individual recovery from torture must be accompanied by adjunct interventions focused on family systems and youth adjustment, to holistically address intergenerational sequala of trauma.

Cognitive predictors of social adjustment in pediatric brain tumor survivors treated with photon versus proton radiation therapy.

BACKGROUND: Pediatric brain tumor survivors are at risk for poor social outcomes. It remains unknown whether cognitive sparing with proton radiotherapy (PRT) supports better social outcomes relative to photon radiotherapy (XRT). We hypothesized that survivors treated with PRT would outperform those treated with XRT on measures of cognitive and social outcomes. Further, we hypothesized that cognitive performance would predict survivor social outcomes. PROCEDURE: Survivors who underwent PRT (n = 38) or XRT (n = 20) participated in a neurocognitive evaluation >1 year post radiotherapy. Group differences in cognitive and social functioning were assessed using analysis of covariance (ANCOVA). Regression analyses examined predictors of peer relations and social skills. RESULTS: Age at evaluation, radiation dose, tumor diameter, and sex did not differ between groups (all p > .05). XRT participants were younger at diagnosis (XRT M = 5.0 years, PRT M = 7.6 years) and further out from radiotherapy (XRT M = 8.7 years, PRT M = 4.6 years). The XRT group performed worse than the PRT group on measures of processing speed (p = .01) and verbal memory (p < .01); however, social outcomes did not differ by radiation type. The proportion of survivors with impairment in peer relations and social skills exceeded expectation; χ2 (1) = 38.67, p < .001; χ2 (1) = 5.63, p < .05. Household poverty predicted peer relation difficulties (t = 2.18, p < .05), and verbal memory approached significance (t = -1.99, p = .05). Tumor diameter predicted social skills (t = -2.07, p < .05). CONCLUSIONS: Regardless of radiation modality, survivors are at risk for social challenges. Deficits in verbal memory may place survivors at particular risk. Results support monitoring of cognitive and social functioning throughout survivorship, as well as consideration of sociodemographic risk factors.

Peer supported Open Dialogue in the National Health Service: implementing and evaluating a new approach to Mental Health Care.

BACKGROUND: Open Dialogue is an internationally developing approach to mental health care based on collaboration between an individual and their family and social network. Our quest for better approaches to Mental Health Care with improved carer and service user experience led us to develop and test a model of Peer Supported Open Dialogue (POD). There is no research currently looking at the implementation and effectiveness of a standalone POD team in the NHS so we evaluate its implementation, clinical outcomes and value to service users and their families. METHOD: A before-after design was used. 50 service users treated by the POD Team were recruited and participants from their family and wider social network. Service user self report questionnaires covering wellbeing, functioning, satisfaction were collected and one carer self report measure; at baseline, three and six months. A clinician reported measure was collected at baseline and six months. Clinicians perceptions of practice were collected following network meetings. RESULTS: 50 service users treated were recruited with a mean age of 35 years with slightly more males than females. Service users reported signficant improvements in wellbeing and functioning. There was a marked increase in perceived support by carers. Over half the meetings were attended by carers. The Community Mental Health Survey showed high satisfaction rates for service users including carer involvement. CONCLUSIONS: The study indicated it was possible to transform to deliver a clinically effective POD service in the NHS. This innovative approach provided continuity of care within the social network, with improved carer support and significant improvements in clinical outcomes and their experiences. TRIAL REGISTRATION: ( isrctn.com/ISRCTN36004039 . Retrospectively registered 04/01/2019.

The impact of changing nonimmigrant visa policies on international students' psychological adjustment and well-being in the United States during the COVID-19 pandemic: a qualitative study.

BACKGROUND: Since the Immigration and Nationality Act of 1952, the number of international students in the United States had been gradually increasing. However, the total numbers have begun to decrease since 2019-2020 school year due to the Trump administration's policy and COVID-19. Still, little is known about how international students' psychological adjustment and well-being have been affected by changing nonimmigrant visa policy and the COVID-19 pandemic.  METHODS: We conducted a total of 34 online semi-structured in-depth interviews with international students from 18 countries of origin studying in the San Francisco Bay Area, California. More than 60% of the participants (21 out of 34) were aged 21 to 25. Among our 34 participants, gender and 18 were male and 16 were female, and 19 were undergraduate students and 15 were master's students. The majority of the participants were first-generation college students (22/34, 64.71%). Verbatim transcription was done for all interviews. NVivo was used for both deductive and inductive approaches to the qualitative analysis. RESULTS: Overall, the recent political climate negatively impacted participants' psychology of adjustment and well-being. July 6, 2020 Policy Directive for international students caused severe uncertainty about whether they can continue studying in the United States. There were many resources or services needed to overcome this period, such as extended mental and emotional support from the counseling services as well as financial and informational support from the international student office and university. Although international students had the benefit of the university's food assistance program, they were not eligible to receive any external support outside of the university and financial aid at the local and federal levels. Whether maintaining F-1 visa status was one of their major concerns. Due to COVID-19, job opportunities were limited, which made international students difficult to obtain Curricular Practical Training (CPT) and secure a job in the United States within the 90-day unemployment limit of Optical Practical Training (OPT). H-1B visa and permanent residency were other challenges to go through, but participants saw positive perspectives from the Biden administration. CONCLUSIONS: Uncertain policy changes due to COVID-19 and presidential transitions impacted international students' psychological well-being and adjustment. International students are important populations in the United States who have supported jobs that are high in demand and economically contributed to the United States. It is expected that future policies at various levels support international students' life and improve their health equity and mental health.

Veteran families with complex needs: a qualitative study of the veterans' support system.

BACKGROUND: Families with complex needs face significant challenges accessing and navigating health and social services. For veteran families, these challenges are exacerbated by interactions between military and civilian systems of care, and the density of the veterans' non-profit sector. This qualitative study was designed to gather rich, detailed information on complex needs in veteran families; and explore service providers' and families' experiences of accessing and navigating the veterans' support system. METHODS: The study comprised participant background questionnaires (n = 34), focus groups with frontline service providers (n = 18), and one-on-one interviews with veteran families (n = 16) in Australia. The semi-structured focus groups and interviews were designed to gather rich, detailed information on four study topics: (i) health and wellbeing needs in veteran families; (ii) service-access barriers and facilitators; (iii) unmet needs and gaps in service provision; and (iv) practical solutions for improving service delivery. The study recruited participants who could best address the focus on veteran families with complex needs. The questionnaire data was used to describe relevant characteristics of the participant sample. The focus groups and interviews were audio-recorded, transcribed, and a reflexive thematic analysis was conducted to identify patterns of shared meaning in the qualitative data. RESULTS: Both service providers and families found the veterans' support system difficult to access and navigate. System fragmentation was perceived to impede care coordination, and delay access to holistic care for veteran families with complex needs. The medico-legal aspects of compensation and rehabilitation processes were perceived to harm veteran identity, and undermine health and wellbeing outcomes. Recovery-oriented practice was viewed as a way to promote veteran independence and self-management. Participants expressed a strong preference for family-centred care that was informed by an understanding of military lifestyle and culture. CONCLUSION: The health and wellbeing needs of veteran families intensify during the transition from full-time military service to civilian environments, and service- or reintegration-related difficulties may emerge (or persist) for a significant period of time thereafter. Veteran families with complex needs are unduly burdened by care coordination demands. There is a pressing need for high-quality implementation studies that evaluate initiatives for integrating fragmented systems of care.

Psychosocial stress, self-esteem, and social adjustment: A moderated mediation analysis in Taiwanese adolescents with Tourette syndrome.

PURPOSE: Recent studies have shown that tics and related comorbidities can cause poorer social adjustment, lower self-esteem, and higher psychosocial stress among adolescents with Tourette syndrome. This study explored the role of self-esteem in mediating the relationship between psychosocial stress and social adjustment among adolescents with Tourette syndrome, and the role of comorbidities in moderating the relationship between self-esteem and social adjustment. DESIGN AND METHODS: In this descriptive cross-sectional study, 118 Taiwanese adolescents with Tourette syndrome aged between 12 and 20 years old were recruited via convenience sampling. Their demographic information, Yale Global Tic Severity Scale, stress index for children and adolescents with Tourette syndrome, social adjustment scale for adolescents with Tourette syndrome, and Self-Esteem Scale results were collected. Moderated mediation analysis of the study data was performed with the Hayes's PROCESS macro. RESULTS: Our results revealed that the self-esteem of adolescents with Tourette syndrome fully mediates the relationship between their psychosocial stress and social adjustment (B = -0.0703, 95% CI, [-0.0176, -0.001]), while comorbidities moderates the relationship between their self-esteem and social adjustment (B = -0.8416, 95% CI, [-1.4529, -0.2302]). The relationship between self-esteem and social adjustment was more pronounced in adolescents without comorbidities than those with comorbidities. CONCLUSIONS: Psychosocial stress correlates negatively with social adjustment and self-esteem, and indirectly influences social adjustment through self-esteem, while comorbidities (particularly their absence) moderates the relationship between self-esteem and social adjustment. PRACTICE IMPLICATIONS: Different self-esteem strengthening programs to enhance social adjustment for adolescents with Tourette syndrome may be developed in future studies.

Ethnic Diversity and Students' Social Adjustment in Dutch Classrooms.

Research in the US indicates that classroom diversity is related to better social adjustment of students, but research on this association in European classrooms is limited in scope and yields inconsistent findings. This study examined how classroom ethnic diversity is related to social adjustment of societally dominant versus minoritized ethnic groups, and how an open classroom climate for discussion contributes to this. This was examined in low to moderately diverse Dutch classrooms (2703 secondary school students, from 119 classrooms and schools, Mage = 14, 50% female, 18% foreign-born parents). Results revealed that students from minoritized groups reported lower social adjustment. For all students, classroom ethnic diversity was related to worse social adjustment which was partly explained by classroom socioeconomic status (SES). An open classroom climate for discussion did not moderate the relation between diversity and social adjustment. The findings indicate that students' social adjustment is worse in ethnically diverse and low-SES classrooms, and an open classroom climate for discussion does not solve this.

Negative parenting styles and social adjustment of university students: a moderated chain mediation model.

This study aimed to explore the relationship between parenting styles and the social adjustment of university students as well as the mediating effects of attachment avoidance and friendship quality. We further examined the moderating role of gender. This study used convenience sampling to recruit 501 Chinese university students to complete the Chinese version of the Negative Parenting subscale of EMBU, Attachment Avoidance Scale, Friendship Quality Questionnaire, and Social Adjustment Scale. SPSS 24.0 and the Process 3.5 macro program were used to carry out descriptive statistical and correlation analyses and mediating effect and moderated chain-mediating effect tests on the data. The analyses revealed that negative parenting styles significantly negatively predicted social adjustment in university students. Attachment avoidance mediated the relationship between negative parenting styles and social adjustment in university students, and friendship quality mediated the relationship between negative parenting styles and social adjustment in university students. Attachment avoidance and friendship quality played a chain-mediating role in the relationship between negative parenting styles and university students' social adjustment. Gender moderated the effect of negative parenting style on friendship quality among university students. These results show how negative parenting styles affect college students' social adjustment and its underlying mechanisms in the context of China's collectivist culture and high power distance and further reveal the gender differences involved, providing insights to better understand the factors influencing college students' social adjustment.

Exploring College Adjustment in First-Year Gen Z Medical Students and Its Contributing Factors.

Background: First-year medical students need to adjust to university life to achieve optimal education. Notably, generation Z (Gen Z) students recently admitted to medical school possess unique characteristics that may affect their adjustment. However, limited studies have evaluated the adjustment of Gen Z medical students. In line with this, the present study explores the adjustment process of Gen Z medical students in their first year of study. Methods: A qualitative phenomenological study was held from January 2020 to October 2020. The respondents comprised first-year students from two medical institutions. Maximum variation sampling was applied to select the respondents. Moreover, 11 focus group discussions (FGDs) with students and 10 in-depth interviews with lecturers were conducted. Curriculum documents were examined, and then the data were analysed thematically. Results: Three themes were identified: i) domain; ii) process and iii) contributing factors to college adjustment. Academic, social and personal-emotional components of adjustment were included in the domain theme. The process theme consisted of transition, transition-transformation and transformation phases. Meanwhile, the contributing factors consisted of existing and supportive factors. Student characteristics, including demographics, mentality, prior educational experiences and social support, were considered the existing factors, while technology, learning system and well-being constituted the supporting factors. Conclusion: College adjustment involves various domains, processes and contributing factors that are unique to Gen Z characteristics, technology dependence and culture. Therefore, well-prepared faculties are needed to support the adjustment of Gen Z students.