Utility of the PROMIS Pediatric Pain Interference Scale in Juvenile Fibromyalgia.

OBJECTIVE: The current study tested the utility of the PROMIS Pediatric Pain Interference (PPI) in relation to the widely-used Functional Disability Inventory (FDI) in a small-scale clinical trial. METHODS: Forty youth with juvenile fibromyalgia (JFM) were randomized to either CBT only or a combined CBT and neuromuscular exercise group (i.e., FIT Teens). Participants completed the PPI and FDI at baseline, post-treatment, and three-month follow-up. RESULTS: The PPI and FDI were significantly correlated at baseline (r = .51) and post treatment (r = .53), and demonstrated similar improvements (d PPI = .87, d FDI = 1.22, p < .05) at post-treatment following FIT Teens. Following CBT only, neither the PPI nor the FDI improved significantly. CONCLUSIONS: The PPI may be appropriate for use in non-pharmacologic interventions for pediatric pain.

Social reward and social punishment sensitivity in relation to dietary restraint and binge/purge symptoms.

Disordered eating symptoms are associated with disrupted sensitivity to reward and punishment, broadly assessed. However, it is unknown how eating pathology is related to sensitivity to social reward and social punishment specifically. Drawing on Reinforcement Sensitivity Theory, the current study utilized a multi-method design to test whether disordered eating symptoms, specifically dietary restraint (DR) and binge/purge (BP), were similarly or uniquely related to sensitivity to social punishment and social reward. Female university students (N = 110, M = 18.66, SD = 0.89) completed self-report measures and a novel behavioral task measuring willingness to work for or to avoid social feedback. DR and BP symptoms were related to increased self-reported and behavioral sensitivity to social punishment, yet only when symptoms were tested in isolation. DR was associated with increased sensitivity to social reward across self-report and behavioral paradigms. BP symptoms were uniquely and positively related to self-reported sensitivity to social reward, but decreased behavioral sensitivity to social reward. Findings suggest that sensitivity to punishment may be a common factor related to DR and BP, whereas sensitivity to social reward may be a key factor differentiating disordered eating symptoms.

Using implicit attitudes of exercise importance to predict explicit exercise dependence symptoms and exercise behaviors.

OBJECTIVES: "Fast" (i.e., implicit) processing is relatively automatic; "slow" (i.e., explicit) processing is relatively controlled and can override automatic processing. These different processing types often produce different responses that uniquely predict behaviors. In the present study, we tested if explicit, self-reported symptoms of exercise dependence and an implicit association of exercise as important predicted exercise behaviors and change in problematic exercise attitudes. DESIGN: We assessed implicit attitudes of exercise importance and self-reported symptoms of exercise dependence at Time 1. Participants reported daily exercise behaviors for approximately one month, and then completed a Time 2 assessment of self-reported exercise dependence symptoms. METHOD: Undergraduate males and females (Time 1, N = 93; Time 2, N = 74) tracked daily exercise behaviors for one month and completed an Implicit Association Test assessing implicit exercise importance and subscales of the Exercise Dependence Questionnaire (EDQ) assessing exercise dependence symptoms. RESULTS: Implicit attitudes of exercise importance and Time 1 EDQ scores predicted Time 2 EDQ scores. Further, implicit exercise importance and Time 1 EDQ scores predicted daily exercise intensity while Time 1 EDQ scores predicted the amount of days exercised. CONCLUSION: Implicit and explicit processing appear to uniquely predict exercise behaviors and attitudes. Given that different implicit and explicit processes may drive certain exercise factors (e.g., intensity and frequency, respectively), these behaviors may contribute to different aspects of exercise dependence.

Perceived maternal and paternal psychological control: relations to adolescent anxiety through deficits in emotion regulation.

The current study compared the differential effects of early adolescents' perceived maternal and paternal psychological control (as well as their discrepancy) on adolescent anxiety. It also tested whether psychological control leads to deficits in youths' ability to regulate their negative emotions, and if, in turn, such deficits lead to anxiety. Sixth- and seventh-grade students (n = 214; 59% girls; 60% Caucasian) completed measures of perceived psychological control, regulation of negative emotions, and anxiety symptoms. The discrepancy between perceived mothers' and fathers' control was also calculated. Although perceptions of mothers' control, fathers' control, and their discrepancy were each bivariately related to adolescent anxiety, when considered together, only a larger discrepancy in parents' psychological control was uniquely associated with higher self-reported anxiety. Further, adolescents' dysregulation of negative emotions partially explained the relation of both maternal psychological control and the discrepancy in parental control to anxiety. Implications for understanding family-based etiological correlates of anxiety are discussed.

Executive Functioning in Adolescents with Chronic Musculoskeletal Pain.

Adolescents with chronic pain often suffer significant impairment in physical, emotional, and social domains. Surprisingly little is known about executive functioning (EF) in youth with chronic pain or how EF deficits may contribute to functional impairment. Study participants included 60 adolescents between the ages of 12 and 17 years (M = 14.57). Thirty participants with chronic musculoskeletal pain and 30 age- and gender-matched healthy controls were recruited from a large Midwestern children's hospital in the United States. Participants completed the Behavior Rating Inventory of Executive Functioning (BRIEF-2) as well as multiple measures of functional impairment across key domains: school, social, emotional (anxiety, depression), and physical. Adolescents with chronic musculoskeletal pain reported significantly greater EF impairment compared to healthy age- and gender-matched peers. Clinically elevated risk levels of impairment were reported across all aspects of EF, with many adolescents in the chronic pain group scoring above the clinical risk cut off for working memory (52%), inhibition (45%), and cognitive flexibility (38%). EF was also significantly related to functional impairment across all domains. Findings suggest that EF may have an impact across several critical domains of functioning for youth with chronic pain.

Development and pilot testing of the treatment and education approach for childhood-onset lupus (TEACH): a cognitive behavioral treatment.

BACKGROUND: To develop and test the feasibility and initial effectiveness of the Treatment and Education Approach for Childhood-onset Lupus (TEACH) protocol, a 6-session cognitive behavioral therapy (CBT) intervention for adolescents and young adults (AYA) with childhood-onset systemic lupus erythematosus (cSLE). METHODS: Females with cSLE (n = 14; ages 13-19 years, M = 16.21 years) presenting to a pediatric rheumatology clinic subsequently completed the protocol, which was iteratively modified based on participant/interventionist feedback. Upon intervention completion, participants provided qualitative data on feasibility, acceptability, potential modifications, and perceived effectiveness of the program via a semi-structured interview, which was analyzed for shared themes. Participants also completed measures of fatigue, psychological distress, and pain intensity before and after the intervention. Nonparametric statistics were conducted to examine changes in outcome measures following the intervention. RESULTS: During the study, several protocol modifications were employed to better address the unique needs of individuals with cSLE (e.g., separate content for adolescents versus young adults). Results suggest that TEACH is feasible, acceptable, and potentially effective in the management of cSLE symptoms. Following the intervention, there was a statistically significant reduction in fatigue (Z = - 2.81, p < .01) and depressive symptoms (Z = - 2.69, p < .01). Reductions in pain and anxiety symptoms were marginal. CONCLUSIONS: TEACH, a tailored CBT protocol for AYA with cSLE, is a feasible and potentially effective intervention for the management of fatigue and depressive symptoms. Future directions include testing the protocol in a larger controlled study.

Parent chronic pain and mental health symptoms impact responses to children's pain.

BACKGROUND: Chronic pain is a prevalent health condition associated with parenting difficulties. Pain-specific parenting, such as protectiveness and catastrophizing, may contribute to chronic pain in children. Additional work is needed to test predictors of pain-specific parenting. Aim: The current study tested parent mental health symptoms as predictors of protectiveness and catastrophizing about child pain and whether comorbid pain and mental health symptoms exacerbate risk for problematic responses to children's pain. METHODS: Parents with chronic pain (n = 62) and parents without chronic pain (n = 80) completed self-report questionnaires assessing pain characteristics, mental health symptoms, and pain-specific parenting responses. RESULTS: Results indicated significantly higher rates of depression, anxiety, and somatization in parents with chronic pain. Depression predicted protectiveness and catastrophizing over and above chronic pain status. Chronic pain status moderated the association between increased anxiety and greater catastrophizing about child pain. CONCLUSIONS: Findings highlight the potential impact of mental health symptoms on pain-specific parenting even when accounting for chronic pain status.

CONTEXTE: La douleur chronique est un problème de santé courant associé à certaines difficultés en matière de pratiques parentales. Les pratiques parentales spécifiques à la douleur, telles que la protection et la dramatisation, peuvent contribuer à la douleur chronique chez l'enfant. Des études additionnelles sont nécessaires afin de tester les prédicteurs des pratiques parentales spécifiques à la douleur. BUT: La présente étude cherchait à savoir si les symptômes de troubles mentaux étaient de bons prédicteurs d'une attitude protectrice et de la dramatisation de la douleur chez l'enfant et si la comorbidité de la douleur et des symptômes de troubles mentaux exacerbait le risque de réponses problématiques à la douleur de l'enfant. MÉTHODES: Des parents souffrant de douleur chronique (n = 62) et des parents sans douleur chronique (n = 80) ont répondu à un questionnaire d'autoévaluation portant sur les caractéristiques de la douleur, les symptômes de troubles mentaux et les réponses parentales à la douleur. RÉSULTATS: Les résultats ont indiqué des taux de dépression, d'anxiété et de somatisation plus élevés chez les parents souffrant de douleur chronique. La dépression était un prédicteur de la protection et de la dramatisation en plus de l'état de douleur chronique. L'état de douleur chronique modérait l'association entre l'augmentation de l'anxiété et une plus grande dramatisation de la douleur chez l'enfant. CONCLUSIONS: Les résultats mettent en lumière l'effet potentiel des symptômes de troubles mentaux sur les pratiques parentales spécifiques à la douleur, même lorsque l'on tient compte de l'état de douleur chronique.

Dimensionality of Helicopter Parenting and Relations to Emotional, Decision-Making, and Academic Functioning in Emerging Adults.

The current study tests the underlying structure of a multidimensional construct of helicopter parenting (HP), assesses reliability of the construct, replicates past relations of HP to poor emotional functioning, and expands the literature to investigate links of HP to emerging adults' decision-making and academic functioning. A sample of 377 emerging adults (66% female; ages 17-30; 88% European American) were administered several items assessing HP as well as measures of other parenting behaviors, depression, anxiety, decision-making style, grade point average, and academic functioning. Exploratory factor analysis results suggested a four-factor, 23-item measure that encompassed varying levels of parental involvement in the personal and professional lives of their children. A bifactor model was also fit to the data and suggested the presence of a reliable overarching HP factor in addition to three reliable subfactors. The fourth subfactor was not reliable and item variances were subsumed by the general HP factor. HP was found to be distinct from, but correlated in expected ways with, other reports of parenting behavior. HP was also associated with poorer functioning in emotional functioning, decision making, and academic functioning. Parents' information-seeking behaviors, when done in absences of other HP behaviors, were associated with better decision making and academic functioning.

Beauty in the eye of the beholder: Using facial electromyography to examine the association between eating disorder symptoms and perceptions of emaciation among undergraduate women.

Thin-ideal internalization, drive for thinness, and over-evaluation of the importance of thinness are associated with eating disorders (EDs). However, little research has examined to what extent perceptions of emaciation are also associated with ED symptoms. In the present study, 80 undergraduate women self-reported on ED symptomatology and perceptions of emaciated, thin, and overweight female bodies. While participants viewed images of these different body types, facial electromyography was used to measure activation of facial muscles associated with disgust reactions. Emaciated and overweight bodies were rated negatively and elicited facial responses consistent with disgust. Further, ED symptomatology was associated with pronounced aversion to overweight bodies (assessed via self-report pleasantness ratings), and attenuated negative affect to emaciated bodies (assessed via facial electromyography). The latter association was significant even when controlling for self-reported perceptions of emaciation, suggesting that psychophysiological methods in ED research may provide valuable information unavailable via self-report.

It's Not Me, It's You: Perceptions of Partner Body Image Preferences Associated With Eating Disorder Symptoms in Gay and Heterosexual Men.

This study explored perceptions of partner body image preferences and symptoms of disordered eating in gay and heterosexual men. Participants were male college students (n = 201; M age = 20.46), and over one third identified as gay. We compared discrepancies between participants' current and ideal body type and participants' current body type and the body type they believed they should have to attract a dating partner. For gay men, the discrepancy between their current body and the body they believed they should have to attract a dating partner was significantly greater than the discrepancy between their current and ideal body types. In gay and heterosexual men, the discrepancy between current body and the body they believed they should have to attract a dating partner predicted eating, shape, and weight concern. Results suggest that perceptions of partner body image preferences may contribute to eating disorder pathology in men.

Dynamics of positive emotion regulation: associations with youth depressive symptoms.

Depression is frequently considered a disorder of impaired affect regulation with deficits across both positive and negative affective systems. However, where deficits in emotion regulation occur in youth, specifically regarding regulation of positive emotions, is relatively unknown. The current study tested whether deficits in broad (felt and expressed) and specific (up-regulation and maintenance) positive emotion processes are associated with youth depressive symptoms. Adolescents (n = 134; 65 girls) in grades 7 to 9 completed a self-report measure of depressive symptoms prior to participating in two parent-child interactions tasks, a rewarding trivia task and a problem-solving conflict task. During the interaction tasks, adolescent's overall self-reported experience and observed expression of positive affect (PA) was examined. Following the reward task, youth's ability to up-regulate PA (PA response) and maintain PA while buffering against NA (PA persistence) was explored observationally. Results suggested that reduced experience and expression of PA was associated with depression symptoms, but only in a context that elicited negative emotions. No association was found between PA response and depression symptoms; however, shorter PA persistence was associated with elevated depressive symptoms. Youth higher in depressive symptoms appear able to respond similarly to rewarding events, but fail to maintain PA and ward off NA when transitioning from a positive to negative task.

Role of adolescent and maternal depressive symptoms on transactional emotion recognition: context and state affect matter.

Depressive symptomatology is associated with impaired recognition of emotion. Previous investigations have predominantly focused on emotion recognition of static facial expressions neglecting the influence of social interaction and critical contextual factors. In the current study, we investigated how youth and maternal symptoms of depression may be associated with emotion recognition biases during familial interactions across distinct contextual settings. Further, we explored if an individual's current emotional state may account for youth and maternal emotion recognition biases. Mother-adolescent dyads (N = 128) completed measures of depressive symptomatology and participated in three family interactions, each designed to elicit distinct emotions. Mothers and youth completed state affect ratings pertaining to self and other at the conclusion of each interaction task. Using multiple regression, depressive symptoms in both mothers and adolescents were associated with biased recognition of both positive affect (i.e., happy, excited) and negative affect (i.e., sadness, anger, frustration); however, this bias emerged primarily in contexts with a less strong emotional signal. Using actor-partner interdependence models, results suggested that youth's own state affect accounted for depression-related biases in their recognition of maternal affect. State affect did not function similarly in explaining depression-related biases for maternal recognition of adolescent emotion. Together these findings suggest a similar negative bias in emotion recognition associated with depressive symptoms in both adolescents and mothers in real-life situations, albeit potentially driven by different mechanisms.