Psycho-social sufferings and sexual difficulties among female survivors of child sexual abuse in Pakistan.

BACKGROUND: Child sexual abuse is a universal social challenge and the victims of childhood sexual abuse suffer a range of short and long term psychological, social, behavioral and physical problems that vary in different cultures. The study was carried out to explore the perceived impacts of childhood sexual abuse in Pakistan, because no such study was conducted in Pakistan earlier. METHODS: Interpretative phenomenological analysis was used to analyze the data. A snowball sampling technique was used to approach the sample of current study. The sample of the study comprised ten female survivors of childhood sexual abuse of age ranged between 18 and 22 years (Mage= 20.10 years) with the education ranging from matric to BSc. Out of these participants, four were married and six were unmarried and belonged to different cities of Punjab, Pakistan. Data were collected via a semi-structured interview schedule and all interviews were verbatim transcribed. RESULTS: A rigorous iterative process of data analysis resulted in three super-ordinate themes and ten sub-ordinate themes: Experiencing Abuse (emotional trauma, and physical distress), Psycho-social Distress (low self-esteem, negative self-concept, psychological pain, social suffering, and retaliation vs. forgiveness), and Sexual Difficulties (passive role, emotionally aloof, aversion from hetero-sexuality and avoidance). CONCLUSION: It was concluded that childhood sexual abuse is an intense experience that has short- and long-term negative impacts on the lives of female survivors and engulfs their lives as a whole. The study has implications for psychiatrists, psychologists, family counselors, social scientists, educationists, and parents.

Social Distress among Cancer Patients: Differential Effects of Risk Factors and Attenuating Role of Culturally Specific Social Support.

Introduction: We investigated the association between social distress or toxicity and patients' clinical conditions, demographic characteristics, and social support and networks, and whether this association differs along the distribution of patients' distress levels. This study included 156 patients treated at King Abdulaziz Medical City, Riyadh, Saudi Arabia. Methods: We used the previously validated Social Toxicity Assessment Tool in Cancer (STAT-C) to assess cancer patients' distress. We analyzed distress level, the outcome variable of interest, and covariates to show distribution and identify associations. We then used logistic quantile regression for bounded outcomes to assess the association between social distress or toxicity and patients' clinical conditions, demographic characteristics, and social support and network. As an extension, we examined the interaction between disease status and social support, focusing on the moderating role of social support in attenuating the impact of disease status on social distress. Results: The median age of the patients was 51.2 (SD = 21.4, range 22 to 89), with 48.1% being older than 50 years. Of the 156 cancer patients analyzed, 82 (52.6%) were classified as burdened, and 50% of those with uncontrolled disease status were socially distressed. However, there were more socially distressed patients diagnosed within a year and patients undergoing treatment. There was a greater number of patients who shared their diagnosis with family, colleagues, and neighbors with social distress. The odds of suffering from social distress were higher in younger patients (50 years or younger) than in older patients. Social distress was lower in patients who underwent combined chemotherapy, surgery, and radiation compared with patients who received a single treatment regimen (OR = 0.65, CI, -0.820 to -0.036, p = 0.033). The odds of social distress were 67% higher in patients diagnosed within one year than in patients diagnosed more than one year prior (OR = 1.664, CI, 0.100-0.918, p = 0.015). Patients with uncontrolled disease conditions who shared their diagnosis and treatment with social networks were 48% less likely to experience social distress. Thus, sharing cancer diagnoses with social networks has a statistically significant moderating effect by attenuating the impact of disease status on social distress. Conclusion: Understanding the risk factors for social distress may be important for cancer management. Additionally, identifying the moderating role that patients' sharing of cancer diagnoses in social networks plays in attenuating the impact of disease status on social distress may provide healthcare providers with valuable insights for holistic culture-specific care.

Autistic traits predict social avoidance and distress: The chain mediating role of perceived stress and interpersonal alienation.

Social avoidance and distress are the primary aspects of social anxiety. Nonautistic people with high levels of autistic traits are more likely to exhibit social avoidance and distress. However, research has yet to reveal how autistic traits induce social avoidance and distress. To fill this gap, the present study recruited 708 participants to complete the 25-item Autism Spectrum Quotient, Social Avoidance and Distress Scale, Chinese Perceived Stress Scale, and Interpersonal Alienation Subscale. The results indicated that autistic traits significantly predicted social avoidance and distress in nonautistic people. In addition, autistic traits induced social avoidance and distress through perceived stress and interpersonal alienation, respectively. Importantly, perceived stress and interpersonal alienation (including the subdimensions of interpersonal alienation: sense of loneliness, sense of social isolation, and alienation between family members) partially mediated the relationships between autistic traits and social avoidance and distress. Overall, autistic traits predict social avoidance and distress via perceived stress and interpersonal alienation. This finding extends the hypothetical model of clinical anxiety in autism spectrum disorders. Furthermore, reducing perceived stress and interpersonal alienation in nonautistic people with high levels of autistic traits may be a valid intervention method to prevent and eliminate their social avoidance and distress.

The positive significance of government-organized nationwide sports events in the post-epidemic era: The impact on citizens' psychological well-being, mindfulness level, and social avoidance distress / La importancia positiva de los eventos deportivos nacionales organizados por el gobierno en la era post-epidemia: el impacto en el bienestar psicológico, el nivel de atención plena y la angustia por evitación social de los ciudadanos

Based on the nationwide sports event "Health Walk" held in Ji'an City, we divided the subjects into sports participation group and non-sports participation group to investigate the differences between the two groups in social avoidance and distress, psychological well-being, and mindfulness level. We also examined the mediating role of mindfulness and social avoidance and distress in whether to participate in sports activities and psychological well-being. In addition, we investigated citizens' approval of the government and their city, and collected basic information about the subjects. We used a 2 (sports participation, non-sports participation) * 2 (high social avoidance and distress, low social avoidance and distress) * 2 (high mindfulness level, low mindfulness level) mixed design. We measured the subjects using Watson's Social Avoidance and Distress Scale, the short version of Ryff's Psychological Well-Being Questionnaire, the Chinese Short Version of the Five-Dimensional Mindfulness Scale, and general survey questionnaires. SPSS 27.0 and the PROCESS plug-in were used to process and analyze the data through descriptive statistics, independent sample t-tests, correlation analysis and mediation effect tests. The results showed that there were significant differences in social avoidance, distress, and mindfulness levels in whether to participate in sports activities (ps <0.001). Whether to participate in sports activities and psychological well-being were significantly correlated with mindfulness (t = 0.368, p <0.001; t = 0.250, p <0.01), and were significantly correlated with social avoidance and distress (t = -0.307, p <0.001; t = -0.443, p <0.001). Mindfulness and social avoidance fully mediated the influence of sports participation on psychological well-being (ps <0.001).(AU)

Disrupting times in the wake of the pandemic: Dispositional time attitudes, time perception and temporal focus.

Introduction: The COVID-19 pandemic has majorly disrupted many aspects of people's lives, provoking psychosocial distress among students. People's positive and negative attitudes towards the past, present and future were a dispositional pre-COVID-19 reality. Faced with a pandemic, people have reported disruptions in the speed of passing time. People can shift their attention more towards the past, present or future when major changes in society occur. These aspects of psychological time would be key to understanding the quality of psychosocial adjustment to the pandemic. We hypothesized that dispositional time attitudes impact psychosocial distress because they would trigger situational changes in our time perception and temporal focus. Methods: One hundred and forty-four university students in Uruguay responded to self-report questionnaires online while in-person classes were cancelled. Students reported on shifts in temporal focus, changes in time awareness and dispositional time attitudes. Reactive psychological, social and learning environment distress were reported. Results: Students reported substantial changes in time perception and temporal focus. A correlation matrix showed significant relationships between time attitudes, focus and awareness. For example, psychological distress was correlated with negative time attitudes, slower passage of time, boredom, blurred sense of time and shifting focus to the past. Mediation models were derived. The indirect effect of time attitudes on psychological distress was significant through past focus. Discussion: Dispositional time attitudes would impact students' capacity to cope with the pandemic. Situational shifts in temporal focus and perception were prevalent and can be viewed as temporal coping mechanisms in the wake of powerful societal change. Our mediation models showed that those with negative time attitudes experienced more psychological distress because they shifted their attention to the past. Future directions for research and practical implications are discussed.

Relationship between Late Effects and Social Distress in Head and Neck Cancer Survivors More Than One Year After Radiation Therapy

Purpose: To investigate the relationship between late effects and social distresses in head and neck cancer survivors more than one year after radiotherapy. Method: An existing subset of head and neck cancer-specific quality of life scale was used to assess late effects and social distresses in survivors who had completed radiotherapy for more than 1 year. Descriptive statistics were performed for each social distresses and symptom, and were analyzed their association. Results: Seventy-three people responded to the survey. All patients had some symptoms. The most prevalent and severe late effect was dry mouth (79.5%). In addition, the most prevalent social distress was trouble with social eating (87.7%), and the most severe was speech problems. There was a significant positive correlation between late effects and social distresses. Social distresses were associated with dysphagia and sticky saliva and a history of surgery. Conclusion: Head and neck cancer survivors may have multiple late effects and social distresses at the same time, and there are a need for a comprehensive assessment of the impact of symptoms in the outpatient setting.

Vulnerability of personality disorder during COVID-19 crises: a multicenter survey of mental and social distress among patients referred to treatment.

BACKGROUND: Relational and emotional problems, dysregulation, self-harming or substance abuse often characterize personality disorders (PD). In Norway, COVID-19 restrictions led to an abrupt shutdown of services from 12 March 2020 also including specialized PD treatments. AIMS: The objective of this study was to investigate social and mental distress among patients with PDs during the first COVID-19 wave. DESIGN: A survey was distributed after the first COVID-19 wave (June-October 2020) among 1120 patients from 12 PD treatment units. RESULTS: The response rate was 12% (N = 133). The survey reflected impairment of occupational activity (53% <50% activity last 6 months), life quality (EQ-5D-VAS: 56, SD 19), and personality functioning (LPFS-BF ≥12: 81%, 35% avoidant PD, 44% borderline PD) and high levels of depression and anxiety (PHQ-9 ≥ 10: 84%, GAD-7 ≥ 10: 68%), 49% with health-related anxiety. Problem increase was reported for anxiety (28%), depression (24%), aggression (23%), substance use (14%), and 70% of parents had more child-care difficulties. Self-destructive behaviors (26%) did not increase. The majority (78%) reported increased or unchanged social isolation and loneliness. Occupational activity declined with negative effects on part-time jobs/rehabilitation. Therapist contact was mainly telephone-based (63% ≥ weekly contact). More severe personality problems, current depressive symptoms, and self-harming before 12 March were associated with more frequent consultations. CONCLUSION: The survey confirms severe, enhanced levels of mental distress among patients receiving telephone-based consultations as the main alternative to specialized PD treatment during the COVID-19 shutdown. The most vulnerable patients received more frequent consultations and self-destructive actions did not increase.

Social distress among medical oncologists and other healthcare professionals during the first wave of COVID-19 pandemic in Italy.

BACKGROUND: Coronavirus disease 2019 (COVID-19) has rapidly spread to every country around the world taking on pandemic proportions. Since 8 March 2020, the Italian government ordered a nationwide lockdown with unavoidable social isolation. Healthcare professionals (HCPs) represent the most physically and emotionally involved category. The aim of this study is to assess the social distress among HCPs in Italy. PATIENTS AND METHODS: In this online, totally anonymous survey, 24 multiple choice questions were posed to medical staff employed in the Italian Healthcare System during the COVID-19 pandemic. Data collection was performed from 30 March to 24 April 2020. RESULTS: A total of 600 HCPs completed the questionnaire. The majority of respondents expressed the fear of being at higher risk of contagion than the general population (83.3%) and the weighty concern of infecting their families (72.5%). An insufficient supply of personal protective equipment (PPE; P = 0.0003) and inadequate training about procedures to follow (P = 0.0092) were seen to significantly coincide with these worries. More than two-thirds declared a change in family organisation, which showed a significant correlation with the concern of infecting their relatives (P < 0.0001). CONCLUSIONS: This is the first Italian survey on social distress among HCPs during the COVID-19 pandemic. The unavailability of PPE, screening procedures and adequate training strongly affected HCPs' emotional status. Although there was a predominance of oncologists (especially from the North of Italy), which impairs the generalisation of our findings, this survey underlined the social impact that this health emergency has had on HCPs.

Employability and Job Insecurity: The Role of Personal Resources on Work-Related Stress.

This study is aimed to assess the effect of both employability and personal resources, in terms of pro-activity and self-efficacy, on the relationship between job insecurity and psycho-social distress. Using survey data from 211 participants, among employed, unemployed and workers in transition, we analyzed the incidence of employability, pro-activity and self-efficacy on psycho-social distress. Our results showed that the above-mentioned variables significantly differed by participants' gender and age. The structural theoretical model proposed to assess the significance of the hypothesized paths exhibited good fit with the data. Thus, all our hypotheses were supported. Findings are in line with previous research, and practical implications may give significant effects when applied in new labor policies undertaken by local governments.

Status of social avoidance and distress in emerging adults with Type 1 diabetes mellitus and its association with self-management and glycemic control. / 成人初显期1åž‹ç³–å°¿ç— æ‚£è€ ç¤¾äº¤å›žé¿ä¸Žè‹¦æ¼çŽ°çŠ¶åŠå ¶ä¸Žè‡ªæˆ‘ç®¡ç†æ°´å¹³å’Œè¡€ç³–æŽ§åˆ¶çš„ç›¸å ³æ€§.

OBJECTIVE: Emerging adult patients with Type 1 diabetes mellitus (T1DM) appear to have a reduced opportunities on learning and exercise, a decreased skill in learning and work, a lower degree of social support due to fear and avoidance of social interaction. This study aimed to assess the level of social avoidance and distress in emerging adults with T1DM, and to explore the correlation between social avoidance and distress and self-management or glycemic control. METHODS: A total of 342 T1DM patients aged 18-30 years old were recruited from 8 tertiary hospitals in Hunan Province from September 2014 to February 2019. The questionnaire included general information questionnaire, the Social Avoidance and Distress Scale (SAD), and Self-management Scale of Type 1 Diabetes for Chinese Adults (SMOD-CA). The total scores of SAD in emerging adult patients with T1DM were compared with those of norm. Correlation between glycated hemoglobin (HbA1c) and social avoidance and distress of emerging adult patients with T1DM was analyzed. RESULTS: The total score of SAD (11.13±6.18) in emerging adults with T1DM was significantly higher than that in healthy adults (t=77.06, P<0.01). Pearson correlation analysis showed that the scores of SAD, social avoidance subscale, and social distress subscale were negatively correlated with the scores of SMOD-CA (all P<0.01), and they were positively correlated with HbA1c (all P<0.01). Multivariate linear regression analysis showed that social avoidance and distress, self-management, gender, and educational level were independent influential factors for HbA1c in emerging adults with T1DM. CONCLUSION: The degree of social avoidance and distress of emerging adult patients with T1DM is higher than that of healthy people. The higher the degree of social avoidance and distress, the lower the level of self-management and the worse the control of blood sugar. Attention should be paid to social avoidance and distress in emerging adults with T1DM, and targeted interventions should be formulated.

What drives distress? Rethinking the roles of emotion and diagnosis among people with diabetes in Nairobi, Kenya.

Type 2 diabetes mellitus is a condition that both results from and produces social and psychological suffering. As 'diabetes' increases among low income patients in poorer nations, new challenges arise that drive, co-occur, and result from the condition. In this article, we describe how social suffering produces diabetes by way of addressing the varied social, psychological, and biological factors that drive diabetes and are reflected in diabetes experiences among patients seeking care at a public hospital in Nairobi, Kenya. We recruited a non-probability sample to participate in a cross-sectional study of 100 patients (aged 35-65 years), where half of the participants sought care from a diabetes clinic and half sought care from the primary healthcare clinic. We obtained informed consent in writing, and collected life history narratives, surveys, anthropometrics, and biomarkers. This paper evaluates survey data using frequencies and regression tables. We found that social factors as opposed to disease factors were major drivers of psychological distress among those with and without diabetes. Psychological distress was associated with female gender and feelings of financial and personal insecurity. We also found insulin resistance was common among those undiagnosed with diabetes, suggesting that many seeking primary care for other health conditions did not receive a routine diabetes test (most likely because it is an out-of-pocket cost, or other competing social factors) and therefore delayed their diagnosis and care. Thus, social and economic factors may drive not only emotional distress among people with diabetes but also delayed care seeking, testing, and self-care as a result of cost and other social challenges.

Status of social avoidance and distress in emerging adults with Type 1 diabetes mellitus and its association with self-management and glycemic control / 中南大学学报(医学版)

: Emerging adult patients with Type 1 diabetes mellitus (T1DM) appear to have a reduced opportunities on learning and exercise, a decreased skill in learning and work, a lower degree of social support due to fear and avoidance of social interaction. This study aimed to assess the level of social avoidance and distress in emerging adults with T1DM, and to explore the correlation between social avoidance and distress and self-management or glycemic control. : A total of 342 T1DM patients aged 18-30 years old were recruited from 8 tertiary hospitals in Hunan Province from September 2014 to February 2019. The questionnaire included general information questionnaire, the Social Avoidance and Distress Scale (SAD), and Self-management Scale of Type 1 Diabetes for Chinese Adults (SMOD-CA). The total scores of SAD in emerging adult patients with T1DM were compared with those of norm. Correlation between glycated hemoglobin (HbA1c) and social avoidance and distress of emerging adult patients with T1DM was analyzed. : The total score of SAD (11.13±6.18) in emerging adults with T1DM was significantly higher than that in healthy adults (=77.06, <0.01). Pearson correlation analysis showed that the scores of SAD, social avoidance subscale, and social distress subscale were negatively correlated with the scores of SMOD-CA (all <0.01), and they were positively correlated with HbA1c (all <0.01). Multivariate linear regression analysis showed that social avoidance and distress, self-management, gender, and educational level were independent influential factors for HbA1c in emerging adults with T1DM. : The degree of social avoidance and distress of emerging adult patients with T1DM is higher than that of healthy people. The higher the degree of social avoidance and distress, the lower the level of self-management and the worse the control of blood sugar. Attention should be paid to social avoidance and distress in emerging adults with T1DM, and targeted interventions should be formulated.

Outcome measurement and complex physical, psychosocial and spiritual experiences of death and dying.

Patients with advanced illnesses, especially near the end of life, often experience multiple complex symptoms which may have profound impact on the quality of life of not only the patients but also their family members. Early and prompt recognition of such clinical challenges is linked with better end of life care for the dying patients, their caregivers and family members. In this narrative, which is not meant to be an in-depth systematic review, we attempt to provide an overview of some commonly used outcome measurement tools available for bedside clinical assessment of the different dimensions of suffering, especially near the time of death. We also mention need for recognition of conditions, like delirium and other personal, environmental and social factors, to draw the readers' attention towards the importance of such assessments, as these may influence interpretation of patient responses on the tools being used to measure outcomes.

Oxytocin receptor gene polymorphisms (rs53576) and early paternal care sensitize males to distressing female vocalizations.

The oxytocinergic system is highly involved in social bonding and early caregiver-infant interactions. Here, we hypothesize that oxytocin receptor (OXTR) gene genotype and parental bonding history interact in influencing social development. To address this question, we assessed adult males' arousal (heart rate changes) in response to different distress vocalizations (human female, human infant and bonobo). Region rs53576 of the OXTR gene was genotyped from buccal mucosa cell samples, and a self-report Parental Bonding Instrument was used (which provide information about parental care or parental overprotection). A significant gene-environment interaction between OXTR genotype and parenting style was found to influence participants' social responsivity to female cry vocalizations. Specifically, a history of appropriate paternal care in participants accentuated the heightened social sensitivity determined by G/G homozygosity, while higher versus lower paternal overprotection lead to distinct levels of physiological arousal particularly in A carriers individuals. These results add to our understanding of the dynamic interplay between genetic susceptibility and early environmental experience in shaping the development of appropriate social sensitivity in males.

Dataset on genetic and physiological adults׳ responses to social distress.

Both expectations towards interactions with conspecifics, and genetic predispositions, affect adults׳ social behaviors. However, the underlying mechanisms remain largely unknown. Here, we report data to investigate the interaction between genetic factors, (oxytocin receptor (OXTR) and serotonin transporter (5-HTTLPR) polymorphisms), and adult interactional patterns in shaping physiological responses to social distress. During the presentation of distress vocalizations (cries of human female, infants and bonobos) we assessed participants׳ (N = 42 males) heart rate (HR) and peripheral nose temperature, which index state of arousal and readiness to action. Self-reported questionnaires were used to evaluate participants' interactional patterns towards peers (Attachment Style Questionnaire, Feeney et al., 1994[1]), and the quality of bond with intimate partners (Experiences in Close Relationships Scale, Fraley et al., 2000 [2]). To assess participants׳ genetic predispositions, the OXTR gene (regions rs53576, and rs2254298) and the 5-HTTLPR gene (region SLC6A4) were genotyped. The data set is made publicly available to enable critical or extended analyzes.

Serotonin Transporter Gene Polymorphisms and Early Parent-Infant Interactions Are Related to Adult Male Heart Rate Response to Female Crying.

Adults' adaptive interactions with intimate partners enhance well-being. Here we hypothesized that adult males' physiological responses to opposite-sex conspecifics' distress result from an interaction between an environmental factor (early social interaction with caregivers) and a genetic factor (a polymorphism within the promoter region of the serotonin transporter gene, 5-HTTLPR). We assessed heart rate changes in 42 non-married male adults to distress vocalizations (female, infant, and bonobo cries). Males' early interaction with parents was assessed using the Parental Bonding Instrument. Buccal mucosa cell samples were collected to assess their 5-HTTLPR genotype. A significant interaction emerged between early experience and genetic predisposition. Males with a genetic predisposition for higher sensitivity to environmental factors showed atypical physiological responses to adult female cries according to their experienced early maternal parenting. Environmental experiences and genetic characteristics are associated with adult males' physiological responses to socially meaningfully stimuli. Understanding the mechanisms that modulate responses to opposite-sex conspecifics may improve personal well-being and social adaptiveness.

Genetic predispositions and parental bonding interact to shape adults' physiological responses to social distress.

Parental bonding and oxytocin receptor (OXTR) gene genotype each influences social abilities in adulthood. Here, we hypothesized an interaction between the two - environmental experience (parental bonding history) and genetic factors (OXTR gene genotype) - in shaping adults' social sensitivity (physiological response to distress). We assessed heart rate and peripheral temperature (tip of the nose) in 42 male adults during presentation of distress vocalizations (distress cries belonging to female human infants and adults as well as bonobo). The two physiological responses index, respectively, state of arousal and readiness to action. Participants' parental bonding in childhood was assessed through the self-report Parental Bonding Instrument. To assess participants' genetic predispositions, buccal mucosa cell samples were collected, and region rs2254298 of the oxytocin receptor gene was analyzed: previous OXTR gene findings point to associations between the G allele and better sociality (protective factor) and the A allele and poorer sociality (risk factor). We found a gene * environment interaction for susceptibility to social distress: Participants with a genetic risk factor (A carriers) with a history of high paternal overprotection showed higher heart rate increase than those without this risk factor (G/G genotype) to social distress.Also, a significant effect of the interaction between paternal care and genotype on nose temperature changes was found. This susceptibility appears to represent an indirect pathway through which genes and experiences interact to shape mature social sensitivity in males.

Validation and Cross-Cultural Adaptation of a Chinese Version of the Emotional and Social Dysfunction Questionnaire in Stroke Patients.

The objectives of this study were to develop a cross-cultural Chinese version of the Emotional and Social Dysfunction Questionnaire (ESDQ-C) and test its validity and reliability among Chinese-speaking stroke patients. Various methods were used to develop the ESDQ-C. A cross-sectional study was used to examine the validity and reliability of the developed questionnaire, which consists of 28 items belonging to six factors, anger, helplessness, emotional dyscontrol, indifference, inertia and fatigue, and euphoria. Satisfactory convergence and known-group validities were confirmed by significant correlations of the ESDQ-C with the Profile of Mood States-Short Form ( p < .05) and with the Hospital Anxiety and Depression Scale ( p < .05). The internal consistency was represented by Cronbach's alpha, which was .96 and .79 to .92 for the entire scale and subscales, respectively. Appropriate application of the ESDQ-C will be helpful to identify critical adjustment-related types of distress and patients who experience difficulty coping with such distress.

Exploring domestic violence and social distress in Australian-Indian migrants through community theater.

In many parts of the world, young adult women have higher levels of common mental disorders than men. The exacerbation of domestic violence (DV) by migration is a salient social determinant of poor mental health. Ecological models describe factors contributing to DV as operating at individual, family, cultural, and societal levels. We explored the interplay among these factors in an Indian community living in Melbourne, Australia, in a qualitative participatory action research study using a modified Forum Theater approach. We here present findings on connections between migration, societal factors, and social/family/cultural factors in DV. The study captured the voices of women living in the community as they describe how DV contributes to their emotional difficulties. Improved understanding of the sociocultural dynamics of DV and the associated social distress in this migrant Indian community can be used to guide the development of culturally sensitive prevention and response programs to assist migrant women from the Indian subcontinent who present with psychopathology and suicidal behaviors associated with DV.

Neural activation during anticipated peer evaluation and laboratory meal intake in overweight girls with and without loss of control eating.

The interpersonal model of loss of control (LOC) eating proposes that socially distressing situations lead to anxious states that trigger excessive food consumption. Self-reports support these links, but the neurobiological underpinnings of these relationships remain unclear. We therefore examined brain regions associated with anxiety in relation to LOC eating and energy intake in the laboratory. Twenty-two overweight and obese (BMIz: 1.9±0.4) adolescent (15.8±1.6y) girls with LOC eating (LOC+, n=10) and without LOC eating (LOC-, n=12) underwent functional magnetic resonance imaging (fMRI) during a simulated peer interaction chatroom paradigm. Immediately after the fMRI scan, girls consumed lunch ad libitum from a 10,934-kcal laboratory buffet meal with the instruction to "let yourself go and eat as much as you want." Pre-specified hypotheses regarding activation of five regions of interest were tested. Analysis of fMRI data revealed a significant group by peer feedback interaction in the ventromedial prefrontal cortex (vmPFC), such that LOC+ had less activity following peer rejection (vs. acceptance), while LOC- had increased activity (p<.005). Moreover, functional coupling between vmPFC and striatum for peer rejection (vs. acceptance) interacted with LOC status: coupling was positive for LOC+, but negative in LOC- (p<.005). Activity of fusiform face area (FFA) during negative peer feedback from high-value peers also interacted with LOC status (p<.005). A positive association between FFA activation and intake during the meal was observed among only those with LOC eating. In conclusion, overweight and obese girls with LOC eating may be distinguished by a failure to engage regions of prefrontal cortex implicated in emotion regulation in response to social distress. The relationship between FFA activation and food intake supports the notion that heightened sensitivity to incoming interpersonal cues and perturbations in socio-emotional neural circuits may lead to overeating in order to cope with negative affect elicited by social discomfort in susceptible youth.