Positive Schemas, Coping, and Quality of Life in Pediatric Recurrent Abdominal Pain.

Pediatric recurrent abdominal pain is commonly associated with negative impacts on quality of life (QOL). Positive schemas (core beliefs about the self with subthemes of self-efficacy, optimism, trust, success, and worthiness) are a resilience factor that has not yet been examined within a pediatric recurrent pain context. This cross-sectional study examined (a) associations between positive schemas, pain coping, and youth QOL, and (b) exploratory analyses to investigate whether specific positive schema subthemes predicted QOL outcomes in youth with recurrent abdominal pain. Participants were 98 youth with recurrent abdominal pain (i.e., pain related to a disorder of gut-brain interaction [DGBI] or organic cause) who completed measures on positive schemas, QOL, and pain coping. Age and diagnostic status were controlled for in analyses. Positive schemas were significantly positively correlated with emotional, social, school, and overall QOL, as well as with approach and problem-focused avoidant coping, and significantly negatively correlated with emotion-focused coping. Worthiness was the strongest and only significant predictor of youth social functioning. Positive schemas may be an important cognitive resilience factor to consider within interventions for pediatric recurrent pain.

Mental Health and Substance Use of Farmers in Canada during COVID-19.

Farmers in Canada faced higher levels of mental distress than the general public prior to the Coronavirus Disease 2019 (COVID-19) pandemic and are generally less likely than the public to seek help. However, the mental health impacts of COVID-19 on farmers in Canada remain unexplored. Our objective was to investigate mental health outcomes among farmers in Canada by gender and within the context of COVID-19. We conducted a national, online, cross-sectional survey of farmers in Canada (February-May 2021). The survey included validated scales of anxiety, depression, perceived stress, burnout (emotional exhaustion, cynicism, professional efficacy), alcohol use, resilience, and questions regarding participants' perceived changes in these outcomes during the pandemic. Data were also collected on the impact of COVID-19 specific social and economic factors on mental health, help-seeking, and sense of community belonging through the pandemic. Descriptive statistics were summarized, and Chi-square analyses and t-tests were conducted to compare survey results between genders and to data collected in our similar 2016 survey and normative population data. A total of 1167 farmers participated in the survey. Participants scored more severely across scales than scale norms and the general Canadian population during COVID-19. Scale means were consistent between the 2016 and 2021 samples. Most participants with moderate to severe scores for any outcome reported worsening symptoms since the pandemic began. Women fared significantly worse than men across measures. Over twice as many women reported seeking mental health or substance use support during the pandemic than men. Participants rated the mental health impacts of all social and economic factors related to COVID-19 examined significantly (p < 0.05) differently than the Canadian public. The pandemic has negatively impacted the mental health of farmers in Canada and in ways that differ from the general population. National level and gender-specific mental health supports are needed to help improve the mental health of farmers in Canada.

Parent Engagement with an Online, School-Based, Character Strengths Promotion Program.

Schools are increasingly bolstering student character strengths to promote academic success and well-being. Schools' character-promotion efforts would benefit from involving students' caregivers. Online resources may be an accessible way to engage students' families, but further research is needed to maximize accessibility and engagement. A brief character strengths program was developed and integrated within online accounts accessed by parents of kindergarten students. Content analysis of parent focus groups (N = 14, 86% women) indicated that access to and engagement with the program was improved by several factors, including visuals, intuitive navigation, strength-based content, and school-based recruitment. Content analysis of caregivers' (N = 54, 91% women, M age = 36.52, SD age = 4.40) responses to the program's reflection questions indicated that parents prefer highly applicable content, particularly information about noticing and developing character strengths in their child. Finally, exploratory descriptive statistics indicated that single parents, fathers, and parents of racial minority children were less likely to engage with the program which alludes to the additional barriers faced by these socio-demographic groups. The results provide specific suggestions for involving parents in school-based character promotion efforts, as well as highlight the importance of additional research to better understand the needs of diverse families. Supplementary Information: The online version contains supplementary material available at 10.1007/s41042-022-00072-4.

Defining and measuring "psychological flexibility": A narrative scoping review of diverse flexibility and rigidity constructs and perspectives.

Psychological flexibility (PF) is a popular construct in clinical psychology. However, similar constructs have existed since the mid-20th century, resulting in different terms, definitions and measures of flexibility, hindering the advancement of the field. The main measure of PF - the Acceptance and Action Questionnaire (AAQ-II; Bond et al., 2011) - has also been heavily criticized. To move towards definitional consensus and improved measurement, we surveyed the literature to map PF and related-terms, examine definitional overlaps, and assessthe psychometric quality of prominent flexibility measures. A scoping review was conducted in two databases (PsycNET and SCOPUS). Twenty-three flexibility constructs appeared across 220 articles, and twelve measures were included and rated for quality. PF, psychological inflexibility (PI), and cognitive flexibility (CF) were most prominent. Definitional similarities among prominent flexibility constructs emerged, namely handling distress or interference, taking action, and meeting goals or values. The Personalized Psychological Flexibility Index (PPFI; Kashdan, Disabato, Goodman, Doorley, & McKnight, 2020) appears to be the best measure available to assess PF. Problems with the current use of the AAQ-II were apparent, hindering current knowledge of PF. Definitional consensus and measurement development are vital to advance the field. To this end, recommendations and next steps for researchers and practitioners are outlined.

Quality of Life in Youth With Chronic Pain: An Examination of Youth and Parent Resilience and Risk Factors.

OBJECTIVES: Pediatric chronic pain has often been examined from a risk perspective, and relatively less is known about the individual and family-level resilience factors that help youth with chronic pain maintain their quality of life (QOL). This cross-sectional study: (1) examined the relations among purported youth and parent resilience (youth pain acceptance and pain self-efficacy, parent psychological flexibility) and risk (youth pain intensity and parent protectiveness) factors with youth QOL, and (2) tested exploratory statistical mechanisms that may explain relations between parent and youth variables. METHODS: Participants included 122 youth (10 to 17 y; M=14.26, SD=2.19) seen in an interdisciplinary pediatric chronic pain program and a parent. Youth completed measures of their average pain, QOL, pain acceptance, and pain self-efficacy. Parents completed measures of their pain-related psychological flexibility and behavioral responses to pain (ie, protectiveness, distraction, monitoring, minimizing). RESULTS: Youth pain acceptance, pain self-efficacy, and parent psychological flexibility were highly positively correlated with each other, and with overall youth QOL. Evidence for a buffering effect of pain acceptance and pain self-efficacy on the association between pain intensity and QOL was not found. Protectiveness was found to be a significant mediator of the relation between parental psychological flexibility and youth QOL. DISCUSSION: The results are discussed in the context of the resilience-risk framework and current understandings of the role of parental factors for pediatric chronic pain.

A Longitudinal Investigation of Cognitive Self-schemas across Adolescent Development.

Research in developmental psychology highlights youth's self-schemas as one possible pathway to improve adolescents' functioning and promote positive developmental outcomes. Despite this, the trajectory of positive and negative self-schemas is relatively understudied. This study addresses this limitation by empirically examining the trajectory of self-schemas in a community sample of 623 youth (M = 13.04 years; 54% female; 49% African American, 4% Biracial, 47% European American) who were followed over a seven-year period. Caregivers completed measures of parenting practices, maternal rumination and negative inferential style, and adolescents completed a computerized behavioral task assessing self-schemas (i.e., mental frameworks that guide attention, interpretation, and memory of one's experiences). Multilevel growth curve modeling results demonstrated a quadratic slope for negative self-schemas and no mean-level change for positive self-schemas. These trajectories did not vary by gender or racial group. However, parenting factors differentially influenced the trajectories. Specifically, higher levels of parental involvement at baseline, or an active interest and engagement in a child's experiences and activities, related to lower levels of negative self-schemas during adolescence. Additionally, higher levels of parental rumination and parental negative control at baseline related to lower levels of youth positive self-schemas at baseline. These findings contribute to models of youth cognitive development.

An Exploration of Positive Parenting in Relation to Psychopathology for Youth with a Diagnosis of Bipolar Spectrum Disorder.

OBJECTIVE: Bipolar Spectrum Disorder (BSD) is a severe psychiatric disorder associated with a host of deleterious sequelae. While researchers have found a robust link between parenting variables and psychopathology for youth with BSD, few have examined positive parenting factors and associated psychopathology for these youth. Furthermore, conclusions from extant literature are hindered by a) exploring a limited range of parenting variables and b) employing retrospective reports of parenting with adult populations. This study addressed these gaps by examining how a range of contemporaneously-measured positive parenting variables were related to psychopathology among youth with a BSD diagnosis. METHODS: One hundred fifty families with a youth aged 5-16 years participated in this study and completed screening for a mood disorder through a tertiary care facility. Participants completed measures of depression, mania, behavioural difficulties, and the parent-child relationship. RESULTS: Parental characteristics (limit setting, autonomy granting, egalitarian views) were related to lower levels of psychopathology for youth screened for BSD. CONCLUSIONS: Taken together, the results from this study contribute to our understanding of the relation between positive parenting characteristics and psychopathology for youth with a diagnosis of BSD.

OBJECTIF: Le trouble du spectre bipolaire (TSB) est un trouble psychiatrique grave associé à une panoplie de séquelles nuisibles. Même si les chercheurs ont constaté un lien robuste entre les variables de la parentalité et la psychopathologie pour les adolescents souffrant de TSB, peu ont examiné les facteurs parentaux positifs et la psychopathologie associée pour ces adolescents. En outre, les conclusions de la littérature existante sont entravées par a) l'exploration d'une gamme limitée de variables parentales et b) l'emploi d'études rétrospectives de parentalité avec des populations adultes. La présente étude a abordé ces lacunes en examinant comment une gamme de variables parentales positives mesurées simultanément était liée à la psychopathologie chez les adolescents ayant reçu un diagnostic de TSB. MÉTHODES: Cent cinquante familles ayant un enfant de 5 à 16 ans ont participé à cette étude et subi un dépistage du trouble de l'humeur dans un établissement de soins tertiaires. Les participants ont répondu à des mesures de dépression, de manie, de difficultés comportementales, et de la relation parent-enfant. RÉSULTATS: Les caractéristiques parentales (établissement de limites, octroi d'autonomie, points de vue égalitaires) étaient liées à des niveaux plus faibles de psychopathologie pour les adolescents ayant subi un dépistage du TSB. CONCLUSIONS: Dans leur ensemble, les résultats de cette étude contribuent à notre compréhension de la relation entre les caractéristiques parentales positives et la psychopathologie des adolescents ayant reçu un diagnostic de TSB.

Cognitive schemas as longitudinal predictors of self-reported adolescent depressive symptoms and resilience.

Given that depression risk intensifies in adolescence, examining associates of depressive symptoms during the shift from childhood to adolescence is important for expanding knowledge about the etiology of depression symptoms and disorder. A longitudinal youth report was employed to examine the trajectory of both the content and structure of positive and negative schemas in adolescence and also whether these schemas could prospectively predict depressive symptoms and youth-reported resilience. One hundred and ninety-eight participants (aged 9 to 14) were recruited from four schools to complete measures of youth depressive symptoms, resilience, and schema content and structure. Those who consented to a follow-up study completed the same measures online (50 participants completed). Negative and positive schema content and structure were related over time. After controlling depressive symptoms/resilience at Time 1, negative schema content was the only significant predictor (trend level) of depressive symptoms and resilience at Time 2. Implications for cognitive theories and clinical practice are discussed.

The secure base script: associated with early maladaptive schemas related to attachment.

OBJECTIVES: To examine the relations between traditionally assessed early maladaptive schemas and the attachment-specific secure base script (a script-like representation of what individuals expect to happen when they face distress), to inform our understanding of beliefs about the self in relation to others. The present study took an ecologically driven approach, assessing knowledge of the secure base script from descriptions of current relationships. DESIGN: A cross-sectional design was used. METHODS: One hundred forty-six undergraduate students, recruited as part of a larger study on adversity and self-concept, provided narrative descriptions of their current relationships. Narratives were coded for attachment-related 'secure base' content using a secure base script scale for relationship narratives. Early maladaptive schemas were assessed with the Young Schema Questionnaire, and attachment was additionally evaluated using the Experiences in Close Relationships questionnaire. RESULTS: Self-reported attachment avoidance and anxiety were related to secure base script content in theory-consistent ways. The extent to which participants described secure base script content was inversely associated with four out of five maladaptive schemas characterized most centrally by disconnection from others. Furthermore, these associations remained significant when controlling for self-reported attachment style. Self-reported attachment avoidance and anxiety also were related to maladaptive schemas in a predictable pattern. CONCLUSIONS: Results bridge cognitive and attachment theories, supporting the interrelatedness of secure base script knowledge assessed in current relationships, and schema-related content regarding connectedness with others. Better integration of theories regarding internal representations may serve to enrich psychotherapeutic formulation from a variety of clinical perspectives. PRACTITIONER POINTS: Schema Therapy's (Young, Klosko, & Weishaar, 2003 , Schema therapy: A practitioner's guide. New York: Guilford Press) early maladaptive schemas, with themes of disconnection from others/in relationships, are related to the attachment construct of knowledge of a secure base script. Applying secure base script coding procedure to a relationship speech task provides a potentially valuable performance-based tool for evaluating important attachment related constructs in a brief, non-obtrusive format. Better understanding of how self-schema and attachment constructs are associated may be of benefit to case formulation for psychotherapeutic intervention.

Sources of emotional maltreatment and the differential development of unconditional and conditional schemas.

Schema theory posits that experiences of maltreatment result in the early development of maladaptive schemas (EMS; Young, Klosko, & Weishaar, 2003, Schema therapy: A practitioner's guide, The Guilford Press: New York, NY). EMS are organized by conditionality; unconditional schemas are theorized to develop early in childhood predominantly in response to experiences of parenting and conditional schemas are theorized to develop later in life in response to other relationships. Despite this distinction, minimal previous research has investigated their differential development. The current study examined the relative contributions of parental and other (peer and intimate partner) emotional maltreatment (EMT) in the differential development of unconditional and conditional schemas. Ninety-seven undergraduate students retrospectively reported their maltreatment experiences using the Lifetime Experiences Questionnaire and completed the Young Schema Questionnaire to measure EMS. Consistent with hypotheses, parental EMT was the strongest predictor of unconditional schemas. Unexpectedly, parental EMT also emerged as the strongest predictor of conditional schemas. Theoretical and clinical implications of these findings are discussed.

Parent prediction of child mood and emotional resilience: the role of parental responsiveness and psychological control.

Research consistently shows low to moderate agreement between parent and child reports of child mood, suggesting that parents are not always the best predictors of child emotional functioning. This study examines parental responsiveness and psychological control for improving prediction of early adolescent mood and emotional resilience beyond parent report of child emotional functioning. Participants were 268 early adolescents administered measures of depression symptoms, emotional resilience, and perceptions of parenting. Parents of participating youth completed measures of youth emotional functioning. Parental responsiveness and psychological control each emerged as family variables that may be of value for predicting child emotional functioning beyond parent reports. Specifically, responsiveness explained significant variance in child depression and resilience after accounting for parent reports, while parental psychological control increased prediction of child mood alone. Results generally suggest that parenting behaviours may be an important consideration when children and parents provide discrepant reports of child emotional well-being. Conceptual and clinical implications of these results are discussed.

Stress generation in adolescent depression: the moderating role of child abuse and neglect.

The present study examined the role of childhood abuse and neglect and depression recurrence in moderating the generation of stressful life events in adolescent depression. Maltreatment history and stressful life events were assessed using two rigorous contextual interviews and rating systems. In a sample of 59 community depressed adolescents we found significantly higher rates of interpersonal events in the 3-month period immediately following depression episode onset versus the 3-month period immediately preceding onset in adolescents with a history of childhood maltreatment. By contrast, rates of events remained constant over a matched period in a control group of non-maltreated adolescents. Furthermore, the generation of interpersonal events only held among those on a first onset of depression. These results suggest that a history of childhood abuse and neglect exacerbates the psychosocial dysfunction associated with the onset of depression, particularly in the very first episode.

The role of childhood abuse and neglect in the sensitization to stressful life events in adolescent depression.

This study examined the role of childhood abuse and neglect in sensitizing adolescents to the effects of proximal stressful life events in a cross-sectional sample of 103 depressed and nondepressed adolescents. Consistent with hypotheses, adolescents with a history of childhood abuse and/or neglect reported a lower level of threat of stressful life events prior to episode onset than that reported by those without. This effect was specific to those on their 1st episode of depression and was specific to independent events (i.e., stressors outside of adolescents' control). Further, this effect was robust when controlling for level of chronic difficulties, which was higher in those with childhood abuse and/or neglect. The authors suggest that childhood abuse and/or neglect may be an important risk factor that sensitizes individuals to the effects of acute independent life events.