Publications by authors named "Joanna Herres"

28 Publications

  • Page 1 of 1

Outcomes of Visual Self-Expression in Virtual Reality on Psychosocial Well-Being With the Inclusion of a Fragrance Stimulus: A Pilot Mixed-Methods Study.

Front Psychol 2020 8;11:589461. Epub 2020 Dec 8.

Department of Psychology, The College of New Jersey, Ewing Township, NJ, United States.

Aims: In this pilot mixed-methods study, we examined the participants experiences of engaging in virtual drawing tasks and the impact of an olfactory stimulus (calming fragrance blend) on outcomes of affect, stress, self-efficacy, anxiety, creative agency, and well-being (satisfaction with life).

Methods: This study used a parallel mixed-methods, simple block randomization design. The study participants included 24 healthy adults aged 18 to 54 years, including 18 women and six men. The participants completed two 1-h immersive virtual art making sessions and were randomly assigned to receive either a fragrance or a non-fragrance condition for the first session. Quantitative (standardized self-report measures) and qualitative (open-ended survey responses and virtual artwork) datasets were collected concurrently and integrated during data analysis.

Results: The quantitative results indicated that the fragrance condition demonstrated a significant reduction in negative affect (e.g., feeling hostile, jittery, upset, distressed, etc.), namely, reduced feelings of negativity when compared to the non-fragrance condition. A trend toward improvement in self-efficacy was also seen in the fragrance condition. No significant changes were found for fragrance or non-fragrance conditions for positive affect, anxiety, and creative agency. The qualitative findings included five themes related to art making experiences in virtual reality in both conditions: fun and joy; novelty of virtual media, experimentation, and play; relaxation and calm; learning curve; and physical discomfort and disorientation. Four themes were identified for virtual art content and visual qualities: nature imagery, references to memories and personal symbols, fantasy and play within imagery, and depiction of everyday objects.

Conclusions: Overall, the participants reported positive responses to the novel virtual art making experiences which were further heightened by the inclusion of the fragrance stimulus for negative affect. These preliminary findings need to be replicated with larger sample sizes to confirm the outcomes and the trends that were seen in this pilot study. Further research is recommended to examine the differences between experiences of virtual and traditional art media and to examine different olfactory stimuli promoting focus and concentration.
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http://dx.doi.org/10.3389/fpsyg.2020.589461DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7793948PMC
December 2020

Prior Day Negative Affect Influences Current Day Procrastination: A Lagged Daily Diary Analysis.

Anxiety Stress Coping 2020 03 3;33(2):165-175. Epub 2020 Feb 3.

Psychology Department, The College of New Jersey, Ewing, New Jersey, USA.

Procrastination is a common problem among college students. Negative affect associated with stress and anxiety is linked to higher levels of procrastination. Although there is a relationship between procrastination and affect, little is known about the direction of this relationship. The current study explored whether changes in daily negative affect (NA) or positive affect (PA) preceded procrastination or whether procrastination preceded changes in affect. The current study is a secondary data analysis of a larger study. After completing an initial survey assessing students' emotional well-being, students were asked to participate in a follow-up daily diary survey. Participants in the daily diary (= 53) completed a brief survey each weekday evening for two weeks that assessed daily affect and events. Multilevel regression tested whether NA and PA predicted next-day procrastination and vice versa. : Cross-lag panel analysis demonstrated that students reported more procrastination following days they experienced higher levels of NA. However, procrastination did not predict changes in NA. PA was not associated with prior day or next day procrastination experiences when controlling for NA. : These findings demonstrate that negative emotions motivate procrastination behavior. Implications for helping students cope with and regulate NA are discussed.
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http://dx.doi.org/10.1080/10615806.2020.1722573DOI Listing
March 2020

Prior Day Negative Affect Influences Current Day Procrastination: A Lagged Daily Diary Analysis.

Anxiety Stress Coping 2020 03 3;33(2):165-175. Epub 2020 Feb 3.

Psychology Department, The College of New Jersey, Ewing, New Jersey, USA.

Procrastination is a common problem among college students. Negative affect associated with stress and anxiety is linked to higher levels of procrastination. Although there is a relationship between procrastination and affect, little is known about the direction of this relationship. The current study explored whether changes in daily negative affect (NA) or positive affect (PA) preceded procrastination or whether procrastination preceded changes in affect. The current study is a secondary data analysis of a larger study. After completing an initial survey assessing students' emotional well-being, students were asked to participate in a follow-up daily diary survey. Participants in the daily diary (= 53) completed a brief survey each weekday evening for two weeks that assessed daily affect and events. Multilevel regression tested whether NA and PA predicted next-day procrastination and vice versa. : Cross-lag panel analysis demonstrated that students reported more procrastination following days they experienced higher levels of NA. However, procrastination did not predict changes in NA. PA was not associated with prior day or next day procrastination experiences when controlling for NA. : These findings demonstrate that negative emotions motivate procrastination behavior. Implications for helping students cope with and regulate NA are discussed.
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http://dx.doi.org/10.1080/10615806.2020.1722573DOI Listing
March 2020

Identifying Risk Factors for Disordered Eating among Female Youth in Primary Care.

Child Psychiatry Hum Dev 2019 10;50(5):727-737

Center for Family Intervention Science, Drexel University, Philadelphia, PA, USA.

Eating disorders are a serious, life-threating condition impacting adolescents and young adults. Providers in primary care settings have an important role in identifying disordered eating (DE) symptoms. Unfortunately, symptoms go undetected in 50% of patients in medical settings. Using the behavioral health screen, this study identified DE risk profiles in a sample of 3620 female adolescents and young adults (ages 14-24), presenting in primary care. A latent class analysis with twenty psychosocial factors identified three DE risk groups. The group at highest risk for DE was characterized by endorsement of internalizing symptoms and a history of trauma. The next risk group consisted of those with externalizing symptoms, particularly substance use. The group at lowest risk for DE reported more time spent with friends compared to their peers. Primary care providers and psychiatric teams can benefit from knowing the psychosocial risk patterns affiliated with DE, and using brief, comprehensive screening tools to identify these symptoms.
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http://dx.doi.org/10.1007/s10578-019-00875-8DOI Listing
October 2019

Identifying Risk Factors for Disordered Eating among Female Youth in Primary Care.

Child Psychiatry Hum Dev 2019 10;50(5):727-737

Center for Family Intervention Science, Drexel University, Philadelphia, PA, USA.

Eating disorders are a serious, life-threating condition impacting adolescents and young adults. Providers in primary care settings have an important role in identifying disordered eating (DE) symptoms. Unfortunately, symptoms go undetected in 50% of patients in medical settings. Using the behavioral health screen, this study identified DE risk profiles in a sample of 3620 female adolescents and young adults (ages 14-24), presenting in primary care. A latent class analysis with twenty psychosocial factors identified three DE risk groups. The group at highest risk for DE was characterized by endorsement of internalizing symptoms and a history of trauma. The next risk group consisted of those with externalizing symptoms, particularly substance use. The group at lowest risk for DE reported more time spent with friends compared to their peers. Primary care providers and psychiatric teams can benefit from knowing the psychosocial risk patterns affiliated with DE, and using brief, comprehensive screening tools to identify these symptoms.
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http://dx.doi.org/10.1007/s10578-019-00875-8DOI Listing
October 2019

Identifying Risk Factors for Disordered Eating among Female Youth in Primary Care.

Child Psychiatry Hum Dev 2019 10;50(5):727-737

Center for Family Intervention Science, Drexel University, Philadelphia, PA, USA.

Eating disorders are a serious, life-threating condition impacting adolescents and young adults. Providers in primary care settings have an important role in identifying disordered eating (DE) symptoms. Unfortunately, symptoms go undetected in 50% of patients in medical settings. Using the behavioral health screen, this study identified DE risk profiles in a sample of 3620 female adolescents and young adults (ages 14-24), presenting in primary care. A latent class analysis with twenty psychosocial factors identified three DE risk groups. The group at highest risk for DE was characterized by endorsement of internalizing symptoms and a history of trauma. The next risk group consisted of those with externalizing symptoms, particularly substance use. The group at lowest risk for DE reported more time spent with friends compared to their peers. Primary care providers and psychiatric teams can benefit from knowing the psychosocial risk patterns affiliated with DE, and using brief, comprehensive screening tools to identify these symptoms.
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http://dx.doi.org/10.1007/s10578-019-00875-8DOI Listing
October 2019

A Socioecological Model of Risk Associated With Campus Sexual Assault in a Representative Sample of Liberal Arts College Students.

J Interpers Violence 2021 04 10;36(7-8):NP4208-NP4229. Epub 2018 Jul 10.

The College of New Jersey, Ewing, USA.

Campus sexual assault (CSA) is a growing area of research and public health concern, yet little research has considered the sociocultural context in which CSA occurs or the effect of sociocultural factors on the posttraumatic stress disorder (PTSD) symptoms of CSA survivors. This study describes the results of a web-based census survey administered to students at a liberal arts college. Of the 1,611 students who completed the survey (74% female; 71.4% White, 4.3% African American, 12% Hispanic), 13.5% reported experiencing at least one type of completed or attempted CSA. Female students, participants in Greek life, and students who reported victimization prior to college were more likely to report having experienced CSA. CSA was positively correlated with PTSD symptoms, and this relationship was stronger for racial/ethnic minorities, those who reported less sense of community, and those who were more aware of campus services to address CSA. This study demonstrates multiple levels of sociocultural influence on the mental health of college students who have experienced CSA and may suggest ways for improving prevention and intervention strategies to address CSA and its consequences.
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http://dx.doi.org/10.1177/0886260518785376DOI Listing
April 2021

A Socioecological Model of Risk Associated With Campus Sexual Assault in a Representative Sample of Liberal Arts College Students.

J Interpers Violence 2021 04 10;36(7-8):NP4208-NP4229. Epub 2018 Jul 10.

The College of New Jersey, Ewing, USA.

Campus sexual assault (CSA) is a growing area of research and public health concern, yet little research has considered the sociocultural context in which CSA occurs or the effect of sociocultural factors on the posttraumatic stress disorder (PTSD) symptoms of CSA survivors. This study describes the results of a web-based census survey administered to students at a liberal arts college. Of the 1,611 students who completed the survey (74% female; 71.4% White, 4.3% African American, 12% Hispanic), 13.5% reported experiencing at least one type of completed or attempted CSA. Female students, participants in Greek life, and students who reported victimization prior to college were more likely to report having experienced CSA. CSA was positively correlated with PTSD symptoms, and this relationship was stronger for racial/ethnic minorities, those who reported less sense of community, and those who were more aware of campus services to address CSA. This study demonstrates multiple levels of sociocultural influence on the mental health of college students who have experienced CSA and may suggest ways for improving prevention and intervention strategies to address CSA and its consequences.
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http://dx.doi.org/10.1177/0886260518785376DOI Listing
April 2021

Observational study of associations between visual imagery and measures of depression, anxiety and post-traumatic stress among active-duty military service members with traumatic brain injury at the Walter Reed National Military Medical Center.

BMJ Open 2018 06 11;8(6):e021448. Epub 2018 Jun 11.

National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland, USA.

Objectives: The study aimed tocompare recurring themes in the artistic expression of military service members (SMs) with post-traumatic stress disorder (PTSD), traumatic brain injury and psychological health (PH) conditions with measurable psychiatric diagnoses. Affective symptoms and struggles related to verbally expressing information can limit communication in individuals with symptoms of PTSD and deployment-related health conditions. Visual self-expression through art therapy is an alternative way for SMs with PTSD and other PH conditions to communicate their lived experiences. This study offers the first systematic examination of the associations between visual self-expression and standardised clinical self-report measures.

Design: Observational study of correlations between clinical symptoms of post-traumatic stress, depression and anxiety and visual themes in mask imagery.

Setting: The National Intrepid Center of Excellence at the Walter Reed National Military Medical Center, Bethesda, Maryland, USA.

Participants: Active-duty military SMs (n=370) with a history of traumatic brain injury, post-traumatic stress symptoms and related PH conditions.

Intervention: The masks used for analysis were created by the SMs during art therapy sessions in week 1 of a 4-week integrative treatment programme.

Primary Outcomes: Associations between scores on the PTSD Checklist-Military, Patient Health Questionnaire-9 and Generalized Anxiety Disorder 7-item scale on visual themes in depictions of aspects of individual identity (psychological injury, military symbols, military identity and visual metaphors).

Results: Visual and clinical data comparisons indicate that SMs who depicted psychological injury had higher scores for post-traumatic stress and depression. The depiction of military unit identity, nature metaphors, sociocultural metaphors, and cultural and historical characters was associated with lower post-traumatic stress, depression and anxiety scores. Colour-related symbolism and fragmented military symbols were associated with higher anxiety, depression and post-traumatic stress scores.

Conclusions: Emergent patterns of resilience and risk embedded in the use of images created by the participants could provide valuable information for patients, clinicians and caregivers.
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http://dx.doi.org/10.1136/bmjopen-2017-021448DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6009636PMC
June 2018

Emotional reactivity to daily events in youth with anxiety disorders.

Anxiety Stress Coping 2018 07 7;31(4):387-401. Epub 2018 May 7.

d Department of Psychology , Temple University , Philadelphia , USA.

Background: Although research supports associations between anxiety and emotional reactivity in adults (Cisler, J. M., Olatunji, B. O., Feldner, M. T., & Forsyth, J. P. (2010). Emotion regulation and the anxiety disorders: an integrative review. Journal of Psychopathology and Behavioral Assessment, 32(1), 68-82.), few studies have examined emotional reactivity in anxious youth (e.g., Carthy et al., 2010; Tan, P. Z., Forbes, E. E., Dahl, R. E., Ryan, N. D., Siegle, G. J., Ladouceur, C. D., & Silk, J. S. (2012). Emotional reactivity and regulation in anxious and nonanxious youth: a cell-phone ecological momentary assessment study. Journal of Child Psychology and Psychiatry, 53(2), 197-206.).

Methods: Using daily diary methodology, this study examined both negative affect (NA) and positive affect (PA) reactivity to daily events in youth diagnosed with anxiety (N = 68; 60% female; 78% non-Hispanic White; M age = 11.18 years, SD = 3.17). We also examined whether parent-reported emotion regulation would predict emotional reactivity.

Results: Participants reported more NA on days they experienced more negative parent and teacher events and less PA on days that they experienced more negative peer events. Additionally, better emotion regulation was associated with less NA reactivity to negative teacher events and to both negative and positive academic events.

Conclusions: Interpersonal events have a salient effect on daily affect for anxious youth. Youth anxiety therapists should target emotion regulation associated with negative events involving adults and address barriers to developing and maintaining positive peer relationships.
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http://dx.doi.org/10.1080/10615806.2018.1472492DOI Listing
July 2018

Evaluating referral, screening, and assessment procedures for middle school trauma/grief-focused treatment groups.

Sch Psychol Q 2018 03;33(1):10-20

UCLA/Duke University National Center for Child Traumatic Stress.

There is a need to delineate best practices for referring, assessing, and retaining students suspected of posttraumatic stress (PTS) and maladaptive grief (MG) in school-based treatment. Evidence-based risk-screening procedures should accurately include students who are appropriate for group treatment and exclude students who do not require treatment or who are better served by other forms of intervention and support. We described and evaluated the sequence of steps used to screen 7th- and 8th-grade students (N = 89) referred by school staff as candidates for an open trial of group-based Trauma and Grief Component Therapy for Adolescents (TGCTA; Saltzman et al., in press). We used t tests to compare included versus excluded students on PTS symptom and MG reaction scores (University of California at Los Angeles Posttraumatic Stress Disorder Reaction Index; Grief Screening Scale) during the group screen, individual interview, and treatment-implementation phases. Logistic regressions tested the incremental utility of including measures of both trauma exposure and related emotional and conduct problems (Strengths and Difficulties Questionnaire) in the screening battery. Results suggest that the group screen helped to detect mental health needs and that the individual interview further identified students with PTS and emotional problems. Conduct problems and trauma exposure predicted attrition among students who qualified for treatment. MG incrementally predicted students who advanced from the group screening to the individual interview, and trauma exposure incrementally predicted attrition from treatment. Findings yield implications for improving research and practice, including procedures for enhancing school-based referral, screening, assessment, and selection procedures. (PsycINFO Database Record
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http://dx.doi.org/10.1037/spq0000231DOI Listing
March 2018

Unique Interactions of Interpersonal Trauma and Positive Peer and Family Experiences on Traumatic Distress Among Pediatric Primary Care Patients.

J Interpers Violence 2021 01 26;36(1-2):976-986. Epub 2017 Sep 26.

Drexel University, Philadelphia, PA, USA.

Individuals with histories of interpersonal trauma are at increased risk for posttraumatic stress disorder (PTSD). Risk of PTSD is particularly salient during critical periods of development, such as adolescence and emerging adulthood. However, little is known about the unique effects and interactions of protective factors and interpersonal trauma on PTSD symptoms in adolescents and young adults. The current study tested whether positive peer and family experiences decrease the associations between interpersonal trauma and PTSD symptoms and whether these associations differed by victim-perpetrator relationships. Participants included 3,618 adolescents and young adults (aged 14-24 years) who completed the Behavioral Health Screen-a web-based screening tool that assesses psychiatric symptoms and associated risk factors-during a routine visit across 10 primary care sites in Pennsylvania. In support of the stress buffering hypothesis, results revealed that positive peer and family experiences buffered the effects of interpersonal trauma by a romantic partner and an adult in the home. Future research should examine whether programs aimed at improving peer or family relationships improve outcomes for traumatized youth.
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http://dx.doi.org/10.1177/0886260517733283DOI Listing
January 2021

Unique Interactions of Interpersonal Trauma and Positive Peer and Family Experiences on Traumatic Distress Among Pediatric Primary Care Patients.

J Interpers Violence 2021 01 26;36(1-2):976-986. Epub 2017 Sep 26.

Drexel University, Philadelphia, PA, USA.

Individuals with histories of interpersonal trauma are at increased risk for posttraumatic stress disorder (PTSD). Risk of PTSD is particularly salient during critical periods of development, such as adolescence and emerging adulthood. However, little is known about the unique effects and interactions of protective factors and interpersonal trauma on PTSD symptoms in adolescents and young adults. The current study tested whether positive peer and family experiences decrease the associations between interpersonal trauma and PTSD symptoms and whether these associations differed by victim-perpetrator relationships. Participants included 3,618 adolescents and young adults (aged 14-24 years) who completed the Behavioral Health Screen-a web-based screening tool that assesses psychiatric symptoms and associated risk factors-during a routine visit across 10 primary care sites in Pennsylvania. In support of the stress buffering hypothesis, results revealed that positive peer and family experiences buffered the effects of interpersonal trauma by a romantic partner and an adult in the home. Future research should examine whether programs aimed at improving peer or family relationships improve outcomes for traumatized youth.
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http://dx.doi.org/10.1177/0886260517733283DOI Listing
January 2021

Unique Interactions of Interpersonal Trauma and Positive Peer and Family Experiences on Traumatic Distress Among Pediatric Primary Care Patients.

J Interpers Violence 2021 01 26;36(1-2):976-986. Epub 2017 Sep 26.

Drexel University, Philadelphia, PA, USA.

Individuals with histories of interpersonal trauma are at increased risk for posttraumatic stress disorder (PTSD). Risk of PTSD is particularly salient during critical periods of development, such as adolescence and emerging adulthood. However, little is known about the unique effects and interactions of protective factors and interpersonal trauma on PTSD symptoms in adolescents and young adults. The current study tested whether positive peer and family experiences decrease the associations between interpersonal trauma and PTSD symptoms and whether these associations differed by victim-perpetrator relationships. Participants included 3,618 adolescents and young adults (aged 14-24 years) who completed the Behavioral Health Screen-a web-based screening tool that assesses psychiatric symptoms and associated risk factors-during a routine visit across 10 primary care sites in Pennsylvania. In support of the stress buffering hypothesis, results revealed that positive peer and family experiences buffered the effects of interpersonal trauma by a romantic partner and an adult in the home. Future research should examine whether programs aimed at improving peer or family relationships improve outcomes for traumatized youth.
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http://dx.doi.org/10.1177/0886260517733283DOI Listing
January 2021

Unique Interactions of Interpersonal Trauma and Positive Peer and Family Experiences on Traumatic Distress Among Pediatric Primary Care Patients.

J Interpers Violence 2021 01 26;36(1-2):976-986. Epub 2017 Sep 26.

Drexel University, Philadelphia, PA, USA.

Individuals with histories of interpersonal trauma are at increased risk for posttraumatic stress disorder (PTSD). Risk of PTSD is particularly salient during critical periods of development, such as adolescence and emerging adulthood. However, little is known about the unique effects and interactions of protective factors and interpersonal trauma on PTSD symptoms in adolescents and young adults. The current study tested whether positive peer and family experiences decrease the associations between interpersonal trauma and PTSD symptoms and whether these associations differed by victim-perpetrator relationships. Participants included 3,618 adolescents and young adults (aged 14-24 years) who completed the Behavioral Health Screen-a web-based screening tool that assesses psychiatric symptoms and associated risk factors-during a routine visit across 10 primary care sites in Pennsylvania. In support of the stress buffering hypothesis, results revealed that positive peer and family experiences buffered the effects of interpersonal trauma by a romantic partner and an adult in the home. Future research should examine whether programs aimed at improving peer or family relationships improve outcomes for traumatized youth.
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http://dx.doi.org/10.1177/0886260517733283DOI Listing
January 2021

Unique Interactions of Interpersonal Trauma and Positive Peer and Family Experiences on Traumatic Distress Among Pediatric Primary Care Patients.

J Interpers Violence 2021 01 26;36(1-2):976-986. Epub 2017 Sep 26.

Drexel University, Philadelphia, PA, USA.

Individuals with histories of interpersonal trauma are at increased risk for posttraumatic stress disorder (PTSD). Risk of PTSD is particularly salient during critical periods of development, such as adolescence and emerging adulthood. However, little is known about the unique effects and interactions of protective factors and interpersonal trauma on PTSD symptoms in adolescents and young adults. The current study tested whether positive peer and family experiences decrease the associations between interpersonal trauma and PTSD symptoms and whether these associations differed by victim-perpetrator relationships. Participants included 3,618 adolescents and young adults (aged 14-24 years) who completed the Behavioral Health Screen-a web-based screening tool that assesses psychiatric symptoms and associated risk factors-during a routine visit across 10 primary care sites in Pennsylvania. In support of the stress buffering hypothesis, results revealed that positive peer and family experiences buffered the effects of interpersonal trauma by a romantic partner and an adult in the home. Future research should examine whether programs aimed at improving peer or family relationships improve outcomes for traumatized youth.
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http://dx.doi.org/10.1177/0886260517733283DOI Listing
January 2021

Unique Interactions of Interpersonal Trauma and Positive Peer and Family Experiences on Traumatic Distress Among Pediatric Primary Care Patients.

J Interpers Violence 2021 01 26;36(1-2):976-986. Epub 2017 Sep 26.

Drexel University, Philadelphia, PA, USA.

Individuals with histories of interpersonal trauma are at increased risk for posttraumatic stress disorder (PTSD). Risk of PTSD is particularly salient during critical periods of development, such as adolescence and emerging adulthood. However, little is known about the unique effects and interactions of protective factors and interpersonal trauma on PTSD symptoms in adolescents and young adults. The current study tested whether positive peer and family experiences decrease the associations between interpersonal trauma and PTSD symptoms and whether these associations differed by victim-perpetrator relationships. Participants included 3,618 adolescents and young adults (aged 14-24 years) who completed the Behavioral Health Screen-a web-based screening tool that assesses psychiatric symptoms and associated risk factors-during a routine visit across 10 primary care sites in Pennsylvania. In support of the stress buffering hypothesis, results revealed that positive peer and family experiences buffered the effects of interpersonal trauma by a romantic partner and an adult in the home. Future research should examine whether programs aimed at improving peer or family relationships improve outcomes for traumatized youth.
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http://dx.doi.org/10.1177/0886260517733283DOI Listing
January 2021

HIV-Related Stigma, Shame, and Avoidant Coping: Risk Factors for Internalizing Symptoms Among Youth Living with HIV?

Child Psychiatry Hum Dev 2016 Aug;47(4):657-64

Government Affairs, Gilead Sciences Inc., Philadelphia, PA, USA.

Youth living with HIV (YLH) are at elevated risk of internalizing symptoms, although there is substantial individual variability in adjustment. We examined perceived HIV-related stigma, shame-proneness, and avoidant coping as risk factors of internalizing symptoms among YLH. Participants (N = 88; ages 12-24) completed self-report measures of these potential risk factors and three domains of internalizing symptoms (depressive, anxiety, and PTSD) during a regularly scheduled HIV clinic visit. Hierarchical regressions were conducted for each internalizing symptoms domain, examining the effects of age, gender, and maternal education (step 1), HIV-related stigma (step 2), shame- and guilt-proneness (step 3), and avoidant coping (step 4). HIV-related stigma, shame-proneness, and avoidant coping were each correlated with greater depressive, anxiety, and PTSD symptoms. Specificity was observed in that shame-proneness, but not guilt-proneness, was associated with greater internalizing symptoms. In multivariable analyses, HIV-related stigma and shame-proneness were each related to greater depressive and PTSD symptoms. Controlling for the effects of HIV-related stigma and shame-proneness, avoidant coping was associated with PTSD symptoms. The current findings highlight the potential importance of HIV-related stigma, shame, and avoidant coping on the adjustment of YLH, as interventions addressing these risk factors could lead to decreased internalizing symptoms among YLH.
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http://dx.doi.org/10.1007/s10578-015-0599-yDOI Listing
August 2016

Dysregulation in Youth with Anxiety Disorders: Relationship to Acute and 7- to 19- Year Follow-Up Outcomes of Cognitive-Behavioral Therapy.

Child Psychiatry Hum Dev 2016 08;47(4):539-47

Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania.

This study evaluated the impact of dysregulation across cognitive, affective, and behavioral domains on acute and 7- to 19-year follow-up outcomes of cognitive-behavioral therapy (CBT) for anxiety, and explored dysregulation as a predictor of psychopathology and impairment in young adulthood among individuals who received anxiety treatment as youth. Participants (N = 64; 50 % female, 83 % non-Hispanic White) from two randomized clinical trials completed a follow-up assessment 7-19 years later. Latent profile analysis identified dysregulation based on Anxious/Depressed, Attention Problems, and Aggressive Behavior scores on the Child Behavior Checklist. Although pretreatment dysregulation was not related to acute or follow-up outcomes for anxiety diagnoses that were the focus of treatment, dysregulation predicted an array of non-targeted psychopathology at follow-up. Among youth with a principal anxiety disorder, the effects of CBT (Coping Cat) appear to be robust against broad impairments in self-regulation. However, youth with a pretreatment dysregulation profile likely need follow-up to monitor for the emergence of other disorders.
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http://dx.doi.org/10.1007/s10578-015-0587-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4798924PMC
August 2016

The relationship between disordered eating and sexuality amongst adolescents and young adults.

Eat Behav 2015 Dec 18;19:115-9. Epub 2015 Aug 18.

Drexel University, United States.

Research shows that gay and bisexual males are at increased risk for disordered eating symptoms (DES); however, studies examining DES amongst lesbians and bisexual women have produced mixed findings. Furthermore, few studies have included questioning or "unsure" individuals. This study examined DES symptoms in adolescents and young adults across self-reported sexual attraction and behavior. Participants were recruited from ten primary care sites in Pennsylvania and administered the Behavioral Health Screen (BHS) - a web-based screening tool that assesses psychiatric symptoms and risk behaviors - during a routine visit. As expected, males who were attracted to other males exhibited significantly higher disordered eating scores than those only attracted to members of the opposite sex. Males who engaged in sexual activities with other males also exhibited significantly higher scores than those who only engaged in sexual activities with females. Amongst females, there were no significant differences in DES scores between females who were only attracted to females and those only attracted to males. Those who reported being attracted to both sexes, however, had significantly higher scores, on average, than those only attracted to one sex. More surprisingly, females who were unsure of who they were attracted to reported the highest DES scores of all. These findings are contrary to previous assumptions that same-sex attraction plays a protective role against eating pathology in females. Females who are unsure or attracted to both sexes may actually be at increased risk for developing DES.
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http://dx.doi.org/10.1016/j.eatbeh.2015.08.001DOI Listing
December 2015

Adolescent coping profiles differentiate reports of depression and anxiety symptoms.

Authors:
Joanna Herres

J Affect Disord 2015 Nov 1;186:312-9. Epub 2015 Aug 1.

Drexel University, Christine McCauley Ohannessian, Connecticut Children's Medical Center and University of Connecticut, School of Medicine, USA. Electronic address:

The purpose of the study was to identify groups of adolescents based on their reported use of different coping strategies and compare levels of depression and anxiety symptoms across the groups. Tenth and eleventh grade public school students (N=982; 51% girls; 66% Caucasian; M age=16.04, SD=0.73) completed a battery of self-report measures that assessed their use of different coping strategies, depressive symptoms, and anxiety symptoms. Latent profile analysis (LPA) classified the participants into four distinct groups based on their responses on subscales of the COPE inventory (Carver et al., 1989). Groups differed in amount of coping with participants in each group showing relative preference for engaging in certain strategies over others. Disengaged copers reported the lowest amounts of coping with a preference for avoidance strategies. Independent copers reported moderate levels of coping with relatively less use of support-seeking. Social support-seeking copers and active copers reported the highest levels of coping with a particular preference for support-seeking strategies. The independent copers reported the lowest levels of depressive symptoms compared to the three other groups. The Social Support Seeking and Active Coping Groups reported the highest levels of anxiety. Although distinct coping profiles were observed, findings showed that adolescents between the ages of 14 and 16 engage in multiple coping strategies and are more likely to vary in their amount of coping than in their use of specific strategies.
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http://dx.doi.org/10.1016/j.jad.2015.07.031DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4565746PMC
November 2015

Emotional Reactivity to Negative Adult and Peer Events and the Maintenance of Adolescent Depressive Symptoms: a Daily Diary Design.

J Abnorm Child Psychol 2016 Apr;44(3):471-81

University of Delaware, Newark, DE, USA.

Emotional reactivity to negative interpersonal events has been consistently linked with depressive symptoms in studies with adults. However, little is known about the role that emotional reactivity plays in the maintenance of depressive symptoms during adolescence. A structured diary, administered to 132 economically disadvantaged adolescents (53% female, 76% African American) at age 14, measured adolescent daily reports of negative events involving parents, teachers, and peers and ratings of negative and positive affect. We examined the relationship between emotional reactivity (changes in negative and positive affect that correspond with negative events) and the maintenance of depressive symptoms between ages 13 and 15. We also tested unique effects of different types of emotional reactivity, depending on the type of interpersonal event. Results provided support for the emotional reactivity model for negative teacher events: heightened reactivity to negative teacher events was related to the maintenance of depressive symptoms. Findings suggest that adolescents' emotional reactivity to teachers has important implications for the continuity of depressive symptoms during early adolescence for disadvantaged youth.
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http://dx.doi.org/10.1007/s10802-015-0043-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4684487PMC
April 2016

Attachment based treatments for adolescents: the secure cycle as a framework for assessment, treatment and evaluation.

Attach Hum Dev 2015 6;17(2):220-39. Epub 2015 Mar 6.

a Department of Psychological and Brain Sciences , University of Delaware , Newark , DE , USA.

The emergence of attachment-based treatments (ABTs) for adolescents highlights the need to more clearly define and evaluate these treatments in the context of other attachment based treatments for young children and adults. We propose a general framework for defining and evaluating ABTs that describes the cyclical processes that are required to maintain a secure attachment bond. This secure cycle incorporates three components: (1) the child or adult's IWM of the caregiver; (2) emotionally attuned communication; and (3) the caregiver's IWM of the child or adult. We briefly review Bowlby, Ainsworth, and Main's contributions to defining the components of the secure cycle and discuss how this framework can be adapted for understanding the process of change in ABTs. For clinicians working with adolescents, our model can be used to identify how deviations from the secure cycle (attachment injuries, empathic failures and mistuned communication) contribute to family distress and psychopathology. The secure cycle also provides a way of describing the ABT elements that have been used to revise IWMs or improve emotionally attuned communication. For researchers, our model provides a guide for conceptualizing and measuring change in attachment constructs and how change in one component of the interpersonal cycle should generalize to other components.
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http://dx.doi.org/10.1080/14616734.2015.1006388DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4872705PMC
January 2016

The role of parent, teacher, and peer events in maintaining depressive symptoms during early adolescence.

J Abnorm Child Psychol 2015 Feb;43(2):325-37

Center for Family Intervention Science, Drexel University, 3020 Market St, 19104, Philadelphia, PA, USA,

Negative interpersonal events have been consistently identified as both antecedents and sequalae of adolescent depressive symptoms. However, little is known about the relative contributions of specific domains of interpersonal events (parents, peers or teachers) to the maintenance of depressive symptoms during early adolescence or whether a lack of positive interpersonal interactions plays a direct role in maintaining depressive symptoms. Further, few studies have examined whether positive interpersonal events moderate associations between negative events and adolescents' depressive symptoms. This study combined stress generation and exposure models to evaluate the contribution of daily events to the maintenance of depressive symptoms in a sample of 132 adolescents (53 % female) followed from ages 13 to 15. Daily phone diaries collected at age 14 assessed adolescents' negative and positive interactions with parents, teachers, and peers in a sample of adolescents from economically disadvantaged families. Negative peer events uniquely accounted for the maintenance of depressive symptoms over the 2 years period. Results did not differ by gender; however, positive parent events buffered the effects of negative parent events for females but not for males. Findings highlight the significance of peer relationships during a period of vulnerability for depressive symptoms.
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http://dx.doi.org/10.1007/s10802-014-9896-3DOI Listing
February 2015

Narrative Focus Predicts Symptom Change Trajectories in Group Treatment for Traumatized and Bereaved Adolescents.

J Clin Child Adolesc Psychol 2015 13;44(6):933-41. Epub 2014 Jun 13.

a Department of Psychological and Brain Sciences , University of Delaware.

Growing evidence supports the effectiveness of Trauma and Grief Component Therapy for Adolescents (TGCT-A) in reducing posttraumatic stress disorder (PTSD) symptoms and maladaptive grief (MG) reactions. This pilot study explored whether the specific focus of students' narratives (i.e., focus on trauma vs. focus on loss) as shared by TGCT-A group members would predict initial pretreatment levels, as well as pre- to posttreatment change trajectories, of PTSD symptoms and MG reactions. Thirty-three adolescents from three middle schools completed a 17-week course of group-based TGCT-A. PTSD and MG symptoms were assessed at pretreatment, twice during treatment, and at posttreatment. The focus (trauma vs. loss) of each student's narrative was coded using transcripts of members' narratives as shared within the groups. The reliable change index showed that 61% of students reported reliable pre-post improvement in either PTSD symptoms or MG reactions. Students whose narratives focused on loss both reported higher starting levels and showed steeper rates of decline in MG reactions than students whose narratives focused on trauma. In contrast, students whose narratives focused on trauma reported higher starting levels of PTSD than students who narrated loss experiences. However, narrative focus was not significantly linked to the rate at which PTSD symptoms declined over the course of treatment. This study provides preliminary evidence that TGCT-A treatment components are associated with reduced PTSD symptoms and MG reactions. Loss-focused narratives, in particular, appear to be associated with greater decreases in MG reactions.
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http://dx.doi.org/10.1080/15374416.2014.913249DOI Listing
April 2016

Teacher-student interactions and attachment states of mind as predictors of early romantic involvement and risky sexual behaviors.

Attach Hum Dev 2012 ;14(3):289-303

Department of Psychology, University of Delaware, Newark, USA.

Adolescents' capacities to negotiate sexual behavior in romantic relationships have important implications for their reproductive and health outcomes. This study examined adolescents' interactions with teachers and attachment states of mind as predictors of their romantic involvement and risky sexual behavior in an economically disadvantaged sample. Negative interactions with teachers predicted increased sexual risk-taking behaviors and females' early romantic involvement. Preoccupied states of mind increased risk for early romantic involvement and the likelihood that females would engage in risky sexual behavior. The findings demonstrate how adolescents' school experiences contribute to adaptation in romantic relationships in mid to late adolescence above and beyond representations of parent-child attachment.
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http://dx.doi.org/10.1080/14616734.2012.672282DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3340017PMC
September 2012
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