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Abstract Background The various systems of diagnosis and classification of mental disorders underline the need to evaluate the interference caused by the different disorders in a person’s daily life. The Maladjustment Inventory (MI) evaluates the impairment in the individual’s functioning in a brief and self-applied way, through six items. The objective of this research was to explore the psychometric properties of the MI scores through two studies, one with a Spanish clinical sample (Study 1) and another with a Spanish university students’ sample (Study 2). Methods The total sample was made up of 928 participants (81.1% women, n = 495 clinical sample). Descriptive analyses, exploration of internal structure and reliability, exploratory and confirmatory factor analyses, relationship with other variables (quality of life, anxiety, depression, neuroticism and extraversion), and percentiles and T-scores were performed. Results The results showed good psychometric properties of the MI, with a good fit model for one factor solution in both samples, Cronbach’s alpha coefficient of 0.84–88, and evidence of validity based on the relationship with other variables. Conclusion The good psychometric properties of the MI, together with its brevity, make it a recommended instrument for the evaluation of interference in both clinical and research contexts.

IntroductionThis study created and validated a scale to measure the level of suicide crisis among international students attending South Korean universities.MethodsStudy 1 developed questions and constructed the components of the scale using an initial survey of 248 people and exploratory factor analysis. Study 2 validated the scale using a second survey of 340 participants and confirmatory factor analysis.ResultsThe results showed that 21 items were confirmed in six factors, which include lack of social support, burdensomeness, maladaptation to Korean culture, academic maladjustment, suicidal thoughts, and suicide risk.DiscussionWe verified the convergent validity, criterion validity, and reliability of the scale. The significance and implications of this study are presented, along with suggestions for future research.

In order to research the age-related specifics of self-regulation among the employees of Federal Penitentiary Service (FPS) of Russia, we conducted an empirical study on a sample of 40 male professionals aged 25-49 (average age was 35.20±7.41 years). Our diagnostic toolset was comprised of the following: Behavior Self-regulation Style Inventory (Moro-sanova V.I., 1999), Self-control Questionnaire (H. Grasmick, 1993, adapted by Bulygina V.G., Abdrazyakova A.M., 2010), BIS/BAS questionnaire (Carver C.S., White T.L., 1994, standardized by Knyazev G.G., Slobodskaya Ye.R., 2007). The empirical data were ana-lyzed using statistical treatment, descriptive analysis, correlation analysis (Pearson’s r). The study of the age-related parameters of the subjects’ conscious self-regulation revealed that the number of links between one’s self-regulation parameters and one’s individual typolog-ical characteristics decreases (with age).

Most people assume studying or working abroad would be stressful - but would one ever think that it could be detrimental to the health? Stress literature relates cross-cultural transactions to the chances of gaining higher levels of chronic stress. This paper reports the results of two studies on international students in Moscow in 2018. Specifically, Study 1 assessed how cross-cultural transactions perceived to affect health state during the first 6 months of their relocation. Study 2 aimed to investigate if the psychological stress linked to relocation to a different country can possibly lead to psychobiological effects of chronic stress. In Study 1, qualitative methods were applied to conduct 21 interviews with international students. In Study 2, a longitudinal pilot study was conducted for 10 foreign students during the first 2-5 (M = 3.6) months of their relocation. Stress related to cross-cultural transactions was expected to affect subjective well-being and health variables. The health state was a relatively silent topic in the interview participants of Study 1. The results of Study 2 showed that the participants had changes in the resting heart rate (RHR) baseline. Perceived chronic stress related to cross-cultural transactions may affect psychophysiological state; however, the affect varies depending on a person. Further research is required for the data consistency and for identifying non-invasive objective risk markers and individual stress pathways, with the goal of identifying at-risk students and providing treatment options before any serious harm is done to their health.

The study focuses on examining the adaptive skills and specifics of professional self-esteem of the penitentiary system officials with varying levels of success in adapting to their duty performance. 50 individuals took part in the questioning: 25 men and 25 women aged 24-51 (the average age is 33), with 1 to 5 years of experience (the average length of service is 4 years). Five methods were used for diagnosis. For data processing we used Kruskal-Wallis one-way analysis of variance and correlation analysis. The results of the study indicate that the effectiveness of adaptation is helped by the official's psychological qualities such as the internal locus of control, mental stability, adaptive and communicative skills, moral normativity. The more successfully an official adjusts to the conditions and content of his/her official duties, the more positive his/her professional self-esteem is, the greater are his/her self-efficacy, professional and life satisfaction. Difficulties in the officials' adaptation to their professional environment entail a decline in their general state, emergence of somatovegetative disorders, reduced motivation for work, deterioration of their social interaction.

The individual’s adaptation problems can lead to risky behaviors such as drug use. This study aimed to analyze the existence of different adaptation profiles (personal, school, and social) in adolescents. Thus, the study aimed to analyze the existence of significant differences in interpersonal risk factors depending on the degree of adaptation. The study participants were 1,201 students of Compulsory Secondary Education (M = 14.43, SD = 1.43), and 50.6% were girls. The TAMAI Test (multifactorial adaptation self-evaluation test) and the FRIDA questionnaire (Interpersonal Risk Factors for Drug Use in Adolescence) were used. A latent class analysis (LCA) revealed three different types of adaptation: maladjusted group, at-risk group, and adjusted group. The results showed the existence of significant differences between the different adaptation profiles based on interpersonal risk factors. The data obtained will help school and mental health plans to prevent misbehaving or risky behaviors.

Adolescent-to-Parent Violence (APV) or Child-to-Parent Violence (CPV) is a specific form of violence that has remained inconspicuous until recently, but is becoming a mounting social issue and is increasingly the focus of scientific research. Of the variables related to APV, the study assessed the characteristics of the family system and its relationship to the psychosocial adjustment of adolescents, an aspect scarcely examined in the literature. Thus, a field study was performed on a community sample of 210 adolescents aged 12–17 years (51.4% girls) who were assessed on measurements of APV, parenting (parental socialization), victimization, and psychological adjustment (personal, family, and school). The results revealed higher rates of psychological APV, and no gender effects in violence exercised against either parent. The adolescents involved in APV exhibited a greater psychological maladjustment in the different areas under analysis. Moreover, adolescents engaging in psychological APV reported a parental socialization style characterized by severe strictness and supervision in comparison to non-aggressors not implicated in psychological APV. Finally, adolescents exercising APV who were victimized by their parents showed more psychological, personal, and school maladjustment. These results have implications for needs analysis and the planning of community prevention strategies.

Objective: The objective of the current study was to examine psychosocial maladjustment related to adolescents’ appraisals of workplace sexual behavior. Method: High school aged adolescents with formal work experience completed a survey containing a battery of scales. Results: Descriptive statistics addressing frequency of exposure showed that 45% of adolescent men reported at least one incident of sexual behavior directed at them personally, and 24% of adolescent women reported the same. Results further indicated that adolescent men reporting a positive experience after being targeted by direct sexual behavior at work also showed signs of internal maladjustment, such as depression and anxiety. Conclusions: Gender role strain model, which suggests that the male adolescents experienced trauma when conforming to hyper-masculine norms that call for acceptance of sexual behavior, was offered to explain why male adolescents differed from female adolescents in associations between sexual behavior appraisal and maladjustment.

Individually-psychological characteristics were studied and profiles of the styles of self-regulation of the employees engaged in hazardous were determined. The mainly group consisted of 30 men aged 21 to 60 years, who are specialists of dangerous professions. The comparison group included 30 men from 22 to 60 years, whose professional activity was not associated with risk. The following methods were used: questionnaire "Style of self-regulation of behavior" by V. I. Morosanova; questionnaire of self-control (H. Grasmik, 1993, adaptation Bulygina V. G., Abdrazakova A. M., 2009); the questionnaire BIS/BAS, used to study the sensitivity to punishment and reward; the questionnaire formal-dynamic properties of individuality by V. M. Rusalov; the aggression questionnaire by A. Buss and M. Perry (adaptation Enikolopov S. N., Cybulski N. P., 2007); the scale of anxiety Charles D. Spielberger (State-Trait Anxiety Inventory – STAI); personal questionnaire of the G. and S. Eysenck – EPQ. It was found that specialists hazardous professions are distinguished by: a higher level of development of the regulatory flexibility and individual system of conscious self-regulation activity; higher levels of extroversion, communication activity, the total adaptability; a lower level of reactive anxiety, trait anxiety and general emotional. Moreover, impulsiveness, egocentrism, lack of restraint and physical activity in the structure of self-monitoring specialists of dangerous professions associated with high levels of affective component of aggression and incoherence of parts of the process of self-regulation. There were allocated a 3 profile of self-regulation in specialists of dangerous professions: a) a high level of self-regulation – coupled with a high intellectual and physical development, the highest level of adaptability and general activity; b) medium – rapid response to emerging changes in the situation, the successful production alternatives, greater flexibility in the process of communicating with less intellectual and physical activity; c) low – the most developed stage of self-regulation is assessment of results with low rates of formal-dynamic properties of individuality and adaptability at the same time.

The differential contribution of maternal and paternal acceptance-rejection to children’s psychological adjustment has been explained by differences in interpersonal power and prestige within families; however, there is not yet enough empirical support for this explanation. This study examines the moderating effects of interpersonal power and prestige on the relationship between perceived parental acceptance-rejection and psychological adjustment across children’s sex and age. The sample was composed of 913 children ranging in age from 9 to 16 years. Multiple hierarchical regression analyses in the total sample showed a significant and independent contribution of parental acceptance-rejection and parental power and prestige. No moderating effects of interpersonal power and prestige were found for the total sample. However, when the regression analyses were conducted across different age groups, maternal acceptance had a higher contribution to psychological adjustment in children from nine to ten years old. Interestingly, the moderating effects of interpersonal prestige (not interpersonal power) were also significant in younger participants. Furthermore, the moderating effects of prestige on maternal acceptance-rejection were different in late childhood than in early adolescence. These results suggest how parental prestige may explain the higher contribution of maternal acceptance to younger children’s psychological adjustment. [ABSTRACT FROM AUTHOR]

Background: Subthalamic nucleus deep brain stimulation (STN-DBS) is an effective treatment for the motor and non-motor signs of Parkinson’s disease (PD), however, psychological disorders and social maladjustment have been reported in about one third of patients after STN-DBS. We propose here a perioperative psychoeducation programme to limit such social and familial disruption. Methods: Nineteen PD patients and carers were included in a randomised single blind study. Social adjustment scale (SAS) scores from patients and carers that received the psychoeducation programme (n = 9) were compared, both 1 and 2 years after surgery, with patients and carers with usual care (n = 10). Depression, anxiety, cognitive status, apathy, coping, parkinsonian disability, quality-of-life, carers’ anxiety and burden were also analysed. Results: Seventeen patients completed the study, 2 were excluded from the final analysis because of adverse events. At 1 year, 2/7 patients with psychoeducation and 8/10 with usual care had an aggravation in at least one domain of the SAS (p = .058). At 2 years, only 1 patient with psychoeducation suffered persistent aggravated social adjustment as compared to 8 patients with usual care (p = .015). At 1 year, anxiety, depression and instrumental coping ratings improved more in the psychoeducation than in the usual care group (p = .038, p = .050 and p = .050, respectively). No significant differences were found between groups for quality of life, cognitive status, apathy or motor disability. Conclusions: Our results suggest that a perioperative psychoeducation programme prevents social maladjustment in PD patients following STN-DBS and improves anxiety and depression compared to usual care. These preliminary data need to be confirmed in larger studies. [ABSTRACT FROM AUTHOR]

Police officers have the capacity to use legitimate force to attain compliance, and the gravity associated with officers’ decisions to use force has generated a number of studies of the influences on these decisions. Very few studies, however, have focused on the consequences that exposure to police use of force has on suspects. In this study, we use data collected from a nationally representative sample of prison inmates to examine whether exposure to police use of force during their arrest contributes to mental health problems among these inmates, after controlling for relevant covariates including pre-existing mental illness. Findings indicate inmates who were exposed to police use of force during their arrest experienced a greater number of manic and depressive symptoms than inmates who were not exposed to police use of force. The implications of our findings for correctional policy include a consideration of police use of force in needs assessment and recognition of the potential treatment needs of inmates exposed to police use of force during their arrest. [ABSTRACT FROM PUBLISHER]

Previous studies have linked higher emotional inertia (i.e., a stronger autoregressive slope of emotions) with lower well-being. We aimed to replicate these findings, while extending upon previous research by addressing a number of unresolved issues and controlling for potential confounds. Specifically, we report results from two studies (Ns = 100 & 202) examining how emotional inertia, assessed in response to a standardized sequence of emotional stimuli in the lab, correlates with several measures of well-being. The current studies build on previous research by examining how inertia of both positive emotions (PE) and negative emotions (NE) are related to both positive (e.g., life satisfaction) and negative (e.g., depressive symptoms) indicators of well-being, while controlling for between-person differences in the mean level and variability of emotions. Our findings replicated previous research and further revealed that a) NE inertia was more strongly associated with lower well-being than PE inertia; b) emotional inertia correlated more consistently with negative indicators (e.g., depressive symptoms) than positive indicators (e.g., life satisfaction) of well-being; and c) these relationships were independent of individual differences in mean level and variability of emotions. We conclude, in line with recent findings, that higher emotional inertia, particularly of NE, may indicate increased vulnerability to depression.

Functional Neurological Symptom Disorder, previously called as Conversion disorder, is very common psychological disorder in eastern countries like Pakistan. This case study is describing how psychosocial factors produce stress and made a young girl dysfunctional in all aspect of life. The patient F.Z was18 years old unmarried girl and educated up till intermediate. She was unemployed and last born among 6 siblings; 4 sisters and 2 brothers. She was brought to the psychiatry indoor ward with speech symptom; unable to speak (aphonia), sensory symptom; could not see (psychogenic blindness) and more over since last few months she had paralysis of lower limbs. Apart from those symptoms she reported poor appetite, remained sad and tearful. She was assessed thro-ugh both informal and formal psychological assessment It was interpreted that she had insecure, disturbed childhood and had lots of stressors in her life which caused severe maladjustment, interpersonal conflict, feeling of rejection and loneliness. According to DSM-5 she was diagnosed with Functional Neurological Symptom Disorder with comorbid Depressive Symptoms. The intervention plan comprised of psychodynamic, behavioral and cognitive approaches; techniques include catharsis, free association, anxiety reduction techniques, cognitive restructuring, graded task, mastery and pleasure technique, family psycho-education along with physiotherapy and physical exercise. Thirteen (13) therapeutic sessions were conducted along with anti-depressants and the patient showed marked improvement in all areas of her daily life. Family was psycho-educated to bring her for follow-up sessions. [ABSTRACT FROM AUTHOR]

Wietse Tol and colleagues discuss some of the key challenges for implementation of new WHO guidelines for stress-related mental health disorders in low- and middle-income countries. Please see later in the article for the Editors' Summary [ABSTRACT FROM AUTHOR]

Background: Surveying survivors from a large fire provides an opportunity to explore the impact of emotional trauma on psychological outcomes. Methods: This is a cross-sectional survey of survivors of The Station Fire. Primary outcomes were post-traumatic stress (Impact of Event Scale – Revised) and depressive (Beck Depression Inventory) symptoms. Linear regression was used to examine differences in symptom profiles between those with and without physical injuries. The free-response section of the survey was analyzed qualitatively to compare psychological sequelae of survivors with and without physical injuries. Results: 104 participants completed the study survey; 47% experienced a burn injury. There was a 42% to 72% response rate range. The mean age of respondents was 32 years, 62% were male, and 47% experienced a physical injury. No significant relationships were found between physical injury and depressive or post-traumatic stress symptom profiles. In the qualitative analysis, the emotional trauma that survivors experienced was a major, common theme regardless of physical injury. Survivors without physical injuries were more likely to experience survivor guilt, helplessness, self-blame, and bitterness. Despite the post-fire challenges described, most survivors wrote about themes of recovery and renewal. Conclusions: All survivors of this large fire experienced significant psychological sequelae. These findings reinforce the importance of mental health care for all survivors and suggest a need to understand factors influencing positive outcomes. [ABSTRACT FROM AUTHOR]

In order to advance our understanding of the etiology of individual differences in child maladjustment (i.e., conduct and emotional problems), we tested hypotheses about the statistical interactions between child temperament and two aspects of the family environment: maternal negativity and positivity, and household chaos (e.g., crowding, noise, lack of routines). Mothers ( n = 149) reported on their child's effortful control, negative affect, surgency, and behavioral/emotional problems. The age range of the children was 3 to 7 years old and half of the sample was girls. Observers rated maternal negativity and positivity based on brief structured interaction tasks in the laboratory. Child temperament moderated the association between maternal negativity/positivity and child maladjustment. Maternal negativity and child problem behavior were associated only for those children who also were high in surgency or negative affectivity. Maternal positivity was associated with less child problem behavior for those high in surgency. Child effortful control interacted with both maternal negativity and chaos. Maternal negativity and child problem behavior were most strongly associated for children who were low in effortful control and living in chaotic homes. The results point to distinct transactions between child temperament and maternal negativity/positivity that depend in part on the dimensions of temperament and parenting behavior in question. [ABSTRACT FROM AUTHOR]

Objective: To compare life satisfaction between women with successful or unsuccessful outcome after assisted reproductive treatment (ART) by taking into account the time since the last ART. Design: Cohort study. Setting: Tertiary hospital. Patients: A total of 987 consecutive women who had undergone ART during 1996–2007 were invited and altogether 505 women participated in the study. Interventions: A postal enquiry with a life satisfaction scale. Main Outcome Measure: Self-reported life satisfaction in respect to the time since the last ART. Results: In general, women who achieved a live birth after ART had a significantly higher life satisfaction than those who had unsuccessful ART, especially when compared in the first three years. The difference disappeared in the time period of 6–9 years after ART. The unsuccessfully treated women who had a child by some other means before or after the unsuccessful ART had comparable life satisfaction with successfully treated women even earlier. Conclusions: Even if unsuccessful ART outcome is associated with subsequent lower level of life satisfaction, it does not seem to threaten the long-term wellbeing. [ABSTRACT FROM AUTHOR]

Spectral and temporal features of human infant crying may detect neurobehavioral effects of prenatal cocaine exposure (PCE). Finding comparable measures of rodent ultrasonic vocalizations (USVs) would promote translational analyses by controlling the effects of correlated variables that confound human studies. To this end, two studies examined the sensitivity of similar acoustic structures in human infant and rat pup vocalizations to effects of PCE. In Study 1, cry sounds of 107 one month-old infants were spectrum analyzed to create a novel set of measures and to detect the presence of hyperphonation - a qualitative shift to an atypically high fundamental frequency (basic pitch) associated with neurobehavioral insult. Infants with PCE were compared to infants with prenatal polydrug-exposure (PPE) without cocaine and with infants in a standard comparison (SC) group with no prenatal drug exposure. In Study 2, USVs of 118 five day-old rat pups with either PCE, prenatal saline exposure or no prenatal exposures were spectrum analyzed to detect the presence of frequency shifts – acoustic features that have a frequency waveform similar to that of hyperphonation. Results of study 1 showed PCE had two sets of sex-dependent effects on human infants: PCE males had higher pitched cries with more dysphonation (turbulence); PCE females had longer pauses between fewer cry sounds that were of lower amplitude than comparison groups. PCE and PPE infants had more cries with hyperphonation than SC infants. In study 2, PCE pups had a greater percentage of USVs with shift in the acoustic structure than pups in the two control groups. As such, the novel measures of human infant crying and rat pup USVs were sensitive to effects of PCE. These studies provide the first known translational analysis of similar acoustic structures of vocalizations in two species to detect adverse effects of prenatal drug exposure. [ABSTRACT FROM AUTHOR]

The main aim of this study was to assess the mental health status of the Navy Special Forces and regular forces three and a half years after the end of combat operations in mid 2009, and compare it with the findings in 2009. This cross sectional study was carried out in the Sri Lanka Navy (SLN), three and a half years after the end of combat operations. Representative samples of SLN Special Forces and regular forces deployed in combat areas were selected using simple random sampling. Only personnel who had served continuously in combat areas during the one year period prior to the end of combat operations were included in the study. The sample consisted of 220 Special Forces and 275 regular forces personnel. Compared to regular forces a significantly higher number of Special Forces personnel had experienced potentially traumatic events. Compared to the period immediately after end of combat operations, in the Special Forces, prevalence of psychological distress and fatigue showed a marginal increase while hazardous drinking and multiple physical symptoms showed a marginal decrease. In the regular forces, the prevalence of psychological distress, fatigue and multiple somatic symptoms declined and prevalence of hazardous drinking increased from 16.5% to 25.7%. During the same period prevalence of smoking doubled in both Special Forces and regular forces. Prevalence of PTSD reduced from 1.9% in Special Forces to 0.9% and in the regular forces from 2.07% to 1.1%. Three and a half years after the end of combat operations mental health problems have declined among SLN regular forces while there was no significant change among Special Forces. Hazardous drinking among regular forces and smoking among both Special Forces and regular forces have increased. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this cluster randomized trial was to evaluate the effectiveness of a school-based theatre intervention program for immigrant and refugee youth in special classes for improving mental health and academic outcomes. The primary hypothesis was that students in the theatre intervention group would report a greater reduction in impairment from symptoms compared to students in the control and tutoring groups. Methods: Special classrooms in five multiethnic high schools were randomly assigned to theater intervention (n = 10), tutoring (n = 10) or control status (n = 9), for a total of 477 participants. Students and teachers were non-blinded to group assignment. The primary outcome was impairment from emotional and behavioural symptoms assessed by the Impact Supplement of the Strengths and Difficulties Questionnaire (SDQ) completed by the adolescents. The secondary outcomes were the SDQ global scores (teacher and youth reports), impairment assessed by teachers and school performance. The effect of the interventions was assessed through linear mixed effect models which incorporate the correlation between students in the same class, due to the nature of the randomization of the interventions by classroom. Results: The theatre intervention was not associated with a greater reduction in self-reported impairment and symptoms in youth placed in special class because of learning, emotional and behavioural difficulties than a tutoring intervention or a non-active control group. The estimates of the different models show a non-significant decrease in both self-reported and impairment scores in the theatre intervention group for the overall group, but the impairment score decreased significantly for first generation adolescents while it increased for second generation adolescents. Conclusion: The difference between the population of immigrant and refugee youth newcomers studied previously and the sample of this trial may explain some of the differences in the observed impact of the theatre intervention. Trial Registration: ClinicalTrials.gov NCT01426451 [ABSTRACT FROM AUTHOR]

Current civil wars are characterized by the increasing involvement of civilian populations and the systematic employment of child soldiers. An example of such wars was the conflict in Northern Uganda, where the war-affected population is still challenged by the reintegration of formerly abducted children and youths. A cross-sectional, population-based survey, using a multistage cluster sampling approach of 1,113 Northern Ugandans aged between 12 and 25 in camps for internally displaced persons and locally validated instruments was conducted to assess symptoms and diagnoses of Posttraumatic Stress Disorder (PTSD) and probable Depression in war-affected, as well as formerly abducted individuals. Further objectives were to determine predictors of psychopathology and to relate indicators of maladjustment (i.e., impairments in daily and community functioning, somatic complaints, suicidality, aggressiveness and discrimination) to abduction, level of exposure to violence and psychopathology. 43% of the sample reported abduction by the rebel army. Exposure to violence among this group was higher than for non-abducted youths (t = 28.05; p<.001). PTSD point prevalence rates were 25% among former child soldiers and 7% among the comparison group. High suicidal ideation was present in 16% and 6% respectively. A higher amount of experienced and witnessed event-types (β = . 32. p<.001), loss of first-degree relatives (β = .13. p<.001) and the number of event-types involving forced perpetration (β = .23. p<.001) were identified as risk factors of PTSD symptoms in former child soldiers. The associations between abductee-status and indicators of maladjustment were fully mediated by level of trauma exposure and psychopathology. Results show that child soldiering and its psychological sequelae affect a substantial proportion of children and youths. After release or flight, their readjustment depends at least partly on their level of mental traumatization. [ABSTRACT FROM AUTHOR]

Background: Combat-related posttraumatic stress disorder (PTSD) can be a difficult condition to treat and has been associated with serious medical and economic issues among U.S. military veterans. Distinguishing between treatment responders vs. non-responders in this population has become an important public health priority. This study was conducted to identify pre-treatment characteristics of U.S. veterans with combat-related PTSD that might contribute to favorable and unfavorable responses to high value treatments for this condition. Method: This study focused on 805 patients who completed a VHA PTSD residential program between 2000 and 2007. These patients completed the PTSD Clinical Checklist at pre-treatment, post-treatment, and a four-month follow-up assessment. Latent growth curve analysis (LCGA) was incorporated to determine trajectories of changes in PTSD across these assessments and whether several key clinical concerns for this population were associated with their treatment responses. Study Findings: LCGA indicated three distinct trajectories in PTSD outcomes and identified several clinical factors that were prospectively linked with changes in veterans' posttraumatic symptomatology. When compared to a group with high PTSD symptom severity that decreased over the program but relapsed at follow-up (41%), the near half (48.8%) of the sample with an improving trajectory had less combat exposure and superior physical/mental health. However, when compared to a minority (10.2%) with relatively low symptomatology that also remained somewhat stable, patients in the improving group were younger and also reported greater combat exposure, poorer physical/mental health status, and more problems with substance abuse before the start of treatment. Conclusions: Findings suggest that veterans are most likely to benefit from residential treatment in an intermediate range of symptoms and risk factors, including PTSD symptom severity, history of combat exposure, and comorbid issues with physical/mental health. Addressing these factors in an integrative manner could help to optimize the effectiveness of treatments of combat-related PTSD in many cases. [ABSTRACT FROM AUTHOR]

Background: North West Pakistan is an area ravaged by conflict and population displacement for over three decades. Recently, drone attacks and military operations have aggravated underlying mental disorders, while access to care is limited. Among patients attending a mental health clinic integrated in district hospital conducted by psychologists; we describe service utilization, patient characteristics, presenting complaints, morbidity patterns, and follow-up details. Methodology/Principal Findings: A retrospective study using routinely collected programme data was conducted from February to December 2012. A total of 1545 consultations were conducted for 928 patients (86% females). There were 71(8%) children and adolescents. An increase was observed from February to July, followed by a decline. 163 new patients (18%) were on psychotropic medication at presentation. The most common morbidity in females (36%) were symptoms of adjustment disorders and acute reactions. Depression and anxiety were common in both genders while post traumatic disorder was frequent in males (21%). Out of the 928 new patients, 639(69%) had a follow up visit planned with their psychologist, but only 220(34%) new patients returned for a follow up visit. Conclusion: In a district hospital, mental health services managed by psychologists were well attended. There is a need to consider widening the current package of care to cater to the diversity of mental health disorders, gender difference, children and adolescents. Standardized diagnostic and monitoring tools would also need to be adapted accordingly and to assess patient progress. Innovative approaches to tackle the problem of the low return rate are needed. [ABSTRACT FROM AUTHOR]

Objective: Adjustment disorders are re-conceptualized in the DSM-5 as a stress-related disorder; however, besides the impact of an identifiable stressor, the specification of a stress concept, remains unclear. This study is the first to examine an existing stress-model from the general population, in patients diagnosed with adjustment disorders, using a longitudinal design. Methods: The study sample consisted of 108 patients consecutively admitted for adjustment disorders. Associations of stress perception, emotional distress, resources, and mental health were measured at three time points: the outpatients’ presentation, admission for inpatient treatment, and discharge from the hospital. To evaluate a longitudinal stress model of ADs, we examined whether stress at admission predicted mental health at each of the three time points using multiple linear regressions and structural equation modeling. A series of repeated-measures one-way analyses of variance (rANOVAs) was performed to assess change over time. Results: Significant within-participant changes from baseline were observed between hospital admission and discharge with regard to mental health, stress perception, and emotional distress (p<0.001). Stress perception explained nearly half of the total variance (44%) of mental health at baseline; the adjusted R2 increased (0.48), taking emotional distress (i.e., depressive symptoms) into account. The best predictor of mental health at discharge was the level of emotional distress (i.e., anxiety level) at baseline (β = −0.23, R2corr = 0.56, p<0.001). With a CFI of 0.86 and an NFI of 0.86, the fit indices did not allow for acceptance of the stress-model (Cmin/df = 15.26; RMSEA = 0.21). Conclusions: Stress perception is an important predictor in adjustment disorders, and mental health-related treatment goals are dependent on and significantly impacted by stress perception and emotional distress. [ABSTRACT FROM AUTHOR]

Background: The association between attachment and mental health symptoms in adolescents in a post-conflict low resource setting has not been documented. Methods: We investigated the relationship between parent and peer attachment and posttraumatic stress, depression and anxiety symptoms in a sample of 551 adolescents aged 13–21 years old. Attachment quality was assessed using the Inventory of Parent and Peer Attachment (IPPA). Post-traumatic stress, depression and anxiety symptoms were assessed using the Impact of Events Scale Revised (IESR) and Hopkins Symptom Checklist for Adolescents (HSCL-37A) respectively. Gender differences in attachment relationships were determined using independent t-tests. Multivariate logistic regression was used to assess whether attachment relationships were independently associated with posttraumatic stress, depression and anxiety symptoms. Hierarchical linear regression analyses were conducted to explore the moderating role of war-related trauma. Results: Our analyses revealed gender differences in attachment to parents, with males reporting stronger attachment than females. Parental attachment was protective against depression and anxiety symptoms but not posttraumatic stress symptoms after adjusting for potential confounders. Alienation by parents was independently associated with an increase in these mental health symptoms while peer attachment was not associated with any of these symptoms. However, in situations of severe trauma, our analyses showed that peer attachment was significantly protective against post-traumatic stress symptoms. Conclusions: Secure parental attachment is associated with better psychosocial adjustment in adolescents affected by war. Further, adolescents with secure peer attachment relationships in situations of severe war trauma may be less likely to develop posttraumatic stress symptoms. Interventions to enhance peer support in this post conflict setting would benefit this vulnerable population. [ABSTRACT FROM AUTHOR]

Background: Mindfulness-based therapy (MBT) has been used effectively to treat a variety of physical and psychological disorders, including depression, anxiety, and chronic pain. Recently, several lines of research have explored the potential for mindfulness-therapy in treating somatization disorders, including fibromyalgia, chronic fatigue syndrome, and irritable bowel syndrome. Methods: Thirteen studies were identified as fulfilling the present criteria of employing randomized controlled trials to determine the efficacy of any form of MBT in treating somatization disorders. A meta-analysis of the effects of mindfulness-based therapy on pain, symptom severity, quality of life, depression, and anxiety was performed to determine the potential of this form of treatment. Findings: While limited in power, the meta-analysis indicated a small to moderate positive effect of MBT (compared to wait-list or support group controls) in reducing pain (SMD  = −0.21, 95% CI: −0.37, −0.03; p<0.05), symptom severity (SMD  = −0.40, 95% CI: −0.54, −0.26; p<0.001), depression (SMD  = −0.23, 95% CI: −0.40, −0.07, p<0.01), and anxiety (SMD  = −0.20, 95% CI: −0.42, 0.02, p = 0.07) associated with somatization disorders, and improving quality of life (SMD  = 0.39, 95% CI: 0.19, 0.59; p<0.001) in patients with this disorder. Subgroup analyses indicated that the efficacy of MBT was most consistent for irritable bowel syndrome (p<0.001 for pain, symptom severity, and quality of life), and that mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MCBT) were more effective than eclectic/unspecified MBT. Conclusions: Preliminary evidence suggests that MBT may be effective in treating at least some aspects of somatization disorders. Further research is warranted. [ABSTRACT FROM AUTHOR]

Aggregation is a defensive strategy employed by many prey species in response to predatory threat. Our group has characterized defensive aggregation (huddling) in Rattus norvegicus in response to a ball of cat fur. In this situation some rats huddle less, and approach the threatening cue more than others (active vs. passive responders). The present study explored whether active responding is a stable phenotype associated with behaviors outside direct predatory encounters. The neural substrates of active and passive responding under predatory threat were explored using c-Fos immunohistochemistry. Finally, we examined whether the presence of conspecifics during predatory threat biases behavior towards active responding. Active and passive responding styles were found to be stable in individual rats across consecutive group exposures to cat fur, and were predicted by anxiety-like behavior in an open-field emergence test. Active responders displayed less conditioned fear in an environment associated with predatory threat, and had higher post-exposure intake of a weak sucrose solution (a test of “anhedonia”). Active responding was associated with: greater cat fur-induced activation of the accessory olfactory bulb, reflecting greater olfactory stimulation in rats actively approaching the fur; lowered activation of somatosensory cortex, reflecting reduced huddling with conspecifics; and reduced activation in the lateral septum. Social exposure to cat fur promoted active responding relative to individual exposure, and lowered c-Fos expression in the dorsomedial periaqueductal grey, medial caudate putamen and lateral habenula. We conclude that individual differences in anti-predator behavior appear stable traits with active responders having a more resilient phenotype. Social exposure to predatory threat has an acute buffering effect, subtly changing the neural and behavioral response towards threat and encouraging active responding. An association between active responding and lower c-Fos expression in the lateral septum is consistent with previous studies that highlight this region as an important neurobiological substrate of defensive aggregation. [ABSTRACT FROM AUTHOR]

Background: Little is known about reliability and validity of instruments measuring externalizing mental health problems in immigrant ethnic minority youths. Aims: To provide an overview of studies on measurement properties of instruments measuring these problems in immigrant ethnic minority youths, their methodological quality and results. Methods: A systematic review of the literature in MEDLINE, EMbase, PsycINFO and Cochrane Library was performed. Evaluation of methodological quality of studies found was done by using the ‘COSMIN-checklist’. Full text, original articles, published in English after 1990 were included. Articles had to concern the development or evaluation of the measurement properties of self-reported, parent-reported and/or teacher- or clinician-reported questionnaires assessing or screening externalizing mental health problems in immigrant ethnic minority youths. Specific results of analyses on (an) immigrant ethnic minority group had to be given. Results: Twenty-nine studies evaluating 18 instruments met our criteria. Most studies concerned instruments with known validity in Western populations, tested mainly in African Americans. Considering methodological quality, inequivalences between ethnicities were found, self-reports seemed to perform better, and administration of an instrument influenced reliability and validity. Conclusion: It seems that the majority of instruments for assessing externalizing problems in immigrant ethnic minority youths is currently not sufficiently validated. Further evaluating existing instruments is crucial to accurately assess and interpreted externalizing problems in immigrant ethnic minority youths. [ABSTRACT FROM AUTHOR]

Background: Research shows that children with Attention Deficit/Hyperactivity Disorder are at elevated risk of criminality. However, several issues still need to be addressed in order to verify whether hyperactivity in itself plays a role in the prediction of criminality. In particular, co-occurrence with other behaviors as well as the internal heterogeneity in ADHD symptoms (hyperactivity and inattention) should be taken into account. The aim of this study was to assess the unique and interactive contributions of hyperactivity to the development of criminality, whilst considering inattention, physical aggression and family adversity. Methodology/Principal Findings: We monitored the development of a population-based sample of kindergarten children (N = 2,741). Hyperactivity, inattention, and physical aggression were assessed annually between the ages of 6 and 12 years by mothers and teachers. Information on the presence, the age at first charge and the type of criminal charge was obtained from official records when the participants were aged 25 years. We used survival analysis models to predict the development of criminality in adolescence and adulthood: high childhood hyperactivity was highly predictive when bivariate analyses were used; however, with multivariate analyses, high hyperactivity was only marginally significant (Hazard Ratio: 1.38; 95% CI: 0.94–2.02). Sensitivity analyses revealed that hyperactivity was not a consistent predictor. High physical aggression was strongly predictive (Hazard Ratio: 3.44; 95% CI: 2.43–4.87) and its role was consistent in sensitivity analyses and for different types of crime. Inattention was not predictive of later criminality. Conclusions/Significance: Although the contribution of childhood hyperactivity to criminality may be detected in large samples using multi-informant longitudinal designs, our results show that it is not a strong predictor of later criminality. Crime prevention should instead target children with the highest levels of childhood physical aggression and family adversity. [ABSTRACT FROM AUTHOR]

Work accidents can be traumatic events that might give rise to a variety of dysfunctional stress responses. An integrated assessment of stress responses after work-related trauma is considered as a valuable approach in clinical practice. The purpose of the present study was to assess affective adjustment after work-related accidents using a multidimensional assessment. Fourteen males who had experienced work-related accidents and 13 male controls were assessed using self-report instruments and the recording of skin conductance response and the startle reflex during the viewing of standardized trauma-related and trauma-unrelated pictures. Participants who underwent a work accident reported more severe maladjustment symptoms than controls, as indicated by higher Post-traumatic stress disorder Symptom Scale (PSS) scores. Moreover, participants with higher PSS scores showed more severe depressive symptomatology and general psychopathology, and lower psychophysiological reactivity than participants with lower PSS scores. Long-lasting maladjustment problems after work-related accidents influence various affective domains even many years after the traumatic event. In those individuals who showed higher post-stress symptoms, an integrated assessment highlights a lack of concordance between self-reported symptoms and physiological activation. Copyright © 2008 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]