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Author(s): Mary Jo Coiro [sup.1] , Kelly H. Watson [sup.2] , Abby Ciriegio [sup.2] , Maile Jones [sup.2] , Amy R. Wolfson [sup.1] , Jennie Reisman [sup.2] , Bruce E. [...], The COVID-19 pandemic has brought unprecedented levels of stress to individuals in the U.S. and throughout the world. These high stress levels place individuals at risk for symptoms of anxiety, depression, and other psychiatric disorders. The current study applies a control-based model of coping to contribute to the development of evidence-based interventions to promote resilience. Data were collected online from April 22 through July 12, 2020. Data from two samples of U. S. community adults who completed an online battery of standardized questionnaires were combined (N = 709). More than a quarter reported moderate to severe levels of depression symptoms, and more than one-fifth reported moderate to severe levels of anxiety symptoms; symptom levels were higher among adults who reported more COVID-19-related stress. As hypothesized, multiple regression analyses indicated that greater use of primary and secondary control coping was associated with lower symptom levels, whereas greater use of disengagement coping was associated with higher symptom levels, above and beyond the association of stress with symptoms. Race and ethnicity emerged as important moderators of these associations, indicating that what constitutes adaptive coping varies according to characteristics of the individual. Implications for public health policy and clinical practice are discussed.

Objective: The present study assessed two theory-driven mediators of the effects of a family group cognitive-behavioral (FGCB) preventive intervention for youth of parents with a history of major depressive disorder (MDD) or dysthymia on long-term youth psychopathology symptoms and diagnoses. Method: Sample included 180 parents (Mage = 41.9, 89% female, 82% White, non-Hispanic) and one of their children/adolescents ages 9–15 years (Mage = 11.4, 49% female, 74% White, non-Hispanic). Changes in the hypothesized mediators, observations of positive parenting (Iowa Family Interaction Rating Scales) and youth secondary control coping (SCC) skills (Responses to Stress Questionnaire), were assessed at 6 months. Changes in youth psychopathology symptoms were assessed on the Child Behavior Checklist and Youth Self-Report at 18- and 24-month follow-ups and MDD diagnoses with the Kiddie Schedule for Affective Disorders and Schizophrenia at 12 and 24 months. Results: Changes in youth SCC skills (e.g., acceptance, reappraisal) after the intervention mediated the effects of the FGCB program on changes in youth internalizing and externalizing symptoms at 18- and 24-month follow-ups. Effects for changes in positive parenting behaviors as a mediator were more limited. SCC skills were further shown to mediate the effects of the FGCB intervention on MDD diagnoses from 12 to 24 months. Conclusions: This study provides clear and strong evidence that changes in youth SCC skills mediated the long-term effects of preventive intervention for families of depressed parents. What is the public health significance of this article?: This study provides evidence for the role of teaching secondary control coping skills to youth and parenting skills in accounting for the effects of a preventive intervention for youth of parents with a history of depression over a period of 2 years. [ABSTRACT FROM AUTHOR]

Regulatory efforts are hypothesized to affect associations between emotions and physiology (i.e., concordance) to facilitate adaptive functioning. Assessing the role of coping on physiological–emotional concordance during ecologically relevant scenarios can elucidate whether concordance can serve as a biomarker of risk or resilience. The present study assessed self‐reported coping as a moderator of minute‐to‐minute associations between autonomic nervous system activity and emotions (i.e., physiological–emotional concordance) in caregivers (N = 97) and adolescents (N = 97; ages 10–15) during a dyadic conflict task. Models included physiological variables (sympathetic, skin conductance level [SCL]; and parasympathetic, respiratory sinus arrhythmia [RSA]) and their interaction (SCL × RSA) as predictors of emotions, with coping variables as moderators. Caregivers' use of primary control coping (e.g., problem solving and emotional expression) and secondary control coping (e.g., cognitive reappraisal and acceptance) use in response to family stress predicted more positive emotional experiences during the laboratory conflict task. Adolescents' use of secondary control coping moderated the SCL–emotion association, such that increases in momentary SCL were associated with more positive emotion ratings for youth reporting higher secondary control coping. For youth who report more adaptive trait‐level coping skills, momentary changes in SCL may reflect active engagement and attentiveness to facilitate more positive emotional experiences. Findings advance our understanding of the interrelationships between physiological responses and psychological experiences during relevant, interactive scenarios. Autonomic responses are differentially related to affective states depending on the coping strategies that adolescents employ, suggesting that concordance may be associated with intervention targets (i.e., coping skills). Regulatory efforts are hypothesized to affect physiological–emotional associations to facilitate adaptive functioning. Results suggest that autonomic responses differentially relate to emotions based on coping. For adolescents utilizing more secondary control coping skills, momentary skin conductance level changes may reflect active engagement and attentiveness to facilitate more positive emotional experiences. [ABSTRACT FROM AUTHOR]

Many interventions are characterized by repeated observations on the same individuals (e.g., baseline, mid-intervention, two to three post-intervention observations), which offer the opportunity to consider differences in how individuals vary over time. Effective interventions may not be limited to changing means, but instead may also include changes to how variables affect each other over time. Continuous time models offer the opportunity to specify differing underlying processes for how individuals change from one time to the next, such as whether it is the level or change in a variable that is related to changes in an outcome of interest. After introducing continuous time models, we show how different processes can produce different expected covariance matrices. Thus, models representing differing underlying processes can be compared, even with a relatively small number of repeated observations. A substantive example comparing models that imply different underlying continuous time processes will be fit using panel data, with parameters reflecting differences in dynamics between control and intervention groups.

The objective was to characterize the relation between different sources of school-based social support (friends, peers, and teachers) and bereaved siblings' grief and grief-related growth and to examine whether nonparental sources of social support buffer the effects of low parent support on bereaved siblings. Families (N = 85) were recruited from cancer registries at 3 pediatric institutions 3-12 months after a child's death. Bereaved siblings were 8-18 years old (M = 12.39, SD = 2.65) and majority female (58%) and White (74%). During home visits, siblings reported their perceptions of social support from parental and nonparental sources using the Social Support Scale for Children, as well as grief and grief-related growth using the Hogan Sibling Inventory of Bereavement. Parent, friend, and teacher support were positively correlated with grief-related growth, whereas parent and peer support were negatively correlated with grief for adolescents. Teacher and friend support significantly moderated the association between parent support and grief such that teacher and friend support accentuated the positive effects of parent support. Friend and peer support moderated associations between parent support and grief/growth for adolescents but not children. School-based social support, namely from friends, peers, and teachers, appears to facilitate the adjustment of bereaved siblings. Findings suggest that bereaved siblings may benefit from enhanced support from teachers and friends regardless of age, with middle/high school students particularly benefitting from increased support from close friends and peers.

Author(s): Emily R. Hamburger [sup.1] , Morgan Lyttle [sup.1] , Bruce E. Compas [sup.2] , Sarah S. Jaser [sup.1] Author Affiliations: (Aff1) grid.412807.8, 0000 0004 1936 9916, Department of Pediatrics, [...], The purpose of the current study was to examine executive function (EF) in adolescents with type 1 diabetes using both performance-based and questionnaire measures in relation to diabetes indicators. Adolescents age 13-17 completed performance-based measures of EF and measures of adherence. Adolescents' parents reported on adolescents' EF and adherence. HbA1c and frequency of blood glucose monitoring (glucometer data) were obtained from adolescents' medical records. None of the performance-based measures of EF were significantly associated with adherence or with HbA1c. Parent-reported problems with EF were associated with poorer adherence, and adolescents who scored in the impaired range of the Behavioral Regulation Index of EF had significantly poorer adherence (both parent-reported adherence and frequency of blood glucose monitoring) and higher HbA1c than those in the normal range. Our findings suggest that parent-reported measures of EF may be more strongly linked to diabetes indicators than performance-based measures.

Objective: The ways that college students cope with stress, particularly interpersonal stress, may be a critical factor in determining which students are at risk for impairing mental health disorders. Using a control-based model of coping, the present study examined associations between interpersonal stress, coping strategies, and symptoms. Participants: A total of 135 undergraduate students from 2 universities. Methods: Interpersonal stress, coping strategies, depression, anxiety, and somatization were assessed via self-report. Results: Students reporting more interpersonal stress reported more depression, anxiety, and somatization, and they reported less use of engagement coping strategies and greater use of disengagement coping strategies. Engagement coping strategies accounted for a significant portion of the association between interpersonal stress and mental health symptoms. Unexpectedly, coping strategies did not moderate the association between stress and mental health symptoms. Conclusion: Interventions designed to improve students' coping strategies may be an effective way to reduce mental health problems on college campuses.

Objective: College students face a significant number of stressors, increasing risk for internalizing and externalizing psychopathology. The current study examines two promising avenues of intervention aimed to reduce stress and prevent psychopathology in this population: a coping skills group and a cognitive training program. Participants: 62 undergraduate students from two universities were recruited from 2013 to 2015. Methods: Students were randomized to a 6-week coping skills group or cognitive training program and completed measures of stress, coping, executive function, and symptoms of anxiety, depression and Attention-Deficit Hyperactivity Disorder (ADHD) at pre- and post-intervention. Results: Participants in both conditions reported significant decreases in social stress, executive function difficulties, and anxiety symptoms post-intervention. Students in the cognitive program improved significantly more on measures of behavior regulation and ADHD symptoms compared to the coping group at post-intervention. Conclusions: Brief stress management interventions targeting coping and executive function may benefit college students at risk for psychopathology.

Background: Huntington's disease (HD) is a neurodegenerative disease that presents families with significant numbers of stressful events. However, relatively little empirical research has characterized the stressors encountered by members of HD-affected families and their correlations with psychological symptoms. Objective: This study examined frequencies of specific stressors in HD patients and at-risk individuals and the correlates of these stressors with demographics, disease characteristics, and symptoms of depression and anxiety. Methods: HD patients (n = 57) and at-risk individuals (n = 81) completed the Responses to Stress Questionnaire –Huntington's Disease Version to assess HD-related stressors. Participants completed measures of depression and anxiety symptoms. Patient health records were accessed to obtain information related to disease characteristics. Results: Patients endorsed a mean number of 5.05 stressors (SD = 2.74) out of the 10-item list. Demographics were not related to total stressors, but disease characteristics were significantly related to specific stressors. At-risk individuals endorsed a mean number of 3.20 stressors (SD = 2.65) out of the 11-item list. Age and sex were significantly related to specific stressors. Total number of stressors was significantly related to depression (β=0.67, p < 0.001) and anxiety symptoms (β=0.58, p < 0.001) in patients and at-risk individuals (β=0.35, p = 0.003 and β=0.32, p = 0.006, respectively). Conclusions: hese findings emphasize the significant burden of stress experienced by HD patients and at-risk individuals. We highlight a need for more specific stress-based measures and psychosocial support interventions for HD-affected families. [ABSTRACT FROM AUTHOR]

It is well-established that disrupted autonomic nervous system (ANS) reactivity exacerbates risk for long-term maladjustment following childhood adversity (CA). However, few studies have integrated measures of both the sympathetic (SNS) and parasympathetic (PNS) branches of the ANS, resulting in a unidimensional understanding of ANS functioning as a mechanism of risk. Further, past work has primarily measured CA only at the aggregate level (e.g. "total CA"), necessitating further research to accurately characterize this risk pathway. The present study examines how CA, measured cumulatively and dimensionally (i.e. CA characterized by threat versus deprivation), moderates the association between the SNS and PNS at rest and in response to acute social and nonsocial stressors. Participants included 97 adolescents ages 10-15 (Mage = 12.22, SDage = 1.68) experiencing a range of CA and one accompanying caregiver. Participants completed questionnaires assessing prior CA exposure. SNS and PNS responses were then continuously measured during rest and two stress tasks. First, results indicate a blunting effect of cumulative CA and CA characterized by threat (e.g. physical abuse) on resting SNS activity. Second, in moderation analyses assessing ANS coordination, threat exposure emerged as a significant moderator of the association between SNS and PNS reactivity to social stress. Results suggest that CA characterized by threat may specifically impact physiologic regulation by disrupting the coordination of the two branches of the ANS. Disentangling the independent and concurrent engagement of biological stress response systems following CA remains an important target for research to identify the etiology of aberrant stress reactivity patterns. [ABSTRACT FROM AUTHOR]

Objective: Limited research has characterized cancer‐related stress (CRS) among families of childhood cancer survivors. We examined the prevalence of CRS among survivors and caregivers, as well as its association with health risk perceptions (i.e., prognosis, risk for diminished quality of life) and views of survivor quality of life (QoL). Methods: At five years post‐diagnosis or relapse, survivors (n = 100; Mage = 15.84 years; 89% White), mothers (n = 127), and fathers (n = 59) reported their CRS. Perceived prognosis and risk for diminished QoL were rated on a 0%–100% visual analogue scale, while the PedsQL assessed QoL. Results: CRS was low (M = 1.6–1.8, scale: 1–4); mothers reported greater stress than survivors, p = 0.038, d = 0.25. There was an indirect effect of survivors' perceived prognosis on their QoL through CRS, CI = 0.04 to 0.25, R2 = 0.32. Among mothers, there was an indirect effect of perceived prognosis/risk for diminished QoL on their reports of survivor QoL through CRS, CI = 0.03 to 0.23 and −0.15 to −0.03, R2 = 0.28 and 0.32, respectively. There were no indirect effects among fathers. Conclusions: CRS may be an important, modifiable factor that could improve survivors' QoL. Research is needed to examine how CRS changes over time to assess the utility of interventions among female survivors, mothers, and those with lower prognosis estimates. [ABSTRACT FROM AUTHOR]

Objectives: We identified types of interventions used by bereaved family members and examined associations with demographic and medical factors. Furthermore, we examined associations between distress and intervention use among bereaved families. Methods: Bereaved families (n = 85) were recruited from three children's hospitals 3–12 months after their child died of cancer. One eligible sibling (ages 8–17) per family was randomly selected for participation. During home visits 1-year post-death, parents reported on their own and the sibling's intervention use, helpfulness, and dose (self-help books, support groups, therapy, medication), and distress, defined as internalizing, externalizing, and total problems (Adult Self Report, Child Behavior Checklist). Results: Fifty percent of mothers used medications (n = 43); utilization was low among fathers (17%, n = 9) and siblings (5%, n = 4). Individuals with more total problems were more likely to use medications (mothers: rpb = 0.27; p = 0.02; fathers: rpb = 0.32; p = 0.02; siblings: rpb = 0.26; p = 0.02). Mothers and siblings with more total problems used more services (r = 0.24; p = 0.03 and r = 0.29; p = 0.01, respectively). Among mothers, the overall regression was significant, R 2 = 0.11, F (2, 80) = 4.954, p = 0.01; the deceased child's age at death was significantly associated with total services used (b = 0.052, p = 0.022). Among fathers, the overall regression was significant, R 2 = 0.216, F (3, 49) = 4.492, p = 0.007; race and years of education were significantly associated with total services used (b = 0.750, p = 0.030 and b = 0.154, p = 0.010). Among siblings, the overall regression was significant R 2 = 0.088, F (2, 80) = 3.867, p = 0.025; greater total problems were significantly associated with total services used (b = 0.012, p = 0.007). Significance of results: Although few background factors were related to intervention use, bereaved mothers and siblings may seek services if they have more distress. Healthcare providers should be aware of the types of services that are most often utilized and helpful to bereaved families to connect them with appropriate resources. Future research should investigate other predictors of intervention use and outcomes after the death of a child. [ABSTRACT FROM AUTHOR]