Interpersonal Difficulties Research Articles

The association between minority stressors, intraminority stressors, and borderline personality disorder symptomatology among sexual minority men.

Sexual minority men are more likely to be diagnosed with borderline personality disorder compared to their heterosexual counterparts. Minority stressors have been associated with criteria for borderline personality disorder (e.g., substance use, suicidality, impulsive behaviors, and interpersonal difficulties with rejection). However, to date, there are no known studies examining the association between traditional minority and intraminority stressors and borderline personality disorder symptomatology. The purpose of the study is to examine the association between traditional and intraminority stressors and borderline personality disorder symptomatology among sexual minority men. Data were collected from 312 sexual minority men (Mage = 24.00, SD = 4.04) via Qualtrics panels across the United States. A hierarchical linear regression was conducted with borderline personality disorder symptomatology as the outcome variable. Minority stressors (i.e., internalized homophobia, sexual orientation concealment, major discrimination, and day-to-day discrimination) were entered in Step 1, and intraminority stress was entered in Step 2. In Step 1, both major and day-to-day discrimination were significantly positively associated with borderline personality disorder symptomatology. In Step 2, intraminority stress was significantly positively associated with borderline personality disorder symptomatology, and day-to-day discrimination remained significant. These findings warrant clinicians to evaluate both minority and intraminority stressors, which may be an additional risk factor in the development and/or maintenance of borderline personality disorder symptomatology. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Anxiety and Associated Factors Among Chinese Preschool Teachers

In China, preschool teachers significantly influence the development of young children aged 3–6 years. Understanding their mental health and its associated factors is imperative to informing policies, optimizing their mental well-being, and supporting their job performance. This study aimed to investigate the factors contributing to anxiety symptoms among preschool teachers. A sample of 393 Chinese preschool teachers (279 women, 114 men), aged 21–56, completed online questionnaires collecting their sociodemographic and work-related information and assessing anxiety symptoms, interpersonal difficulties, personality traits, perceived stress, resilience, and inner strength. Pearson correlation and multiple linear regression analyses identified significant predictors of anxiety symptoms. The prevalence of anxiety symptoms among the studied cohort was found to be 12.2%. Statistically significant factors that positively correlated with anxiety symptoms included objective work-related stress (B = 0.149, p < 0.001), interpersonal difficulties (B = 0.921, p < 0.001), perceived stress (B = 0.108, p = 0.001), and neuroticism (B = 0.071, p = 0.002). These findings highlight the urgent need for measures to reduce work-related stress and anxiety. However, when negative mental health factors were included, the effect of positive psychological factors became nullified. Positive mental health might have a moderating role in a negative mental health outcome such as anxiety. Therefore, further research is required to understand the impact of positive mental health factors more clearly.

Eating Disorder-Related Symptom Reduction, Suicidal/Self-Injurious Behavior, Emotional Dysregulation and Interpersonal Difficulties in an Eating Disorder-Specific Treatment - A Clinical Study

This study exploratively investigated a possible relationship between suicidal/self-injurious behavior and the change in self-reported eating disorder symptoms as well as emotional dysregulation and interpersonal difficulties during eating disorder-specific treatment. For this purpose, the symptom index of the Eating Disorder Inventory-2 (EDI-SI) and the scale for the assessment of impulsivity and emotional dysregulation of borderline personality disorder (IES-27) with its subscales suicidal and self-injurious behavior (SVV/SEV), emotional dysregulation (EmotDys) and interpersonal difficulties (BezSchw) were collected from 167 female patients at a psychosomatic clinic. The participants were divided into four groups depending on the occurrence of SVV/SEV before the start and/or end of treatment. A one-way multivariate analysis of variance (MANOVA) with repeated measures showed an interaction of time and SVV/SEV group with regard to EDI-SI, EmotDys and BezSchw. The effect sizes of the pre-post comparison of the EDI-SI were very different in the groups divided according to the occurrence of SVV/SEV (0.27<g*< 1.32). No significant improvement in the EDI-SI was found on average for people with new occurrence of SVV/SEV during the course of treatment. People who were able to cease SVV/SEV in the course of treatment also benefited in terms of the EDI-SI. The decisive factor for the consideration of SVV/SEV in patients with eating disorders appears to be less the SVV/SEV reported before the start of treatment, but rather newly occurring or persistent SVV/SEV during the course of treatment.

Sexual life in adults treated for brain tumors: a retrospective study.

Sexual functioning is a multifaceted aspect of human life that can be profoundly affected in patients with glioma. Most frequent symptoms include reduced sexual desire, difficulties in sexual arousal, or low satisfaction. Such symptoms may cause distress or interpersonal difficulties, inevitably resulting in negative outcomes on different domains of patients' quality of life. Despite this, sexuality is rarely addressed by medical staff and remains understudied. An important question still unanswered is whether sexual dysfunctions in glioma patients correlate with features of the tumor itself, with its treatment, or with the secondary effects of the tumor on the patient's psychological status. To answer this question, the present study aims to investigate the incidence of sexual life impairments in a very large population of patients with low- and high-grade gliomas, focusing on demographic, clinical, and treatment factors associated with their occurrence and developments. A total of 148 patients treated for glioma were evaluated for sexual functioning, i.e., sexual dysfunction (SD), relationship status (RS), intercourse frequency (IF), and sexual satisfaction (SS), by using a specific anonymous questionnaire. Descriptive statistics were utilized to investigate participant characteristics and to evaluate the occurrence of sexual problems. Chi-squared tests were performed to detect the association between "SS" or "IF" and different clinical/demographic factors as well as between "SS" or "IF" and the "subjective-personal skills judgment". Results showed no difference between male and female patients, a very low frequency (1.4%) of SD, but a consistent percentage (25%) of subjective deterioration in sexual wellbeing. Notably, 24% of patients reported to have interrupted their relationship after the diagnosis. Chi-squared analyses reveal an association between adjuvant treatments (chemotherapy and radiotherapy) and reduction of IF. Interestingly, "SS" or "IF" was not associated with demographic, clinical, or histomolecular factors. Our study showed that sexual problems in glioma patients are not uncommon, and they are especially linked to SS, RS, and IF. Specifically, intercourse frequency reduction is associated with the adjuvant treatments. Results highlight the need for improved assessment strategies and interventions tailored to the unique needs of brain tumor patients.

Impulsive adolescents exhibit inefficient processing and a low decision threshold when decoding facial expressions of emotions.

Borderline personality disorder (BPD) is a debilitating psychiatric illness whose symptoms frequently emerge during adolescence. Initial studies in adults suggest that the interpersonal difficulties common in BPD may emerge from disrupted processing of social and emotional stimuli. Less is known about these processes in adolescents with BPD symptoms, despite substantial changes in socioemotional processing during this developmental period. 86 adolescents and young adults with and without BPD symptoms completed an emotional interference task involving the identification of a facial emotion expression in the presence of a conflicting or congruent emotion word. We used hierarchical drift diffusion modeling to index speed of processing and decision boundary. Using Bayesian multilevel regression, we characterized age-related differences in facial emotion processing. We then examined whether BPD symptom dimensions were associated with facial emotion processing on this task. To determine the specificity of our effects, we analyzed behavioral data from a corresponding nonemotional interference task. Impulsivity, but not negative affectivity or interpersonal dysfunction, predicted inefficient processing when presented with conflicting negative emotional stimuli. Across both tasks, impulsivity in adolescents was further associated with a lower decision boundary. Impulsive adolescents were especially likely to make fast, but inaccurate decisions about another person's emotional state. Impulsive adolescents with BPD symptoms are prone to making errors when appraising facial expressions of emotions, which may potentiate or worsen interpersonal conflicts. Our findings highlight the role of lower-level social cognitive processes in interpersonal difficulties among vulnerable youth during a sensitive developmental window.

Psychosocial and pandemic-related circumstances of suicide deaths in 2020: Evidence from the National Violent Death Reporting System.

To describe and explore variation in 'pandemic-related circumstances' among suicide decedents during the first year of the COVID-19 pandemic. We identified pandemic-related circumstances using decedents' text narratives in the 2020 National Violent Death Reporting System. We use time-series analysis to compare other psychosocial characteristics (e.g., mental health history, interpersonal difficulties, financial strain) of decedents pre-pandemic (2017/2018: n = 56,968 suicide and n = 7,551 undetermined deaths) to those in 2020 (n = 31,887 suicide and n = 4,100 undetermined). We characterize common themes in the narratives with pandemic-related circumstances using topic modeling, and explore variation in topics by age and other psychosocial circumstances. In 2020, n = 2,502 (6.98%) narratives described pandemic-related circumstances. Compared to other deaths in 2020 and to the pre-pandemic period, decedents with pandemic-related circumstances were older and more highly educated. Common themes of pandemic-related circumstances narratives included: concerns about shutdown restrictions, financial losses, and infection risk. Relative to decedents of the same age that did not have pandemic-related circumstances in 2020, those with pandemic-related circumstances were more likely to also have financial (e.g., for 25-44 years, 43% vs. 12%) and mental health (76% vs. 66%) psychosocial circumstances, but had similar or lower prevalence of substance abuse (47% vs. 49%) and interpersonal (40% vs. 42%) circumstances. While descriptive, these findings help contextualize suicide mortality during the acute phase of the COVID-19 pandemic and can inform mental health promotion efforts during similar public health emergencies.

Problem-Solving and Coping Skills Training for Youth with Deliberate Self-Harm Behaviors: A Scoping Review

There has been an urgent need for the youths to be furnished with the capacity to apply the use of strategies such as problem-solving and coping skills in other to ameliorate their deliberate self-harming behavior inclinations. It is important to recognize the underlying emotional and psychological underpinnings of these self-harming behaviors. I have searched three data bases; Scopus, Google Scholar advanced search, and PubMed, using keywords such as “problem-solving,” “coping,” “youth,” and “deliberate self-harm.” The articles were then screened to ensure that they all met the inclusion criteria and only those published in the English language were selected and relevant to problem-solving and coping skills in the context of deliberate self-harm. Deliberate self-harm behaviors pose a substantial risk to the mental health of the individuals involved. Integrating emotional regulation and coping skills has been shown to improve mental health outcomes in these youths significantly. Problem-solving and coping skills programs have emerged as effective interventions for addressing deliberate self-harm behaviors in youth. Those who are engrossed in deliberate self-harm often struggle with problem-solving abilities and resort to maladaptive social problem-solving, such as self-harming, as a coping mechanism. Incorporating problem-solving techniques within therapy approaches can be an effective strategy to address deliberate self-harm behaviors and promote healthier coping mechanisms. There is the need for structured interventions to meet the unique and diverse need of the youths engaged in this act. Interventions can target the core issues, such as emotional dysregulation, interpersonal difficulties, or trauma history.

Interpersonal Difficulties Arising from Child Sexual Abuse: Differences Between Intra-familial and Extra-familial Abuse Victims.

Child sexual abuse (CSA) often has serious implications for the victims. The scientific literature reflects a diversity of sequelae that may appear in the short and long term. Interpersonal difficulties have been shown to be one of the most common consequences. However, studies comparing these sequelae between victims of intra-familial (IF) and extra-familial (EF) CSA are scarce. The aim of this research was to analyze differences in dyadic satisfaction, sexual satisfaction, and attachment patterns in adulthood between Spanish IF victims, EF victims, and non-victims of CSA. The Sexual Victimization Subscale of the Juvenile Victimization Questionnaire, the Relationship Assessment Scale, the New Sexual Satisfaction Scale, and the Adult Attachment Questionnaire were administered to 140 adults (94 CSA victims and 46 non-victims) aged 18 to 54 years. CSA victims scored lower than the non-victims on the personal sexual satisfaction factor and attachment factors characterized by the need for approval, hostile resolution of conflicts, and emotional self-sufficiency. Statistically significant differences were also found between the victim groups in the factors characterized by the need for approval and communication of feelings and comfort with relationships showing the IF group to have more impairment in these areas than the EF group. In conclusion, CSA may have serious implications for the development of victims' interpersonal relationships. The context of sexual abuse and the relationship between victim and offender appears to play a role in the development of relational problems. These findings highlight the need to implement specific strategies in the psychological treatment of victims depending on their relationship with the offender and the environment in which the abuse occurred.

Complex PTSD symptoms predict positive symptoms of psychosis in the flow of daily life.

Post-traumatic stress disorder (PTSD) has been shown to predict psychotic symptomology. However, few studies have examined the relative contribution of PTSD compared to broader post-traumatic sequelae in maintaining psychosis. Complex PTSD (cPTSD), operationalized using ICD-11 criteria, includes core PTSD (intrusions, avoidance, hyperarousal) as well as additional "disturbances of self-organisation" (DSO; emotional dysregulation, interpersonal difficulties, negative self-concept) symptoms, more likely to be associated with complex trauma histories. It was hypothesized that DSOs would be associated with positive psychotic symptoms (paranoia, voices, and visions) in daily life, over and above core PTSD symptoms. This study (N = 153) employed a baseline subsample of the Study of Trauma And Recovery (STAR), a clinical sample of participants with comorbid post-traumatic stress and psychosis symptoms. Core PTSD, DSO and psychosis symptoms were assessed up to 10 times per day at quasi-random intervals over six consecutive days using Experience Sampling Methodology. DSOs within the preceding 90 min predicted paranoia, voices, and visions at subsequent moments. These relationships persisted when controlling for core PTSD symptoms within this timeframe, which were themselves significant. The associations between DSOs and paranoia but not voices or visions, were significantly stronger than those between psychosis and core PTSD symptoms. Consistent with an affective pathway to psychosis, the findings suggest that DSOs may be more important than core PTSD symptoms in maintaining psychotic experiences in daily life among people with comorbid psychosis and cPTSD, and indicate the potential importance of addressing broad post-traumatic sequelae in trauma-focused psychosis interventions.

Parental styles are associated with eating disorder symptoms, anxiety, interpersonal difficulties, and nucleus accumbens response

ObjectivesEating disorders (EDs) typically emerge during adolescence. Parental bonding has a lasting impact on a child’s mental health during those developmentally critical years. There remains uncertainty over whether parental bonding is a risk factor for developing or maintaining specifically EDs or, rather, general psychopathology and the associated underlying brain function.MethodsForty-one young adult healthy control individuals (HC, 26.6 ± 3.5 years) and 46 individuals with EDs (25 with anorexia nervosa, AN, 22.8 ± 6.4 years, and 21 with bulimia nervosa, BN, 23.5 ± 4.2 years) completed the parental bonding instrument (PBI), assessments for anxiety, depression, and ED behaviors, and underwent a conditioning paradigm during brain imaging.ResultsIn both groups, perceived parental care and overprotection were correlated with state and trait anxiety and interpersonal alienation, and in HC only, with body dissatisfaction and drive for thinness. Individuals with an ED reported lower self-perceived parental care, but higher overprotection compared to the HC group. Nucleus accumbens (NAc) response was related to bonding measures in both groups and right NAc response mediated the relationship between maternal care and trait anxiety in HC.ConclusionsPerceived parental bonding is associated with general psychopathology, including elevated anxiety and interpersonal difficulties across HC and ED groups. Lower perceived parental care and higher overprotection could predispose healthy individuals to develop problems with body shape or weight; however, other, maybe biological factors may determine whether a person will develop an ED. The link between perceived parental bonding, NAc valence processing and anxiety implicates dopaminergic circuits that should be studied further.Level of Evidence: Level III: Case–control analytic study

The link between hoarding symptoms and interpersonal difficulties during the COVID-19 pandemic

Hoarding is characterized by difficulties discarding, clutter, and excessive acquiring. Disruptions in interpersonal attachment and associated interpersonal difficulties have been implicated in the development and maintenance of hoarding; however, limited research has investigated the link between interpersonal functioning and hoarding. The current study examined the association between hoarding symptoms and multiple interpersonal factors in young adults during the COVID-19 pandemic. Participants (N = 137) completed an online survey in Spring 2020 which included measures of perceived social support, thwarted belongingness, depression, and hoarding symptoms, including difficulties discarding and acquiring. Participants also completed an ecological momentary assessment protocol where they provided daily ratings of connectedness. At a basic level, both difficulties discarding and acquiring symptoms were correlated with greater thwarted belongingness and lower social support. These associations remained significant even after controlling for depression, with the exception of the relationship between difficulty discarding and thwarted belongingness. Greater acquiring was also associated with greater variability in daily connectedness. This study is the first to demonstrate a unique relationship between hoarding symptoms and multiple interpersonal factors, controlling for depression. Our findings suggest that interpersonal functioning is a potential mechanism underlying hoarding. Clinically, addressing interpersonal difficulties may improve the efficacy of current treatments for hoarding disorder.

Trauma-related mental health problems among mothers in Taiwan and their relationship with children’s emotional and behavioral problems

ABSTRACT Background: Trauma can give rise to mental health problems and emotional and interpersonal difficulties, which in turn can perpetuate the cycle of trauma and adversity for future generations. However, little is known about the prevalence and potential effects of trauma and trauma-related mental health problems among parents. Objective: The primary goal of this study was to examine childhood and adulthood trauma and trauma-related symptoms among mothers of children aged between 6 and 18. We also conducted exploratory analyses of their potential relationship with children’s emotional and behavioural problems. Method: A total of 817 mothers living with a child aged between 6 and 18 in Taiwan completed standardized self-report assessments of trauma exposure, trauma-related symptoms, and children’s emotional and behavioural problems. A subsample (n = 256) also provided follow-up data after six months. Results: Most surveyed mothers reported at least one childhood traumatic event (74.79%) and one adulthood traumatic event (78.70%); 4.4% met the ICD-11 criteria for PTSD, and 12.1% for complex PTSD; 11.4% reported clinically significant dissociative symptoms. Mothers’ complex PTSD and dissociative symptoms were cross-sectionally correlated with children’s emotional and behavioural problem (rs = .186 to .239, p < .001). After controlling for possible confounding variables and baseline scores, mothers’ childhood non-betrayal trauma reported at baseline was found to be a predictor of children's emotional and behavioural problems reported at follow up. Conclusion: This study is the first to provide data regarding childhood and adulthood trauma and trauma-related disorders, including ICD-11 complex PTSD, among mothers in the community. It calls for more studies to understand the potential effects of intergenerational trauma.

Loneliness and shyness from the perspective of emotion regulation

Research aim: Loneliness and shyness are two of our increasing psychological problems today. It is considered important to understand how emotion regulation dimensions affect these two problem areas, as one of the main factors underlying our psychological problems. In this study, it was aimed to determine how both intra and interpersonal emotion regulation strategies and difficulties in emotion regulation predict loneliness and shyness. Method: For this aim, it was carried out with the participation of 462 people (58.4% women and 41.6% men; Rage:18-69; Mage: 28.08) from two different countries, Turkey (51.5%) and Pakistan (48.5%). It is quantitative research and descriptive and relational analyzes were made. Findings: When the findings were examined, it was found that difficulties in emotion regulation predicted both loneliness and shyness. In terms of emotion regulation strategies, while ‘expressive suppression’ and ‘social modelling’ predicts loneliness; ‘expressive suppression’ and ‘enhancing positive affect’ seem to predict shyness. It was found that other emotion regulation strategies did not predict statistically significantly. In addition, the findings obtained according to the relevant demographic variables (according to gender, country, being in a romantic relationship, having a child/children) and emotion regulation strategies were discussed in the context of the relevant literature. Conclusions: As a result of the study, it was seen that there are emotion regulation types and strategies associated with loneliness and shyness.

Social sharing and expressive suppression in major depressive disorder and borderline personality disorder: An experience sampling study

AbstractMajor depressive disorder (MDD) and borderline personality disorder (BPD) are characterized by disturbed patterns of emotional and interpersonal functioning, which might imply altered use of emotion regulation in interpersonal contexts. In the current study, we examined how individuals with MDD and/or BPD differ from healthy controls in (1) their overall daily life use of expressive suppression and social sharing and (2) their tendency to adjust the use of these strategies to the emotional context (i.e., preceding negative and positive affect). Thirty‐four individuals with MDD, 20 individuals with BPD, 19 individuals with comorbid MDD and BPD, and 40 healthy controls participated in a week of experience sampling during which they reported their use of expressive suppression, social sharing, and experienced negative and positive affect. The results indicated that all clinical groups reported more expressive suppression and social sharing in their daily lives than healthy controls. Group differences remained when controlling for differences in mean experienced affect, except for increased suppression for MDD and increased sharing for BPD and comorbid MDD and BPD, which seemed related to these participants' overall higher levels of negative affect. Additionally, associations between within‐person fluctuations in negative or positive affect and subsequent strategy use were equally strong for clinical and control participants, indicating that clinical groups did not differentially adjust the use of suppression and sharing to the emotional context. In conclusion, individuals with MDD and/or BPD showed increased use of suppression and sharing in daily life, which might contribute to, or follow from their emotional and interpersonal difficulties.

An Investigation of the Correlation between Self- Control, Impulsivity and Interpersonal Difficulties among College Students: An Empirical Study

An Investigation of the Correlation between Self- Control, Impulsivity and Interpersonal Difficulties among College Students: An Empirical Study

Intentional Imperfection Program: A pilot randomised controlled trial to help university students manage perfectionism

Given that perfectionism has been associated with interpersonal, academic, and mental health difficulties in university students, helping them manage their perfectionism is crucial. This pilot trial examined the feasibility, acceptability, and potential efficacy of an online perfectionism program designed to target the mechanisms that link perfectionism to psychological distress. Seventy first-year psychology students from Macquarie University with high levels of perfectionism were recruited into this two-arm pilot trial and randomised to either the intervention (i.e., perfectionism program) or attention placebo control (i.e., lifestyle program) condition. We assessed indicators of feasibility and acceptability, as well as measures related to perfectionism, psychological distress, emotion regulation skills, interpersonal and academic functioning at baseline, one-month post treatment, and three-month follow-up (blinded outcome assessment). Our analyses revealed that, while participants expressed overall satisfaction with the program, there was low engagement with it (Mcompletion rate=36.23%), and retention in the study was low (response rates for post-treatment: 65.71% and follow-up: 48.57%). Bearing this in mind, our linear mixed model analyses revealed greater reductions in perfectionistic traits and cognitions, interpersonal hostility, and loneliness, as well as increases in self-compassion in the intervention group compared to the control group at post-treatment and/or follow-up. However, we did not observe statistically significant changes in other important treatment outcomes (e.g.,psychological distress). Given these findings, adjustments to improve engagement and retention should occur before proceeding with a larger, definitive trial. This trial was retrospectively registered on the Australian and New Zealand Clinical Trials Registry (no. ACTRN12622000960752).

Social episodic memory in severe alcohol use disorder: Positive encoding bias and negative bias in accessibility of interpersonal information.

Alterations in higher-order social cognition are well documented in individuals with severe alcohol use disorder (SAUD). However, the basic mechanisms underpinning them are not well understood. This knowledge gap hampers the development of targeted therapeutic interventions. Here, we investigated whether individuals with SAUD show abnormalities in social episodic memory processes, which may represent relevant candidate mechanisms for alterations in social cognition. Recently detoxified patients with SAUD and matched healthy controls (HCs) completed two experimental tasks. We first used a Social Recognition Task in 40 SAUD patients and 40 HCs to measure the participants' ability to implicitly memorize the facial identity and emotion of novel interpersonal cues (i.e., dynamic facial expressions of anger and happiness). We then used a Social Memory Accessibility Task in 29 SAUD patients and 30 HCs) to measure participants' access to and fluency for already existing social memories by asking them to retrieve as many specific positive and negative interpersonal events as possible within equal time limits. In the Social Recognition Task, we found that, compared to HCs, patients with SAUD had a globally lower recognition performance for the facial identities of novel social stimuli, but a preserved bias toward positive information. Conversely, in the social memory accessibility task, patients showed greater access to and fluency for negative interpersonal memories than controls (no group differences were observed for positive ones), resulting in a negative accessibility bias. This exploration of episodic social memory in individuals with SAUD showed (1) a preserved bias for the encoding of positive versus negative novel social information, and (2) greater access to negative than positive interpersonal memories. These results enhance our understanding of socio-affective processing in individuals with SAUD and identify social memory alterations that may contribute to social cognition and interpersonal difficulties.

Mediation role of interpersonal problems between insecure attachment and eating disorder psychopathology

PurposeAlthough insecure attachment and interpersonal problems have been acknowledged as risk and maintaining factors of eating disorders (EDs), the mediating role of interpersonal problems between attachment style and ED psychopathology has been poorly explored. The purpose of this study was to investigate the mediating role of interpersonal problems between insecure attachment and ED psychopathology.MethodsOne-hundred-nine women with anorexia nervosa and 157 women with bulimia nervosa filled in the Eating Disorder Inventory-2 (EDI-2) and the Experiences in Close Relationships (ECR) revised scale to assess ED core symptoms and attachment styles, respectively. Interpersonal difficulties were evaluated by the Inventory of Interpersonal Problems (IIP-32). A mediator’s path model was conducted with anxious and avoidant attachment subscores as independent variables, ED core symptoms as dependent variables and interpersonal difficulties as mediators. The diagnosis was entered in the model as a confounding factor.ResultsThe socially inhibited/avoidant interpersonal dimension was a mediator between avoidant attachment and the drive to thinness as well as between avoidant attachment and body dissatisfaction. An indirect connection was found between attachment-related anxiety and bulimic symptoms through the mediation of intrusive/needy score.ConclusionsSocial avoidance and intrusiveness mediate the relationships between avoidant and anxious attachment styles and ED psychopathology. These interpersonal problems may represent specific targets for psychotherapeutic treatments in individuals with EDs and insecure attachment.Level of evidenceLevel III: Evidence obtained from well-designed cohort or case–control analytic studies.

Social Media in the Aftermath of the 2016 US Presidential Election: Disruption at the Cost of Connection

This data captures people’s experiences as unknowing targets of disinformation. Participants were US citizens naive to the actions of the different entities using social media to target Americans with disinformation in the months leading up to the 2016 US presidential election. Results indicated participants reported notable changes in their interactions on social media in the form of disruptions to existing relationships. Specifically, participants reported that they argued with their connections more, observed others disagree more, and reported an increase in the loss of friends and family connections through the unfriending or unfollowing features of social media. While, some participants found these changes amusing, most reported increased psychological distress. Not one participant mentioned Russian election interference or disinformation as the cause of these interpersonal difficulties. Analysis of text responses did not include any mention of disinformation, Cambridge Analytica, or Russia as causes of these disruptions. These results suggest that social media use has implications for individuals’ social relationships and these disruptions may impact their psychological functioning. Implications of these results for the psychological impacts of social media use will be discussed.

Preliminary Efficacy of Topical Sildenafil Cream for the Treatment of Female Sexual Arousal Disorder: A Randomized Controlled Trial.

To assess the efficacy of topical sildenafil cream, 3.6% among healthy premenopausal women with female sexual arousal disorder. We conducted a phase 2b, exploratory, randomized, placebo-controlled, double-blind study of sildenafil cream. Coprimary efficacy endpoints were the change from baseline to week 12 in the Arousal Sensation domain of the SFQ28 (Sexual Function Questionnaire) and question 14 of the FSDS-DAO (Female Sexual Distress Scale-Desire, Arousal, Orgasm). Two hundred women with female sexual arousal disorder were randomized to sildenafil cream (n=101) or placebo cream (n=99). A total of 174 participants completed the study (sildenafil 90, placebo 84). Among the intention-to-treat (ITT) population, which included women with only female sexual arousal disorder and those with female sexual arousal disorder with concomitant sexual dysfunction diagnoses or genital pain, although the sildenafil cream group demonstrated greater improvement in the SFQ28 Arousal Sensation domain scores, there were no statistically significant differences between sildenafil and placebo cream users in the coprimary and secondary efficacy endpoints. An exploratory post hoc subset of the ITT population with an enrollment diagnosis of female sexual arousal disorder with or without concomitant decreased desire randomized to sildenafil cream reported significant increases in their SFQ28 Arousal Sensation domain score (least squares mean 2.03 [SE 0.62]) compared with placebo cream (least squares mean 0.08 [SE 0.71], P =.04). This subset achieved a larger mean improvement in the SFQ28 Desire and Orgasm domain scores. This subset population also had significantly reduced sexual distress and interpersonal difficulties with sildenafil cream use as measured by FSDS-DAO questions 3, 5, and 10 (all P ≤.04). Topical sildenafil cream improved outcomes among women with female sexual arousal disorder, most significantly in those who did not have concomitant orgasmic dysfunction. In particular, in an exploratory analysis of a subset of women with female sexual arousal disorder with or without concomitant decreased desire, topical sildenafil cream increased sexual arousal sensation, desire, and orgasm and reduced sexual distress. ClinicalTrials.gov , NCT04948151.