Predictors Of Psychological Symptoms Research Articles

B - 39 Resilience in Active Duty US Military Service Members: Factor Analysis and Prediction of Psychological Symptoms in a Mild Traumatic Brain Injury Sample

Abstract Objective The factor structure of the Connor-Davidson Resilience Scale (CD-RISC) varies between cultures, settings, and samples, yet has not been assessed in an active-duty United States (US) military sample. We used factor analysis to characterize resilience in a generalizable sample of active-duty service members (ADSMs) and explored its associations with self-reported psychological outcomes in ADSMs with a history of mild traumatic brain injury (mTBI). Method Exploratory factor analysis (EFA) of the 25-item CD-RISC was performed on a non-clinical convenience sample of 212 active duty SMs followed by a confirmatory factor analysis (CFA) for model validation. Hierarchical regressions compared the relationships among the resulting factors and total scores on the Post Traumatic Stress Disorder Checklist (PCL-5), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI) between subgroups with self-reported history of mTBI (n = 60) and TBI-negative controls (n = 54). Results EFA returned a 4-factor, 19-item solution. After modifications to improve model fit, CFA validated a 4-factor, 17-item solution: Fortitude, Resoluteness, Decisiveness, and Dedication. The interaction of TBI history with the Decisiveness and Dedication factors significantly predicted BDI and PCL-5 total scores (p < 0.05), but not BAI total scores. Fortitude and Resoluteness did not differentially predict any psychological outcomes between groups. Conclusion Four latent factors of resilience that are unique to ADSMs were identified and validated from the 25-item CD-RISC. Decisiveness and Dedication more strongly predicted depressive and PTSD symptoms in ADSMs with a history of mTBI than in controls, suggesting these factors of resilience are especially critical for better psychological outcomes following mTBI in military populations.

Longitudinal Assessment of Hair Cortisol as a Predictor of Psychological Symptoms During COVID-19

BackgroundThere is a lack of evidence regarding enduring psychoneuroendocrine changes following an initial traumatic event, particular in the presence of an ongoing stressor. The coronavirus pandemic presents an opportunity to explore this matter. Consequently, the purpose of the present study was to investigate the impact of the ongoing pandemic (2021) on individuals, who experienced a first-time motor vehicle crash (MVC) at least 6 years earlier. To this end, we hypothesized that hair cortisol concentrations (HCC) following a first-time traumatic event positively predict symptoms of depression. MethodWe investigated N = 69 individuals (18 – 65 yrs.), who were victims of a MVC during 2010 – 2014. Hair strands were collected 10 days (t1) and 3 months after the MVC (t2), as well during the pandemic in 2021 (t3). To assess symptoms of depression, the participants filled out the Beck Depression Inventory at t1 - t3 and were additionally interviewed (Structured Clinical Interview for DSM-IV Axis I) at t1 and t2. Exclusion criteria conveyed a lifetime or acute mental disorder (incl. past trauma exposure). ResultsElevated pre-pandemic HCC following adversity (i.e., MVC) significantly predicted symptoms of depression in adults during the coronavirus pandemic (BDI: ß =.44, p =.010, R2 =.20), even after controlling for confounders. HCC significantly decreased over time, while in average psychological symptoms remained consistent. ConclusionCortisol dysregulation in the past presents an enduring vulnerability to ongoing stress. In this regard, vulnerable groups may benefit from preventive measures. This finding validates the predictive power of HCC and extended past evidence in this regard, at the same time reinforcing the concept of the diathesis-stress model.

Can the positive buffer the negative? Testing the impact of protective childhood experiences on adjustment in adults following trauma exposure

ABSTRACTBackgroundIt is unclear if protective childhood experiences (PCEs), like emotional support and economic stability, exert influence on adulthood adjustment. Prior research suggests PCEs can promote childhood resilience through increased social connection. In contrast, research has demonstrated potential life-long negative impacts of adverse childhood experiences (ACEs) on psychological health. This study examined the role of PCEs and ACEs in psychological symptoms following potentially traumatic events (PTE) in adults.MethodsParticipants (N = 128) were adults admitted to two Level 1 Trauma Centers following violence, motor-vehicle crashes, or other accidents. Participants reported childhood experiences and completed assessments of depression, PTSD, and social support at one, four, and nine months post-PTE.ResultsStructural Equation Modeling was used to simultaneously model PCEs and ACEs as predictors of psychological symptoms over time, with potential mediation through social support. PCEs overall did not directly affect psychological symptoms nor indirectly through social support. However, the emotional support component of PCEs had an indirect effect on psychological symptoms at baseline through social support. ACEs predicted greater psychological symptoms at baseline and over time.ConclusionPCEs consisting of childhood emotional support indirectly promote adjustment in adults after PTEs through initial social support, while ACEs exert direct effects on psychological symptoms.

Neuropsychiatric Manifestations, Reduced Self-Esteem and Poor Quality of Life in Children and Adolescents with Neurofibromatosis Type 1 (NF1): The Impact of Symptom Visibility and Bullying Behavior.

Neurofibromatosis type 1 (NF1) is an autosomal dominant condition, associated with neurocutaneous manifestations and neuropsychiatric manifestations. The present study explored the prevalence of bullying/cyberbullying behaviors and victimization behaviors in a cohort of children and adolescents with NF1. Possible gender differences and predictors of psychological symptoms, quality of life (QoL), and self-esteem were also examined. Thirty-eight school-aged participants with NF1 completed a psychological evaluation designed to assess anxiety and depression symptomatology, QoL, self-esteem, and the prevalence and extent of bullying/cyberbullying and victimization behaviors. We found that our participants frequently reported victimization behaviors rather than bullying/cyberbullying ones. Moreover, participants complained of depressive and anxiety symptomatology together with reduced self-esteem, and low psychosocial quality of life, with females reporting more severe performances than males. Furthermore, we found that reduced self-esteem was associated with more visibility of the NF1 symptoms, and victimization behaviors were found to mediate the relationship between anxiety and psychosocial QoL. Our findings indicated the presence of a maladaptive loop in children and adolescents with NF1 patients characterized by psychological symptoms, unfavorable self-perception, low self-esteem, and psychosocial difficulties that might be worsened by experiencing victimization behaviors. These results suggest the need to use a multidisciplinary approach in the diagnosis and treatment of NF1.

The Role of Self-Construals on Gender Roles, Difficulties in Emotion Regulation and Psychological Symptoms

Previous studies have revealed the relationship between self-construals, gender roles, emotion regulation and psychological symptoms. The purpose of the study was to examine the effects of self-construals on the relationship between gender roles, emotion regulation difficulties and psychological symptoms (depression, anxiety, somatization). The sample of the study consists of 471 participants (273 females, 58%; 198 males, 42%; Mage=33.86, SD=10.5). Participants completed Balanced Integration-Differentation Scale (BID), Difficulties in Emotion Regulation-Brief Form (DERS-16), Gender Roles Attitude Scale, Brief Symptom Inventory (BSI) and demographic information form. The result of the Multiple Linear Regression analyses revealed that predictors of psychological symptoms and their predictive strength differed for self-types. Difficulty in accepting one’s emotions predicted anxiety only for the separated-individuation self-type. Egalitarian gender attitudes and difficulties in managing negative feelings predicted somatization for the relational-individuation self-type. Marriage related gender attitudes and impulsivity predicted somatization for the relational-patterned self-type. Additionally, the strength of predictions was higher for the separated-individuation self type. The study draws attention to social factors of psychological symptoms and contributes to the literature within the field of self-construals and psychological health.

Psychological Flexibility, Mindfulness and Perceived Social Support as Predictors of Psychological Symptoms among Nursing Faculty Students at Mansoura University

Psychological Flexibility, Mindfulness and Perceived Social Support as Predictors of Psychological Symptoms among Nursing Faculty Students at Mansoura University

Psychometric properties of the Cognitive Fusion Questionnaire in females with fibromyalgia

Cognitive fusion, or the degree to which a person is entangled with their thoughts and takes them literally, is considered a normal yet detrimental cognitive process associated with diverse negative outcomes across healthy and disordered functioning, including in fibromyalgia. Given the relevance of this cognitive process, the aim of the present study is to generate empirical evidence on the reliability and validity of the Cognitive Fusion Questionnaire (CFQ) in a sample of Spanish females with fibromyalgia. In this cross-sectional study, 230 Spanish females diagnosed with fibromyalgia (mean age 56.89 years; SD = 8.96) were assessed on cognitive fusion, pain catastrophizing, personality traits, positive and negative affect, anxiety symptoms, depressive symptoms and disease severity. Confirmatory factor analysis, reliability and validity analyses were performed. The CFQ showed a unidimensional structure, adequate temporal stability and good internal consistency. In addition, convergent and discriminant validity were found with respect to dispositional, pain-related, affective, mood and anxious measures; as well as incremental and criterion validity in the prediction of psychological symptoms or the disease severity status. The CFQ has been revealed as a solid and valid measure in the evaluation of cognitive fusion in Spanish females suffering from fibromyalgia, and may also be useful in clinical contexts due to the relationships it has shown with important outcomes. Limitations and future directions are also discussed.

Investigation of Emotional Expression as a Predictor of Psychological Symptoms

The main purpose of the study is to determine whether the level of emotional expression is a predictor of psychological symptoms. The study was performed with 338 participants, including 170 women and 168 men. Data were collected by “Expressing Feelings Scale” and “SCL-90 Symptom Checklist-90-Revised”. Data was analyzed with Pearson product moment correlation coefficient and regression analysis was performed. According to results, emotional expression was significantly related to psychological symptoms. While the levels of emotional expression have increased, psychological symptoms have decreased. The levels of psychological symptoms was predicted significantly by emotional expression. Finally, emotional expression predicted higher levels of somatization and lower levels of phobic anxiety.

Predictors of stress and depressive mood in Portuguese middle-aged women

ABSTRACTThis cross-sectional study investigates the predictors of psychological symptoms—stress and depressive mood—in a sample of middle-aged women. A community sample of 1,003 women filled in the questionnaires and instruments, which included the Depression, Anxiety and Stress Scales and the Life Events Survey; sociodemographic, health, and menopause-related and lifestyle information was also collected. Structural equation modeling was used to build the model that had stress and depressive mood as dependent variables. Health status (both physical and psychological), recent life events, income and menopausal phase were significantly associated with the frequency of stress and depressive symptoms. Additionally, educational level and parity were also significant predictors of depressive mood. This study emphasizes that psychological symptoms occurrence in midlife depends not only on personal variables (such as health and menopausal status) but also on contextual ones (including recent stressful events) that can be a strong influence on how middle-aged women feel.

Trauma and event centrality: Valence and incorporation into identity influence well-being more than exposure.

Although the association between trauma exposure and posttraumatic stress disorder (PTSD) symptoms is well established, how such trauma is incorporated into identity, or the centrality of the negative event, is also of considerable importance in understanding the development of psychological symptoms. Alternatively, positive event centrality may have positive effects on well-being in the face of trauma. Thus, the current study examined associations between positive and negative event centrality, and both adaptive and maladaptive outcomes, above and beyond the impact of traumatic experience. A sample of 214 college students completed a series of self-report questionnaires. As anticipated, negative event centrality predicted PTSD and other maladaptive measures of functioning, even after controlling for traumatic experience. High levels of positive event centrality predicted adaptive, as opposed to maladaptive, psychological functioning. Results also suggested that both positive and negative event centrality predicted posttraumatic growth, controlling for traumatic experience. These findings suggest that assessing centrality of trauma may also be valuable in the prediction of psychological symptoms. The implications of these findings and proposals for future work are discussed further.

Emotional intelligence, cognitive flexibility and psychological symptoms in pre-service teachers

The purpose of this study is to examine the relationship between emotional intelligence, cognitive flexibility and psychological symptoms in pre-service teachers. The study included 414 pre-service teachers at the Faculty of Education, Mersin University, Turkey. Pearson product-moment correlation and multiple regression analyses were used to analyze the data. The results indicated that emotional intelligence and cognitive flexibility showed significant negative correlation with anxiety and depression. In addition, evaluation of emotions, which is one of the dimensions of emotional intelligence, was the strongest predictor of psychological symptoms. Key words: Emotional intelligence, cognitive flexibility, psychological symptoms

Prediction of psychological symptoms in family members of patients with burns 1 year after injury

To report a study of predictors of psychological symptoms in family members of patients with burns. Family members are important as a source of social support for patients undergoing prolonged rehabilitation. Little is known about psychological symptoms of family members of patients with burns, especially in the long term. The design of the study was prospective and longitudinal. Forty-four family members of adult patients treated in a burn centre between 2000-2007 completed questionnaires during care and at 3, 6, and 12 months after injury. Psychological symptoms were assessed with the Hospital Anxiety and Depression Scale. Predictors for anxiety and depression were explored in regression analyses. The mean scores indicated normal to mild symptoms in general. Moderate and severe symptom levels during care and at 12 months were demonstrated on the anxiety subscale by 15/44 and 5/39, respectively, and on the depression subscale by 5/44 and 0/39 of the family members, respectively. In the final regression models, the primary predictor was psychological symptoms at the previous assessment. Other predictors were previous life events, age, and the coping strategy avoidance. Family members of patients with burns demonstrate normal to mild levels of psychological symptoms that decrease over time. One-third show moderate to severe anxiety symptoms during care and may benefit from counselling. Previous symptoms predict later symptoms, indicating that screening with a validated instrument is useful. The results provide guidance for nurses in assessing and planning adequate interventions for family members.

Insomnia as predictor versus outcome of PTSD and depression among Iraq combat veterans

The study conducted a longitudinal assessment of insomnia as an antecedent versus consequence of posttraumatic stress disorder (PTSD) and depression symptoms among combat veterans. Two postdeployment time points were used in combination with structural equation modeling to examine the relative strength of two possible directions of prediction: insomnia as a predictor of psychological symptoms, and psychological symptoms as a predictor of insomnia. Participants were active duty soldiers (N = 659) in a brigade combat team who were assessed 4 months after their return from a 12-month deployment to Iraq, and then again eight months later. Although both insomnia and psychological symptoms were associated at both time periods and across time periods, insomnia at 4 months postdeployment was a significant predictor of change in depression and PTSD symptoms at 12 months postdeployment, whereas depression and PTSD symptoms at 4 months postdeployment were not significant predictors of change in insomnia at 12 months postdeployment. Results support the role of insomnia in the development of additional psychological problems and highlight the clinical implications for combat veterans, to include the importance of longitudinal assessment and monitoring of sleep disturbances, and the need for early intervention.

Predictors of psychological symptoms in morbidly obese patients after gastric bypass surgery

BackgroundMorbid obesity is associated with debilitating psychosocial consequences, such as depression, anxiety, and low self-esteem. One of the main goals of bariatric surgery should not only be reducing weight and counteracting co-morbid conditions, but also improving postoperative psychosocial functioning. The objective of our study was to determine the preoperative variables that could predict the psychological symptoms 6 and 12 months after surgery to improve the clinical outcome of morbidly obese patients undergoing bariatric surgery. The setting was a university hospital in Spain. MethodsThe study group consisted of 60 morbidly obese patients (46 women and 14 men) who had undergone gastric bypass surgery for weight reduction and had ≥1 year of follow-up. The patients were evaluated using different questionnaires (Symptom Checklist-90-Revised, Body Shape Questionnaire, Rosenberg Self-Esteem Questionnaire, COPE, Medical Outcomes Study Social Support Survey) at 3 points: before surgery, at 6 months postoperatively, and at 1 year postoperatively. To determine the influence of preoperative variables on long-term psychological status, a step-by-step multivariate linear regression analysis was performed, taking P < .05 as statistically significant. ResultsThe variables of self-esteem, instrumental support, and coping focused in the emotions were the main preoperative predictors for psychological symptoms 6 months after surgery. Preoperative drug abuse as a strategy of problem solving and mainly body image significantly predicted most of the psychological disorders 1 year after surgery. ConclusionThe study of different psychosocial variables in patients before bariatric surgery is an important aid to predict postoperative psychological functioning. Self-esteem and body image were the most influential factors in the postoperative psychological outcome of morbidly obese patients in our study.

Emotional and behavioral problems and mental health service utilization of youth living with HIV acquired perinatally or later in life

This study sought to examine predictors of psychological symptoms and psychiatric service receipt among youth with HIV. Data were from the baseline assessment of Adolescent Impact, a study of 13–21-year-old youth with HIV in three US cities. Between August 2003 and February 2005, participants completed the age-appropriate youth or adult self-report symptom checklists (Achenbach system of empirically based assessment) and reported their psychiatric treatment history. Psychiatric diagnoses were abstracted from medical records. The 164 participating youth living with HIV were Black (81%), female (52%), Heterosexually identified (62%), and perinatally HIV-infected (60%). Thirty-one percentage reported levels of internalizing (i.e., self-focused/emotional), externalizing (i.e., outwardly focused/behavioral), or overall symptoms consistent with clinical psychopathology. In multivariate analyses, questioning one's sexual identity was associated with greater internalizing problems, whereas identifying as Bisexual was associated with greater externalizing problems (p<0.05). Symptoms were not associated with HIV transmission group. Participants with ≥1 composite score within the clinical range were more likely to have received ≥1 psychiatric service (Odds ratio (OR): 2.51; 95% confidence interval (CI): 1.22, 5.13) and a psychiatric diagnosis in the past year (OR: 2.16; 95% CI: 1.09, 4.27). However, 27% with clinically elevated scores had never received psychiatric care. Results suggest that among youth with HIV, those who identify as Bisexual or Questioning are at greatest risk for emotional and behavioral problems. Despite available mental health services, some youth with HIV are not receiving needed mental health care. Enhanced evaluation, referral and mental health service linkage is needed for these high-risk youth.

Predictors of psychological morbidity in liver transplant assessment candidates: is alcohol abuse or dependence a factor?

Orthotopic liver transplantation candidates with depressive and other symptoms report poorer perceived quality of life when compared with nondepressed patients, and are also significantly more likely to die while awaiting transplantation. Alcohol abuse and dependence have been associated with increased levels of psychological co-morbidity. This article presents data about psychological morbidity from a prospective study of patients being assessed for liver transplantation in Birmingham, UK, and explores whether those with a diagnosis of alcohol abuse or dependence are at increased risk of psychological symptoms. Of 399 consecutive patients assessed for liver transplantation between July 2004 and July 2005, a sample of 155 was included in the study. Eighty-three (53.5%) patients were identified as having general psychological distress that merited referral for specialist assessment using the Symptom Checklist-90-Revised instrument. The alcohol-dependent group achieved the highest overall 'caseness' rates, with 72% (n = 26) compared with 52% (n = 12) of the alcohol-abuse group and 47% (n = 45) of those with no alcohol-related diagnosis. However, alcohol abuse or dependence was not the significant predictor of psychological symptoms in the final regression model. Higher rates of psychological distress were associated with greater severity of liver disease, being unemployed, and being a tobacco smoker. Possible reasons for these findings and potential future management strategies are discussed.

Predictors of Psychological Symptoms 1 Year After Traumatic Brain Injury

To examine self-reported psychological symptoms 1 year after traumatic brain injury (TBI) in a population-based sample. There were 1560 adults who had sustained TBI. A telephone survey with questions about recent mood and anxiety symptoms, and diagnoses since TBI. Polychotomous logistic regression with 3 response levels (probable, possible, and no mood or anxiety symptoms) identified predictors of psychological symptoms. Overall, 40% of participants had clinically significant mood or anxiety symptoms-12.6% with probable symptoms and 27.5% with possible symptoms. Main risk factors for probable symptoms included younger age, poor physical functioning, inadequate social support, and being a white woman. Other risk factors included being retired or unemployed, and pre-TBI psychiatric disorder or multiple concussions. These findings suggest the need for careful screening of persons with TBI who are at particular risk of developing psychological symptoms, and persons who have recently sustained TBI and their families to be educated about the possibility of developing such symptoms.

Using Self-Report Assessment Methods to Explore Facets of Mindfulness

The authors examine the facet structure of mindfulness using five recently developed mindfulness questionnaires. Two large samples of undergraduate students completed mindfulness questionnaires and measures of other constructs. Psychometric properties of the mindfulness questionnaires were examined, including internal consistency and convergent and discriminant relationships with other variables. Factor analyses of the combined pool of items from the mindfulness questionnaires suggested that collectively they contain five clear, interpretable facets of mindfulness. Hierarchical confirmatory factor analyses suggested that at least four of the identified factors are components of an overall mindfulness construct and that the factor structure of mindfulness may vary with meditation experience. Mindfulness facets were shown to be differentially correlated in expected ways with several other constructs and to have incremental validity in the prediction of psychological symptoms. Findings suggest that conceptualizing mindfulness as a multifaceted construct is helpful in understanding its components and its relationships with other variables.

Psychological symptoms among persons 50 years of age and older living with HIV disease

Although persons 50 years of age and older account for 10% of all US AIDS cases, the mental health needs of this growing group remain largely overlooked. The current study delineated patterns and predictors of psychological symptoms amongst late middle-aged and older adults living with HIV/AIDS in two large US cities. In late 1998, 83 HIV-infected individuals 50-plus years of age ( M = 55.2, Range = 50-69) completed self-report surveys eliciting data on psychological symptomatology, HIV-related life-stressor burden, social support, barriers to health care and social services, and sociodemographic characteristics. Based on the Beck Depression Inventory, 25% of participants reported 'moderate' or 'severe' levels of depression. HIV-infected older adults also evidenced an elevated number of symptoms characteristic of somatization. A hierarchical multiple regression analysis revealed that HIV-infected older adults who endorsed more psychological symptoms also reported more HIV-related life-stressor burden, less support from friends, and reduced access to health care and social services due to AIDS-related stigma. As the impact of HIV on older communities continues to increase, geropractitioners must be prepared to provide care to greater numbers of HIV-infected older adults, a substantial minority of whom will present with complex comorbid physical and mental health conditions.

Does emotionality predict stress? Findings from the normative aging study.

Investigated whether emotionality, assessed in 1975, predicted the reporting of both objective stress (life events) and subjective stress (hassles) 10 years later, and how emotionality affected the relation between both objective and subjective stress and mental health. The sample consisted of 1,159 older men, participants in the Normative Aging Study. Path analysis revealed that the reporting of stress was confounded with personality: Individuals higher in emotionality reported both more life events and more hassles. Furthermore, individuals higher in emotionality exhibited slightly higher levels of symptoms under stress than did individuals lower in emotionality. Nonetheless, both stress measures contributed independent variance to the prediction of psychological symptoms, even controlling for prior levels of emotionality. Implications for the assessment of stress are discussed.