Adult Psychological Adjustment Research Articles

Factors Associated With Psychological Adjustment in Adults With Cleft Lip and/or Palate: Findings From a National Survey in the United Kingdom.

Research has identified adults born with cleft lip and/or palate (CL/P) to be at risk of poorer psychological outcomes compared to the general population. This study investigated factors that may contribute to positive and negative adjustment in adults born with CL/P. A survey was designed and distributed by the Cleft Lip and Palate Association in collaboration with the Centre for Appearance Research CAR at the University of the West of England (UWE). There were 207 eligible responses (95% completed online) received between July and October 2018. Dependent variables included the Body Esteem Scale for Adolescents and Adults, Harter's Self Perception Profile for Adults (Global Self-Worth, Social Competence, and Intimacy subscales), the Fear of Negative Appearance Evaluation Scale, and the Revised Adult Attachment Scale. Independent variables were the Revised Life Orientation Test, biodemographic data, and self-reported single-item questions. Factors associated with positive adjustment included reports of a happy childhood, talking about CL/P with family, close friendships, comfort in public spaces, satisfaction with appearance, and a positive life orientation. Psychological distress was associated with a desire for further surgery to improve appearance and/or function. Several factors were identified that may influence psychological adjustment in adults with CL/P. Throughout childhood, family-centered practice to support family cohesion and an open dialogue about CL/P is indicated, as is support for young people to develop social confidence. For adults returning to the cleft service, treatment options for appearance and/or functional concerns should be explored, with access to psychological support when indicated. Interventions to increase optimism, resilience, and self-acceptance may also be warranted throughout the life span.

Childhood Trauma and Adult Psychological Adjustment: Resilience in Older Adult Survivors of Institutional Abuse

Several international cohorts of older adults share past experiences of welfare-related adversity. In Ireland, reports of childhood maltreatment, neglect, and abuse within institutional welfare settings included a harsh regime, childhood labour, and physical and sexual assault. Preliminary research with these Irish survivors revealed a high prevalence of psychological disorders in adulthood. A pathological perspective of aging is often applied to such older adults, due to the long-term health consequences associated with childhood trauma. However, little is known about later life resilience or resilience mechanisms in this population. Therefore, using conceptual models of resilience, this qualitative study aimed to investigate factors associated with resilience in older adult survivors of childhood institutional abuse. Participants were 17 Irish older adults, 50-77 years of age, with experiences of childhood abuse in institutional care settings. Semi-structured interviews were conducted, lasting 60-120 minutes. Transcribed interviews were analysed using the Framework Analysis method. Nine themes were derived from the data, including core, internal, and external resilience factors: Individual characteristics, personality characteristics, support systems, goal attainment, adaptive belief systems, processing, influential events and experiences, recognition and collective identity, and access to services. Results suggest that resilience can be understood not only as an inherent trait, but also as a learnable set of behaviours, thoughts, and attitudes, which can be supported by external resources in an older adults’ environment. The identification of personal and contextual factors underpinning resilience in older adults with trauma experiences may help foster a more positive, strengths-based approach to aging in psychological research and practice.

Love Attitude, Friendship Dimensions as Correlates of Health and Adjustment

The link between social relationships (parental, romantic, friendships, acquaintances) and one’s psychological well-being has been investigated deeply in the area of adult psychological adjustment. With respect to this, there has been an increasing emphasis on adolescents and their interpersonal relationships lately. Adolescence, a developmental phase characterized by broadening social networks and changing interpersonal requirements, is a domain of research in which theintricacies of interpersonal attachments is becoming common. It is important to better understand these interpersonal intricacies to contribute to the evolution of attachment theory. Two important aspects of interpersonal relationship during adolescent stage are love and friendship, which may affect overall psychological wellbeing. As adolescents make the transition into young adulthood; love and friendshipattitudes are especially important sources of support and even at times, act as a buffer from stress. The paper aimed to examine the love attitude and friendship dimensions of adolescents in relation to their health andadjustment. Datawas collectedfrom 300 school going adolescents, attending classes 11thand 12th;boys (n=150) and girls (n= 150) in the age group of 16-18 years from Rohtak district of Haryana, India. The results highlighted the significant role of love attitude and different dimensions of friendship in shaping the health & adjustment of school going adolescents.

How Memory Structures Influence Distress and Recovery.

The treatment of emotional distress has stalled. There has been no improvement in depression outcomes for 30 years, and recent opinions have highlighted the lack of clear validity for the mechanisms involved in current models of complex psychological interventions. Emotional distress is a phenomenon that underpins a swathe of apparently diverse mental health conditions. Childhood trauma has been found to be endemic and common in those with poor psychological adjustment in adults. Executive processes cause a split between knowledge of an event and knowledge of its negative ongoing emotional effects so making integration of the memory of such events and resolution of its effects is a challenge. Recent research into the relationship between well-being and memory structures has converged with research into episodic memories and their key role in goal programming, giving an opportunity to describe a new model with plausible mechanisms for emotional distress, regulation, resilience, and recovery. Humans seek goals that fulfil their universal basic psychological need for self-determination, and the structures of memory networks drive behavioral algorithms that can satisfy or thwart that goal. We propose that a single underlying deficit in memory networks could underpin the psychopathology of emotional distress and that a new formulation of distress and recovery could drive a useful update on the mechanisms of psychological interventions with greater validity and utility for recovery and propose the NEMESIS (Negative MEmorieS Integration Systems) model.

Is personal growth initiative associated with later life satisfaction in Chinese college students? A 15‐week prospective analysis

Personal growth initiative (PGI) is presumed to foster positive change leading to positive psychological adjustment. Accordingly, in this study we examined PGI as a predictor of life satisfaction 15 weeks later in a sample of 152 Chinese college students. Time 1 PGI was found to explain a significant amount of unique variance in Time 2 life satisfaction, even after controlling for Time 1 life satisfaction and Time 2 PGI. Specifically, (lower) intentional behavior and planfulness at baseline emerged as significant predictors of later life satisfaction. No evidence was found indicating that life satisfaction at Time 1 accounted for any significant amount of unique variance in PGI processes at Time 2, after controlling for baseline PGI processes and concurrent life satisfaction. Overall, the present findings are the first to demonstrate the importance of PGI as a prospective predictor of positive psychological adjustment in adults.

Childhood peer victimization experiences and adult psychological adjustment: Examining race/ethnicity and race-related attributions

Few studies have examined young adults’ perceptions of childhood peer victimization (CPV) experiences and whether people of different racial/ethnic backgrounds perceive CPV differently. The current study examined the prevalence of CPV reported by members of the dominant racial majority (e.g., White), and individuals with racial minority backgrounds, and assessed the link between CPV and young adults’ psychological adjustment. Additionally, by examining attributions of skin color/ethnicity for CPV, both generally speaking and in light of possible moderating effects, the current study provides information on possible racial/ethnic differences in the causal interpretations of CPV. Data from 258 undergraduates (188 = majority; 70 = ethnic minority) revealed that racial/ethnic minority participants reported greater frequencies of CPV than majority White participants, and CPV was significantly associated with poorer psychological adjustment in young adulthood for all participants. Although attributions of skin color/ethnicity did not exacerbate the relationship between CPV and poor adjustment, the results do show that racial/ethnic minority participants are more likely than White participants to attribute all types of CPV to their skin color/ethnicity.

Perceived parental religiosity and emerging adult psychological adjustment: Moderated mediation by gender and personal religiosity.

Perceived parental religiosity and emerging adult psychological adjustment: Moderated mediation by gender and personal religiosity.

Mental health and psychological adjustment in adults who were adopted during their childhood: A systematic review

In the two last decades, research of the psychosocial needs of adopted children and adolescents has advanced dramatically. Nevertheless, less is known about their mental health when they reach adulthood. The aim of this paper is to systematically review the evidence about mental health and psychological adjustment in adult adoptees. A systematic search was conducted on Web of Science and PsycInfo. The review includes 27 studies that fulfilled the selection criteria (ages between 20 and 40, domestic adoptions and articles published since 1995). Evidence suggests that psychological adjustment in adult adoptees is more unfavourable (with higher levels of depression, anxiety, personality and behavioural disorders and neuroticism) than in non-adoptees. A small group of studies shows similar psychological adjustment of adoptees and non-adoptees. Moreover, there is evidence that the adopted population is quite heterogeneous, involving individual and contextual variables. There are clear diagnostic differences when gender is taken into account. Some family variables (e.g., attachment, parenting styles) emerge as mediating factors of the effects of the adoptive status on psychological adjustment. Other risk and protective factors have been insufficiently studied (e.g., age at the time of adoption), so additional research is needed.

Is the PGIS-II redundant with the Hope Scale?: Evidence for the utility of the PGIS-II in predicting psychological adjustment in adults

Shorey et al. (2007) found that the Personal Growth Initiative Scale (PGIS; Robitschek, 1998) did not add to the prediction of psychological adjustment (e.g., optimism, psychological distress) when hope was controlled for. Recently, Robitschek et al. (2012) developed the Personal Growth Initiative Scale-II (PGIS-II) which is predicated on four distinct dimensions, namely readiness for change, planfulness, using resources, and intentional behaviors. To determine if the PGIS-II accounts for additional variance in psychological adjustment above hope, we conducted the present study to address this concern in a sample of 227 college students. Results from our analysis indicated that scores on the PGIS-II scales explained for, beyond hope, an additional 3–5% of variance in life satisfaction, optimism, depression, and anxiety. However, within the PGIS-II predictor set, planfulness was found to be the only unique and consistent predictor of psychological adjustment. Our findings suggest that within the broader construct of personal growth initiative, planfulness is not only a unique construct associated with psychological adjustment, but a construct that is distinct from hope.

Early Adolescent Peer Foundations of Late Adolescent and Young Adult Psychological Adjustment.

The long-term impacts of failing to establish autonomy and relatedness within close friendships are poorly understood. Adolescent behaviors undermining autonomy and relatedness in friendships at 13 were examined as predictors of friendship competence at 18 and depressive symptoms and social withdrawal at 21. A diverse community sample of 184 adolescents participated in self, peer, and observational assessments. Teens' inability to establish autonomy and connection with friends at 13 predicted decreases in friendship competence at 18 (ß=-.20, p=.02). Direct links to increases in depressive symptoms (ß=.34, p<.001) and social withdrawal (ß=.18, p=.03) were observed, with friendship competence partially mediating these relations. Results highlight the importance of problematic adolescent peer relationships as risk factors for the development of young adult internalizing symptoms.

Effective and Ineffective Parenting

The current study examined the impact of effective and ineffective parenting on emerging adult psychological adjustment as well as parenting characteristics associated with adjusted and maladjusted emerging adults. Participants were 175 male and 309 female emerging adults who completed questionnaires assessing their perceptions of their parents’ parenting practices, discipline strategies, and psychopathology as well as their own psychological adjustment. Participants reporting effective parenting from two parents experienced the best adjustment, whereas participants reporting ineffective parenting from two parents experienced the worst adjustment, and participants reporting effective parenting from at least one parent appeared to be protected against the particularly harmful effects of ineffective parenting from two parents. Parental psychopathology, harsh discipline, involvement, and regard for parent and child all strongly differentiated adjusted and maladjusted participants.

Family income and appraisals of parental conflict as predictors of psychological adjustment and diurnal cortisol in emerging adulthood.

The goal of the current study was to provide the first investigation of whether appraisals of parental marital conflict mediate associations of family income with emerging adult psychological adjustment and diurnal cortisol production. Participants were 178 college students who provided 3 saliva samples across the day and reported their family income, adjustment (depressive symptoms, perceived daily stress, internalizing problems, and externalizing problems), and appraisals of their parents' conflict (including perceptions of frequency, intensity, resolution, stability, as well as perceived threat and self-blame for conflict). Results indicated that emerging adults from low-income families reported more-negative conflict appraisals, which in turn predicted lower levels of adjustment; there was no association between income and patterns of cortisol production across the day. However, emerging adults who felt responsible for their parents' conflict displayed cortisol levels that were lower early in the day, with a tendency toward blunted cortisol slopes across the day; those who appraised their parents' conflict less negatively displayed a more normative pattern of cortisol production. These results suggest that effects of family income on psychological adjustment are explained, in part, by appraisals of parental conflict, particularly of appraisals of conflict as threatening, whereas self-blame conflict appraisals have main effects on cortisol, and predict a dysregulated and potentially maladaptive pattern of cortisol production across the day for emerging adults.

Relations of religiosity and spirituality with depressive symptoms in primary care adults: Evidence for hope agency and pathway as mediators

This study examined hope agency and pathway as potential mediators of the associations of religiosity and spirituality with depressive symptoms in an adult sample of 101 primary care adults. Results of conducting multiple mediation tests indicated that hope agency and pathway fully and significantly accounted for the associations of religiosity and spirituality with depressive symptoms. In contrast, an alternative mediation model involving religiosity and spirituality as potential mediators of the associations of hope agency and pathway with depressive symptoms failed to be supported. Overall, our findings offer support for the contention that hope agency and pathway play important roles in accounting for the associations of religiosity and spirituality with psychological adjustment in adults. Some implications of the present findings are discussed.

Adult Intimate Relationships and Psychological Adjustment

This study explored relations among perceived acceptance and behavioral control by intimate partners, remembrances of parents’ acceptance and behavioral control in childhood, and adults’ psychological adjustment. The study was conducted on 98 American adults (50 men and 48 women) between ages 18 and 50 (mean 26 years). Measures used were the Adult version of the Parental Acceptance-Rejection/Control Questionnaire for Mothers and Fathers(Adult PARQ/Control: Mother and Father); Intimate Partner Acceptance-Rejection/Control Questionnaire (IPAR/CQ); and, the Adult version of the Personality Assessment Questionnaire (Adult PAQ). Results showed significant positive correlations between psychological adjustment and perceived partner acceptance and parental acceptance for both women and men. Results also showed significant negative correlations between psychological adjustment and perceived partner control and parental control for both women and men. Regression analyses, however, revealed a significant independent effect of only paternal acceptance (but not of maternal and partner acceptance) on the psychological adjustment of men. Regression analyses also revealed significant independent effects of both paternal and maternal acceptance (but not partner acceptance) on the psychological adjustment of women.

Gender differences in the effect of breastfeeding on adult psychological well-being

Little is known about whether the positive effect of breastfeeding on child health extends to adult psychological adjustment. We hypothesized that breastfed babies would have higher psychological well-being in adulthood in relation to the pathway of childhood psychosocial adjustment. We used the available cases with normal birthweight from the National Child Development Study (NCDS, N=7304, born in 1958) and the 1970 British Cohort Study (BCS70, N=6205, born in 1970). Childhood psychosocial adjustment was assessed by the child's teacher, using the Bristol Social Adjustment Guides for the NCDS and the Rutter Behaviour Scale for the BCS70. Adult psychological well-being was defined in terms of measures of emotional distress and self-efficacy. In this study, we controlled the effects of socio-demographic factors at birth: maternal age and educational status, two-parenthood and being a first-born child. We used path analysis to test life-course pathways between breastfeeding and adult psychological well-being independent of socio-demographic factors at birth and the role childhood psychosocial adjustment. After accounting for the effects of the socio-demographic factors at birth, being breastfed indirectly contributed to adult psychological well-being among women through the pathway from childhood psychosocial adjustment. Moreover, this was directly associated with better psychological well-being in adulthood among women from the BCS70. Being breastfed was not associated with psychological outcomes amongst men in either cohort. Being breastfed contributed to psychological outcomes in women, especially from the later born cohort. Our findings suggest that being breastfed can be important for women's psychological well-being throughout the lifecourse.

Attachment Relationships and Psychological Adjustment of Married Adults

The present study explored relations among remembered parental (paternal and maternal) acceptance in childhood, spouse acceptance and psychological adjustment of adults. It also explored whether remembered childhood experiences of parental acceptance mediate the relation between perceived spouse acceptance and psychological adjustment. The sample consisted of 354 married adult men (178) and women (176). Results showed that the more accepting both men and women perceived their spouses to be, the better was their psychological adjustment. Similarly, the more accepting both men and women remembered their parents had been to them during childhood, the better was their psychological adjustment. Standard multiple regression analyses revealed that paternal acceptance mediated the relation between perceived spouse acceptance and the psychological adjustment of both men and women. In addition, remembered maternal acceptance mediated the relation between men’s (but not women’s) perceived spouse acceptance and psychological adjustment.

Sexual revictimization and adjustment in college men.

Child sexual abuse (CSA) and adult sexual assault (ASA) occur at alarming rates in the United States and are associated with a number of adult psychological adjustment problems. Moreover, having a history of CSA may increase risk for sexual victimization in adulthood (revictimization). A number of studies explore the issues of CSA, ASA, revictimization, and adjustment in women, but far fewer studies investigate these issues in men. This study explored the phenomenon of sexual revictimization and related adjustment difficulties in 1,002 male college students who completed the Life Experiences Questionnaire, an expanded version of the Sexual Experiences Survey, and the Symptom Checklist-90—Revised. Results indicated that male CSA survivors are more likely than nonvictims to experience ASA and that sexual victimization and revictimization are related to increased adult adjustment difficulties in the forms of posttraumatic stress, hostility, depression, and general distress. Research and clinical implications are discussed, such as the need to assess male psychotherapy clients for sexual victimization and revictimization histories and the need for research on the mechanisms resulting in psychological adjustment difficulties in male survivors of sexual victimization and revictimization.

Efficacy of cognitive behavior therapy for the management of psychological outcomes following spinal cord injury A meta-analysis

This meta-analysis evaluated the impact of cognitive behavior therapy (CBT) on the psychological adjustment of adults with spinal cord injury (SCI). A comprehensive search of six electronic databases identified 10 studies (424 participants) that met the inclusion criteria. Pre- and post-data for participants who received CBT were pooled and analyzed. Large and significant group differences were noted for measures of assertiveness, coping, self-efficacy, depression and quality of life. These data suggest that CBT has a significant positive impact on short-term psychological outcomes following SCI. However, further research is needed to establish the long-term benefits.

Symptoms of Anxiety and Depression Among Teens and Adults in the Thalassemia Longitudinal Cohort Study.

Abstract 555 Background and Significance:Individuals with chronic medical conditions are vulnerable to symptoms of anxiety and depression. Promoting healthy emotional functioning is important not only to psychological well-being, but also to physical health as it has been shown to impact adherence to medical regimens. Thalassemia is an inherited blood disorder which requires lifelong intervention and may be associated with treatment and disease-related complications that impact both the length and quality of life for most who are affected.While several studies have examined the prevalence of anxiety and depressive symptoms in patients with thalassemia, most have been conducted with small, homogeneous samples of children. In addition, the one study which examined psychological adjustment in adults included patients from only one medical center (Messina et al.; Intern Emerg Med, 3:339, 2008). Further, few studies have examined demographic, medical, and psychosocial variables possibly correlated with the occurrence of these symptoms. Understanding the factors that are related to the experience of depressive and anxiety symptoms may help us to identity individuals at risk and help in developing targeted interventions.The current study aimed to (1) determine the prevalence of depressive and anxiety symptoms in adolescent and adult patients with thalassemia; and (2) explore possible demographic, medical, and psychosocial correlates of these symptoms. Specifically, we hypothesized that (1) anxiety and depressive symptoms in this sample would be similar to the rates of these symptoms in individuals diagnosed with other chronic medical conditions and higher than in individuals without chronic medical conditions; (2) symptoms of depression and anxiety would be inversely correlated with measures of adherence (i.e., subjective report, ferritin); and (3) symptoms of depression and anxiety would be inversely correlated with functional health and well-being. Method:Data on quality of life and mental health self assessments were collected as part of the Thalassemia Longitudinal Cohort (TLC), a multi-center multinational study conducted by the NHLBI-sponsored Thalassemia Clinical Research Network. The current analysis included 281 participants (14-58 years old, M age=27.83; 52% female) who completed the Hospital Anxiety and Depression Scale (HADS), a 14-item questionnaire examining presence of anxiety and depression symptoms. Participants also completed a measure of functional health and well-being (SF-36), as well as questions related to adherence to their medical regimen. In addition, as part of the larger TLC study, medical data such as ferritin and method of chelation was collected. Results:32% of participants indicated experiencing at least mild symptoms of anxiety and 11% at least mild symptoms of depression. While these rates are higher than rates of symptoms of depression and anxiety found in the general population, they are similar to rates found in other groups with chronic illness (e.g., diabetes). Older age, female gender, and chelation with deferoxamine (as compared to deferasirox) were factors that were significantly associated with anxiety and/or depression and were statistically controlled for in subsequent analyses. Symptoms of depression, but not anxiety, were inversely correlated with subjective reports of adherence (p<.05), although not with ferritin levels. However, a significant correlation in the expected direction between subjective report of adherence and ferritin was found (p<.01). Finally, as hypothesized, both symptoms of depression and anxiety were significantly and negatively correlated with functional health and well-being (p<.0001). Conclusion:While the majority of patients with thalassemia do not report significant symptoms of anxiety and depression, the rates are higher than in the general population. Given that symptoms of anxiety and depression were associated with poor adherence and lower functional health and well-being, regular screening for anxiety and depression symptoms could help to identify at risk individuals in order to provide them with appropriate psychological support with the goal of improving both emotional and physical health. Disclosures:Porter:Novartis: Research Funding. Thompson:Novartis: Research Funding. Neufeld:Novartis: Research Funding.

Remarkable differences: the course of life of young adults with galactosaemia and PKU

Although the need for insight in factors influencing the quality of life of patients with an inborn error of metabolism is recognized, psychological adjustment of adults with metabolic diseases has not been properly studied. Adult patients with PKU were demonstrated not to differ from healthy controls in terms of their course of life (CoL) and health-related quality of life (HRQoL). However, adults with galactosaemia had a lower HRQoL with significant lower scores on the domains of cognitive and social function. This study investigated the CoL and the social demographical outcomes in these young adults with galactosaemia, and compared them with the general population and with PKU patients. A total of 15 (88%) adult patients with classical galactosaemia participated in this study. Classical galactosaemia patients had a delayed social and psychosexual development compared to their peers from the general population and to PKU patients. Also, they were significantly less frequently married or living together and significantly less frequently employed than the general population. Our study shows a stark contrast between patients with galactosaemia and patients with PKU, although both are diagnosed in the neonatal period and need life-long dietary restrictions. The observed difference is likely due to the long-term somatic complications frequently seen in galactosaemia and thus not due to the burden of a chronic disease necessitating life-long dietary restrictions. We conclude that it is essential that parents and clinicians encourage children with galactosaemia to participate in peer-related activities in order to stimulate social performance, which may result in a more normal CoL.