Of sound mind
Cognitive emotion regulation fails the stress test
Candace Raio et al.
Proceedings of the National Academy of Sciences, forthcoming
Abstract:
Cognitive emotion regulation has been widely shown in the laboratory to be an effective way to alter the nature of emotional responses. Despite its success in experimental contexts, however, we often fail to use these strategies in everyday life where stress is pervasive. The successful execution of cognitive regulation relies on intact executive functioning and engagement of the prefrontal cortex, both of which are rapidly impaired by the deleterious effects of stress. Because it is specifically under stressful conditions that we may benefit most from such deliberate forms of emotion regulation, we tested the efficacy of cognitive regulation after stress exposure. Participants first underwent fear-conditioning, where they learned that one stimulus (CS+) predicted an aversive outcome but another predicted a neutral outcome (CS−). Cognitive regulation training directly followed where participants were taught to regulate fear responses to the aversive stimulus. The next day, participants underwent an acute stress induction or a control task before repeating the fear-conditioning task using these newly acquired regulation skills. Skin conductance served as an index of fear arousal, and salivary α-amylase and cortisol concentrations were assayed as neuroendocrine markers of stress response. Although groups showed no differences in fear arousal during initial fear learning, nonstressed participants demonstrated robust fear reduction following regulation training, whereas stressed participants showed no such reduction. Our results suggest that stress markedly impairs the cognitive regulation of emotion and highlights critical limitations of this technique to control affective responses under stress.
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Cara MacInnis et al.
Personality and Individual Differences, October 2013, Pages 789–793
Abstract:
Although authoritarianism can negatively impact others (e.g., by predicting prejudiced intergroup attitudes), implications for the self are mixed and require clarification. Extending previous research, we examined the association between generalized authoritarianism (GA, indicated by right-wing authoritarianism and social dominance orientation) and subjective well-being (SWB, indicated by positive affect, negative affect, and life satisfaction) by testing simultaneously the general-level association between GA and SWB as well as specific residual associations between GA and SWB components, independent of basic personality dimensions. We observed a significant general-level association between GA and SWB whereby heightened authoritarianism predicted greater SWB. No residual associations were found between specific GA and SWB components. Despite being “bad” for others, generalized authoritarianism may be “good” for the self.
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Firearms and Suicide in the United States: Is Risk Independent of Underlying Suicidal Behavior?
Matthew Miller et al.
American Journal of Epidemiology, forthcoming
Abstract:
On an average day in the United States, more than 100 Americans die by suicide; half of these suicides involve the use of firearms. In this ecological study, we used linear regression techniques and recently available state-level measures of suicide attempt rates to assess whether, and if so, to what extent, the well-established relationship between household firearm ownership rates and suicide mortality persists after accounting for rates of underlying suicidal behavior. After controlling for state-level suicide attempt rates (2008–2009), higher rates of firearm ownership (assessed in 2004) were strongly associated with higher rates of overall suicide and firearm suicide, but not with nonfirearm suicide (2008–2009). Furthermore, suicide attempt rates were not significantly related to gun ownership levels. These findings suggest that firearm ownership rates, independent of underlying rates of suicidal behavior, largely determine variations in suicide mortality across the 50 states. Our results support the hypothesis that firearms in the home impose suicide risk above and beyond the baseline risk and help explain why, year after year, several thousand more Americans die by suicide in states with higher than average household firearm ownership compared with states with lower than average firearm ownership.
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Association of suicide rates, gun ownership, conservatism and individual suicide risk
Augustine Kposowa
Social Psychiatry and Psychiatric Epidemiology, September 2013, Pages 1467-1479
Objectives: The purpose of the study was to examine the association of suicide rates, firearm ownership, political conservatism, religious integration at the state level, and individual suicide risk. Social structural and social learning and social integration theories were theoretical frameworks employed. It was hypothesized that higher suicide rates, higher state firearm availability, and state conservatism elevate individual suicide risk.
Method: Data were pooled from the Multiple Cause of Death Files. Multilevel logistic regression models were fitted to all deaths occurring in 2000 through 2004 by suicide.
Results: The state suicide rate significantly elevated individual suicide risk (AOR = 1.042, CI = 1.037, 1.046). Firearm availability at the state level was associated with significantly higher odds of individual suicide (AOR = 1.004, CI = 1.003, 1.006). State political conservatism elevated the odds of individual suicides (AOR = 1.005, CI = 1.003, 1.007), while church membership at the state level reduced individual odds of suicide (AOR = 0.995, CI = 0.993, 0.996). The results held even after controlling for socioeconomic and demographic variables at the individual level.
Conclusion: It was concluded that the observed association between individual suicide odds and national suicide rates, and firearm ownership cannot be discounted. Future research ought to focus on integrating individual level data and contextual variables when testing for the impact of firearm ownership. Support was found for social learning and social integration theories.
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Adam Watkins & Alan Lizotte
Youth & Society, September 2013, Pages 324-346
Abstract:
The aim of this research is to assess if home firearm access increases the risk of nonfatal suicidal attempts among adolescents. Such a gun focus has largely been limited to case-control studies on completed suicides. This line of research has found that household gun access increases the risk of suicide due to features of available firearms (e.g., provide little time for rescue). We extend this “risk factor” perspective to the study of nonfatal suicide attempts among a national sample of adolescents. Current findings reveal that home handgun access, but not long gun only access, is associated with an increased risk of attempted suicide in cross-sectional models. In panel models, however, we find no significant association between home firearm access (of any gun type) and risk of attempted suicide. The implications of these findings for research on suicidal behavior among adolescents are discussed.
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Serge Brand et al.
Journal of Adolescent Health, forthcoming
Purpose: Mental toughness (MT) is understood as the display of confidence, commitment, challenge, and control. Mental toughness is associated with resilience against stress. However, research has not yet focused on the relation between MT and objective sleep. The aim of the present study was therefore to explore the extent to which greater MT is associated with objectively assessed sleep among adolescents.
Methods: A total of 92 adolescents (35% females; mean age, 18.92 years) completed the Mental Toughness Questionnaire. Participants were split into groups of high and low mental toughness. Objective sleep was recorded via sleep electroencephalograms and subjective sleep was assessed via a questionnaire.
Results: Compared with participants with low MT, participants with high MT had higher sleep efficiency, a lower number of awakenings after sleep onset, less light sleep, and more deep sleep. They also reported lower daytime sleepiness.
Conclusions: Adolescents reporting higher MT also had objectively better sleep, as recorded via sleep electroencephalograms. A bidirectional association between MT and sleep seems likely; therefore, among adolescence, improving sleep should increase MT, and improving MT should increase sleep.
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Unmet Aspirations as an Explanation for the Age U-Shape in Human Wellbeing
Hannes Schwandt
Princeton Working Paper, August 2013
Abstract:
A large literature in behavioral and social sciences has found that human wellbeing follows a U-shape over age. Some theories have assumed that the U-shape is caused by unmet expectations that are felt painfully in midlife but beneficially abandoned and experienced with less regret during old age. In a unique panel of 132,609 life satisfaction expectations matched to subsequent realizations, I find people to err systematically in predicting their life satisfaction over the life cycle. They expect -- incorrectly -- increases in young adulthood and decreases during old age. These errors are large, ranging from 9.8% at age 21 to -4.5% at age 68, they are stable over time and observed across socio-economic groups. These findings support theories that unmet expectations drive the age U-shape in wellbeing.
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Against All Odds: Genocidal Trauma Is Associated with Longer Life-Expectancy of the Survivors
Abraham Sagi-Schwartz et al.
PLoS ONE, July 2013
Abstract:
Does surviving genocidal experiences, like the Holocaust, lead to shorter life-expectancy? Such an effect is conceivable given that most survivors not only suffered psychosocial trauma but also malnutrition, restriction in hygienic and sanitary facilities, and lack of preventive medical and health services, with potentially damaging effects for later health and life-expectancy. We explored whether genocidal survivors have a higher risk to die younger than comparisons without such background. This is the first population-based retrospective cohort study of the Holocaust, based on the entire population of immigrants from Poland to Israel (N = 55,220), 4–20 years old when the World War II started (1939), immigrating to Israel either between 1945 and 1950 (Holocaust group) or before 1939 (comparison group; not exposed to the Holocaust). Hazard of death – a long-term outcome of surviving genocidal trauma – was derived from the population-wide official data base of the National Insurance Institute of Israel. Cox regression yielded a significant hazard ratio (HR = 0.935, CI (95%) = 0.910–0.960), suggesting that the risk of death was reduced by 6.5 months for Holocaust survivors compared to non-Holocaust comparisons. The lower hazard was most substantial in males who were aged 10–15 (HR = 0.900, CI (95%) = 0.842–0.962, i.e., reduced by 10 months) or 16–20 years at the onset of the Holocaust (HR = 0.820, CI (95%) = 0.782–0.859, i.e., reduced by18 months). We found that against all odds genocidal survivors were likely to live longer. We suggest two explanations: Differential mortality during the Holocaust and “Posttraumatic Growth” associated with protective factors in Holocaust survivors or in their environment after World War II.
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The Effect of Sex Ratios on Suicide
Masanori Kuroki
Health Economics, forthcoming
Abstract:
Whereas sex ratios are likely to affect the likelihood of marriage, how sex ratios affect health and survival is underexplored. This study uses suicide as a measure of mental health and examines how suicides are affected by sex ratios. As women tend to marry men older than themselves, shrinking populations will lead to higher sex ratios (i.e., higher proportions of men) in the marriage market. Using data from Japan, I find that high sex ratios, both early-life and current, are correlated with higher male suicide rates, whereas female suicide rates are generally not affected. The results of this study have important implications for public health in countries where imbalanced sex ratios are a concern.
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Elevated self-esteem 12 months following a 10-day developmental voyage
John Hunter et al.
Journal of Applied Social Psychology, forthcoming
Abstract:
The following article examined elevated self-esteem as a function of a 10-day developmental voyage. Two studies were conducted. Study 1 demonstrated that participants who completed the voyage experienced elevated self-esteem. Study 2 replicated and extended these results insofar as it revealed that (a) elevated self-esteem was maintained 12 months following the voyage; and (b) increasing levels of perceived self-efficacy and belonging (as assessed on the last day of the voyage), but not social support, each made a unique contribution to these effects. Together, these findings provide converging evidence to suggest that a 10-day developmental voyage upon the Spirit of New Zealand promotes elevated self-esteem that is maintained over time, and that perceived self-efficacy and belonging contribute to this outcome.
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Antidepressant Usage and Method of Suicide in the United States: Variation by Age and Sex, 1998-2007
Julie Phillips & Colleen Nugent
Archives of Suicide Research, forthcoming
Abstract:
This study examines the association between antidepressant use and suicide rates, by sex, age and method of suicide, between 1998 and 2007 in the United States. Overall suicide rates for the young and elderly declined but rates for the middle-aged increased. All age groups experienced increases in antidepressant use. The elderly exhibited the largest increase in antidepressant usage and biggest declines in suicide rates. Firearm suicides for men and women declined but suicide by drug poisoning rose, particularly for women. For young males and elderly males and females, better treatment of severe depression may have contributed to declining suicide rates. However, rising rates of prescription drug use are associated with higher levels of suicide by drug poisoning.
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Some key differences between a happy life and a meaningful life
Roy Baumeister et al.
Journal of Positive Psychology, forthcoming
Abstract:
Being happy and finding life meaningful overlap, but there are important differences. A large survey revealed multiple differing predictors of happiness (controlling for meaning) and meaningfulness (controlling for happiness). Satisfying one’s needs and wants increased happiness but was largely irrelevant to meaningfulness. Happiness was largely present oriented, whereas meaningfulness involves integrating past, present, and future. For example, thinking about future and past was associated with high meaningfulness but low happiness. Happiness was linked to being a taker rather than a giver, whereas meaningfulness went with being a giver rather than a taker. Higher levels of worry, stress, and anxiety were linked to higher meaningfulness but lower happiness. Concerns with personal identity and expressing the self contributed to meaning but not happiness. We offer brief composite sketches of the unhappy but meaningful life and of the happy but meaningless life.
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Outcomes of Prolonged Exposure Therapy for Veterans With Posttraumatic Stress Disorder
Jason Goodson et al.
Journal of Traumatic Stress, August 2013, Pages 419–425
Abstract:
Prolonged Exposure (PE) is an evidenced-based psychotherapy for posttraumatic stress disorder (PTSD) that is being disseminated nationally within the U.S. Department of Veterans Affairs (VA) with promising initial results. Empirical evidence, however, regarding the effectiveness of PE for treatment of PTSD in military veterans is limited. Building on previous treatment outcome research, the current study investigated the effectiveness of PE in a diverse veteran sample. One-hundred fifteen veterans were enrolled in PE at an urban VA medical center and its surrounding outpatient clinics. PTSD and depression symptoms as well as quality of life were measured before and after treatment. Several baseline patient characteristics were examined as predictors of treatment response. Eighty-four participants completed treatment. Participants experienced a 42% reduction in PTSD symptoms, a 31% reduction in depression symptoms, and an increase in quality of life following PE. Veterans not prescribed psychotropic medication reported greater PTSD symptom reduction than veterans prescribed such medication. The implications of these results for treatment programs targeting PTSD in veterans are discussed.
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Community Violence Exposure and Adolescents’ School Engagement and Academic Achievement Over Time
Larissa Borofsky et al.
Psychology of Violence, forthcoming
Objective: This study examined the relationships between community violence exposure and two related, but meaningfully distinct, academic outcomes: school engagement and academic achievement (grade point average, GPA). Psychological symptoms were investigated as mediators of these relationships.
Method: One-hundred and eighteen youth reported on community violence exposure and school engagement twice during adolescence, and both parents and adolescents reported on psychological symptoms. Cumulative GPA was also acquired from participants. A path model and hierarchical multiple regression analyses were used to assess these relationships longitudinally.
Results: Earlier community violence exposure inversely predicted later school engagement, but earlier school engagement did not predict later community violence exposure. School engagement mediated the association between community violence exposure and school GPA. Internalizing and externalizing symptoms, but not posttraumatic stress symptoms, mediated the association between community violence and school engagement.
Conclusions: When adolescents are exposed to community violence, they may become vulnerable to a cascade of events including psychological symptoms and decreased connectedness to school, which ultimately can lead to overall poor academic achievement. The more proximal, changeable experiences of school connectedness and psychological symptoms offer targets for interventions offsetting long-term adverse academic consequences in violence-exposed youth.
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Internalizing and Externalizing Behaviors Predict Elevated Inflammatory Markers in Childhood
Natalie Slopen, Laura Kubzansky & Karestan Koenen
Psychoneuroendocrinology, forthcoming
Background: Children with behavior problems, such as internalizing or externalizing disorders, are at increased risk for poorer physical health in adulthood. Inflammation has been posited as a potential biological mediator underlying this association. However, it is unclear how early in development associations between behavior problems and inflammation may be detected, and whether associations are present for both internalizing and externalizing behaviors in pre-pubertal children.
Methods: Using data from children in the Avon Longitudinal Study of Parents and Children, we examined associations between behavior problems at age 8 (assessed via the parent-report Strengths and Difficulties Questionnaire) and inflammatory markers assessed at age 10. Inflammatory markers included C-reactive protein (CRP; n = 4069) and interleukin-6 (IL-6; n = 4061). We further evaluated whether body mass index (BMI) mediated associations, and tested for potential reverse causality by considering whether age 10 inflammation was associated with changes from initial levels to age 12 behavior problems.
Results: After adjusting for relevant covariates, age 8 externalizing behaviors were associated with elevated CRP at age 10, and age 8 internalizing and externalizing behaviors were associated with elevated IL-6 at age 10 (p's<.05). We found no evidence that observed associations were mediated by BMI or that inflammatory markers at age 10 were associated with increased internalizing or externalizing behavior problems at age 12.
Conclusions: These findings document an association between behavior problems and elevated concentrations of CRP and IL-6 at 10 years. Heightened inflammation in childhood may be a pathway through which early behavior problems increase risk for adult chronic diseases.
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Laura Hickman et al.
Journal of Experimental Criminology, September 2013, Pages 301-331
Objectives: The study tests whether participation in interventions offered by a subset of sites from the National Safe Start Promising Approaches for Children Exposed to Violence initiative improved outcomes for children relative to controls.
Methods: The study pools data from the nine Safe Start sites that randomized families to intervention and control groups, using a within-site block randomization strategy based on child age at baseline. Caregiver-reported outcomes, assessed at baseline, 6 and 12 months, included caregiver personal problems, caregiver resource problems, parenting stress, child and caregiver victimization, child trauma symptoms, child behavior problems, and social-emotional competence.
Results: Results revealed no measurable intervention impact in intent-to-treat analyses at either 6- or 12-month post-baseline. In 6-month as-treated analyses, a medium to high intervention dose was associated with improvement on two measures of child social-emotional competence: cooperation and assertion. Overall, there is no reliable evidence of significant site-to-site effect variability, even in the two cases of significant intervention effect.
Conclusions: Since families in both the intervention and control groups received some degree of case management and both groups improved over time, it may be advantageous to explore the potential impacts of crisis and case management separately from mental health interventions. It may be that, on average, children in families whose basic needs are being attended to improve substantially on their own.
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Laura DiCola et al.
Journal of the American Academy of Child & Adolescent Psychiatry, September 2013, Pages 953–960
Objective: The goals of this study were to identify treatment rates among adolescents with co-occurring major depressive episode (MDE) and substance use disorder (SUD), and to examine the role of health insurance in the treatment of these disorders.
Method: Seven years of cross-sectional data (2004–2010) were pooled from the National Survey on Drug Use and Health to derive a nationally representative sample of 2,111 adolescents who had both a past-year MDE and SUD and whose insurance status was known. The associations of public and private insurance with MDE and SUD treatment were examined using multinomial logistic regressions that controlled for health status and sociodemographic variables.
Results: Less than one-half (48%) of adolescents received any form of MDE treatment in the past year, and only 10% received any form of SUD treatment. Only 16% of adolescents who received MDE treatment also received SUD treatment. Relative to no insurance, public insurance was associated with an increased likelihood of receiving MDE treatment alone, but not with an increased likelihood of receiving both MDE and SUD treatment. Involvement in the criminal justice system was the major factor affecting the likelihood that an adolescent would receive both MDE and SUD treatment, as opposed to either no treatment or treatment for MDE alone.
Conclusions: Exceptionally low rates of SUD treatment were observed in this high-risk sample. Study findings highlight a missed opportunity to assess and to treat SUD among adolescents with cooccurring MDE and SUD who have received some form of MDE treatment in the past year.