Research suggests that perceived social stress influences illness presentation and course among y... more Research suggests that perceived social stress influences illness presentation and course among youth in the clinical high-risk (CHR) phase of psychosis. Little is known, however, about the social cognitive factors associated with social stress perception in this population, particularly relative to youth with non-CHR psychopathology. Individuals with psychosis tend to endorse an external locus of control (LOC), which is associated with the stress response in healthy individuals. LOC may therefore be related to perceived social stress in youth at CHR. We examined the differential relations of self-reported LOC and perceived social stress, as measured by the Behavior Assessment System for Children, Second Edition, across 45 CHR and 65 help-seeking control (HSC) participants. Youth at CHR reported more social stress (F[1, 107] = 6.28, p = 0.01) and a more external LOC (F[1, 107] = 4.98, p = 0.03) than HSCs. Further, external LOC was more strongly associated with feelings of social stress in the CHR group relative to the HSC group (interaction: b = 0.35, t[105] = 2.32, p b 0.05, f 2 = 0.05). Group differences in social stress, however, were nonsignificant at internal levels of LOC (b = − 2.0, t[105] = − 0.72, p = 0.48; f 2 = 0.00). Results suggest that perceptions of uncontrollability over one's social environment may more often induce or exacerbate feelings of stress and tension in CHR youth relative to HSCs. A better understanding of the social cognition-stress relation may improve understanding of CHR phenomenology, etiology, and treatment.
The 28-item Multidimensional Measure of Emotional Abuse (MMEA) assesses four common forms of emot... more The 28-item Multidimensional Measure of Emotional Abuse (MMEA) assesses four common forms of emotional abuse in intimate relationships and has been used extensively to study the development of intimate partner violence (IPV), the consequences of emotional abuse, and the outcomes of IPV interventions. The current study provides psychometric analyses of a shortened version of the MMEA using self-report data from a sample of men receiving treatment at a community-based relationship violence intervention program (RVIP; N = 467) and reports from their relationship partners (N = 252), and data from a sample of undergraduate students (N = 194) who reported on their own and their partners' abusive behavior. Theoretical and statistical considerations, including internal consistency after item deletion,
This study evaluated whether alcohol abstinence self-efficacy at the end of alcohol treatment was... more This study evaluated whether alcohol abstinence self-efficacy at the end of alcohol treatment was moderated by utilization of behavioral processes of change (coping activities used during a behavior change attempt). It was hypothesized that self-efficacy would be differentially important in predicting posttreatment drinking outcomes depending on the level of behavioral processes, such that the relation between self-efficacy and outcomes would be stronger for individuals who reported low process use. Analyses were also estimated with end-of-treatment abstinence included as a covariate. Data were analyzed from alcohol-dependent individuals in both treatment arms of Project MATCH (Matching Alcoholism Treatments to Client Heterogeneity; N ϭ 1,328), a large alcohol treatment study. Selfefficacy was moderated by behavioral process use in predicting drinking frequency 6 and 12 months posttreatment and drinking quantity 6 months posttreatment such that self-efficacy was more strongly related to posttreatment drinking when low levels of processes were reported than high levels, but interactions were attenuated when end-of-treatment abstinence was controlled for. Significant quadratic relations between end-of-treatment self-efficacy and 6-and 12-month posttreatment drinking quantity and frequency were found (p Ͻ .001, ƒ 2 ϭ 0.02-0.03), such that self-efficacy most robustly predicted outcomes when high. These effects remained significant when end-of-treatment abstinence was included as a covariate. Findings highlight the complex nature of self-efficacy's relation with drinking outcomes. Although the interaction between self-efficacy and behavioral processes was attenuated when end-oftreatment abstinence was controlled for, the quadratic effect of self-efficacy on outcomes remained significant. The pattern of these effects did not support the idea of "overconfidence" as a negative indicator.
Objective: Untreated mental health (MH) concerns have significant implications for college studen... more Objective: Untreated mental health (MH) concerns have significant implications for college students. This study examined the efficacy of a video contact intervention targeting students' intentions to seek counseling. Participants: One-hundred and sixty-three college students (M age ¼ 21.05, SD ¼ 2.20) from a Mid-Atlantic university participated. The sample was predominantly female (74%). Method: Students were randomly assigned to view a student-targeted contact video (ie, clips from college students who share their mental health experiences), a MH comparison contact video, or a non-MH comparison video. Intentions to seek counseling and psychological distress were measured pretest and post-test. Results: Intentions to seek counseling significantly increased from pretest to post-test in the student-targeted contact video condition (F[1, 156] ¼ 22.75, p < .001, partial g 2 ¼ .13), but not in the comparison conditions. Further, this effect was only observed among participants who reported preexisting psychological distress (F[1, 153] ¼ 28.00, p < .001, partial g 2 ¼ .16). Conclusions: This study provides initial support for the utility of a student-targeted contact intervention video for increasing help-seeking intentions among those reporting current psychological distress.
The 28-item Multidimensional Measure of Emotional Abuse (MMEA) assesses four common forms of emot... more The 28-item Multidimensional Measure of Emotional Abuse (MMEA) assesses four common forms of emotional abuse in intimate relationships and has been used extensively to study the development of intimate partner violence (IPV), the consequences of emotional abuse, and the outcomes of IPV interventions. The current study provides psychometric analyses of a shortened version of the MMEA using self-report data from a sample of men receiving treatment at a community-based relationship violence intervention program (RVIP; N = 467) and reports from their relationship partners ( N = 252), and data from a sample of undergraduate students ( N = 194) who reported on their own and their partners’ abusive behavior. Theoretical and statistical considerations, including internal consistency after item deletion, were used to select items for the shortened version. In the clinic sample (for self- and partner reports) and in the undergraduate sample (for self-report only), the 16-item MMEA-Short Form (MMEA-SF) retains the 4-factor structure of the 28-item MMEA. In both samples and across reporting methods (self and partner), the 16-item MMEA-SF has good internal consistency, good concurrent validity with the Revised Conflict Tactics Scales (CTS2) psychological aggression subscale, and similar correlations with CTS2 physical assault subscale as the original 28-item MMEA version. The MMEA-SF can reduce assessment burden while maintaining good domain coverage and strong psychometric properties and will be an asset to researchers and practitioners who need a brief, multifaceted measure of emotional relationship abuse in both clinic and undergraduate samples.
School-related difficulties have received relatively little attention as environmental risk facto... more School-related difficulties have received relatively little attention as environmental risk factors for psychotic experiences (PEs), despite being characterized by marginalization and social defeat during critical periods of psychological development. This study examined both childhood age relative to one's classmates and school mobility as risk factors for adult psychotic experiences in the National Comorbidity Survey-Replication (NCS-R). Weighted logistic regression models were used to explore the hypotheses that lifetime psychotic experiences reported on the World Health Organization psychosis screen would be more prevalent among those younger than their classmates during childhood and for those with frequent school mobility. Younger perceived relative age (odds ratio (OR) ¼2.05, 95% confidence interval¼1.43-2.95) was independently associated with psychotic experiences in the fully adjusted model, but school mobility was not. School-related risk factors for psychosis provide promising points for community-level intervention, and support the claim that environmental factors characterized by disadvantage and marginalization contribute to psychosis etiology.
The primary aim of this study was to explore the potential moderating effect of social support on... more The primary aim of this study was to explore the potential moderating effect of social support on the relation between distress caused by psychosis risk symptoms and self-stigma among college students with mental health diagnoses. Methods: Participants were young adult college students who endorsed having a past or present mental health diagnosis (n ϭ 63). Self-report data were examined from the Prodromal Questionnaire-Brief, a measure of subthreshold psychosis risk symptoms; the Self-Concurrence/Application subscale of the Self-Stigma of Mental Illness Scale, a measure of self-stigma; and the Friendships subscale of the Lubben Social Network Scale-Revised, a measure of social support from peers. Results: There was a modest direct relation between distress associated with psychosis risk symptoms and self-stigma. There was a larger relation between distress from risk symptoms and self-stigma for those with low social support compared to those with mean and high social support. Conclusions and Implications for Practice: Although causality cannot be determined based on this study, a strong relation between symptom distress and stigma was found among those reporting low peer social support. Interventions that target both self-stigma and social support might be relevant for young adults with a history of mental health concerns who currently endorse subthreshold psychotic symptoms.
Objective To provide a brief, nontechnical introduction to individual growth curve modeling for t... more Objective To provide a brief, nontechnical introduction to individual growth curve modeling for the analysis of longitudinal data. Several applications of individual growth curve modeling for pediatric psychology research are discussed. Methods To illustrate these applications, we analyze data from an ongoing pediatric psychology study of the possible impact of spina bifida on child and family development (N = 135). Three repeated observations, spaced by approximately 2 years, contributed to the analyses (M age at baseline = 8.84). Results Results indicated that individual linear growth curves of emotional autonomy varied as a function of the youth gender by spina bifida group membership interaction. Conclusions Strengths of individual growth curve modeling relative to more traditional methods of analysis are highlighted (e.g., completely flexible specification of the time variable, explicit modeling of both aggregate-level and individual-level growth curves).
The current paper uses data from a longitudinal study of a high-risk sample to test the relation ... more The current paper uses data from a longitudinal study of a high-risk sample to test the relation between adolescent alcohol and drug use and later young adult autonomy, positive activity involvement, and perceived competence. Participants (children of alcoholics and demographically matched controls) were assessed in three annual interviews in adolescence (mean age: 12.7 years at Time 1) and then again 5-7 years later, in young adulthood (median age: 20 years). Path analyses and latent growth curve models tested the effects of adolescent substance use on both selfreported and collateral-reported outcomes, controlling for correlated risk factors (parental alcoholism, adolescent psychopathology, and parental support), preexisting levels of the outcome, and concurrent young adult substance use. Results showed that adolescent drug use had a significant, unique negative effect on later autonomy and perceived competence. Alcohol use effects were more complex. Adolescent heavy drinking was associated with less positive adult outcomes, but more so in collateral reports than in self-reported outcomes. Moreover, young adult heavy drinking was either uncorrelated with or positively correlated with higher levels of perceived competence, suggesting different developmental significance of alcohol use in adolescence than in young adulthood.
Journal of Consulting and Clinical Psychology, 2002
This study describes binge drinking trajectories from adolescence to emerging adulthood in 238 ch... more This study describes binge drinking trajectories from adolescence to emerging adulthood in 238 children of alcoholics and 208 controls. Mixture modeling identified three trajectory groups: early-heavy (early onset, high frequency), late-moderate (later onset, moderate frequency), and infrequent (early onset, low frequency). Nonbingers were defined a priori. The early-heavy group was characterized by parental alcoholism and antisociality, peer drinking, drug use, and (for boys) high levels of externalizing behavior, but low depression. The infrequent group was elevated in parent alcoholism and (for girls) adolescent depression, whereas the nonbinger and late-moderate groups showed the most favorable adolescent psychosocial variables. All 3 drinking trajectory groups raised risk for later substance abuse or dependence compared with the nonbingers, with the early-heavy group at highest risk.
Research suggests that social stress exposure influences illness presentation and course among yo... more Research suggests that social stress exposure influences illness presentation and course among youth at clinical high-risk (CHR) for psychosis, though less is known about the extent to which self-reported perceptions of social stress relate to the severity of positive symptoms. Importantly, despite the notion that youth at CHR are especially susceptible to elevations in positive symptoms under conditions of stress, no study has examined this presumption relative to other psychiatric groups. Extending previous work demonstrating that perceived social stress was higher in a CHR group than in a clinical group of non-CHR, help-seeking controls, the current study aimed to: (1) examine whether perceived social stress is related to the severity of attenuated positive symptoms in the full sample (N = 110); and (2) determine whether CHR status moderates the stress-symptom relation. Exploratory analyses examined relations of perceived social stress to negative, disorganized, and general symptoms. Greater perceptions of social stress were associated with more severe positive symptoms in the entire sample; however, although positive symptoms and perceived social stress were higher in the CHR group, the strength of this relation was statistically indistinguishable across groups. No differential effect of perceived social stress was observed for any symptom domain. Results provide some support for the diathesis-stress model of psychosis, while also suggesting that social stress and symptomatology are related independent of clinical vulnerability to psychosis. Future research would benefit from longitudinal studies of stress-symptom relations across CHR and help-seeking control groups.
Objective: Racial inequities in mental health care utilization (MHCU) are well documented. Margin... more Objective: Racial inequities in mental health care utilization (MHCU) are well documented. Marginalized racial groups are more likely to report psychosis-like experiences (PLEs) and are at elevated risk for racial discrimination and trauma, impacting PLE severity. Little is known about how factors associated with race impact treatment seeking among individuals reporting PLEs. The present study examined associations between race, trauma, discrimination, PLEs, and MHCU among people endorsing high levels of PLEs. Method: Participants were Asian/Asian American, Black/African American, or White/European American college students ages 18-25 years meeting PLE self-report measure cutoff scores (N = 177). Binary logistic and multiple linear regressions were used to examine associations between past, current, and prospective MHCU and race, potentially traumatic events, discrimination, and PLEs. Results: Participants endorsing more PLEs were more likely to report past and current treatment and to be considering future services. Asian/Asian American and Black/African American participants were less likely to endorse past, current, and prospective future mental health care. Potentially traumatic events predicted increased utilization of past treatment. Conclusions: Results suggest service differences among participants, such that Black/African American and Asian/Asian American young adults reporting PLEs were less likely than White/European American counterparts to seek treatment even when accounting for traumatic events and discrimination. These findings highlight the need to further elucidate MHCU among marginalized racial groups experiencing psychosis-like symptoms. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Subjective quality of life can be compromised in individuals with psychosis-risk symptoms, with p... more Subjective quality of life can be compromised in individuals with psychosis-risk symptoms, with poorer quality of life being associated with worse functioning and later transition to psychosis. Individuals who experience psychosis-related symptoms also tend to endorse more internalized (or self-) mental health stigma when compared to controls, potentially contributing to delays in seeking treatment and increased duration of untreated psychosis, as well as interfering with treatment engagement and retention in those already receiving care. Despite these findings, and the growing recognition for prevention in earlier phases of psychotic illness, few studies have examined the relation between psychosis-risk symptoms, internalized stigma, and subjective quality of life in a younger, help-seeking sample. The present study examined whether internalized stigma mediates the relation between psychosis-risk symptoms and subjective quality of life in a transdiagnostic sample of youth (M age = 17.93, SD = 2.90) at clinical high-risk for psychosis (CHR), with early psychosis, or with non-psychotic disorders (N = 72). Psychosis-risk symptom severity was assessed using the Structured Interview for Psychosis-Risk Syndromes (SIPS). Internalized stigma was assessed using the Internalized Stigma of Mental Illness Inventory (ISMI), and subjective quality of life was assessed using the Youth Quality of Life Instrument - Short Form (YQOL-SF). Internalized stigma fully mediated the relation between psychosis-risk symptoms and subjective quality of life across the full sample (p < .05, f2 = 0.06). Findings suggest that internalized stigma may be an important target in efforts to improve quality of life for individuals in early stages of psychosis.
Background-Youth at clinical high-risk (CHR) for psychosis often experience difficulties in socia... more Background-Youth at clinical high-risk (CHR) for psychosis often experience difficulties in social and role functioning. Given evidence that family stress and support can impact psychosisrisk symptoms, as well as an individual's ability to fulfill social and role functions, family dynamics are hypothesized to moderate the effect of psychosis-risk symptoms on functioning. Methods-Participants at CHR (N = 52) completed the clinician-administered Structured Interview for Psychosis-risk Syndromes (SIPS) and the Family Assessment Device (FAD) General Functioning Scale, a self-report measure of family functioning including cohesion and support. Interviewers rated participants' current social and role functioning using the Global Functioning: Social and Role Scales. Results-Regression results indicated that positive symptoms, but not ratings of family functioning, statistically predicted social and role functioning. Perceived family functioning, however, moderated the effect of symptoms on social/role functioning. For individuals who perceived lower levels of family functioning, symptoms were moderately associated with social and role functioning (f 2 = .17 and f 2 = .23, respectively). In contrast, psychosis-risk symptoms were not significantly associated with social/role functioning for individuals with higher levels of perceived family functioning. Notably, positive symptoms and perceived family functioning were not associated with one another, suggesting that perceived family functioning did not directly impact symptom severity, or vice versa. Conclusions-Findings support the notion that family functioning may be a clinically meaningful factor for individuals at CHR. Although this cross-sectional data limits our discussion
Multiple regression analysis (MR) is a highly flexible system for examining the relationship of a... more Multiple regression analysis (MR) is a highly flexible system for examining the relationship of a collection of independent variables (or predictors) to a single dependent variable (or criterion). The independent variables may be quantitative (e.g., personality traits, family income) or categorical (e.g., ethnic group, treatment conditions in an experiment). The present chapter explores ordinary least-squares regression with a continuous dependent variable. The chapter has two foci: (1) testing of theoretical predictions through multiple regression and (2) identification of problems with implementation of regression analysis, both from the perspectives of model specification and the data themselves. The structure of MR is described, including the regression equation, estimation of partial regression coefficients, measures of overall model fit, and the contribution of individual predictors and sets of predictors to prediction accuracy. The treatment of categorical predictors through ...
Early detection and prevention of psychosis has become an international priority. Much of this wo... more Early detection and prevention of psychosis has become an international priority. Much of this work has focused on youth presenting with attenuated symptoms of psychosis-those at Clinical High Risk for psychosis (CHR)-given their elevated probability of developing the full disorder in subsequent years. Individuals at CHR may be prone to exacerbated psychological distress during DeLuca et al.
Research suggests that perceived social stress influences illness presentation and course among y... more Research suggests that perceived social stress influences illness presentation and course among youth in the clinical high-risk (CHR) phase of psychosis. Little is known, however, about the social cognitive factors associated with social stress perception in this population, particularly relative to youth with non-CHR psychopathology. Individuals with psychosis tend to endorse an external locus of control (LOC), which is associated with the stress response in healthy individuals. LOC may therefore be related to perceived social stress in youth at CHR. We examined the differential relations of self-reported LOC and perceived social stress, as measured by the Behavior Assessment System for Children, Second Edition, across 45 CHR and 65 help-seeking control (HSC) participants. Youth at CHR reported more social stress (F[1, 107] = 6.28, p = 0.01) and a more external LOC (F[1, 107] = 4.98, p = 0.03) than HSCs. Further, external LOC was more strongly associated with feelings of social stress in the CHR group relative to the HSC group (interaction: b = 0.35, t[105] = 2.32, p b 0.05, f 2 = 0.05). Group differences in social stress, however, were nonsignificant at internal levels of LOC (b = − 2.0, t[105] = − 0.72, p = 0.48; f 2 = 0.00). Results suggest that perceptions of uncontrollability over one's social environment may more often induce or exacerbate feelings of stress and tension in CHR youth relative to HSCs. A better understanding of the social cognition-stress relation may improve understanding of CHR phenomenology, etiology, and treatment.
The 28-item Multidimensional Measure of Emotional Abuse (MMEA) assesses four common forms of emot... more The 28-item Multidimensional Measure of Emotional Abuse (MMEA) assesses four common forms of emotional abuse in intimate relationships and has been used extensively to study the development of intimate partner violence (IPV), the consequences of emotional abuse, and the outcomes of IPV interventions. The current study provides psychometric analyses of a shortened version of the MMEA using self-report data from a sample of men receiving treatment at a community-based relationship violence intervention program (RVIP; N = 467) and reports from their relationship partners (N = 252), and data from a sample of undergraduate students (N = 194) who reported on their own and their partners' abusive behavior. Theoretical and statistical considerations, including internal consistency after item deletion,
This study evaluated whether alcohol abstinence self-efficacy at the end of alcohol treatment was... more This study evaluated whether alcohol abstinence self-efficacy at the end of alcohol treatment was moderated by utilization of behavioral processes of change (coping activities used during a behavior change attempt). It was hypothesized that self-efficacy would be differentially important in predicting posttreatment drinking outcomes depending on the level of behavioral processes, such that the relation between self-efficacy and outcomes would be stronger for individuals who reported low process use. Analyses were also estimated with end-of-treatment abstinence included as a covariate. Data were analyzed from alcohol-dependent individuals in both treatment arms of Project MATCH (Matching Alcoholism Treatments to Client Heterogeneity; N ϭ 1,328), a large alcohol treatment study. Selfefficacy was moderated by behavioral process use in predicting drinking frequency 6 and 12 months posttreatment and drinking quantity 6 months posttreatment such that self-efficacy was more strongly related to posttreatment drinking when low levels of processes were reported than high levels, but interactions were attenuated when end-of-treatment abstinence was controlled for. Significant quadratic relations between end-of-treatment self-efficacy and 6-and 12-month posttreatment drinking quantity and frequency were found (p Ͻ .001, ƒ 2 ϭ 0.02-0.03), such that self-efficacy most robustly predicted outcomes when high. These effects remained significant when end-of-treatment abstinence was included as a covariate. Findings highlight the complex nature of self-efficacy's relation with drinking outcomes. Although the interaction between self-efficacy and behavioral processes was attenuated when end-oftreatment abstinence was controlled for, the quadratic effect of self-efficacy on outcomes remained significant. The pattern of these effects did not support the idea of "overconfidence" as a negative indicator.
Objective: Untreated mental health (MH) concerns have significant implications for college studen... more Objective: Untreated mental health (MH) concerns have significant implications for college students. This study examined the efficacy of a video contact intervention targeting students' intentions to seek counseling. Participants: One-hundred and sixty-three college students (M age ¼ 21.05, SD ¼ 2.20) from a Mid-Atlantic university participated. The sample was predominantly female (74%). Method: Students were randomly assigned to view a student-targeted contact video (ie, clips from college students who share their mental health experiences), a MH comparison contact video, or a non-MH comparison video. Intentions to seek counseling and psychological distress were measured pretest and post-test. Results: Intentions to seek counseling significantly increased from pretest to post-test in the student-targeted contact video condition (F[1, 156] ¼ 22.75, p < .001, partial g 2 ¼ .13), but not in the comparison conditions. Further, this effect was only observed among participants who reported preexisting psychological distress (F[1, 153] ¼ 28.00, p < .001, partial g 2 ¼ .16). Conclusions: This study provides initial support for the utility of a student-targeted contact intervention video for increasing help-seeking intentions among those reporting current psychological distress.
The 28-item Multidimensional Measure of Emotional Abuse (MMEA) assesses four common forms of emot... more The 28-item Multidimensional Measure of Emotional Abuse (MMEA) assesses four common forms of emotional abuse in intimate relationships and has been used extensively to study the development of intimate partner violence (IPV), the consequences of emotional abuse, and the outcomes of IPV interventions. The current study provides psychometric analyses of a shortened version of the MMEA using self-report data from a sample of men receiving treatment at a community-based relationship violence intervention program (RVIP; N = 467) and reports from their relationship partners ( N = 252), and data from a sample of undergraduate students ( N = 194) who reported on their own and their partners’ abusive behavior. Theoretical and statistical considerations, including internal consistency after item deletion, were used to select items for the shortened version. In the clinic sample (for self- and partner reports) and in the undergraduate sample (for self-report only), the 16-item MMEA-Short Form (MMEA-SF) retains the 4-factor structure of the 28-item MMEA. In both samples and across reporting methods (self and partner), the 16-item MMEA-SF has good internal consistency, good concurrent validity with the Revised Conflict Tactics Scales (CTS2) psychological aggression subscale, and similar correlations with CTS2 physical assault subscale as the original 28-item MMEA version. The MMEA-SF can reduce assessment burden while maintaining good domain coverage and strong psychometric properties and will be an asset to researchers and practitioners who need a brief, multifaceted measure of emotional relationship abuse in both clinic and undergraduate samples.
School-related difficulties have received relatively little attention as environmental risk facto... more School-related difficulties have received relatively little attention as environmental risk factors for psychotic experiences (PEs), despite being characterized by marginalization and social defeat during critical periods of psychological development. This study examined both childhood age relative to one's classmates and school mobility as risk factors for adult psychotic experiences in the National Comorbidity Survey-Replication (NCS-R). Weighted logistic regression models were used to explore the hypotheses that lifetime psychotic experiences reported on the World Health Organization psychosis screen would be more prevalent among those younger than their classmates during childhood and for those with frequent school mobility. Younger perceived relative age (odds ratio (OR) ¼2.05, 95% confidence interval¼1.43-2.95) was independently associated with psychotic experiences in the fully adjusted model, but school mobility was not. School-related risk factors for psychosis provide promising points for community-level intervention, and support the claim that environmental factors characterized by disadvantage and marginalization contribute to psychosis etiology.
The primary aim of this study was to explore the potential moderating effect of social support on... more The primary aim of this study was to explore the potential moderating effect of social support on the relation between distress caused by psychosis risk symptoms and self-stigma among college students with mental health diagnoses. Methods: Participants were young adult college students who endorsed having a past or present mental health diagnosis (n ϭ 63). Self-report data were examined from the Prodromal Questionnaire-Brief, a measure of subthreshold psychosis risk symptoms; the Self-Concurrence/Application subscale of the Self-Stigma of Mental Illness Scale, a measure of self-stigma; and the Friendships subscale of the Lubben Social Network Scale-Revised, a measure of social support from peers. Results: There was a modest direct relation between distress associated with psychosis risk symptoms and self-stigma. There was a larger relation between distress from risk symptoms and self-stigma for those with low social support compared to those with mean and high social support. Conclusions and Implications for Practice: Although causality cannot be determined based on this study, a strong relation between symptom distress and stigma was found among those reporting low peer social support. Interventions that target both self-stigma and social support might be relevant for young adults with a history of mental health concerns who currently endorse subthreshold psychotic symptoms.
Objective To provide a brief, nontechnical introduction to individual growth curve modeling for t... more Objective To provide a brief, nontechnical introduction to individual growth curve modeling for the analysis of longitudinal data. Several applications of individual growth curve modeling for pediatric psychology research are discussed. Methods To illustrate these applications, we analyze data from an ongoing pediatric psychology study of the possible impact of spina bifida on child and family development (N = 135). Three repeated observations, spaced by approximately 2 years, contributed to the analyses (M age at baseline = 8.84). Results Results indicated that individual linear growth curves of emotional autonomy varied as a function of the youth gender by spina bifida group membership interaction. Conclusions Strengths of individual growth curve modeling relative to more traditional methods of analysis are highlighted (e.g., completely flexible specification of the time variable, explicit modeling of both aggregate-level and individual-level growth curves).
The current paper uses data from a longitudinal study of a high-risk sample to test the relation ... more The current paper uses data from a longitudinal study of a high-risk sample to test the relation between adolescent alcohol and drug use and later young adult autonomy, positive activity involvement, and perceived competence. Participants (children of alcoholics and demographically matched controls) were assessed in three annual interviews in adolescence (mean age: 12.7 years at Time 1) and then again 5-7 years later, in young adulthood (median age: 20 years). Path analyses and latent growth curve models tested the effects of adolescent substance use on both selfreported and collateral-reported outcomes, controlling for correlated risk factors (parental alcoholism, adolescent psychopathology, and parental support), preexisting levels of the outcome, and concurrent young adult substance use. Results showed that adolescent drug use had a significant, unique negative effect on later autonomy and perceived competence. Alcohol use effects were more complex. Adolescent heavy drinking was associated with less positive adult outcomes, but more so in collateral reports than in self-reported outcomes. Moreover, young adult heavy drinking was either uncorrelated with or positively correlated with higher levels of perceived competence, suggesting different developmental significance of alcohol use in adolescence than in young adulthood.
Journal of Consulting and Clinical Psychology, 2002
This study describes binge drinking trajectories from adolescence to emerging adulthood in 238 ch... more This study describes binge drinking trajectories from adolescence to emerging adulthood in 238 children of alcoholics and 208 controls. Mixture modeling identified three trajectory groups: early-heavy (early onset, high frequency), late-moderate (later onset, moderate frequency), and infrequent (early onset, low frequency). Nonbingers were defined a priori. The early-heavy group was characterized by parental alcoholism and antisociality, peer drinking, drug use, and (for boys) high levels of externalizing behavior, but low depression. The infrequent group was elevated in parent alcoholism and (for girls) adolescent depression, whereas the nonbinger and late-moderate groups showed the most favorable adolescent psychosocial variables. All 3 drinking trajectory groups raised risk for later substance abuse or dependence compared with the nonbingers, with the early-heavy group at highest risk.
Research suggests that social stress exposure influences illness presentation and course among yo... more Research suggests that social stress exposure influences illness presentation and course among youth at clinical high-risk (CHR) for psychosis, though less is known about the extent to which self-reported perceptions of social stress relate to the severity of positive symptoms. Importantly, despite the notion that youth at CHR are especially susceptible to elevations in positive symptoms under conditions of stress, no study has examined this presumption relative to other psychiatric groups. Extending previous work demonstrating that perceived social stress was higher in a CHR group than in a clinical group of non-CHR, help-seeking controls, the current study aimed to: (1) examine whether perceived social stress is related to the severity of attenuated positive symptoms in the full sample (N = 110); and (2) determine whether CHR status moderates the stress-symptom relation. Exploratory analyses examined relations of perceived social stress to negative, disorganized, and general symptoms. Greater perceptions of social stress were associated with more severe positive symptoms in the entire sample; however, although positive symptoms and perceived social stress were higher in the CHR group, the strength of this relation was statistically indistinguishable across groups. No differential effect of perceived social stress was observed for any symptom domain. Results provide some support for the diathesis-stress model of psychosis, while also suggesting that social stress and symptomatology are related independent of clinical vulnerability to psychosis. Future research would benefit from longitudinal studies of stress-symptom relations across CHR and help-seeking control groups.
Objective: Racial inequities in mental health care utilization (MHCU) are well documented. Margin... more Objective: Racial inequities in mental health care utilization (MHCU) are well documented. Marginalized racial groups are more likely to report psychosis-like experiences (PLEs) and are at elevated risk for racial discrimination and trauma, impacting PLE severity. Little is known about how factors associated with race impact treatment seeking among individuals reporting PLEs. The present study examined associations between race, trauma, discrimination, PLEs, and MHCU among people endorsing high levels of PLEs. Method: Participants were Asian/Asian American, Black/African American, or White/European American college students ages 18-25 years meeting PLE self-report measure cutoff scores (N = 177). Binary logistic and multiple linear regressions were used to examine associations between past, current, and prospective MHCU and race, potentially traumatic events, discrimination, and PLEs. Results: Participants endorsing more PLEs were more likely to report past and current treatment and to be considering future services. Asian/Asian American and Black/African American participants were less likely to endorse past, current, and prospective future mental health care. Potentially traumatic events predicted increased utilization of past treatment. Conclusions: Results suggest service differences among participants, such that Black/African American and Asian/Asian American young adults reporting PLEs were less likely than White/European American counterparts to seek treatment even when accounting for traumatic events and discrimination. These findings highlight the need to further elucidate MHCU among marginalized racial groups experiencing psychosis-like symptoms. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Subjective quality of life can be compromised in individuals with psychosis-risk symptoms, with p... more Subjective quality of life can be compromised in individuals with psychosis-risk symptoms, with poorer quality of life being associated with worse functioning and later transition to psychosis. Individuals who experience psychosis-related symptoms also tend to endorse more internalized (or self-) mental health stigma when compared to controls, potentially contributing to delays in seeking treatment and increased duration of untreated psychosis, as well as interfering with treatment engagement and retention in those already receiving care. Despite these findings, and the growing recognition for prevention in earlier phases of psychotic illness, few studies have examined the relation between psychosis-risk symptoms, internalized stigma, and subjective quality of life in a younger, help-seeking sample. The present study examined whether internalized stigma mediates the relation between psychosis-risk symptoms and subjective quality of life in a transdiagnostic sample of youth (M age = 17.93, SD = 2.90) at clinical high-risk for psychosis (CHR), with early psychosis, or with non-psychotic disorders (N = 72). Psychosis-risk symptom severity was assessed using the Structured Interview for Psychosis-Risk Syndromes (SIPS). Internalized stigma was assessed using the Internalized Stigma of Mental Illness Inventory (ISMI), and subjective quality of life was assessed using the Youth Quality of Life Instrument - Short Form (YQOL-SF). Internalized stigma fully mediated the relation between psychosis-risk symptoms and subjective quality of life across the full sample (p < .05, f2 = 0.06). Findings suggest that internalized stigma may be an important target in efforts to improve quality of life for individuals in early stages of psychosis.
Background-Youth at clinical high-risk (CHR) for psychosis often experience difficulties in socia... more Background-Youth at clinical high-risk (CHR) for psychosis often experience difficulties in social and role functioning. Given evidence that family stress and support can impact psychosisrisk symptoms, as well as an individual's ability to fulfill social and role functions, family dynamics are hypothesized to moderate the effect of psychosis-risk symptoms on functioning. Methods-Participants at CHR (N = 52) completed the clinician-administered Structured Interview for Psychosis-risk Syndromes (SIPS) and the Family Assessment Device (FAD) General Functioning Scale, a self-report measure of family functioning including cohesion and support. Interviewers rated participants' current social and role functioning using the Global Functioning: Social and Role Scales. Results-Regression results indicated that positive symptoms, but not ratings of family functioning, statistically predicted social and role functioning. Perceived family functioning, however, moderated the effect of symptoms on social/role functioning. For individuals who perceived lower levels of family functioning, symptoms were moderately associated with social and role functioning (f 2 = .17 and f 2 = .23, respectively). In contrast, psychosis-risk symptoms were not significantly associated with social/role functioning for individuals with higher levels of perceived family functioning. Notably, positive symptoms and perceived family functioning were not associated with one another, suggesting that perceived family functioning did not directly impact symptom severity, or vice versa. Conclusions-Findings support the notion that family functioning may be a clinically meaningful factor for individuals at CHR. Although this cross-sectional data limits our discussion
Multiple regression analysis (MR) is a highly flexible system for examining the relationship of a... more Multiple regression analysis (MR) is a highly flexible system for examining the relationship of a collection of independent variables (or predictors) to a single dependent variable (or criterion). The independent variables may be quantitative (e.g., personality traits, family income) or categorical (e.g., ethnic group, treatment conditions in an experiment). The present chapter explores ordinary least-squares regression with a continuous dependent variable. The chapter has two foci: (1) testing of theoretical predictions through multiple regression and (2) identification of problems with implementation of regression analysis, both from the perspectives of model specification and the data themselves. The structure of MR is described, including the regression equation, estimation of partial regression coefficients, measures of overall model fit, and the contribution of individual predictors and sets of predictors to prediction accuracy. The treatment of categorical predictors through ...
Early detection and prevention of psychosis has become an international priority. Much of this wo... more Early detection and prevention of psychosis has become an international priority. Much of this work has focused on youth presenting with attenuated symptoms of psychosis-those at Clinical High Risk for psychosis (CHR)-given their elevated probability of developing the full disorder in subsequent years. Individuals at CHR may be prone to exacerbated psychological distress during DeLuca et al.
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