Selective Serotonin Reuptake Inhibitor/Serotonin-Norepinephrine Reuptake Inhibitor Use as a Predictor of a Diagnosis of Restless Legs Syndrome.

OBJECTIVE/BACKGROUND: Because restless legs syndrome (RLS) is a problematic syndrome, demonstrating an association between use of selective serotonin reuptake inhibitors (SSRIs)/serotonin-norepinephrine reuptake inhibitors (SNRIs) and RLS may help direct patient care. The goals of this study were (1) to establish the incidence of RLS in mental health patients being treated with SSRIs or SNRIs in a local Veterans Affairs medical center and (2) to evaluate the frequency with which certain SSRIs or SNRIs are associated with RLS and the trend in frequency of the diagnosis since the revision of the criteria for RLS offered by the International Restless Leg Syndrome Study Group (IRLSSG), the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), and the International Classification of Sleep Disorders, Revised (ICSD-3). METHODS: A retrospective chart review was used to evaluate the number of patients receiving SSRI/SNRI therapy with and without a diagnosis of RLS, with the date of the RLS diagnosis and initiation of SSRI/SNRI therapy noted. The frequency with which certain SSRIs/SNRIs were associated with RLS, and the frequency of RLS diagnoses since January 2012 were also noted. Descriptive statistics and logistic regression were used for data analysis. RESULTS: A total of 254 charts were reviewed. A majority of the patients (89.8%) were male, and 14 (5.5%) were diagnosed with RLS. A logistic regression equation approached significance in predicting RLS (P=0.053). Age and sex emerged as significant predictors of RLS. The prevalence of any individual SSRI or SNRI being associated with RLS was indeterminable. No difference was seen in the number of RLS diagnoses since the refining of the IRLSSG, DSM-5, and ICSD-3 criteria. CONCLUSIONS: The use of SSRIs/SNRIs does not seem to be associated with a diagnosis of RLS. In addition, the diagnosis of RLS does not seem to have become more common since the revision of the diagnostic criteria for the disorder.

Cumulative risk hypothesis: Predicting and preventing child maltreatment recidivism.

Although Child Protective Services (CPS) and other child welfare agencies aim to prevent further maltreatment in cases of child abuse and neglect, recidivism is common. Having a better understanding of recidivism predictors could aid in preventing additional instances of maltreatment. A previous study identified two CPS interventions that predicted recidivism: psychotherapy for the parent, which was related to a reduced risk of recidivism, and temporary removal of the child from the parent's custody, which was related to an increased recidivism risk. However, counter to expectations, this previous study did not identify any other specific risk factors related to maltreatment recidivism. For the current study, it was hypothesized that (a) cumulative risk (i.e., the total number of risk factors) would significantly predict maltreatment recidivism above and beyond intervention variables in a sample of CPS case files and that (b) therapy for the parent would be related to a reduced likelihood of recidivism. Because it was believed that the relation between temporary removal of a child from the parent's custody and maltreatment recidivism is explained by cumulative risk, the study also hypothesized that that the relation between temporary removal of the child from the parent's custody and recidivism would be mediated by cumulative risk. After performing a hierarchical logistic regression analysis, the first two hypotheses were supported, and an additional predictor, psychotherapy for the child, also was related to reduced chances of recidivism. However, Hypothesis 3 was not supported, as risk did not significantly mediate the relation between temporary removal and recidivism.

Coming Out and the Potential for Growth in Sexual Minorities: The Role of Social Reactions and Internalized Homonegativity.

Coming out is a significant and sometimes difficult process in the lives of sexual minorities, but disclosure can also affect wellbeing in positive ways, including reduced distress and greater relationship satisfaction. This study investigates the possibility of stress-related growth and depreciation following coming out. To obtain a diverse sample with varying coming-out experiences, data were collected from undergraduate students as well as from online sources, including lesbian, gay, and bisexual support groups and Pride groups. Regression analyses indicated that negative social reactions to coming out predicted both growth and depreciation, although they more strongly predicted depreciation. Positive social reactions were positively related to stress-related growth, while internalized homonegativity was inversely associated with growth. Although the two sample sources (online and campus) differed in some ways, sample source was not a significant predictor in the regressions, nor was it indicated as a moderator in exploratory ANOVA analyses.

Experiences in the military may impact dual-axis neuroendocrine processes in veterans.

Military stressors such as survival training can affect endocrine functioning in the short term, and combat has been associated with endocrine changes linked to psychopathology. However, studies with military samples examining whether there are individual differences in these changes as part of normal development, or as an adaptive mechanism in adulthood are lacking. This study examined whether exposure to combat in a sample of veterans was associated with differential endocrine activity to a laboratory frustration task. Results indicated that Army veterans demonstrated significant testosterone reactivity to frustration and negative coupling between cortisol and testosterone. Alternatively, Navy and Marine veterans demonstrated little testosterone reactivity to frustration and positive coupling between cortisol and testosterone. Positive cortisol-testosterone coupling was stronger among individuals who had more dangerous combat experiences. This latter pattern may better prepare individuals for stressful life experiences and supports the contention that adulthood stressors may calibrate endocrine systems. Results are explained in the context of the Adaptive Calibration Model (Ellis et al., 2012, Developmental Psychology, 48(3), 598-623) which proposes that exposure to key environmental dimensions during endocrinologically malleable life stages (e.g., puberty) can change stress responsivity, resulting in a faster life history trajectory (e.g., increased risk-taking and aggression).

Perceived stress, external locus of control, and social support as predictors of psychological adjustment among female inmates with or without a history of sexual abuse.

Given the growing number of women who are incarcerated across the United States, the current study investigated the relationships among female inmates' perceptions of their own stress, external locus of control (LOC), social support adequacy, and various aspects of psychological functioning. Generally, female inmates with a self-reported history of childhood sexual abuse did not differ from their nonabused counterparts on the variables of interest. Results suggested that female inmates' perceptions of higher stress, a higher degree of external LOC, and inadequate social support correlated with greater symptoms of depression and hopelessness as well as lower self-esteem. In regression analyses, stress and social support were significant predictors for depression and anxiety. In contrast, stress was the only significant predictor of hopelessness and self-esteem. Finally, none of the predictors examined here was significant in the prediction of traumatic stress. Overall, findings suggested the importance of stress and social support in the prediction of female inmates' adjustment, specifically their symptoms of depression and anxiety.

Hostility/anger as a mediator between college students' emotion regulation abilities and symptoms of depression, social anxiety, and generalized anxiety.

Internalizing problems are common among college students and have been linked consistently to deficits in emotion regulation (ER). Also, hostility/anger (animosity toward others, phenomenological aspect of anger) is an important feature of internalizing problems, but has received limited attention as a mediator between ER and outcomes. Results (N = 160) indicated that although college students' ER abilities corresponded with all three types of internalizing symptoms, hostility/anger mediated fully the relationship for symptoms of depression and social anxiety, but not generalized anxiety (GAD). The stronger interpersonal aspect inherent in depression and social anxiety relative to GAD may in part explain findings, but findings must be viewed in lieu of limitations, which include self-report, a non-clinical sample, and a cross-sectional design. Overall, hostility/anger may be important to address in interventions and programs aimed at reducing internalizing problems, especially among those who demonstrate ER deficits and are prone to depression and social anxiety.

Dopamine receptor (D4) polymorphism is related to comorbidity between marijuana abuse and depression.

The rates of marijuana abuse are steadily increasing in the U.S. Data suggest that comorbid marijuana abuse and depression is associated with worse outcomes than either diagnosis. Genetic studies independently link the DRD4 gene polymorphism to substance use and to internalizing disorders, but no study has examined whether the DRD4 polymorphism is linked to comorbid marijuana use and depression in a population sample. This study examined associations between the DRD4 gene 48bp VNTR polymorphism and comorbidity between marijuana use frequency and depression in a diverse, non-clinical adolescent sample (n=1882; ages 14 to 18) from the National Longitudinal Study of Adolescent Health (Add Health). Multinomial regression analyses indicated that the odds of being comorbid for depressive symptoms and marijuana use are approximately 2.5≥ with the ≥7R/≥7R genotype than youths who carry the <7R/<7R genotype, controlling for the effects of ethnicity, gender, age, violent victimization, and alcohol related problems. Findings provide genetic clues for psychopathology characterized by prominent externalizing and internalizing features.

Substance use coping as a mediator of the relationship between trauma symptoms and substance use consequences among incarcerated females with childhood sexual abuse histories.

Rates of substance use and maltreatment are alarmingly high among incarcerated women. Although the direct link between trauma and substance use has been established, less is known about potential mediators. Thus, we examined substance use coping as a mediator between trauma symptoms and substance use consequences among a sample of incarcerated females (N = 111) who were survivors of childhood sexual abuse. Trauma symptoms predicted the severity of substance use consequences, with this relationship being mediated fully by avoidance coping (e.g., using substances to cope). Overall, trauma histories are important in predicting outcomes but must be examined in the context of current coping behaviors and substance use. Findings (data collected in 2007/2008) may help promote interventions that target patterns of coping and/or emotional avoidance among trauma survivors with substance use problems in incarcerated populations. The study's limitations are noted.

A structural equation modeling approach to the study of stress and psychological adjustment in emerging adults.

Today's society puts constant demands on the time and resources of all individuals, with the resulting stress promoting a decline in psychological adjustment. Emerging adults are not exempt from this experience, with an alarming number reporting excessive levels of stress and stress-related problems. As a result, the present study addresses the need for a comprehensive model of emerging adult adjustment in the context of stress and coping variables and highlights the importance of accounting for differences between males and females in research concerning stress, social support, coping, and adjustment. Participants for this study are 239 college students (122 males and 117 females), the majority of whom are Caucasian. Results of structural equation modeling suggest that stress, social support, coping, and adjustment show unique patterns of relationships for males versus females. For both males and females, stress and social support show similar relationships to adjustment. In contrast, social support is related only to coping behaviors in females. Finally, social support appears to be a more important variable for female adjustment, whereas other coping behaviors appear to be more pertinent to male adjustment. Limitations and suggestions for future research will be discussed.

Perceptions of ambiguously unpleasant interracial interactions: a structural equation modeling approach.

Despite a general consensus in the United States that overtly racist acts are unacceptable, many ambiguous situations in everyday life raise questions of whether racism has influenced a person's behavior in an interracial encounter. The authors of the present study sought to (a) examine simultaneously an array of variables thought to be related to perceived racism and (b) investigate how the contribution of these variables may differ with respect to the asymmetry hypothesis, which suggests that acts of discrimination from a dominant person toward a subordinate person will be viewed as more biased than if the situation were reversed. The authors used a dual structural equation modeling approach. Results indicated that ethnic identity significantly predicted perceived racism. In addition, the extent to which cognitive interpretation style significantly predicted perceived racism depended on the ethnicity of participants involved in the interaction.