Severe drought exposure in utero associates to children's epigenetic age acceleration in a global climate change hot spot.

The goal of this study is to examine the association between in utero drought exposure and epigenetic age acceleration (EAA) in a global climate change hot spot. Calculations of EAA in adults using DNA methylation have been found to accurately predict chronic disease and longevity. However, fewer studies have examined EAA in children, and drought exposure in utero has not been investigated. Additionally, studies of EAA in low-income countries with diverse populations are rare. We assess EAA using epigenetic clocks and two DNAm-based pace-of-aging measurements from whole saliva samples in 104 drought-exposed children and 109 same-sex sibling controls in northern Kenya. We find a positive association between in utero drought exposure and EAA in two epigenetic clocks (Hannum's and GrimAge) and a negative association in the DNAm based telomere length (DNAmTL) clock. The combined impact of drought's multiple deleterious stressors may reduce overall life expectancy through accelerated epigenetic aging.

Epigenetic mechanisms underlying the association between maternal climate stress and child growth: characterizing severe drought and its impact on a Kenyan community engaging in a climate change-sensitive livelihood.

Pastoralists in East Africa are among the world's most vulnerable communities to climate change, already living near their upper thermal limits and engaging in a climate-sensitive livelihood in a climate change global hot spot. Pregnant women and children are even more at risk. Here, we report the findings of a study characterizing Samburu pastoralist women's experiences of severe drought and outcomes in their children (N = 213, 1.8-9.6 y). First, we examined potential DNA methylation (DNAm) differences between children exposed to severe drought in utero and same-sex unexposed siblings. Next, we performed a high-dimensional mediation analysis to test whether DNAm mediated associations of exposure to severe drought with body weight and adiposity. DNAm was measured using the Infinium MethylationEPIC BeadChip array. After quality control; batch, chip, and genomic inflation corrections; covariate adjustment; and multiple testing correction, 16 CpG sites were differentially methylated between exposed and unexposed children, predominantly in metabolism and immune function pathways. We found a significant indirect effect of drought exposure on child body weight through cg03771070. Our results are the first to identify biological mediators linking severe drought to child growth in a low-income global hot spot for climate change. A better understanding of the mechanisms underlying the association between drought exposure and child growth is important to increasing climate change resilience by identifying targets for intervention.

For pregnant women in populations engaging in climate-sensitive livelihoods, severe drought is characterized by multiple stressors, including intense, sometimes hazardous labour, food and water insecurity, and other stressors. This study found differential methylation between children exposed to severe drought in utero versus their unexposed same-sex siblings in 16 CpG sites in pathways relevant to the immune system and metabolism. Cg03771070 was found to mediate the association between severe drought exposure and child body weight. The necessary next step includes context-nuanced prospective studies to further refine our understanding of biological mechanisms for climate-associated child outcomes. This is necessary for targeted interventions to improve climate change resilience in these communities.

Experiential Avoidance and Emotion Dysregulation as Mediators in the LGBTQ Minority Stress Model.

Gender and sexual minorities are at increased risk for psychological disorders compared to the general population. The minority stress model has been proposed to explain these elevated rates of psychological distress. Per this model, minority stress factors (e.g., prejudice, discrimination, rejection, internalized homophobia/ transphobia) combine to create a unique stress which negatively impacts the mental health of gender and sexual minority individuals. With support for the general minority stress model established, attention has turned to investigating possible mediators in this model. In other words, how does minority stress cause psychological distress and negative mental health outcomes? The aim of the present study was to investigate experiential avoidance and emotion dysregulation as potential mediators in the relationship between minority stress factors and psychological distress. Final parallel mediation models supported that experiential avoidance and emotion dysregulation were significant mediators in the relationship between minority stress variables and psychological distress. These final models support that minority stress experiences, experiential avoidance, and emotion dysregulation are all factors that contribute to psychological distress in gender and sexual minority individuals. The implications of these findings are discussed.

Lifetime stress and war exposure timing may predict methylation changes at NR3C1 based on a pilot study in a warrior cohort in a small-scale society in Kenya.

OBJECTIVES: Candidate gene methylation studies of NR3C1 have identified associations with psychosocial adversity, including war trauma. This pilot study (sample sizes from 22 to 45 for primary analyses) examined NR3C1 methylation in a group of Kenyan pastoralist young men in relation to culturally relevant traumatic experiences, including participation in coalitional lethal gun violence. METHODS: Adolescent and young adult Samburu men ("warriors") were recruited for participation. DNA was obtained from whole saliva and methylation analyses performed using mass spectrometry. We performed a data reduction of variables from a standardized instrument of lifetime stress using a factor analysis and we assessed the association between the extracted factors with culturally relevant and cross-culturally comparative experiences. RESULTS: Cumulative lifetime trauma exposure and forms of violence to which warriors are particularly susceptible were associated with DNA methylation changes in the NR3C1 1F promoter region but not in the NR3C1 1D promoter region. However, sensitivity analyses revealed significant associations between individual CpG sites in both regions and cumulative stress exposures, war exposure timing, and war fatalities. CONCLUSIONS: This study supports the importance of NR3C1 methylation changes in response to challenging life circumstances, including in a global south cultural context that contrasts in notable ways from global north contexts and from the starkly tragic examples of the Rwandan genocide and war-associated rape explored in recent studies. Timing of traumatic exposure and culturally salient means to measure enduring symptoms of trauma remain important considerations for DNA methylation studies.

Prosocial Emotion, Adolescence, and Warfare : DNA Methylation Associates with Culturally Salient Combat Variables.

Examining the costs and motivations of warfare is key to conundrums concerning the relevance of this troubling phenomenon to the evolution of social attachment and cooperation, particularly during adolescence and young adulthood-the developmental time period during which many participants are first recruited for warfare. The study focuses on Samburu, a pastoralist society of approximately 200,000 people occupying northern Kenya's semi-arid and arid lands, asking what role the emotionally sensitized, peer-driven adolescent life stage may have played in the cultural and genetic coevolution of coalitional lethal aggression. Research in small-scale societies provides unparalleled opportunities for sharply defined variables, particularly in age generation societies in which all young men are initiated into "warriorhood." Proposing an epigenetic and component behavior approach, we examine whether raiding activities such as number of raids, killing, and sparing enemy lives associate with DNA methylation in two candidate genes: MAOA, linked to mood and arousal, and NR3C1, linked to stress and immune response. We report statistically significant associations between the epigenetic variables and the combat (exposure) variables of overall raiding activity and reportedly showing mercy to enemies. In contrast, epigenetic variables did not associate with post-traumatic stress disorder (PTSD) symptom scores (a potential outcome measure), and the only combat variable associated with PTSD (but not DNA methylation) was losing one's own livestock in a raid. These findings raise important questions concerning the mechanisms driving warfare's paradoxical mix of violent and altruistic behaviors.

The role of emotion regulation in predicting personality dimensions.

Dimensional models of personality have been widely acknowledged in the field as alternatives to a trait-based system of nomenclature. While the importance of dimensional models has been established, less is known about the constructs underlying these personality dimensions. Emotion regulation is one such potential construct. The goal of the current study was to examine the relationship between personality dimensions and emotion regulation. More specifically, the predictive capacity of emotion regulation in accounting for personality dimensions and symptoms on the Schedule for Nonadaptive and Adaptive Personality-2 above and beyond a measure of general distress was evaluated. Emotion regulation was found to be predictive of most personality dimensions and symptoms of most personality disorders. Consistent with hypotheses, emotion regulation variables associated with undercontrol of emotions were most predictive of traits associated with Cluster B personality disorders whereas Cluster A and C traits were most associated with emotion regulation related to overcontrol of emotions. These findings provide preliminary evidence that some personality dimensions never assessed in relation to emotion regulation are strongly predicted by emotion regulation variables. Thus, the present study facilitates an initial step in understanding the relationship between personality dimensions and a multidimensional model of emotion regulation. Copyright © 2017 John Wiley & Sons, Ltd.

Measuring Experiential Avoidance: Evidence toward Multidimensional Predictors of Trauma Sequelae.

The current study sought to investigate measurement discrepancies in self-report assessment of experiential avoidance (EA). Recent research indicates that EA may be more appropriately conceptualized as a multidimensional construct, operationally defined in terms of specific avoidance strategies. To test this notion, EA was measured using two self-report assessment instruments, the Acceptance and Action Questionnaire-II (AAQ-II) and the Multidimensional Experiential Avoidance Questionnaire (MEAQ) in a convenience sample of university students. Measurement differences across measures and unique contributions to prediction of posttraumatic stress symptoms (PTSS) and engagement in problematic behaviors were evaluated. Both the AAQ-II and MEAQ were found to significantly mediate the effect of childhood trauma exposure on PTSS. However, when levels of PTSS were dummy coded into dichotomies of those with a likely PTSD diagnosis and those without, the MEAQ was a stronger predictor symptoms of those with a likely PTSD diagnosis than AAQ-II did. These results provide initial support for the discriminant validity of the MEAQ, which appears to be a more specific predictor of trauma-related symptoms.

An Experimental Examination of the Interaction between Mood Induction Task and Personality Psychopathology on State Emotion Dysregulation.

While emotion dysregulation has been investigated as a key variable in the development and persistence of personality psychopathology, few studies have explored state emotion dysregulation among individuals with personality disorders (PDs). The current study addresses this void in the literature through a laboratory investigation of state emotion dysregulation among participants with and without PDs. To facilitate this goal, participants were matched to pairs based on similar personality features and were randomized to one of two behavioral analogues; either the Paced Auditory Serial Addition Task-Computerized (PASAT-C) or an interpersonally based mood induction. As hypothesized, PD participants in the PASAT-C reported significantly more difficulty with impulsivity and emotion regulation strategies. Contrary to expectations, the PD group in the interpersonal task demonstrated significantly less difficulty with non-acceptance of emotion and emotional clarity and significantly greater positive affect compared to non-PD participants. Implications for these findings and directions for future research are discussed.

Attitudes toward empirically-supported treatments among pastoral mental health care providers: exploratory findings and future directions.

The current study describes the findings of an online survey of pastoral mental health care providers The survey included brief demographic information, and a validated measure of attitudes toward empirically-supported psychological interventions, the Evidence-based Practices Attitude Scale (EBPAS; Aarons, 2004). The responses of 55 pastoral providers' are described and compared to national norms (Aarons et al., 2010). Recommendations for future collaboration between EST developers and pastoral clinicians are provided.

Ethical issues in research on sensitive topics: participants' experiences of distress and benefit.

While many studies ask participants to disclose sensitive information or to participate in emotionally arousing tasks, little is known about participants' subjective experiences of discomfort and benefit. Ethics review committees, therefore, have little information about participant experiences to guide their informed decision-making. We asked undergraduate females about their experiences in a study that included an experimental session, interviews, and self-report measures on sensitive topics. We examined results overall, and compared the responses of individuals with and without childhood abuse experiences. Participants who had experienced child abuse were more likely to report distress due to remembering the past, but also more likely to report that participation was helpful. Implications for future research, and recommendations for review boards, are discussed.

Therapist training in empirically supported treatments: a review of evaluation methods for short- and long-term outcomes.

Therapist training efforts have been assessed using several outcomes. A model for evaluating therapist training in empirically supported treatments is presented, adapted from Kirkpatrick's (in: Craig and Bittel (eds.) Training and development handbook, 1967) training evaluation model. The adapted framework includes short-term outcomes, such as reactions to training and changes in attitude, knowledge, or skills, and longer-term outcomes, such as changes in therapist behavior in practice or client outcomes. Evaluation methods for these outcomes are reviewed, with information on their validity, reliability, and feasibility. An agenda for further research to improve therapist training evaluation is presented, with discussion of how evaluation can inform other areas of the field.

Intimate partner violence theoretical considerations: moving towards a contextual framework.

Several theories have been developed to provide a conceptual understanding of intimate partner violence (IPV) episodes. Although each of these theories has found some degree of empirical support, they are limited in their explanatory power of IPV episodes and their ability to significantly impact the efficacy of IPV prevention and treatment programs. The current paper provides a review and critique of current IPV theories and highlights strategies for improving upon these theories. An alternative theoretical conceptualization is introduced that incorporates existing IPV and functional analytic literature into a contextual framework for conceptualizing IPV episodes. Components of the IPV contextual framework include distal, static and proximal antecedents; motivating factors; behavioral repertoire; discriminative stimuli (i.e. environmental cues/signals); verbal rules; and IPV consequences. The proposed theoretical framework offers two primary advantages over former IPV theories. First, it provides a comprehensive conceptualization of IPV by integrating components of previous IPV theories and their related empirical findings into one, cohesive conceptual framework. Additionally, it allows for a more fine-grained analysis of more proximal variables potentially related to discrete IPV episodes. A discussion of how the proposed theoretical framework may influence future IPV research and clinical practice is provided.

Cognitive-behavioral psychology: implications for disaster and terrorism response.

Given the personal and societal costs associated with acute impairment and enduring post-traumatic stress disorder (PTSD), the mental health response to disasters is an integral component of disaster response planning. The purpose of this paper is to explore the compatibility between cognitive-behavioral psychology and the disaster mental health model, and explicate how cognitive-behavioral perspectives and intervention methods can enhance the effectiveness of disaster mental health services. It is argued that cognitive-behavioral methods, if matched to the contexts of the disaster and the needs of individuals, will improve efforts to prevent the development of PTSD and other trauma-related problems in survivors of disaster or terrorist events. First, the similarities between models of care underlying both disaster mental health services and cognitive-behavioral therapies are described. Second, examples of prior cognitive-behavioral therapy-informed work with persons exposed to disaster and terrorism are provided, potential cognitive-behavioral therapy applications to disaster and terrorism are explored, and implications of cognitive-behavioral therapy for common challenges in disaster mental health is discussed. Finally, steps that can be taken to integrate cognitive-behavioral therapy into disaster mental health are outlined. The aim is to prompt disaster mental health agencies and workers to consider using cognitive-behavioral therapy to improve services and training, and to motivate cognitive-behavioral researchers and practitioners to develop and support disaster mental health response.

Ethics of asking trauma-related questions and exposing participants to arousal-inducing stimuli.

This study examined ethical concerns related to exposing participants with childhood victimization histories to both trauma-specific and non-trauma-specific stimuli. We asked participants questions about childhood victimization experiences and exposed participants to a negatively-arousing experimental condition. Following each of these procedures and at a one-week follow-up session, participants completed a measure designed to asses their reactions to participation. The measure included several questions to assess reactions including questions about distress, benefit, and willingness to participate in the study again. Overall, participants reported low levels of distress and described their participation experience as interesting, enjoyable, and somewhat beneficial. Participants also indicated that they would be willing to participate in the study again with the knowledge of what participation was actually like. Participants with childhood trauma histories and PTSD symptoms reported more distress during the childhood maltreatment screening compared to other participants. However, the level of distress they experienced was mild and transitory. Our findings add to the emerging data indicating that individuals find their participation in trauma-related research to be a positive experience overall, rather than a harmful one.

Risk factors for suicidal behavior among a national sample of adolescents: implications for prevention.

Factors associated with suicidal ideation and attempts were examined among a national probability sample of adolescents. Sample prevalences of suicidal ideation and attempts were 24.3% and 3.3%, respectively, yielding weighted population prevalence estimates of 23.3% and 3.1%. Suicidal ideation was positively associated with female gender, age, family alcohol and drug problems, violence exposure, lifetime depression, and posttraumatic stress disorder (PTSD). Suicide attempts were associated with female gender, age, sexual and physical assault, lifetime substance abuse or dependence, PTSD, and depression. Implications for intervention and prevention are discussed.

Effects of social desirability on students' self-reporting of partner abuse perpetration and victimization.

Little is still known about the degree to which social desirability affects reports of partner abuse. The current study builds on existing research exploring the relationship between social desirability and partner abuse reports by analyzing 49 male and 155 female students' responses to the Revised Conflict Tactics Scale (CTS2) and the Marlowe-Crowne Social Desirability Scale (MCSDS). Sex differences were not associated with partner abuse rates, regardless of type, severity, and violence role. Women had significantly higher social desirability scores than men, and women's MCSDS scores were negatively correlated with partner abuse perpetration and victimization rates. Social desirability was a significant predictor of psychological abuse perpetration, whereas gender was a significant predictor of sexual coercion perpetration. In all partner abuse cases, however, social desirability and gender accounted for less than 10% of the variance in partner abuse reports.

Child sexual abuse and adulthood sexual assault among military veteran and civilian women.

The purpose of this study was to investigate childhood sexual abuse (CSA), adulthood sexual victimization (ASV), and adulthood sexual assault experiences in a comparison sample of female military veterans (n = 142) and civilian community members (n = 81). Women veterans were significantly more likely than civilian women to report adult sexual assault. Although comparable rates of CSA and ASV were found across groups, veterans more frequently reported having been sexually abused by a parental figure, reported longer durations of CSA, and significantly greater severity of ASV than civilians. Implications for mental health professionals providing sexual trauma services to female military personnel and veterans are discussed.

Disaster and terrorism: Cognitive-Behavioral interventions.

The mental health effects of disaster and terrorism have moved to the forefront in the recent past following the events of 11 September 2001 in the United States. Although there has been a protracted history by mental health researchers and practitioners to study, understand, prevent, and treat mental health problems arising as a result of disasters and terrorism, there still is much to learn about the effects and treatment of trauma. Continued communication among disaster workers, first-response medical personnel, and mental health professionals is part of this process. This paper outlines current knowledge regarding the psychological effects of trauma and best cognitive-behavioral practices used to treat trauma reactions. More specifically, the information presented is a summary of Cognitive-Behavioral Therapy (CBT) interventions that are relevant for responding to and dealing with the aftermath of disasters.

Sexual assault prevention with college-aged women: a bibliotherapy approach.

The present research evaluated the efficacy of a skills-based bibliotherapy approach to sexual assault prevention for college-aged women. One hundred and ten participants were followed prospectively for 16 weeks. A self-help book, written by the authors, was compared to a wait-list control on several self-report measures. Results revealed significant differences between groups, with bibliotherapy participants reporting decreased participation in risky dating behaviors and improvement in sexual communication strategies across a variety of dating situations. However, results suggested that the self-help book was no more effective than the wait-list control in reducing rates of sexual victimization. Limitations of the study and directions for future sexual assault prevention research with women are discussed.

Common behavioral dilemmas of the school-aged child.

PCPs are typically the first professionals to come into contact with children who have behavioral or developmental problems. The most common behavioral concerns that PCPs encounter in the pediatric primary care setting include noncompliance, temper tantrums, and problems with eating and sleeping routines. To adequately detect these types of problems, it essential that PCPs incorporate behavioral assessment procedures (eg, clinical interviews, behavior rating scales, ABC recording form) into the consultation process. Behavioral assessment procedures are useful in identifying the environmental events (ie, antecedents and consequences) that may be maintaining the problem behavior. Data that are collected from behavioral assessment can be used to develop a tentative hypothesis on functions of the behavioral problem. By identifying the potential function of the behavior, more effective behavioral management strategies can be developed. An existing model of behavioral consultation can be used by PCPs during office visits to more effectively identify and manage many of the common and less severe behavioral problems.