This cross-sectional mixed-method study examined healthcare experiences among individuals in the US with hypermobile Ehlers-Danlos syndrome (hEDS) and hypermobility spectrum disorder (HSD), genetic ...connective tissue disorders. We hypothesized that many individuals with these conditions would report low satisfaction with healthcare and low health-related quality of life, and that lower healthcare satisfaction would be related to lower health-related quality of life and self-efficacy for symptom management.
Adults living in the US with hEDS or HSD (N= 2125) completed an online survey assessing satisfaction with healthcare, health-related quality of life, and symptom management self-efficacy. Qualitative data also were gathered on desired changes to improve healthcare.
Participants reported low satisfaction with healthcare and lower health-related quality of life and symptom management self-efficacy than norm groups. Lower satisfaction with healthcare was associated with lower health-related quality of life and lower symptom management self-efficacy, ps <.001. The most common desired change to improve healthcare was more knowledge about hEDS and HSD among healthcare professionals.
U.S. adults with joint hypermobility report negative healthcare experiences and poor health-related quality of life. Future research should explore ways to improve the healthcare experiences and quality of care for individuals with hEDS and HSD.
Implications for Rehabilitation
Individuals with hypermobility spectrum disorder (HSD) and hypermobile Ehlers-Danlos syndrome (hEDS) score worse than the U.S. population on most health-related quality of life domains and symptom management self-efficacy.
Individuals with HSD and hEDS report low levels of satisfaction with healthcare compared to norm groups.
Participants particularly wanted to see improvements in the level of awareness and education about HSD and hEDS among healthcare professionals, provider attitudes about HSD and hEDS, and healthcare accessibility and convenience.
Individuals who were less satisfied with their healthcare reported lower health-related quality of life and lower symptom management self-efficacy, underscoring the importance of improving healthcare experiences.
The goal of this study was to assess the feasibility and effectiveness of a theory-based online intervention designed to improve stress management in undergraduate students. The intervention focused ...on present control because it has been found to be associated with a range of positive outcomes, including lower levels of depression, anxiety, and stress, controlling for a range of other variables (e.g., Frazier et al., 2011, 2012). Two pilot studies were first conducted to confirm that our intervention could increase present control. We then randomly assigned psychology students (n = 292) who were prescreened to have lower scores on the present control subscale of the Perceived Control Over Stressful Events Scale (Frazier et al., 2011) to 1 of 3 conditions: the present control intervention, the present control intervention plus feedback, and stress-information only. Seventy-six percent (n = 223) began the intervention, and 87% (n = 195) of those completed the posttest and 3-week follow-up. The 2 present control intervention groups had lower levels of stress, depression, and anxiety symptoms (on the Depression Anxiety Stress Scales; Lovibond & Lovibond, 1995) and perceived stress (on the Perceived Stress Scale; Cohen, Kamarck, & Mermelstein, 1983) relative to the stress-information-only group at posttest and 3-week follow-up (mean between group d at follow-up = .35, mean within group d for intervention groups at follow-up = −.46). Further, mediation analyses revealed that these effects were mediated by changes in present control. Our intervention represents a potentially valuable tool for college mental health services.
In this study, we evaluated the validity of selfreported posttraumatic growth (PTG) by assessing the relation between perceived growth and actual growth from pre-to posttrauma. Undergraduate students ...completed measures tapping typical PTG domains at Time 1 and Time 2 (2 months later). We compared change in those measures with scores on the Posttraumatic Growth Inventory (PTGI; Tedeschi & Calhoun, 1996) for those participants who reported a traumatic event between Time 1 and Time 2 (n = 122). PTGI scores generally were unrelated to actual growth in PTG-related domains. Moreover, perceived growth was associated with increased distress from pre-to posttrauma, whereas actual growth was related to decreased distress, a pattern suggesting that perceived and actual growth reflect different processes. Finally, perceived (but not actual) growth was related to positive reinterpretation coping. Thus, the PTGI, and perhaps other retrospective measures, does not appear to measure actual pre-to posttrauma change.
•Certain demographic factors are related to poorer mental health among students (79 characters)•These include being female, sexual minority, undergraduate, and having a disability (83 ...characters)•These factors are more related to mental health than is the pandemic (68 characters)•These students generally have not been disproportionately affected by the pandemic (82 characters)•Mental health resources should be directed to these groups regardless of pandemic (81 characters)
The purposes of this study were to assess differences between sociodemographic groups in student mental health before and during the COVID-19 pandemic, to investigate whether the pandemic disproportionately affected certain groups, and to examine between-group differences in pandemic-related stressors. Data from Minnesota undergraduate and graduate students who completed an online survey in 2020 (N = 2,067) were compared to data collected from students in 2018 (N = 3,627). The survey assessed days of poor mental health, stress, stress management ability, days of adequate sleep, and pandemic-related stressors (2020 only). Multivariate analyses of variance assessed differences between study years (2020 vs. 2018), sociodemographic groups (gender, sexual orientation, race, disability, international student), and their interactions with study year in predicting mental health, and the sociodemographic groups in predicting pandemic stressors, among undergraduate and graduate students. Stress management ability decreased and sleep improved from 2018 to 2020. The sociodemographic variables most associated with poorer mental health were identifying as female, a sexual minority, or having a disability. Undergraduates reported poorer mental health than graduate students. Differences between sociodemographic groups were not larger during the pandemic, except among students with disabilities. All five sociodemographic variables were related to greater pandemic stressors in some domains.
The aims of this study were to identify latent classes of adverse childhood experiences (ACEs) in a large sample of college students (N = 8997), investigate the relations between ACEs classes and ...life functioning, and compare results using latent class analysis to analyses using cumulative risk scores. Nine types of ACEs were assessed (three types of child abuse and six types of household dysfunction). Outcomes were self-report measures of mental health, physical health, alcohol consequences, and academic performance. Latent class analysis (LCA) results indicated that four classes fit the data best across random halves of the sample and were labeled High ACEs, Moderate Risk of Non-Violent Household Dysfunction, Emotional and Physical Child Abuse, and Low ACEs. Comparing across latent classes, the largest differences in outcomes were between the High ACEs and Low ACEs classes. There were no differences in outcomes between the Moderate Risk of Non-Violent Household Dysfunction and Emotional and Physical Child Abuse classes. The largest between-class differences were found for mental health and the smallest differences were found for academic performance. Comparing results using LCA latent classes and cumulative ACEs scores, the differences between the High and Low ACEs latent classes were similar to the differences between those with zero ACEs and those with 5 or more ACEs. Both approaches also accounted for roughly equivalent amounts of variance in all outcomes. Thus, latent class and cumulative risk analyses provided similar results with regard to predicting outcomes of interest among college students.
Many issues of interest to counseling psychologists involve questions regarding how individuals change over time. Although counseling psychologists often examine average levels of change, statistical ...methods can also identify patterns of change over time by empirically grouping together individuals with similar patterns of change (e.g., group-based trajectory modeling and latent growth mixture modeling). The purpose of this article is to provide an overview of these methods for counseling psychologists. We discuss the conceptual frameworks and assumptions of average-level and person-centered techniques such as group-based trajectory modeling and latent growth mixture modeling. We provide a nontechnical guide for conducting these analyses using data from a study of psychotherapy outcomes in a sample of mental health center clients (N = 1,050). We discuss caveats associated with these methods, including the potential for overinterpreting nongeneralizable results. Last, we suggest best practices for reporting and interpreting results.
Most research and theory on identity integration focuses on adolescents and young adults under age 30, and relatively little is known about how identity adjusts to major life events later in life. ...The purpose of the present study was to operationalize and investigate identity disruption, or a loss of temporal identity integration following a disruptive life event, within the developmental context of established adulthood and midlife. We used a mixed-methods approach to examine identity disruption among 244 Afghanistan and Iraq war veterans with reintegration difficulty who participated in an expressive writing intervention. Participants completed measures of social support, posttraumatic stress disorder (PTSD) symptom severity, satisfaction with life, and reintegration difficulty at baseline right before writing, and 3 and 6 months after the expressive writing intervention. The expressive writing samples were coded for identity disruption using thematic analysis. We hypothesized that identity disruption would be associated with lower social support, more severe PTSD symptoms, lower satisfaction with life, and greater reintegration difficulty at baseline. Forty-nine percent (n = 121) of the sample indicated identity disruption in their writing samples. Identity disruption was associated with more severe PTSD symptoms, lower satisfaction with life, and greater reintegration difficulty at baseline, and with less improvement in social support. The findings suggest that identity disruption is a meaningful construct for extending the study of identity development to established adult and midlife populations, and for understanding veterans' adjustment to civilian life.
The goals of this article are to (a) describe differences between moderator and mediator effects; (b) provide nontechnical descriptions of how to examine each type of effect, including study design, ...analysis, and interpretation of results; (c) demonstrate how to analyze each type of effect; and (d) provide suggestions for further reading. The authors focus on the use of multiple regression because it is an accessible data-analytic technique contained in major statistical packages. When appropriate, they also note limitations of using regression to detect moderator and mediator effects and describe alternative procedures, particularly structural equation modeling. Finally, to illustrate areas of confusion in counseling psychology research, they review research testing moderation and mediation that was published in the
Journal of Counseling Psychology
during 2001.
Sexual harassment affects a large percentage of higher education students in the US. A previous study identified several risk factors for sexual harassment using hurdle models and classification and ...regression tree (CART) analyses. The purpose of the present study was to assess the robustness of these findings by replicating the analyses with a new sample of students. Secondary data analysis was conducted using data from 9,552 students from two- and four-year colleges. Hurdle model coefficients were assessed for replicability based on statistical significance and consistency of the replication effect size relative to the original effect size. Kotzé et al.'s findings were robust, with 91% of all tested effects meeting at least one of two replication criteria in the hurdle models and 88% of the variables replicating in the CARTs. Being younger, consuming alcohol more frequently, attending a four-year college, and having experienced more prior victimization and adversity were important predictors of peer harassment whereas being LGBQ+ was an important predictor of sexual harassment from faculty/staff. These findings can inform targeted prevention and intervention programs. More research is needed to understand why certain demographic and contextual variables are associated with greater harassment risk.
Celotno besedilo
Dostopno za:
DOBA, IJS, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
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