Current models of pain coping typically focus on how pain contributes to poor physical and psychological functioning. Researchers have argued that this focus on the negative consequences is too narrow and does not account for times when individuals are able to maintain meaningful functioning despite their pain. Thus, the current study sought to investigate the day-to-day processes that both help and hinder recovery from pain and persistence towards daily goals. Specifically, the present study tested: a) a two-factor model of risk and resilience “factors” that capture key processes across affective, cognitive and social dimensions of functioning, and b) whether the relation between morning pain and end-of-day physical disability is mediated by increases in these afternoon risk and resilience factors. Within-day study measures were collected for 21 days via an automated phone system from 220 participants with Fibromyalgia. The results of multi-level confirmatory factor analysis indicated that, consistent with prediction, risk and resilience do constitute two factors. Findings from multilevel structural equation models also showed resilience factor mediated the link between late morning increases in pain and end-of-day disability, in line with hypotheses. Although the vulnerability factor as a whole did not mediate the within-day link between pain and disability, pain-catastrophizing individually did serve as a significant mediator of this relation. This study was the first to empirically test a within-day latent factor model of resilience and vulnerability and the first to capture the multidimensional nature of the pain experience by examining mechanisms across affective, cognitive and social domains of functioning. The findings of the current study suggest that in addition to studying the processes by which pain has a negative influence on the lives of pain sufferers, our understanding of the pain adaptation process can be further improved by concurrently examining mechanisms that motivate individuals to overcome the urge to avoid pain and to function meaningfully despite it.

Research has consistently shown that gay/lesbian/bisexual (GLB) or sexual minority youth are at an increased risk for adverse outcomes resulting from the stress caused by continual exposure to negative events (e.g., victimization, discrimination). The present study used a nationally representative sample of adolescents to test mechanisms that may be responsible for the differences in offending behaviors among sexual minority and heterosexual adolescents. Specifically, this study tested whether bisexual adolescents received less maternal support than did heterosexual adolescents because of their sexual orientation, thus increasing the likelihood that they run away from home. This study then examined whether the greater likelihood that bisexual adolescents running away would lead to them committing a significantly higher variety of income-based offenses, but not a significantly higher variety of aggression-based offenses. This study tested the hypothesized mediation model using two separate indicators of sexual orientation measured at two different time points, modeled outcomes in two ways, as well as estimated the models separately for boys and girls. Structural equation modeling was used to test the hypothesized direct and indirect relations. Results showed support for maternal support and running away mediating the relations between sexual orientation and offending behaviors for the model predicting the likelihood of committing either an aggressive or an income offense, but only for girls who identified as bisexual in early adulthood. Results did not support these relations for the other models, suggesting that bisexual females have unique needs when it comes to prevention and intervention. Results also highlight the need for a greater understanding of sexual orientation measurement methodology.

Mexican American adolescents report high rates of internalizing symptomatology and alcohol use. However, very little research has explored to what extent internalizing distress may contribute to alcohol use among this population. The current study utilized longitudinal data from a community sample of Mexican American adolescents (n=626, 51% female) to test a series of hypotheses about the role of internalizing distress on alcohol use and misuse. Specifically, this study used a bifactor modeling approach to investigate (1) whether different forms of internalizing distress are composed of common and unique components; (2) whether and to what extent such components confer risk for alcohol use; and (3) whether youth cultural orientation plays a role in these associations. Confirmatory factor analyses revealed that a bifactor model with a general factor and three specific factors (depressed mood, general worry, social anxiety) provided good fit to the data. The general distress factor was significantly associated with past month alcohol use but not binge drinking. However, these effects were conditional based on level of acculturation. Differential relations were found between the specific factors of internalizing distress and alcohol use. Depressed mood predicted past month alcohol use among girls; social anxiety negatively predicted past three month binge drinking among boys. Overall, results highlight the multidimensional nature of internalizing distress and suggest that both common and unique components of internalizing distress may be relevant to the etiology of alcohol use among Mexican-American adolescents. Findings underscore the importance of considering cultural orientation as a moderating factor when investigating substance use among Hispanic youth. Implications for future research examining the etiological relevance of the internalizing pathway to alcohol use among Hispanic adolescents are discussed.

Parental over-control (excessively restrictive and regulatory parenting behaviors) has been consistently identified as a robust risk factor in the development and maintenance of child anxiety problems. However, current understanding of the parental over-control to child anxiety relation is limited by a lack of specificity. The broad ‘parental over-control’ construct represents a heterogeneous category of related but distinct parenting behaviors each of which may exert a unique effect on child anxious emotion. Still, research to date has generally failed to consider this possibility. Moreover, culturally cognizant theory and emerging empirical evidence suggest cross-ethnic (Caucasian vs. Hispanic/Latino) differences in the utilization of various parenting strategies as well as the effects of parenting behaviors on child outcomes. But, only a handful of studies have considered the potential differences in the functioning of parental over-control behaviors within a Hispanic/Latino cultural framework. Using a sample of 98 pre-adolescent children at-risk for anxiety problems, the present study sought to further explicate the association between parental over-control and child anxiety symptoms in the context of ethnic and cultural diversity. Results suggest that parents’ use of overprotection and (lack of) autonomy granting might be particularly relevant to child anxiety, compared to parental intrusiveness and behavioral control. Findings also indicate that some youth may be more vulnerable to parental over-control and suggest that cultural values may play a role in the relation between over-controlling parenting and child anxiety symptoms. Knowledge about cross-cultural variations in the relation among parental over-control behaviors and the development of anxiety symptoms is important because it can improve the cultural robustness of child anxiety theory and has potential to inform culturally sensitive child anxiety prevention and intervention efforts.

Positive alcohol outcome expectancies (AOEs) are consistent longitudinal predictors of later alcohol use; however, exclusion of solitary drinking contexts in the measurement of AOEs may have resulted in an underestimation of the importance of low arousal positive (LAP) effects. The current study aimed to clarify the literature on the association between AOEs and drinking outcomes by examining the role of drinking context in AOE measurement. Further, exclusion of contextual influences has also limited understanding of the unique effects of AOEs relative to subjective responses (SR) to alcohol. The present study addressed this important question by exploring relations between AOEs and SR when drinking context was held constant across parallel measures of these constructs. Understanding which of these factors drives relations between alcohol effects and drinking behavior has important implications for intervention. After conducting confirmatory factor analysis (CFA) and tests of measurement invariance for the AOE and SR measures, 4 aims collectively examined the role of context in reporting of AOEs (Aims 1 and 2), the extent to which context specific AOEs uniquely relate to drinking outcomes (Aim 3), and the importance of context effects on correspondence between AOEs and SR (Aim 4). Results of Aims 1 and 2 demonstrated that participants are imagining contexts when reporting on measures of AOEs that do not specify the context, and found significant mean differences in high and low arousal positive AOEs across contexts. Contrary to the hypotheses of Aim 3, context-specific AOEs were not significantly associated with drinking behavior. Results of Aim 4 indicated that while LAP AOEs for both unspecified and solitary contexts were associated with LAP SR in a solitary setting, unspecified context AOEs had a stronger relation than the solitary context AOEs. No significant relations between high arousal positive (HAP) AOEs and HAP SR emerged. The findings suggest that further investigation of the relation between context-specific AOEs and drinking outcomes/SR is warranted. Future studies of these hypotheses in samples with a wider range of drinking behavior, or at different stages of alcohol involvement, will elucidate whether mean level differences in context specific AOEs are important in understanding alcohol related outcomes.

Although research has documented robust prospective relationships between externalizing symptomatology and subsequent binge drinking among adolescents, the extent to which internalizing symptoms increase risk for drinking remains controversial. In particular, the role of anxiety as a predictor of binge drinking remains unclear. Recent evidence suggests that one possible reason for these mixed findings is that separate dimensions of anxiety may differentially confer risk for alcohol use. The present study tested two dimensions of anxiety - worry and physiological anxiety -- as predictors of binge drinking in a longitudinal study of juvenile delinquents. Overall, results indicate that worry and physiological anxiety showed differential relations with drinking behavior. In general, worry was protective against alcohol use, whereas physiological anxiety conferred risk for binge drinking, but both effects were conditional on levels of offending. Implications for future research examining the role of anxiety in predicting drinking behavior among youth are discussed.

Recent reports have indicated that there are both mental health and educational disparities between Latino youth and their European American counterparts. Specifically, Latin youth are at a heightened risk for negative mental health outcomes in comparison to their non-Latino youth (e.g., Eaton et al., 2008). Further, 16.7% of Latino adolescents dropped out of high school compared to 5.3% of European American youth over the past several decades (1960-2011; U.S. Department of Education, 2013). Mexican American (M.A. youth in particular, have the lowest educational attainment among all Latino ethnic groups in the U.S. (U.S. Census Bureau, 2010). While these mental health and educational disparities have often been attributed to discrimination experiences that Latino youth encounter, there is also consistent empirical evidence linking discrimination with these maladjustment problems. These studies confirmed that discrimination directly related to depressive symptoms (e.g., Umana-Taylor et al., 2007), externalizing behaviors (Berkel et al., 2010), self-esteem (e.g., Zeiders et al., 2013), and academic outcomes (e.g., Umana-Taylor et al., 2012). Few studies to date have examined the underlying mechanisms (i.e., moderation and mediation) that help us to better understand resiliency paths for those Latino youth that display positive adjustment outcomes despite being faced with similar discrimination encounters that their maladjusted peers face. Therefore, the following two studies examined various mechanisms in which discrimination related to adjustment to better understand potential risk and resiliency processes in hopes of informing intervention research. Paper 1 explored cultural influences on the association between discrimination, active coping, and mental health outcomes in M.A. youth. Paper 2 examined how trajectories of discrimination across 5th, 7th, and 10th grades related to cultural values, externalizing behaviors, and academic outcomes in M.A. youth. Taken together, these studies provide a culturally informed overview of adjustment processes in M.A. adolescents who face discrimination in addition to identifying critical directions for future research in efforts to gaining a more contextualized and comprehensive understanding of the dynamic processes involved in discrimination and adjustment in M.A. youth.

Type 1 Diabetes Mellitus (T1DM) is a chronic disease that requires maintaining tight metabolic control through complex behavioral and pharmaceutical regimens. Subtle cognitive impairments and stress response dysregulation may partially account for problems negotiating life changes and maintaining treatment adherence among emerging adults. The current study examined whether young adults with T1DM physiologically respond to psychological stress in a dysregulated manner compared to non-diabetic peers, and if such individuals also demonstrated greater cognitive declines following psychological stress. Participants included 23 young adults with T1DM and 52 non-diabetic controls yoked to T1DM participants based on age, gender, ethnicity, participant education, and maternal education. Participants completed a laboratory-based social stressor, pre- and post-stressor neurocognitive testing, provided fingerstick blood spots (for glucose levels) and salivary samples (for cortisol levels) at five points across the protocol, and completed psychosocial questionnaires. Related measures ANOVAs were conducted to assess differences between T1DM participants and the average of yoked controls on cortisol and cognitive outcomes. Results demonstrated that differences in cortisol reactivity were dependent on T1DM participants' use of insulin pump therapy (IPT). T1DM participants not using IPT demonstrated elevated cortisol reactivity compared to matched controls. There was no difference in cortisol reactivity between the T1DM participants on IPT and matched controls. On the Stroop task, performance patterns did not differ between participants with T1DM not on IPT and matched controls. The performance of participants with T1DM on IPT slightly improved following the stressor and matched controls slightly worsened. On the Trail Making Test, the performance of participants with T1DM was not different following the stressor whereas participants without T1DM demonstrated a decline following the stressor. Participants with and without T1DM did not differ in patterns of performance on the Rey Verbal Learning Task, Sustained Attention Allocation Task, Controlled Oral Word Association Task, or overall cortisol output across participation. The results of this study are suggestive of an exaggerated cortisol response to psychological stress in T1DM and indicate potential direct and indirect protective influences of IPT.

The use of bias indicators in psychological measurement has been contentious, with some researchers questioning whether they actually suppress or moderate the ability of substantive psychological indictors to discriminate (McGrath, Mitchell, Kim, & Hough, 2010). Bias indicators on the MMPI-2-RF (F-r, Fs, FBS-r, K-r, and L-r) were tested for suppression or moderation of the ability of the RC1 and NUC scales to discriminate between Epileptic Seizures (ES) and Non-epileptic Seizures (NES, a conversion disorder that is often misdiagnosed as ES). RC1 and NUC had previously been found to be the best scales on the MMPI-2-RF to differentiate between ES and NES, with optimal cut scores occurring at a cut score of 65 for RC1 (classification rate of 68%) and 85 for NUC (classification rate of 64%; Locke et al., 2010). The MMPI-2-RF was completed by 429 inpatients on the Epilepsy Monitoring Unit (EMU) at the Scottsdale Mayo Clinic Hospital, all of whom had confirmed diagnoses of ES or NES. Moderated logistic regression was used to test for moderation and logistic regression was used to test for suppression. Classification rates of RC1 and NUC were calculated at different bias level indicators to evaluate clinical utility for diagnosticians. No moderation was found. Suppression was found for F-r, Fs, K-r, and L-r with RC1, and for all variables with NUC. For F-r and Fs, the optimal RC1 and NUC cut scores increased at higher levels of bias, but tended to decrease at higher levels of K-r, L-r, and FBS-r. K-r provided the greatest suppression for RC1, as well as the greatest increases in classification rates at optimal cut scores, given different levels of bias. It was concluded that, consistent with expectations, taking account of bias indicator suppression on the MMPI-2-RF can improve discrimination of ES and NES. At higher levels of negative impression management, higher cut scores on substantive scales are needed to attain optimal discrimination, whereas at higher levels of positive impression management and FBS-r, lower cut scores are needed. Using these new cut scores resulted in modest improvements in accuracy in discrimination. These findings are consistent with prior research in showing the efficacy of bias indicators, and extend the findings to a psycho-medical context.

In rehabilitation settings, activity limitation can be a significant barrier to recovery. This study sought to examine the effects of state and trait level benefit finding, positive affect, and catastrophizing on activity limitation among individuals with a physician-confirmed diagnosis of either Osteoarthritis (OA), Fibromyalgia (FM), or a dual diagnosis of OA/FM. Participants (106 OA, 53 FM, and 101 OA/FM) who had no diagnosed autoimmune disorder, a pain rating above 20 on a 0-100 scale, and no involvement in litigation regarding their condition were recruited in the Phoenix metropolitan area for inclusion in the current study. After initial questionnaires were completed, participants were trained to complete daily diaries on a laptop computer and instructed to do so a half an hour before bed each night for 30 days. In each diary, participants rated their average daily pain, benefit finding, positive affect, catastrophizing, and activity limitation. A single item, "I thought about some of the good things that have come from living with my pain" was used to examine the broader construct of benefit finding. It was hypothesized that state and trait level benefit finding would have a direct relation with activity limitation and a partially mediated relationship, through positive affect. Multilevel modeling with SAS PROC MIXED revealed that benefit finding was not directly related to activity limitation. Increases in benefit finding were associated, however, with decreases in activity limitation through a significant mediated relationship with positive affect. Individuals who benefit find had a higher level of positive affect which was associated with decreased activity limitation. A suppression effect involving pain and benefit finding at the trait level was also found. Pain appeared to increase the predictive validity of the relation of benefit finding to activity limitation. These findings have important implications for rehabilitation psychologists and should embolden clinicians to encourage patients to increase positive affect by employing active approach-oriented coping strategies like benefit finding to reduce activity limitation.