Contexts of Concealment: Initial Validation of Three Disclosure Avoidance Process Measures

The choice to withhold subjective distress reflects a multifactorial decision highly sensitive to context. Unfortunately, existing measures are built on unidimensional models (i.e., concealment-disclosure as a single, bipolar dimension) and operationalize the construct as a stable trait. In this article, we outline the development and initial validation of a self-report inventory that accounts for problem-context and assesses multiple processes central to both the concealment and disclosure of emotional distress. Exploratory analysis of pilot items in Study 1 (male student sample; N = 373) guided subsequent item development and revisions to our conceptual model. In Study 2 (mixed-gender community sample; N = 297), we refined the item-pool based on additional tests of latent scale structure and associations with concurrent criteria. In a final validation sample (Study 3; international community participants; N = 978), confirmatory factor analyses corroborated our hypothesized three-factor model (Privacy Management, Disclosure Desire, and Social Fear) and supported measurement invariance by sex. The three Contexts of Concealment Scales (CCS) were internally consistent and associated in expected directions with external indices of concurrent concealment, disclosure, depression, anxiety, loneliness, experiential avoidance, and self-stigma.

Alcohol use and treatment utilization in a national sample of veterans and nonveterans

BACKGROUND

Research comparing prevalence of alcohol use problems and alcohol treatment utilization between veterans and nonveterans is lacking. Whether predictors of alcohol use problems and alcohol treatment utilization differ in veterans vs. nonveterans is also unclear.

METHODS

Using survey data from national samples of post-9/11 veterans and nonveterans (N = 17,298; 13,451 veterans, 3847 nonveterans), we investigated associations between veteran status and 1) alcohol consumption, 2) need for intensive alcohol treatment, and 3) past-year and lifetime alcohol treatment utilization. We also investigated associations between predictors and these three outcomes in separate models for veterans and nonveterans. Predictors included age, gender, racial/ethnic identity, sexual orientation, marital status, education, health coverage, financial difficulty, social support, adverse childhood experiences (ACEs), and adult sexual trauma.

RESULTS

Population weighted regression models demonstrated that veterans reported modestly higher alcohol consumption than nonveterans, but were not significantly more likely to need intensive alcohol treatment. Veterans and nonveterans did not differ in past-year alcohol treatment utilization, but veterans were 2.8 times more likely to utilize lifetime treatment than nonveterans. We found several differences between veterans and nonveterans in associations between predictors and outcomes. For veterans, being male, having higher financial difficulty, and lower social support were associated with need for intensive treatment, but for nonveterans, only ACEs were associated with need for intensive treatment.

CONCLUSIONS

Veterans may benefit from interventions with social and financial support to reduce alcohol problems. These findings can help to identify veterans and nonveterans who are more likely to need treatment.

The Moderating Role of Social Support in the Relationship between Poor Mental Health and Excessive Alcohol Consumption: A Gender-Specific Analysis

Background: Social support can potentially attenuate the positive relationship between poor mental health and excessive drinking. The present study tried to understand: (1) whether there is a gender-specific relationship between poor mental health and excessive drinking; and (2) if and how social support moderates the relationship between poor mental health and excessive drinking. Methods: We analyzed the data from 2016 Behavioral Risk Factor Surveillance System (BRFSS; N = 33,705). Weighted data were stratified by gender and controlled for demographic variables. We assessed poor mental health and social support as correlates of heavy and binge drinking, followed by analyzing the moderation effect of social support X poor mental health interaction terms. Results: Poor mental health is linked with excessive drinking across genders. The interaction analysis shows that social support moderates the effect of ever having a poor mental health day in men's heavy drinking, but the interaction term is not significant in all other excessive drinking models, suggesting that social support may not buffer the negative impact of poor mental health on problem drinking, particularly among women. Conclusion: Individuals with greater mental health challenges are more likely to drink hazardously, regardless of gender. Those who have low level of social support and poor mental health, particularly men, are at risk for heavy drinking. Given the majority of the interaction results is not significant, the study provides limited support for the buffering role of social support between poor mental health and problem drinking.

Loneliness and psychological distress in everyday life among Latinx college students

OBJECTIVE

Changes in surroundings and social relationships may heighten feelings of loneliness, suggesting the need to measure as a state. This study tested whether loneliness fluctuates within and across days and the resultant associations with psychological distress. Further it tested familism as a moderator as endorsing this cultural value may buffer the negative effects of state loneliness.

PARTICIPANTS

Participants (n = 220) were Latinx undergraduate students.

METHODS

Students reported their loneliness levels and psychological distress twice a day for two weeks using an ecological momentary assessment approach.

RESULTS

Results showed that experiencing a higher than usual level of loneliness predicted greater sadness, stress, and anxiety at both the moment-to-moment and day-to-day level. Familism, measured at baseline, only moderated the relationship between loneliness and sadness.

CONCLUSIONS

The findings suggest being in a lonely moment may lead to the initiation or amplification of psychological distress immediately and the effects may linger over the day.Supplemental data for this article can be accessed online at https://doi.org/10.1080/07448481.2021.1927051.

Associations Between Sleep and Mental Health Among Latina Adolescent Mothers: The Role of Social Support

Adolescent mothers experience poorer sleep than adult mothers, and Latina adolescent mothers are at greater risk of postpartum depression compared with other racial/ethnic groups. However, social support may be protective against the negative effects of poor sleep in this population. The current study examined (1) associations between the quality and quantity of Latina adolescent mothers’ sleep and mental health (depressive symptoms and anxiety), and (2) whether social support buffered the effects of poor sleep on mental health. A sample of Latina adolescent mothers (N = 84) from an agricultural region in the United States reported on their sleep duration/quality, social support from family, friends, and significant others, and their depressive and anxiety symptoms. Results showed that adolescent mothers reported poorer sleep than pediatric recommendations, and poorer sleep quality was associated with greater depressive and anxiety symptoms. Interestingly, when adolescent mothers reported better sleep, they had fewer depressive symptoms in the context of high support from friends compared with low support from friends. Sleep is important for mental health in Latina adolescent mothers, and better sleep combined with strong social support has positive associations with mental health in this population. Findings hold implications for improving mental health in adolescent mothers.

Prevalence of Mental Health Problems and Willingness to Participate in a Mindfulness Treatment: An Examination among Veterans Injured in Combat

Numerous studies have demonstrated that combat-exposed military veterans are at risk for numerous psychiatric disorders and rates of comorbid mental health and substance use disorders are high. Veterans wounded in combat are a particularly high-risk group of military veterans, however treatment services are often underutilized among this group and it is unclear whether an online treatment program that targets emotional and physical distress (including mental health symptoms and substance use disorders) would be appealing to Veterans wounded in combat. The goal of the current study was to conduct formative research on whether veterans wounded in combat would be interested in an online mindfulness-based treatment to help them cope with emotional and physical discomfort. We recruited Veterans from Combat Wounded Coalition (n = 163; 74.2% non-Hispanic White; 95.7% male) to complete an online survey of mental health and substance use disorder symptoms and willingness to participate in mindfulness treatment. The majority of participants reported significant mental health symptoms and indicated that they would be willing to participate in mindfulness treatment, either at the VA (54.0%) or online (59.5%). Those with problems in multiple health domains and lower self-compassion were significantly more likely to express interest in treatment and likely to represent a very high need group of veterans. The development of a mindfulness-based treatment for this group of individuals could be very helpful in reducing mental health symptoms and improving quality of life among wounded warriors.