Reout Arbel

Daily Patterns of Stress and Conflict in Couples: Associations With Marital Aggression and Family-of-Origin Aggression.

For many married individuals, the ups and downs of daily life are connected such that stressors impacting one person also impact the other person. For example, stress experienced by one individual may “spill over” to negatively impact marital functioning. This study used both partners’ daily diary data to examine same-day and cross-day links between stress and marital conflict and tested several factors that make couples vulnerable to spillover. Assessment of 25 wide-ranging sources of daily stress included both paid and unpaid work, health issues, financial concerns, and having to make difficult decisions. Results showed that both husbands’ and wives’ experiences of total daily stress were associated with greater same-day marital conflict and that conflict was greater on days both spouses experienced high levels of stress. Evidence of cross-day spillover was found only in those couples with high concurrent marital aggression and in couples where wives reported high family-of-origin aggression. These results highlight both the common, anticipated nature of same-day spillover and the potentially problematic aspects of more prolonged patterns representing failure to recover from stressors that occurred the previous day. The discussion focuses on how reactivity in one life domain puts that individual at risk for generating stress in another life domain and how current marital aggression and family-of-origin aggression are associated with difficulty recovering from stressful events.

Adolescents’ Daily Worries and Risky Behaviors: The Buffering Role of Support Seeking

With worries and risky behaviors becoming more prominent in adolescence, this study investigated bidirectional temporal connections between these two important adolescent concerns, that is, whether change in one concern is linked to change in the other either within the same day or during the next day. We also tested whether the coping strategy of seeking support from family and friends moderated the link between worries and risky behaviors. For 10 days, an ethnically and racially diverse sample of adolescents (N = 103; M age = 18.0) reported on 26 common worries, 18 risky behaviors, and the impact of seeking support from others. Multilevel models showed that worries and risky behaviors covaried on the same day and that worries predicted next-day risky behavior for male but not female participants. In contrast, risky behaviors did not predict next-day worries. For adolescents reporting negative experiences of support seeking, worries led to next-day risky behaviors and risky behaviors led to next-day worries. Female adolescents’ positive support-seeking experiences buffered the association between risky behaviors and next-day worries. These results were significant beyond any influence of daily negative mood or depressive and anxiety symptoms. The data demonstrate that worries and risky behaviors may be situational triggers for each other and highlight the importance, from intervention perspectives, of adolescents’ communication of concerns to others.

Revisiting poor insight into illness in anorexia nervosa: true unawareness or conscious disagreement?

Background. To investigate and validate a novel approach to distinguishing between two possible sources of poor insight in anorexia nervosa: true unawareness, in which a patient is not aware that other people think there is a problem, and disagreement, in which a patient does recognize that others think there is a problem. Methods. Thirty-nine patients with anorexia nervosa or eating disorder not otherwise specified–anorexia nervosa were given two versions of the Scale of Unawareness of Mental Disorder (SUMD), one in which they were asked about their own opinion and one in which they were asked about their clinicians’ opinion. Clinicians also completed the SUMD with their opinion about the patient’s illness. Patients and clinicians both also completed a Visual Analog Scale assessing treatment acceptance. Results. About 57% of the overall level of poor insight was explained by disagreement. Prediction of treatment acceptance was significantly improved when poor insight was broken down into true unawareness and disagreement. Conclusions. These data suggest that impaired insight in anorexia nervosa is an additive outcome of true unawareness and disagreement. (Journal of Psychiatric Practice 2014;20:85–93)

Does the cortisol awakening response link childhood adversity to adult BMI

Objectives: Childhood adversity is a risk factor for the development of obesity in adulthood. Dysregulated hypothalamic-pituitary-adrenal (HPA) activity, which has been associated separately with both adverse childhood experiences and obesity, has been posited as a mechanism by which stressful experiences influence body mass index (BMI); however, this mechanism has not yet been tested longitudinally. The present study uses multireporter, longitudinal data across three time points to test whether the adolescent cortisol awakening response (CAR), an index of diurnal HPA activity, mediates the association between adversity in childhood and BMI in adulthood. Method: Eighty-two youth, mothers, and fathers reported on adverse childhood experiences from middle childhood to late adolescence. During adolescence, youth provided saliva samples three times each morning across three days, which were assayed for cortisol to calculate CAR. During early adulthood, youth reported height and weight to calculate BMI. Results: Greater adversity predicted flatter CAR and higher young adult BMI. Flatter CAR partially mediated the association between childhood adversity and young adult BMI. Conclusions: Stress-related alterations to HPA activity account in part for the childhood adversity–adult obesity link. Findings are consistent with theoretical models implicating HPA alterations as linking childhood adversity to metabolic and behavioral determinants of BMI in adulthood.

Parenting styles, food-related parenting practices, and children's healthy eating: A mediation analysis to examine relationships between parenting and child diet

Parents exert a strong influence on their childrens diet. While authoritative parenting style is linked to healthier weight and dietary outcomes in children, and authoritarian and permissive parenting styles with unhealthy eating, little is known about the mechanisms that mediate these relationships. Feeding styles are often examined in relation to child diet, but they do not consider the social and physical environmental contexts in which dietary behaviors occur. Therefore, this study examined whether parenting styles (authoritative, authoritarian, and permissive) were associated with three specific food-related parenting practices - mealtime structural practices (e.g., eating meals as a family), parent modeling of healthy food, and household food rules and whether these parenting practices mediated the association between parenting styles and childrens diet. Participants were 174 mother-child dyads. Mothers (68% married, 58% college graduates, Mage = 41 years [SD = 6.2]) reported on their parenting practices using validated scales and parenting style using the Parenting Styles and Dimensions Questionnaire. Children (52% female, Mage = 10 years [SD = 0.9]) completed two telephone-based 24-hour dietary recalls. Dietary outcomes included the Healthy Eating Index (HEI)-2010 score, and fruit and vegetables and added sugar intake. Using PROCESS, multiple mediation cross-sectional analyses with parallel mediators using 10,000 bootstraps were performed. Significant indirect effects were observed with mealtime structure and the relationships between authoritative parenting and HEI-2010 score (b = 0.045, p < .05, CI = [0.006, 0.126]), authoritarian parenting and HEI-2010 score (b = -0.055, p < .05, CI = [-0.167, -0.001]), and permissive parenting and HEI-2010 score (b = -0.093, p < .05, CI = [-0.265, -0.008]). Child diet quality is affected by mealtime structural practices. Further examination of the features by which mealtime structural practices serve as a mechanism for parents to support healthy eating among their children may improve childrens diet quality.