Experiencing and upregulating positive emotions may be beneficial for adolescents’ well-being. However, in contrast to studies on regulating negative emotions, studies on positive emotion regulation (ER) have focused mainly on savoring strategies. The purpose of our study was to examine the factor (variable-centered) and profile (person-centered) structure of a novel adolescent report measure, Positive Emotion Regulation Questionnaire (PERQ), of 10 positive ER strategies used to maintain or increase happiness and investigate convergent validity with ER and mental health indicators. We recruited a sample of 349 English-speaking 13-17-year-old adolescents (50

INTRODUCTION:Past research suggests that adolescents may be subject to anti-youth ageism from adults. However, little research has investigated adolescents' subjective awareness and experiences of anti-youth ageism by adults toward their specific age group. Thus, the purpose of this study was to conduct a secondary qualitative analysis of open-ended response data to better understand how adolescents perceive adult beliefs about teenagers generally and whether (and how) they personally have been treated differently due to their age. METHOD:Seven-hundred and seventeen adolescents (ages 13-18 years; 62.9% female; 67.9% Caucasian/White) completed an online survey that included two open-ended questions related to how adults feel about teenagers (prejudice) and whether they had ever been treated differently based on their age (age-based discrimination). Emic and etic coding approaches were used to identify codes and themes from the data. RESULTS:Results demonstrated that most of the adolescents in this sample believed that adults held negative views toward teenagers (e.g., entitled, rude, lazy, inferior), and they personally were treated differently because of their age. CONCLUSION:These findings extend upon recent theory and research and highlight the importance of asking adolescents how they perceive adults' beliefs about them and their interactions with adults (positive and negative). Moreover, the results of this study underscore the critical need for adults, especially those adults in authority (e.g., parents, teachers), to consider how their beliefs and actions may be internalized by adolescents. Further investigation into how these perceptions of anti-youth ageism toward adolescents is warranted.

Mass customization is the concept of integrating advanced designing and fabrication approaches to produce personalized products while ensuring efficiency and low cost over the entire customization cycle. The escalation of COVID-19 in the past few years has stimulated massive demand for personal protective equipment (PPE), including surgery masks, oxygen respirators, and other wearable equipment that could prevent the virus from spreading. Both performance and comfort are affected by the fit of facial masks; thus, implementing mass customization on PPE could improve user comfort and enhance air impermeability while maintaining low costs during design and fabrication. Current mass customization methods for surgery masks, oxygen respirators, or other general purpose medical masks mostly use a 3D scanner or integrated smartphone applications to acquire the patient’s facial data profile. However, these methods are manual and either require a high-precision scanner or cameras with the depth mapping function. To fill these gaps, this paper proposed a video-based method for supporting automated facial mask design customization. More specifically, the proposed method records a short facial video as the primary input, where facial data is extracted from each video frame and forms a cross-validated dataset with facial variations. The dataset further supports the generative design of customized facial masks based on defined regions of interest. Finally, design considerations of additive manufacturing are integrated into the fabrication of customized masks. Preliminary user feedback has shown promising results for the proposed method.

Rural youth suicide represents a major source of mental health inequity in the United States (US). School-based suicide prevention programs may provide an effective avenue to address this mental health crisis among rural youth. This study’s primary goal is to demonstrate the feasibility and acceptability of a novel implementation approach (utilizing teachers from a neighboring school) for delivering the Youth Aware of Mental Health (YAM) program, an evidence-based, universal youth suicide prevention curriculum, to high school students in rural Montana. We will recruit approximately 1300 9th grade student in four Montana schools. Using a non-inferiority design, we will randomize classrooms in each school to be instructed by a teacher from another school (YAM-TE; experimental) or a traditional external instructor (YAM-EXT; control). We will assess program fidelity of both YAM training and implementation via independent observer and instructor-reporter ratings. Youth will complete measures of acceptability at post-YAM and outcome measures at pre-YAM, post-YAM, and 12 month follow-up. Standard and mixed linear and logistic regression models will be used to test the main hypothesis that the YAM-TE does not differ from YAM-EXT regarding fidelity (teachers) and acceptability (teachers and youth). Exploratory analyses will test moderation of the intervention effect (e.g., sex, poverty) and the mediating effect of mental health literacy, belongingness, and perceived burdensomeness on the intervention effect. Results of this pilot study will inform the development of subsequent, fully powered noninferiority trials. Our long-term goal is to scale YAM-TE for implementation across rural US communities or, if culturally appropriate, more globally.

(1) Background: Due to the mental health crisis that has spiraled since the onset of COVID-19, particularly among the nation’s youth, the purpose of this study was to examine the efficacy of a novel, school-based mental health intervention for high school students (ages 15–17 years). This project’s main aim was to determine which intervention modality was more effective with students across two school districts with varying degrees of rurality (in-person delivery vs. remote delivery). A secondary aim of this study was to determine the efficacy of a remotely delivered, concurrent intervention for educators across both school districts. This study took place in rural southwestern Montana. (2) Methods: Utilizing a 6-week, trauma-informed yoga intervention, comparisons of mental and physical health outcomes were performed using cohort data drawn from participants’ physiological data and validated mental health survey measures. (3) Results: While physiological results were mixed across experimental groups, mental health outcomes were overwhelmingly positive for all groups. Additionally, educators reported improvements in career satisfaction and burnout levels. (4) Conclusions: Findings indicate a great deal of promise with this intervention in improving mental health outcomes for both students and educators. Moreover, a face-to-face intervention for students showed dramatic improvement in physiological stress indicators.

Currently available pain assessment scales focus on pain-related symptoms and limitations imposed by pain. Validated assessment tools that measure how pain is regulated by those who live well with pain are missing. This study seeks to fill this gap by describing the development and preliminary validation of the Biobehavior Life Regulation (BLR) scale. The BLR scale assesses engagement, social relatedness, and self-growth in the presence of chronic pain and the unpredictability of chronic pain. Sources for items included survivor strategies, patient experiences, existing scales, and unpredictable pain research. Review for suitability yielded 52 items. Validation measures were identified for engagement, social relatedness, self-growth, and unpredictability of pain. The study sample (n = 202) represented patients treated in the Phoenix VA Health Care System (n = 112) and two community clinics (n = 90). Demographic characteristics included average age of 52.5, heterogeneous in ethnicity and race at the VA, mainly Non-Hispanic White at the community clinics, 14 years of education, and pain duration of 18 years for the VA and 15.4 years for community clinics. Exploratory factor analysis using Oblimin rotation in the VA sample (n = 112) yielded a two-factor solution that accounted for 48.23% of the total variance. Confirmatory factor analysis (CFA) in the same sample showed high correlations among items in Factor 1, indicating redundancy and the need to further reduce items. The final CFA indicated a 2-factor solution with adequate fit to the data. The 2-factor CFA was replicated in Sample 2 from the community clinics (n = 90) with similarly adequate fit to the data. Factor 1, Pain Regulation, covered 8 items of engagement, social relatedness, and self-growth while Factor 2, Pain Unpredictability, covered 6 items related to the experience of unpredictable pain. Construct validity showed moderate to higher Pearson correlations between BLR subscales and relevant well-established constructs that were consistent across VA and community samples. The BLR scale assesses adaptive regulation strategies in unpredictable pain as a potential tool for evaluating regulation resources and pain unpredictability.

Collaboration plays an important role in educational contexts. However, little is known about students’ metacognitive beliefs about collaboration. The present study used an online survey to investigate students’ beliefs toward group study/recall, their studying preferences, strategies they use when studying individually and in groups, and important characteristics of their group members. Results indicate that, although students generally perceive collaboration as beneficial, they prefer individual study, indicating that their beliefs are inconsistent with their learning preferences. Students report social learning as the primary reason for collaborative benefits but prefer to study alone to minimize distraction and increase personal accountability. Further, they use different strategies when studying individually or in a group. When studying individually, students most frequently report re-reading their notes. However, when studying in groups, students most frequently use strategies emphasizing collaboration and interaction, such as quizzing each other. Also, students prefer to work with group members who are focused, motivated, and hard working. Students’ beliefs, preferences, and favored characteristics of group members are related to their frequency of using study groups. Students’ metacognitive beliefs about collaboration have implications for theories of self-regulated learning and better use of collaboration in educational contexts.

INTRODUCTION:The ability to effectively regulate one's emotions is important for adolescent mental health. However, extant assessments of how adolescents regulate their emotions can be expanded upon in several ways, including incorporating more strategies (e.g., cultural and spiritual) and positive emotions, and being informed by adolescents and expert consultation during the development process. Thus, our study aimed to improve the construct validity of an emotion regulation measure by adapting and refining the Emotion Regulation Skills Questionnaire (ERSQ) into an adolescent self-report. METHODS:We recruited 24 13-17-year-olds (12 males; 11 females; 1 gender fluid) via social media advertisement in the United States in 2020. We used an iterative qualitative approach in which we combined expert consultation, cognitive interviewing with adolescents, and top-down and bottom-up coding to review and provide feedback on the ERSQ. RESULTS:Findings of thematic analysis showed that a need for clarity in wording and inclusion of strategy examples across all sections of the ERSQ was needed. Adolescents also identified the need to replace the Silly/Excited section with a more age-appropriate positive emotion section. CONCLUSION:Findings indicate cognitive interviewing can be successfully completed in a virtual format when necessary, youth utilize a wider range of strategies to maintain or upregulate positive emotions than what is represented in current measures, and use of qualitative methods may have reduced construct underrepresentation and construct-irrelevant variance in the adapted ERSQ.

Given the prevalence of mental health issues for both educators and adolescents in rural Montana, this project is designed to help mitigate the impact of stressors by providing coping strategies linked to improvements in overall mental health outcomes for teachers, which may ultimately lead to improved co-regulation of students and classroom climate. The immediate goal of this pilot study was to measure physical and mental health outcomes of educators resulting from a remotely-delivered trauma-informed yoga intervention. Findings suggest improvements in participants' depression and anxiety levels, trauma symptoms, sleep quality, and non-significant changes in heart rate variability and cortisol levels.

Developing research collaborations with Indigenous communities to understand the expression and experience of anxiety and depression in American Indian (AI) youth and identifying protective and risk factors may be an important first step toward addressing AI health inequities. We used a community-based participatory research (CBPR) approach to investigate anxiety and depressive disorder symptoms among AI youth living on a Northern Plains reservation. Moreover, we examined whether symptoms were related to two potential protective and risk factors, anxiety control beliefs and rumination. Our tribal research team collected multi-reporter survey data from 71 AI 3(rd)-6(th) graders (8-13-years-old; 62.3% female) attending a tribal school, their caregivers, and teachers. Results pointed toward resilience in this sample with 7.3% and 8.7% of AI youth reporting clinical levels of anxiety and depressive disorder symptoms, respectively, and on average experiencing symptoms "Sometimes." There were moderate correlations between youth- and teacher-reported anxiety and depressive disorder symptoms, but no correlation with caregivers. Anxiety control beliefs were lower in older compared to younger AI youth and negatively related to youth-reported anxiety and depressive disorder symptoms, while rumination was positively related to youth-reported anxiety and depressive disorder symptoms and teacher-reported anxiety disorder symptoms. Age moderated relations between anxiety control beliefs and both youth-reported anxiety and depressive disorder symptoms with only significant relations found for older youth. Our findings are consistent with research showing resilience to internalizing problems in AI youth living on a reservation, but replication of their relations to anxiety control beliefs and rumination in other Indigenous peoples is warranted.

Parenting behaviors play an essential role in healthy youth development, and poor parenting behaviors place youth at risk of developing problem behaviors, mental health problems, and difficulties in emotional self-regulation. This study explores the associations among various types of parent anxiety, parent emotion regulation abilities via self-report and high-frequency heart rate variability (HF-HRV), and parenting behaviors. This study also tests a model where emotion regulation is hypothesized to buffer the link between parent anxiety and less effective parenting behaviors or where poor emotion regulation strengthens the association between anxiety and less effective parenting. Caregivers of adolescents (N = 80) completed self-report measures of parenting behaviors, anxiety, and emotion regulation. Caregivers also completed an HF-HRV assessment during a resting state and a mild stress task. Results indicate that parent anxiety is associated with parenting behaviors and that parent emotion regulation is also associated with parenting with three significant moderating effects of HF-HRV stress reactivity. Trait anxiety interacted with low HF-HRV reactivity to predict negative parenting practices and poor monitoring, and somatization interacted with low HF-HRV reactivity to predict poor monitoring. Findings suggest that poor emotion regulation, indexed by physiological reactivity to stress, may strengthen the relationship between parent psychopathology and poor parenting behaviors. This study did not find a buffering effect of optimal emotion regulation abilities on the relationship between anxiety and parenting. Our findings add incremental insight into the way we conceptualize how anxiety and emotion regulation affect parenting behaviors.

PURPOSE:Monitoring suicide risk in clinical practice requires valid and reliable assessment instruments. This study evaluated the psychometric properties of the 7-item version of the Concise Health Risk Tracking Self-Report, CHRT-SR7 in a primarily rural population.METHODS:The sample comprised 788 participants (81.7% female) of an effectiveness trial of an internet-based self-help intervention for depression. Participants completed self-report questionnaires, including the CHRT-SR7 , Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, Work and Social Adjustment Scale, Connor-Davidson Resilience Scale-10, and Barriers to Seeking Mental Health Care. Four-week test-retest reliability was calculated for a subsample of 147 participants randomized to a waitlist control group.FINDINGS:The CHRT-SR7 internal consistency was α = 0.80 (total sample), α = 0.80 (women), and α = 0.83 (men). The 4-week test-retest reliability was strong for women (r = 0.78) and moderate for men (r = 0.66). Confirmatory factor analysis supported the original 3-factor solution: Hopelessness (2 items), Perceived Lack of Social Support (2 items), and Current Suicidal Thoughts and Plans (3 items), which was invariant across gender and rural status. Convergent and divergent validity was supported as reflected in significant correlations of the CHRT-SR7 and its subscales with measures of depression, anxiety, adjustment, and resilience. Limitations include the limited demographic diversity (mostly non-Hispanic White women) and reliance on self-report data.CONCLUSIONS:Our findings complement those reported in prior studies of patients with severe depression and support the use of the CHRT-SR7 for measuring suicide risk in rural adults; future studies should further test the instrument's psychometric properties in racial or ethnic minority rural residents.

Washington state has observed increases in polydrug use in fatal crashes, primarily involving the combination of cannabis and alcohol. The purpose of this article is to explore the belief system associated with driving under the influence of cannabis and alcohol (DUICA) in Washington state using structural equation modeling (SEM). A convenience sample (n = 737) of surveys collected from adults in Washington state was analyzed using SEM to reveal the latent structure of the belief system associated with DUICA. The results of this analysis indicated that the reported DUICA behavior (frequency) was predicted by intention and willingness. Willingness also predicted intention. Intention and willingness were predicted by positive attitudes toward DUICA, as well as normative perceptions that it was acceptable to important people and common behavior for most people. These components were themselves predicted by corresponding beliefs (behavioral beliefs, normative beliefs, and control beliefs). Finally, these beliefs were also influenced by the values that were most important to the respondents. Based on these results, it is reasonable to speculate that strategies to change these beliefs may also reduce DUICA behavior and associated fatal crashes.

Current treatments for chronic pain have limited benefit. We describe a resilience intervention for individuals with chronic pain which is based on a model of viewing chronic pain as dysregulated homeostasis and which seeks to restore homeostatic self-regulation using strategies exemplified by survivors of extreme environments. The intervention is expected to have broad effects on well-being and positive emotional health, to improve cognitive functions, and to reduce pain symptoms thus helping to transform the suffering of pain into self-growth. A total of 88 Veterans completed the pre-assessment and were randomly assigned to either the treatment intervention (n = 38) or control (n = 37). Fifty-eight Veterans completed pre- and post-testing (intervention n = 31, control = 27). The intervention covered resilience strengths organized into four modules: (1) engagement, (2) social relatedness, (3) transformation of pain and (4) building a good life. A broad set of standardized, well validated measures were used to assess three domains of functioning: health and well-being, symptoms, and cognitive functions. Two-way Analysis of Variance was used to detect group and time differences. Broadly, results indicated significant intervention and time effects across multiple domains: (1) Pain decreased in present severity [F(1, 56) = 5.02, p < 0.05, η2p = 0.08], total pain over six domains [F(1, 56) = 14.52, p < 0.01, η2p = 0.21], and pain interference [F(1, 56) = 6.82, p < 0.05, η2p = 0.11]; (2) Affect improved in pain-related negative affect [F(1, 56) = 7.44, p < 0.01, η2p = 0.12], fear [F(1, 56) = 7.70, p < 0.01, η2p = 0.12], and distress [F(1, 56) = 10.87, p < 0.01, η2p = 0.16]; (3) Well-being increased in pain mobility [F(1, 56) = 5.45, p < 0.05, η2p = 0.09], vitality [F(1, 56) = 4.54, p < 0.05, η2p = 0.07], and emotional well-being [F(1, 56) = 5.53, p < 0.05, η2p = 0.09] Mental health symptoms and the cognitive functioning domain did not reveal significant effects. This resilience intervention based on homeostatic self-regulation and survival strategies of survivors of extreme external environments may provide additional sociopsychobiological tools for treating individuals with chronic pain that may extend beyond treating pain symptoms to improving emotional well-being and self-growth. Clinical Trial Registration: Registered with ClinicalTrials.gov (NCT04693728).

Psychological reactance to persuasive messages can undermine and contradict the goals of those messages. This study examined the effect of message characteristics (forcefulness and framing) on psychological reactance to traffic safety messages that promoted safe behavior (seat belt wearing) and prohibited risky behavior (distracted driving) in terms of threat appraisal, emotional reaction, and message attitude. The study also included perceiver characteristics (reactance proneness, behavior attitude, and risk-taking propensity). Using a within-subject design, subjects completed an online experiment that presented short traffic safety messages followed by questions that measure psychological reactance. The results demonstrated that forceful messages could increase psychological reactance. However, the perceiver characteristics were often significant as covariates affecting this relationship. The study concludes that the design of effective traffic safety messages must consider both the characteristics of the message content and the characteristics of the message audience. (C) 2021 Elsevier Ltd. All rights reserved.

The reliable and valid assessment of heart rate variability (HRV) is important to understanding autonomic functioning in youth. However, use of electrocardiogram (ECG) signals to derive estimates of parasympatheticmediated HRV may present logistical barriers in applied settings. Thus, this study investigated the concordance between high-frequency HRV [HF-HRV] and root mean square of successive differences [RMSSD] derived from ECG and photoplethysmography (PPG) signals during a video baseline, resting baseline, and mental arithmetic among an ethnically diverse sample of ninety-six youths (Mage = 13.84; 51% male; 62.5% ethnic minority). Results showed moderate to almost perfect agreement between PPG- and ECG- derived HF-HRV and RMSSD for video and resting baselines (Lin's correlations ranged from 0.93 to 0.99) and limits of agreement (LoA) ranging from -0.48 to 0.58 (HF-HRV) and - 11.37 to 9.32 (RMSSD). Conversely, we found poor to moderate agreement for the mental arithmetic task (Lin's correlations ranged from 0.88 to 0.91) and LoA ranging from -0.68 + 0.94 (HF-HRV) and - 17.58 + 20.69 (RMSSD), though we did find ethnic minority youth had higher and moderate Lin's correlations (0.93 to 0.94). Overall, there was a bias towards higher HF-HRV and RMSSD values with PPG. Findings suggest that PPG-derived HF-HRV and RMSSD may be viable alternatives for ECG in baseline conditions, but tasks requiring movement or eliciting mild stress responses may result in less than perfect values and missing data patterns. It is imperative that future studies replicate these findings in other ethnically diverse youth samples and expand to younger children and applied settings.

BACKGROUND:The development of reasoning as to the potential negative consequences of emotional sensations is a critical aspect of emotion knowledge and central to cognitive risk for anxiety disorders. The purpose of this paper is to explore the reasoning children and adolescents give for negative interpretations of anxiety sensations, testing a priori hypotheses quantitatively and exploring the content of the reasons qualitatively.METHODS:This study used a cross sectional design with interviews as well as cognitive and emotional assessments in a sample of 227 youth aged 6-17 years. Coding schemes to assess the logical validity, affective valence, and qualitative reasons that youth give to evaluate anxiety sensations and anxiety situations were developed.RESULTS:Findings indicated diverse reasoning was used and responses could be reliably coded with developmental differences across age, cognitive, and verbal development. The logical sophistication of the reasoning used by youth increased across age in a non-linear manner and linearly with cognitive and verbal abilities. Child anxiety sensitivity and internalizing symptom levels moderated the main effect of age.CONCLUSIONS:The results add to the existing understanding of emotional development and are consistent with the idea that the process of cognitive-emotional understanding is not a simple linear one because various domains may show differential development.

The Family Bereavement Program (FBP) is a family-based intervention for parentally bereaved children and surviving caregivers. Results are reported of a randomized controlled trial, examining intervention effects on emotional reactivity and regulation of young adults who participated in the program 15 years earlier. Participants (N = 152) completed four emotion challenge tasks: reactivity to negative images, detached reappraisal while viewing negative images, positive reappraisal while viewing negative images, and reengagement with positive images. Outcomes included cardiac interbeat interval (IBI), pre-ejection period (PEP), and respiratory sinus arrhythmia (RSA) as well as self-reported emotional experience and regulation effectiveness. Direct intervention effects and effects mediated through improved parenting were estimated. Several significant effects were observed in primary analyses; however, none remained significant after correction for familywise Type I error. Parenting mediated FBP effects on IBI during negative reactivity (b = 15.04), and on RSA during positive reengagement (b = 0.35); the latter effect was accounted for by changes in breathing. Intervention condition was a direct predictor of self-reported detached reappraisal effectiveness (b = 1.00). Intervention and gender interacted in predicting self-reported negative emotion during the negative reactivity (b = 1.04) and positive reappraisal tasks (b = 1.31) such that intervention-condition men reported more negative emotions during those tasks. Although these findings should be considered preliminary given the limited power of the corrected statistical tests, they suggest long-term effects of family intervention following the death of a parent on offspring's emotional reactivity and regulation ability that should be pursued further in future research.