Parental burnout has detrimental consequences for both parents and children, highlighting the importance of identifying accessible resources that buffer against parental burnout. Digital media may be one tool that parents use to regulate their day-to-day emotions, but existing research that primarily relies on global estimates of typical media use limits our understanding of real-time processes. In the current study, 401 predominantly White, college-educated parents of infants 12-24 months old completed 21 daily diaries reporting on parental burnout symptoms, parenting experiences, and motivations for family media use. Temporal network analysis revealed different findings across time scales (same-day vs. next-day) and levels (within- vs. between-subjects). On days when parents reported more burnout symptoms (i.e., exhaustion, distance, overwhelm) compared to their usual levels, they also reported using more media to regulate their emotions on the same day. Exhaustion, specifically, predicted parents' regulatory media use the next day, though there were no between-person links. Using media to connect was associated with feeling less distant from children in general and on the same day. Parents who found their children more difficult to manage used more media to regulate their own emotions on the same day, but less overall. These patterns and differences across networks suggest that media use may be an adaptive short-term strategy that parents use when feeling more burned out or struggling in their parenting role. Understanding why a specific strategy might be adaptive for parents can inform targeted guidance to help parents better manage their day-to-day parenting-related emotional challenges.

This study examined antipsychotic prescribing patterns with respect to mental health diagnoses and racial/ethnic differences among privately insured youth. We leveraged 2009-2021 data from Optum's de-identified Clinformatics Data Mart Database, derived from a database of administrative claims for members of large commercial and Medicare Advantage healthcare insurance plans. There were 46,372 new antipsychotic users between 6-17 years old. For each antipsychotic user, we identified a non-user with the same age, sex, and year of enrollment. We first examined sociodemographic and mental health characteristics of antipsychotic users. We then compared the odds of being an antipsychotic user across different racial/ethnic groups. Comparisons were repeated in subgroups of youth diagnosed with attention-deficit/hyperactivity disorder (ADHD), depressive disorders, and disruptive behavior disorders to examine racial/ethnic differences within common, off-label diagnoses. At least 61% of antipsychotic users had no recorded FDA-approved diagnoses. Depressive disorders and ADHD appeared most frequently, in 46% and 40% of antipsychotic users, respectively. Across the full sample, racial/ethnic minority youth had approximately 25-60% lower odds of antipsychotic use compared with White youth. However, racial/ethnic differences were greatly reduced or eliminated within groups of youth with ADHD, depressive disorders, and disruptive behavior disorders. These findings suggest most privately insured antipsychotic users lack recorded diagnoses for which antipsychotic use in youth is FDA-approved or has established guidelines. Furthermore, it is possible that observed differences in antipsychotic use among racial/ethnic minoritized groups can be attributed at least in part to disparities upstream of initial diagnoses.

This commentary addresses Herman et al. (2024)'s article on applying the Knowledge-to-Action (KTA) model to the dissemination of evidence-based online mental health resources. Herman et al. (2024)'s article emphasizes the need for a decision-making tool to aid the intended audience in identifying their own problems and matching them to respective solutions. We propose the utility of audience segmentation research when designing and tailoring decision-making tools to the unique needs of heterogenous audiences. A conceptual overview of audience segmentation research is outlined, including two commonly used approaches (i.e., demographic separation, empirical clustering). In sum, audience segmentation prior to the development of a decision-making tool may aid in tailoring dissemination strategies and ultimately expanding the reach and adoption of evidence-based resources among the intended audience, which may more effectively minimize the know-do gap.

Racially minoritized transgender and gender expansive (i.e., gender identities that exist beyond the cisgender binary of male or female) young adults (RMTGEYA) experience both individual-level and structural stigma that negatively impacts mental health outcomes. RMTGEYA have any array of strength resources that are tied to culture, community, and identity that are vital resources for mental health. Unfortunately, they are rarely included in the research literature. We aimed to qualitatively spotlight resilience resources as sources of standalone strength possessed by RMTGEYA as well as tools for mitigating the impact of stigma. We interviewed 16 RMTGEYA and conducted thematic analyses on their responses to questions on topics of strength, stigma, and mental health. Results of team-based thematic analysis yielded a reliable codebook (Krippendorff's α = 0.87) from which we derived 5 major themes related to: 1) internal strength; 2) collectivist strength; 3) intersectional strength; 4) macro-level strengths and privileges; and 5) strength in the absence of macro-level supports that are not always adequate in the presence of greater structural oppression. RMTGEYA's are abundant with strength, but there is opportunity for clinical science and practice to leverage these strengths to improve mental health outcomes. Our results spotlight the importance of taking a strength-based approach to research, assessment, and intervention that also promotes advocacy for better structural supports to materially improve the lives off RMTGEYA.

The COVID-19 pandemic disturbed the lives of adolescents during a well-established, sensitive period of development, and further disadvantaged communities already burdened with limited resources. Although there has consistently been discourse on human suffering during and since the COVID-19 pandemic, very little attention has been given to flourishing during this time of extraordinary adversity. Flourishing is a construct that describes a group of individuals who are concurrently reporting high or frequent hedonic (positive emotions) and eudaimonic (purpose, fulfilment) experiences. In the present study we modeled resilience as indexed by the association between early life adversity (ELA) and flourishing, as well as the mediating role of two indices of psychosocial resources (cumulative and compensatory) as a function of individual differences in the impact of COVID-19 in their lives. To do so, we used data collected from 223 predominantly Hispanic/Latino youth (age 11-18) assessed between April 2021 and April 2022 as part of a community-engaged partnership. Based on adolescent self-report on the Mental Health Continuum (MHC-SF), 36.3% of the sample met criteria for flourishing. Parallel moderated mediation showed that having more exposure to ELA was associated with a lower likelihood of flourishing ( < .001), and that this association was differentially explained by compensatory psychosocial resources depending on COVID-19 impact. Specifically, among adolescents experiencing high COVID-19 impact, ELA was associated with a lower likelihood of flourishing via lower compensatory psychosocial resources, indirect effect at high COVID-19 impact = -0.01 ( = 0.007), [-0.03, -0.002]. These results underscore the importance of considering ELA and recent stress in conceptualizations of adolescent flourishing and demonstrate the potential advantages of identifying interventions that increase compensatory psychosocial resources among ELA-exposed youth.

Given the multiple layers of intersectional stigma and discrimination faced by gay and bisexual men and other men who have sex with men (GBMSM) in Kenya, substances may be used to cope with minority stressors. The majority of research on substance use for this population has focused on reporting rates of substance use and its association with HIV risk and mental health. This study provides an in-depth and nuanced exploration of what motivates substance use and substance use reduction, and how substance use impacts various aspects of Kenyan GBMSM's lives. Individual in-depth interviews were conducted with 60 GBMSM (ages 20-45) in Western Kenya as part of a larger study focused on developing an HIV prevention and sexual health promotion intervention. Thematic qualitative analyses were conducted by a diverse team of analysts. Substance use was perceived to have positive and negative effects within three primary thematic areas of functioning: sexual health, physical health, and economic well-being. Motivations or reasons for using substances included coping with stigma, increasing social connectedness, increasing sexual confidence, lowering sexual inhibitions, and peer pressure. Various motivations or reasons to reduce substance use were discussed, including improving sexual health, improving mental well-being, having better sex, maintaining power during sex work, and maintaining physical good looks. These data provide a more complex understanding of the role that substance use plays in Kenyan GBMSM's lives, and provide valuable information for community-based interventions to prevent negative health outcomes from substance use.

Lesbian, gay, bisexual, transgender, and queer (LGBTQ+) individuals face health care disparities, highlighting the need for inclusive and affirming health care environments. Critical to this issue is the willingness to disclose sexual orientation and gender identity (SOGI) in health care settings, as it can significantly influence the quality of care. Despite prior literature emphasizing affirming spaces, the link between the physical health care office environment and SOGI disclosure remains underexplored. This study investigates the impact of health care office environments on the disclosure of SOGI in a diverse sample of = 399 participants (LGBTQ+ = 196; cisgender and heterosexual: cishet = 203). Findings reveal that affirming health care settings enhance willingness to disclose SOGI status, particularly among sexual minorities who identify as cisgender (LGBQ) individuals, while transgender and gender diverse individuals exhibit less willingness to disclose compared to LGBQ and cishet individuals. Individual factors (e.g., outness, internalized stigma) significantly influence willingness to disclose SOGI status. Affirming health care environments mitigated the negative impact of internalized LGBTQ+ stigma on willingness to disclose. These results highlight the need for affirming spaces, addressing both external discrimination and internalized LGBTQ+ stigma to mitigate LGBTQ+ health disparities.

Deliberate Emotion Regulation (ER), the effortful regulation of emotions, is strongly linked to psychopathology. In adults, deliberate ER is often experienced as a self-narrative, such as reappraising a negatively perceived scenario. However, researchers have yet to study how young children articulate deliberate ER strategies, whether these strategies relate to real-time ER neurophysiological processes, and how these strategies are associated with psychopathology. We examined preschool-aged children's verbally articulated ER strategies prior to a frustration challenge, and related these strategies to subsequent real-time neural and physiological responses to frustration and psychopathology in a sample of 59 children. We categorized children's responses into two groups: those who articulated any emotion regulation strategy (i.e., "strategy") and those who did not articulate a strategy (i.e., "no strategy"). We found that about 70% of children in our sample were able to articulate an emotion regulation strategy. Children who articulated a strategy had lower psychophysiological stress during a frustration task compared to children who did not articulate a strategy. Children who articulated a strategy also had fewer ADHD symptoms compared to peers who did not, but also significantly smaller variability of symptoms, and when these unequal variances were taken into account the difference was outside of the traditional p < .05 threshold for significance. To our knowledge, this pilot study is the first to show that emotion regulation strategy articulation may be an emerging skill in early childhood connected to successful modulation of physiological stress and fewer symptoms of psychopathology.

Dysregulated irritability is the most robust early childhood transdiagnostic predictor of psychopathology. However, this evidence has failed to translate to practice due to a dearth of efficient, developmentally-based screening tools. Drawing on the well-validated Multidimensional Assessment Profiles (MAPS) Temper Loss Scale, early feasibility testing of a preliminary clinical screener (MAPS-Early Assessment Screener for Irritability; MAPS-EASI 1.0) was well-received. However, large-scale clinical implementation requires enhanced precision, with age-banded norms psychometrically derived in a large representative sample. Here, we aim to optimize MAPS-EASI for routine pediatric care via psychometric validation of the MAPS-EASI 2.0 Irritability Screener and Impact Rating. Data on 2-5-year-old children (N=1,508) were utilized to derive generalizable thresholds for MAPS-EASI 2.0. Analyses were guided by timing of toddler (=463) and preschool (=1045) age well-child visits, generating two Irritability Screener forms: () 3 items for toddlers (18-33 months); and () 4 items for preschoolers (34-66 months). Irritability Screener severity cut-points were established with good-to-excellent classification (areas under the curve=0.84, 0.88), sensitivity (0.83, 0.82), and specificity (0.72, 0.79), for toddlers and preschoolers respectively. Over-identification was reduced by including impairment in the screening algorithm via the MAPS-EASI 2.0 Impact Rating. The clinical threshold for this integrative algorithm identified 15% and 18% of toddlers and preschoolers, respectively; these rates align with established population prevalence. Pragmatic, transdiagnostic developmental screening tools for routine care may accelerate real-world impact of irritability science for early mental health.

Verbal coercion, a form of sexual violence, is a common problem that is related to various psychological and physical outcomes. Cognitive interviewing is an important technique used to understand how people perceive items on a questionnaire. The current study utilized cognitive interviewing and sought to examine the content validity of a potentially ambiguous item, "my partner insisted on sex", from the Revised Conflict Tactics Scales, a measure of intimate partner violence. Participants were mostly college students at a local Midwestern University (N = 39). Participants responses were qualitatively coded, and the following themes emerged: coercion (42.68%) (physical (4.88%) and verbal (37.80%)), consent (30.49%), compliance (4.88%), hesitancy to have sex (13.41%), personal experiences (6.10%), and perpetrator's intent (2.44%). The results show that most participants viewed the item, "partner insisted on sex" as a verbally coercive tactic; this theme was mentioned more often than non-coercive themes. Participants were also asked to rate quantitatively how consensual they considered the insistence item, and comparison items representing other tactic types. Three tactics were rated as clearly nonconsensual using a < .05 standard, including the insistence item ( = 1.946, = 1.70) with a range from "0-not consensual at all" to "7-completely consensual". This suggests evidence of consent validity since the item was perceived as representing coercive behavior.

Neighborhood physical disorder is linked to deleterious resident physical and mental health. It is thus critical to develop low-cost, reliable methods that utilize publicly available imagery (e.g., Google Street View; GSV) to comprehensively audit neighborhoods. We aimed to create a reliable, efficient, and scale-flexible virtual audit of neighborhood disorder (Lot Assessment of Neighborhood Disorder; LAND) that can be aggregated to larger geographical units. A total of 710 block faces on 355 street segments were coded in Detroit, MI. We tested reliability between coders on 20% of the sample (71 segments (i.e., two sides of the street); 146 block faces (i.e., one side of the street) and found reliability was adequate at the individual lot (Kappas ranged from .60 - 1), block face (ICCs ranged from .94 -.98), and segment (ICCs ranged from .96-.98) levels, with the sole exception of graffiti (for which ICCs were typically in the .56 to .57 range). Moreover, LAND's score was positively correlated with number of vacant lots, area deprivation, and resident perceptions of their neighborhood. Overall, LAND evidence higher levels of reliability than previous physical neighborhood disorder virtual audits and evidenced significant correlations across several known correlates of physical neighborhood disorder, thus highlighting LAND as an effective virtual audit tool in the study of physical neighborhood disorder.

Engagement on social media among adolescents and young adults (AYAs) is almost universal. AYAs use social media for socialization, connection, and expression, as well as to obtain news and information. Adolescence and young adulthood also represent developmental periods characterized by the emergence of risk behaviors and many forms of psychopathology. Given that risk behaviors and mental health depictions are often displayed and observed online, social media platforms have become an optimal research tool to examine AYA behaviors that may not be visible offline. Social media platforms have the potential to increase recruitment and retention, especially among hard-to-reach, and understudied youth, and to connect AYA with resources for risk behaviors and mental health in a more naturalistic setting. Despite these advantages, the limited consensus on social media ethics across institutions and internal review boards, and the rapidly evolving features on each platform has made it difficult to develop study protocols, navigate and adapt to platform changes, and predict ethical issues that may arise in the context of research. Thus, the purpose of this manuscript is to discuss ethical considerations specific to AYA in social media research. Two research approaches, self-report and observational, are discussed with a focus on informed consent, privacy, and confidentiality. The goal of this manuscript is to highlight the nuances associated with social media research, and the implications for the promotion of ethical practices when adopting social media as a research tool to improve our understanding of AYA behavior.

Research suggests that bilingual experience is associated with gray matter changes, such that initial language gains are associated with expansion and language expertise is associated with renormalization. Previous studies on language proficiency development primarily focused on between-subjects, quasiexperimental comparisons of monolinguals and bilinguals. This study proposes a new paradigm to examine language expertise and cortical thickness within heritage bilinguals ( = 215), as well as between bilinguals and monolinguals ( = 145), using data combined from eight previous magnetic resonance imaging studies. In general, results highlight variability within bilinguals, finding relationships between cortical thickness and English proficiency that are relatively consistent within monolinguals, but inconsistent within bilinguals. In all participants, higher levels of proficiency in English-monolinguals' only language and bilinguals' second but stronger language-were negatively related to cortical thickness. In bilinguals, higher proficiency in the weaker, albeit first learned, language was positively related to cortical thickness. Moreover, there was an interaction between language group and English proficiency in predicting cortical thickness, such that the relationship between proficiency and thickness was stronger in monolinguals than in bilinguals. Findings also demonstrate that the regions associated with language expertise differ between bilinguals and monolinguals. Future directions for cognitive-developmental neuroscience research in bilinguals are suggested, particularly the longitudinal examination of cortical changes in relation to bilingual experiences.

The problem size effect (PSE) is defined by better performance solving small problems (e.g., 2x4) than large problems (e.g., 8x9). For monolinguals, the PSE is larger when problems are presented in unfamiliar formats (e.g., written words), reflecting increased processing difficulty. Bilinguals are typically faster and more accurate at retrieving multiplication facts in the language of learning (LA+) than in their other language (LA-). We hypothesized that the less familiar arithmetic language (i.e., LA-) would elicit larger PSEs than LA+. Here, fluent Spanish-English bilingual adults verified spoken multiplication problems presented in LA+ and LA- while event-related potentials (ERPs) were recorded (Experiment 1A). To further promote language differences, we increased task difficulty by presenting problems at a faster pace (Experiment 1B) and requiring bilinguals to verbally produce solutions (Experiment 2). Language differences in performance were only observed for Experiment 2, where solutions were produced more slowly in LA- than LA+. In the ERPs, a PSE was driven by larger P300s for small than large solutions. A language effect was only observed under time pressure where LA- elicited a PSE at the 2 operand. Additionally, the PSE was smaller for LA- at the solution. This suggests that categorizing multiplication facts is more effortful in LA-. In sum, very subtle language differences arise in fluent bilinguals when problems are more difficult, such as larger problems presented under time pressure in a weaker language. Critically, the effect of LA+ is at the level of response production and not access to the facts from memory.

The present study examined whether monolingual and bilingual language experience -- including first and second language proficiency, exposure, and age of acquisition -- modify the neural mechanisms of attention during nonverbal sound discrimination. English monolinguals and Korean-English bilinguals performed an auditory two-stimulus oddball task while their EEG was recorded. Participants heard a series of two different tones (high pitch tone versus low pitch tone), one of which occurred less frequently (deviant trials) than the other (standard trials), and were asked to mentally count the number of infrequent tones. We found that in the early time window, bilinguals had larger amplitudes than monolinguals in response to both standard and deviant trials, suggesting that bilinguals initially increased attention to identify which of the two tones they heard. In the later time window, however, bilinguals had a smaller ERP effect (deviant minus standard trials) relative to monolinguals, suggesting that bilinguals used fewer cognitive resources for the infrequent stimuli at later stages of processing. Furthermore, across the entire sample, increased exposure to the native language led to larger early, middle, and late ERP effects. These results suggest that native language exposure shapes perceptual processes involved in detection and monitoring. Knowing more than one language may alter sustained attentional processes, with implications for perception and learning.

Language switching is common in bilingual environments, including those of many bilingual children. Some bilingual children hear rapid switching that involves immediate translation of words (an '' pattern), while others hear their languages most often in long blocks of a single language (a '' pattern). Our two-site experimental study compared two groups of developing bilinguals from different communities, and investigated whether differences in the timing of language switching impose different demands on bilingual children's learning of novel nouns in their two languages: do children learn differently if they hear a translation immediately vs. if they hear translations more separated in time? Using an at-home online tablet word learning task, data were collected asynchronously from 3- to 5-year-old bilinguals from French-English bilingual families in Montreal, Canada (N = 31) and Spanish-English bilingual families in New Jersey, USA (N = 22). Results showed that bilingual children in both communities readily learned new words, and their performance was similar across the and conditions. Our findings highlight that different types of bilingual interactions can provide equal learning opportunities for bilingual children's vocabulary development.

Bilingualism and multilingualism provide a unique lens for exploring how human experiences influence language and cognition. This editorial presents a collection of studies on the relationship between bilingualism/multilingualism and cognition in typically developing and neurodiverse populations. The articles assembled in this issue synthesize findings from diverse linguistic populations (e.g., second-language learners, heritage speakers, different-script bilinguals, etc.) and techniques (e.g., behavioral, magnetic resonance imaging, electroencephalography, eye-tracking, etc.) to provide compelling evidence that knowing more than one language can benefit learning, health, and social outcomes. Translational research on bilingualism and multilingualism is necessary for informing policy and can serve as a guide to researchers, practitioners, and educators who work with linguistically diverse populations, as well as individuals and parents who speak multiple languages. We conclude that multilingualism shapes cells, selves, and societies.

The GAD-7 is a brief, freely available questionnaire measuring anxiety, which is a common mental health problem among college students. The current study examined the psychometric properties of the GAD-7 among undergraduate students from a public midwestern university (=582; =19.0±1.0 years-old; 79.4% women; 81.6% White) who completed the GAD-7, State-Trait Anxiety Inventory-Trait subscale (STAI-T), and Behavioral Inhibition/Activation Scale-Reward subscale (BIAS-R). The psychometric properties of two GAD-7 models were examined: a one-factor model, equivalent to a single total score, and a two-factor model, including cognitive-emotional and somatic tension factors. The GAD-7 total score had excellent reliability (both and =0.91) and evidence for convergent ( with STAI-T=0.70, <.001) and discriminant validity ( with BIAS-R=-0.04, =.350). The cognitive-emotional factor had excellent reliability (=0.90; =0.91), whereas the somatic tension factor had adequate reliability (=0.76; =0.77). Both factors had evidence for convergent validity (cognitive-emotional: with STAT-T=0.70, <.001; somatic tension: with STAT-T=0.60, <.001) and discriminant validity (cognitive-emotional: with BIAS-R=-0.05, =.227; somatic tension: with BIAS-R=-0.02, =.700). Confirmatory factor analyses supported both the one-factor model (RMSEA=.098, CFI=.994) and the two-factor model (RMSEA=.069, CFI=.997), albeit with a high inter-factor correlation (=.91). Measurement invariance was supported across gender, race/ethnicity, and college class for both models. The findings support using the GAD-7 total score among U.S. college students, as is common in practice, but also provided evidence for the two-factor model in this population. Considering its parsimony, the total score would be preferable in applied settings for a quick measurement of anxiety symptom severity.

The majority of research on media use in the digital age during early childhood has consisted of parental reports or experimental lab research, however, little research has captured media use in the home. Thus, the purpose of the current study was to capture early childhood media use in the moment it occurs. Participants included 231 parent-child dyads ( child age = 41.17 months) who completed a one-week study. Parents were contacted multiple times per day via text. If children happened to be using media (or be in a room where media was present) when parents received the notification, parents were asked to take a 10-15 second video of their child. Most families submitted at least one video over the course of the week. These videos were coded in the current study using a coding scheme to capture the context around media use in early childhood (including the environment, child behavior, and media characteristics). Results revealed that children were most likely to view media on a television or tablet. Although most children were paying attention to media, about half were also physically active while consuming media. Another person was present in the majority of videos with children, most frequently siblings or peers. Most children showed a very flat and calm affect while viewing media. These findings were generally consistent across gender and family income. Overall, this study adds to the literature on children and media that uses other methods, but provides additional insight into the importance of the specific context during early childhood media use in the digital age.

Adolescent development and wellbeing now involve how the use of social technologies (e.g., social media and other online spaces) impact daily life. Especially during crises such as COVID-19 and persistent injustices, adolescents rely on online spaces for social connectedness and informational knowledge. Psychosocial impacts, both positive and negative, have been found among racial-ethnic minority adolescents. However, the role of racial-ethnic identity on social media use and wellbeing has been understudied. The current study addresses differential associations on social media experiences and mental health (i.e., depressive, online anxiety symptoms) among a diverse group of adolescents ( = 668; ages 10-17; 45.7% non-White). Furthermore, the roles of self-identified racial-ethnic groups, identity importance, exposure to hate messaging, and gender are investigated. Our study found significant moderating effects of racial-ethnic importance, gender, and online hate messaging. Additionally, the moderating role of race-ethnicity reveals a stronger association between greater social media frequency and heightened depressive symptoms among Asian adolescents. Black adolescents showed a significant association between greater social media frequency and decreased online social anxiety. Significant effects of online hate messaging exposure also reveal associations between online behaviors and depression and online social anxiety across adolescents. As social media adoption coincides with identity exploration, this study highlights how racial-ethnic identity and its formation in the digital age is important to understand its association with online interactions that may help or hinder adolescent wellbeing. Future work should continue examining trajectories of identity formation in relation to social media content and differential mental health impacts.

Mental and physical health are closely tied, and a deeper understanding of how the mind, brain, and body are connected has the potential to substantially improve health outcomes. In particular, a translational approach that integrates research on mind-brain-body connections at multiple levels of analysis (e.g., basic science, patient-oriented, and intervention science perspectives) can contribute toward the development, targeting, and implementation of mechanistically informed and effective interventions to improve mental and physical health. The three articles in this special issue elucidate a range of biological and behavioral mechanisms within the mind, brain, and body that contribute to health. The varying levels of analysis examined in each article complement each other to arrive at deeper insights than any one article would alone. Taken together, their research highlights the added value of moving from separate mental and physical health care models toward holistic care, and of considering how context may inform "for whom" a given intervention is most effective.

The COVID-19 pandemic resulted in global monumental upheaval. Many people were displaced from their jobs and sources of income. COVID-19 was also linked to increased mental health difficulties and increased alcohol consumption and problems. The current study aims to identify the indirect effect of depression, stress, and anxiety on the relations between the economic burden of COVID-19 and alcohol problems. Participants ( = 344) were recruited via Amazon's Mechanical Turk (MTurk). Participants completed a questionnaire about substance use, mood, and the economic burden of COVID-19. Eligible participants were 18 years or older, consumed alcohol or cannabis within the past week, and verified through Amazon. Results indicated significant indirect effects of depression, stress, and anxiety on the association between the economic burden of COVID-19 and alcohol problems regardless of use. Findings revealed large effect sizes, suggesting that mental health symptomatology may have a large impact on the association between COVID-19's economic burden and alcohol-related problems. Findings suggest mental health difficulties indirectly effect the association between COVID-19's economic burden and alcohol-related problems. Intervention efforts targeting mental health may be beneficial in reducing alcohol problems among individuals experiencing distress due to large-scale public health impact, such as the COVID-19 pandemic.

Informal caregivers experience a great deal of stress due to care-related duties and responsibilities. Caregiving stress has the ability to impact caregivers' physical health, but has been largely understudied in caregivers of children with a chronic illness. In this study, we examine the associations of stress to both caregiver self-rated health and biomarkers of the hypothalamic-pituitary-adrenal (HPA) axis and immune systems (arginine vasopressin, c-reactive protein, tumor necrosis factor alpha). We also examine whether coping style (proactive, avoidant, support coping) buffers the links of stress to health across two different stressor contexts: caregiving for a child with a rare or undiagnosed disease ( = 101) and caregiving for a typically developing child ( = 69). Results indicated perceived stress was linked to worse self-rated health, however, stress was only linked to biological markers of health for caregivers of typically developing children. Results also suggest that coping style may moderate some of the links of stress to health, as proactive coping was linked to lower arginine vasopressin. However, models also suggested the role of coping style may differ based on caregiving context, as support coping was linked to better health only for caregivers of typically developing children, and more proactive coping overall was observed in the rare disease context. Future research should continue to examine how stress and coping interact within different caregiving contexts to protect caregiver health and well-being.

Interventions led by peer recovery specialists (PRSs) have rapidly expanded in response to a global shortage of access to substance use treatment. However, there is a lack of guidance on how to incorporate PRSs' lived experience into the delivery of evidence-based interventions (EBIs). Moreover, few resources exist to assess fidelity that integrate both content fidelity, peer competence, and incorporation of lived experience (i.e., PRS role fidelity). This study aimed to: (1) describe a novel PRS fidelity monitoring approach to assess both content and PRS role fidelity; (2) compare independent rater and PRS-self-reported content fidelity; (3) examine associations between content and PRS role fidelity; and (4) assess whether the PRS role fidelity was associated with substance use at post-treatment. This study was conducted across two PRS-led behavioral intervention trials conducted in global resource-limited settings: Baltimore City, US, and Khayelitsha, South Africa. A significant difference was found between PRS- and independent rater content fidelity in both interventions, with PRSs reporting significantly higher content fidelity in both sites. PRS role and content fidelity were not significantly correlated, suggesting greater adherence to the PRS role is not associated with lower adherence to structured EBI content. PRS role fidelity was not significantly associated with substance use at post-treatment. This study provides an important step towards understanding how to assess PRS role fidelity in the context of EBIs for underserved individuals with SUD that also incorporates their lived experience.

North American Indigenous youth experience disproportionate rates of racial discrimination as well as consequences associated with alcohol use. Self-compassion has been found to be related to both racial discrimination and alcohol use, separately. However, no work to date has examined the role of self-compassion as a moderator of the links among racial discrimination and alcohol use and alcohol-related problems. First Nation adolescents ( = 106, = 14.6, 50.0% female) from reserve communities in Eastern Canada completed a pencil-and-paper survey regarding their experiences of racial discrimination, self-compassion, alcohol use, and alcohol-related problems. The associations between racial discrimination and both alcohol use and alcohol-related problems were significantly moderated by self-compassion. Simple slopes analysis revealed that the associations between racial discrimination and alcohol use was significant for those with low ( = 6.03, = .002) but not high ( = -0.30, = .88) levels of self-compassion. Similarly, the association between racial discrimination and alcohol-related problems was significant for those with low ( = 21.81, = .001) but not high ( = 0.64, = .93) levels of self-compassion. Findings of the present study suggest that low levels of self-compassion may increase risk for alcohol use and experiencing negative alcohol-related consequences in the context of racial discrimination among North American Indigenous adolescents. Future work should examine the utility of interventions targeting self-compassion to examine their effects on responses to racial discrimination and alcohol use.

Contingency management (CM) has robust evidence of effectiveness as an adjunct to medication for opioid use disorders. However, CM implementation in opioid treatment programs has been limited by a myriad of well-documented barriers. One relatively unexplored barrier that may hinder CM implementation is health professional stigma toward patients with opioid use disorders. Qualitative interviews were conducted with 43 health professionals (21 leaders, 22 front-line counselors) from 11 different opioid treatment programs across Rhode Island to explore their familiarity with CM and to elucidate barriers and facilitators to CM implementation. Interviews were transcribed and coded by 3 independent raters using a reflexive team approach. Transcripts were analyzed for both a priori and emergent themes. Health professional stigma was identified as an emergent major theme with 4 distinct subthemes: (a) distrust of patients (44%, = 19); (b) infantilizing views about patients (19%, = 8); (c) belief that patients do not deserve prizes (19%, = 8); and (d) recognition of patient self-stigma and community-based stigma (23%, = 10). In addition, we identified multiple instances of health professional use of potentially stigmatizing language toward patients with opioid use disorders via terms such as drug , , and or urine screens (70%, = 30). Stigma themes were identified in 86% of the transcripts, highlighting potential targets for multilevel implementation strategies. Findings of this study suggest that multiple types of health professional stigma should be considered and proactively addressed in efforts by psychologists to implement CM and other evidence-based interventions in opioid treatment programs.

As treatment expansion in the opioid epidemic continues, it is important to examine how the makeup of individuals with opioid use disorder (OUD) is evolving. Treatment programs are increasingly utilizing buprenorphine, an effective OUD medication. This exploratory study examines sex and gender differences in psychosocial, clinical and substance use treatment characteristics of a clinical population in outpatient medication treatment for OUD with buprenorphine. This is a secondary data analysis from a cross-sectional survey study with retrospective medical record review conducted with patients recruited from an office-based opioid treatment clinic between July-September 2019. Participants on buprenorphine for at least 28 days at time of survey completion were included (n=133). Differences between men and women were explored with Pearson χ and Fisher's Exact Tests for categorical variables and T-Tests for continuous variables. The sample was 55.6% women and nearly three-fourths Black (70.7%). Mean days in current treatment episode was 431.6 (SD=244.82). Women were younger and more likely to be unemployed, identify as a sexual minority, and live alone with children than men. More women than men had a psychiatric comorbidity. Women reported more prescription opioid misuse while men had more heroin only opioid use. More men reported comorbid alcohol use and a history of drug overdose. One-third of participants reported recent discrimination in a healthcare setting due to substance use. As buprenorphine-based outpatient treatment programs continue to expand, present study findings support evaluation of the unique needs of men and women in order to better tailor OUD-related services and improve treatment outcomes.

Preparation to address ethical challenges is an essential component of graduate training, and no less so for the psychological sciences. However, in the absence of uniform guidelines, approaches to training vary in form and quality. Classroom lectures and online training seem to be the mechanisms of choice, but these fall short. First, such approaches conflict with the scholarship on teaching and learning that makes it clear that having a meaningful impact depends on having students actively engaged in constructing their own learning. Second, research is consistent with intuition that the impact of courses is likely to be far less than what happens in a graduate student's research environment. The conclusion is that promoting an ethical culture, and for the training of graduate students in particular, will be well served by enhancing the role of mentors. Examples of options to consider are: (1) recognizing that a primary advisor can be a mentor, but should certainly not be considered the only mentor; (2) emphasizing the importance of mentoring for individuals from underrepresented groups (e.g., because of gender or ethnicity); (3) strengthening the APA code of ethics to more fully articulate the full range and importance of mentoring; (4) developing and implementing mechanisms to evaluate and reward effective mentoring; and (5) providing targeted training for faculty advisors to empower them with tools and resources to be effective mentors for ethics generally and the responsible conduct of research specifically.

Scientific work is demanding and complex, requiring those leading research to be simultaneously innovative and ethical in their work. Along with this, those leading scientific teams need to be able to influence both the work being done and lab members doing the work. Thus, both leadership and management skills are necessary to navigating the organizational, social, and ethical components of the research process in order to do rigorous, ethical, and high-quality scientific work. This paper recommends a number of practices that leaders of research teams should engage in, including management behaviors for "leading the work" and leadership behaviors for "leading the people" that foster excellence and integrity in research labs. Researchers can take an intentional approach to leadership and management to create a robust environment for ethical research. Overall, a researcher's routine behaviors as leaders of their labs should establish a healthy work environment and promote effective interpersonal interactions among lab members. Further, the lab requires routine procedures and structure to provide adequate oversight of the research. This paper also addresses challenges that may arise when implementing leadership and management practices, along with strategies for overcoming these strategies. Avenues for future research and policy development related to leadership and management in scientific contexts are discussed.

Metacognition, self-awareness, self-knowledge, and insight each refer to the process by which individuals reflect upon and appraise their own abilities. Self-awareness is a complex, dynamic, and multifactorial construct that spans various domains such as motor, sensory, functional and cognitive abilities. Various disciplines including cognitive psychology, neuropsychology, psychiatry and neurology have attempted to understand healthy and pathologic self-awareness of cognition in particular. Although intrinsically connected, the study of healthy and pathologic states of self-awareness have remained relatively discrete from one another. Indeed, different disciplines examining self-awareness of cognition have operationalized and measured awareness through distinct theoretical frameworks. More recently, however, various authors have attempted to bridge constructs across disciplines in an effort to develop a unitary theoretical model for self-awareness of cognitive abilities. In this commentary, we summarize the study of self-awareness of cognitive abilities across various disciplines, highlighting translational aspects between them.