Ostensible psychiatric comorbidity can sometimes be explained by shared relations between diagnostic constructs and higher order internalizing and externalizing dimensions. However, this possibility has not been explored with regard to comorbidity between personality pathology and other clinical constructs in adolescents. In this study, personality pattern scales from the Millon Adolescent Clinical Inventory in a sample of 492 adolescent inpatients were subjected to a principal components analysis to yield oblique internalizing and externalizing dimensions. Relations between personality dimensions and well-established measures of psychopathology (depression, alcohol abuse, drug abuse) and other indicators of clinical dysfunction (self-esteem, suicidality, violence) were assessed before and after controlling for these higher-order personality dimensions. Associations between personality scales and indicators of psychopathology and clinical dysfunction were minimal with these higher order components controlled. These results suggest that internalizing and externalizing personality dimensions explain most of the associations between personality patterns and indicators of psychopathology and clinical dysfunction in adolescent patients.

Although many studies examine the biological phenomena that mediate the relationship between stress and illness, more research is needed regarding psychological variables that may mediate this relationship. Thus, the current study investigates the mediating effects of locus of control and self-efficacy in the relationships among stress, illness, and the utilization of health services in a sample of 159 college students. Results suggest that participants who endorse higher levels of stress also endorse higher levels of illness, higher levels of external locus of control, and lower levels of self-efficacy. In addition, structural equation modeling suggests that there are direct relationships between stress and illness and between illness and the utilization of health services. Further, locus of control appears to be a partial mediator in the relationship between stress and illness. Given the link established between stress and illness and the individual differences associated with reactions to stressful situations, it is important for future examinations to continue to identify potential mediators of the stress-illness link.

Anal sexual intercourse represents the highest transmission risk for infection with the human immunodeficiency virus (HIV), yet much of what we know about anal sex is based on men who have sex with men (MSM). Less is known about heterosexual adults who practice anal sex, especially those who may be at risk for HIV such as substance users. The present study examined the demographic, sexual behaviors, substance use, and psychosocial correlates of recent anal intercourse among a heterosexual young adult sample of nightclub goers who also use substances. Data were drawn from an on-going natural history study of participants (n = 597) in Miami’s club scene who use club drugs, use prescription medications for non-medical reasons, and were regular attendees of nightclubs. Participants who reported anal sex (n = 118) were more likely to be male, of moderate income, Latino, trade sex, have unprotected sex, and report victimization. Event-based and qualitative studies are needed to better understand the context in which anal sex occurs. Interventions that target heterosexual populations should include discussion about the risks of anal sex.

This study examined the exchange of sexual services for compensation (e.g., money, drugs, alcohol) in high school students. The sale of sex in young people from nonclinical samples has been the subject of recent studies, but buying such services has received far less attention. This study described these two phenomena and associated factors within a nonclinical sample of 815 high school students (M = 15.86 years) from Québec. According to our results, 3% of these youth reported having bought and 4% reported having sold such services in their lifetime. More girls were involved in selling sexual services and more boys were involved in buying them. Young people generally disapproved of prostitution. Logistic regressions revealed that attitudes in support of prostitution, history of sexual abuse, casual sex, and the number of stressful life events were related to the sale of sex. Furthermore, observing sexualized social activities and exhibiting approving attitudes towards prostitution were associated with buying sexual services.

While prior research has identified the impact, nature, and causes of medical error in general medical settings, little is known about errors in inpatient psychiatry. Understanding the broad range of errors that occur in inpatient psychiatry is a critical step toward improving systems of care for a vulnerable patient population. An explorative qualitative analysis of key informant interviews identified a preliminary typology of errors and the contextual factors that precipitate them in inpatient psychiatry. The types of errors and their contextual factors fall broadly within the rubric of categories identified in medicine and surgery. However, many of the specific errors and contextual factors manifest themselves differently and are shaped by the uniqueness of the inpatient psychiatric setting and patient population. Interventions geared toward improving systems of care for psychiatric patients should draw on best practices for safety in medicine and surgery, but also be complemented with new strategies specifically tailored to the inpatient psychiatric setting.

This study revealed that attributional style can identify gay men at risk for adverse mental health correlates of discrimination, as well as those resilient in the face of frequent discriminatory events. Men identifying as gay (N = 307) completed online self-reports of social anxiety, perceived frequency of discriminatory events, attributions for discriminatory events, and key minority stress constructs: internalized homonegativity and gay identity development. A new measure was constructed to assess different types of attributions regarding discrimination, with factor analyses yielding promising psychometric properties. Global attributions and the importance ascribed to discrimination were associated with increased social anxiety, above and beyond other minority stress constructs related to mental health in gay men. Attribution style also served as a moderator, as perceived discrimination was only associated with increased social anxiety in gay men who attributed high globality/importance to discriminatory events. Attributions may serve as risk or protective factors in the context of discrimination.

This research examined an integration of cognitive and interpersonal theories of depression by investigating the prospective contribution of depressive rumination to perceptions of social support, the generation of interpersonal stress, and depressive symptoms. It was hypothesized that depressive ruminators would generate stress in their relationships, and that social support discontent would account for this association. Further, depressive rumination and dependent interpersonal stress were examined as joint and unique predictors of depressive symptoms over time. Participants included 122 undergraduate students (M age = 19.78 years, SD = 3.54) who completed assessments of depressive rumination, perceptions of social support, life stress, and depressive symptoms across three waves, each spaced 9 months apart. Results revealed that social support discontent accounted for the prospective association between depressive rumination and dependent interpersonal stress, and that both depressive rumination and dependent interpersonal stress contributed to elevations in depressive symptoms over time. These findings highlight the complex interplay between cognitive and interpersonal processes that confer vulnerability to depression, and have implications for the development of integrated depression-focused intervention endeavors.