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Relations among behavioral, psychological, and electrophysiological correlates of Linguistic Empathy were examined in two experiments using lateralized stimuli. Linguistic Empathy is defined as a linguistic manifestation of the point of view the speaker assumes toward the content of the utterance, and of the speaker's attitude toward/identification with the referents therein. Linguistic choices made by the speaker among multiple logically and referentially synonymous lexical and grammatical options reveal the speaker's perspectives. In experiment 1, acceptability ratings were measured for Context-Target sentence pairs that did or did not violate two Empathy Hierarchies (Person Empathy Hierarchy and Topic Empathy Hierarchy); the Empathy Quotient (EQ) test of Psychological Empathy was also administered. Ratings were lower for sentence pairs that violated both hierarchies than for those violating neither and were intermediate for sentences violating only one hierarchy. Linguistic Empathy (LE) was operationalized as the difference in ratings between sentences violating both vs. neither empathy hierarchy; this measure correlated positively with EQ. Experiment 2 replicated those results with new participants and measured reaction time and EEG during ratings. While there were no effects of hemisphere or visual field on the linguistic variables, the amplitude of a positive event-related potential deflection at 380 ms provided a partial electrophysiological correlate for LE. Its difference measure correlated with behavioral LE but not with EQ. Though preliminary, these experiments show that Linguistic Empathy may share information processing computations with Psychological Empathy and have an electrophysiological correlate.

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Trauma can alter the course of identity development and destabilize existing identity commitments. Trauma, whether past or current, can also impact the resources a person brings to identity work. However, identity can also be a lens through which trauma is perceived and interpreted, helping to determine whether a traumatic experience results in posttraumatic stress disorder or posttraumatic growth. Despite the apparent implications each construct has for the other, the scholarship at the intersection of trauma and identity remains sparse. This Special Issue explores how and when trauma and identity influence one another by considering their association across various adolescent populations, methodologies, traumatic event types, and facets of identity. In doing so, this Special Issue lays the groundwork necessary for exploring, proposing, and testing more complex and nuanced reciprocal relations models between identity and trauma.

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BACKGROUND: Premenstrual dysphoric disorder (PMDD) is an understudied, debilitating disorder of women. Given evidence for prefrontal cortical and limbic dysfunction in PMDD, we compared intrinsic connectivity of the executive control network (ECN), default mode network (DMN), and amygdala in women with PMDD vs. controls. METHODS: Thirty-six women (18 PMDD, 18 control) participated in fMRI during the follicular and luteal phases of the menstrual cycle. At each time, resting-state functional connectivity was evaluated both before and after participants performed an emotion regulation task. The ECN was identified using independent components analysis, and connectivity of left and right amygdala seeds was also evaluated. RESULTS: Nonparametric permutation testing identified a cluster in the left middle temporal gyrus (MTG) with significantly stronger connectivity to the left ECN in women with PMDD vs. controls in all four fMRI sessions. Women with PMDD exhibited no difference in functional connectivity between menstrual cycle phases. Amygdala connectivity did not differ between the groups but differed significantly with menstrual phase, with left amygdala connectivity to cingulate cortex being significantly stronger during the follicular vs. luteal phase. Right amygdala connectivity to the middle frontal gyrus was also stronger during the follicular vs. luteal phase, with no group differences. These findings suggest that women with PMDD have different intrinsic network dynamics in the left executive control network compared to healthy controls.

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INTRODUCTION: This study examines the relations among native and host country acculturation, identity distress, and internalizing symptoms among multicultural adolescent refugees (N = 33) resettled to the United States from a range of countries including Cuba, Iraq, Jordan, Haiti, Colombia, and Venezuela. Despite previous research supporting the advantages of developing a bicultural style to acculturation, mixed results have been found regarding native and host country acculturation patterns among resettled refugees and how these patterns may be associated with refugee mental health outcomes. METHODS: The objective of this study was not only to consider the roles that US and native acculturation may play on the self-report of identity distress and internalizing symptoms among refugee adolescents more broadly, but also to consider the role various dimensions of acculturation (e.g., cultural identity, language competence, and cultural competence) may play for refugee adolescents post-resettlement. RESULTS AND CONCLUSIONS: The study findings indicate that native acculturation, and more specifically native cultural identity, may serve as significant protective factors against identity distress among adolescent refugees post-resettlement, with native cultural identity additionally serving as a protective factor against internalizing symptoms. US acculturation was not found to be significantly associated with identity distress or internalizing symptoms, nor were the acculturative dimensions of language learning (i.e., English and native language competencies), cultural knowledge (i.e., US and native cultural knowledge competencies), or US cultural identity. Recommendations and implications for practice and future research are discussed.

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BACKGROUND: Difficulties in regulating emotions are linked to the core symptoms of premenstrual dysphoric disorder (PMDD). We therefore investigated the neural substrates of emotion-regulation problems in women with PMDD. METHODS: On the basis of self-evaluations over 2 months on the Daily Record of Severity of Problems, eligible participants were assigned to two groups: PMDD and control (18 per group). Functional magnetic resonance imaging (fMRI) and a well-validated task were used to assess brain function during emotion regulation. Participants were tested twice, once during the follicular (asymptomatic) and once in the late luteal (symptomatic) phase of the menstrual cycle. RESULTS: Women with PMDD gave higher ratings of negative affect in the luteal phase than in the follicular phase, and compared with healthy control participants during the luteal phase. A region-of-interest fMRI analysis indicated that during the late luteal phase, women with PMDD had hypoactivation in right dorsolateral prefrontal cortex (dlPFC) during all conditions of the emotion-regulation task, not only in the contrast that isolated emotion regulation. An exploratory whole-brain, voxel-wise analysis showed that women with PMDD had less activation in the precentral gyrus during the luteal phase than the follicular phase, and less activation in the postcentral gyrus compared with control participants. CONCLUSIONS: During the luteal phase of the menstrual cycle, women with PMDD experience difficulty regulating emotions. Hypoactivation in the right dlPFC may contribute to this problem, but may be related more generally to other affective symptoms of PMDD. Hypofunction in the right pre- and postcentral gyri warrants additional study.

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Exposure to natural disasters can be highly traumatic and have a detrimental effect on youth mental health by threatening the satisfaction of basic human needs and goals. Recent research in adults suggests that exposure to disasters may exacerbate existential anxiety about the meaning of life. The current study expands this investigation to adolescents, who may be particularly vulnerable to the negative effects of disaster. Data came from 325 adolescents (mean age = 15.05 years, SD = 1.05) residing in the Greater New Orleans area who were exposed to Hurricanes Katrina and/or Gustav. Existential anxiety concerns were highly prevalent in the sample and were associated with elevated levels of posttraumatic stress disorder (R2 = .09) and depression symptoms (R2 = .13). Consistent with theoretical predictions, disaster exposure levels moderated the association between facets of existential anxiety and mental health symptoms. Findings highlight the salience of existential concerns in disaster exposed youth, and provide evidence that exposure to traumatic stress may strengthen their association with mental health problems.

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Identity distress involves intense or prolonged upset or worry about personal identity issues including long-term goals, career choice, friendships, sexual orientation and behavior, religion, values and beliefs, and group loyalties. Research suggests that trauma exposure and subsequent PTSD symptoms may negatively impact identity development and psychological adjustment. However, little is known about their specific associations with identity distress and internalizing problems among disaster-exposed adolescents. The purpose of this study was to examine these relationships in a sample of 325 adolescents (60% female; 89% African American) who experienced a major natural disaster and its aftermath. The results indicated that identity distress was positively associated with age, hurricane exposure, PTSD symptoms, and internalizing problems. Linear regression analyses also showed that identity distress was uniquely associated with internalizing symptoms and that there was an indirect effect of hurricane exposure on identity distress via PTSD symptoms. Finally, PTSD symptoms moderated the link between identity distress and internalizing symptoms, with a significant positive slope found for youth with more PTSD symptoms. Findings were generally consistent with previous work and predictions, and add to the extant knowledge about identity distress by providing data on the linkages between disaster exposure, posttraumatic stress and internalizing problems in adolescents.

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The cerebellum constitutes ten percent of brain volume and contains the majority of brain neurons. Although it was historically viewed primarily as processing motoric computations, current evidence supports a more comprehensive role, where cerebro-cerebellar feedback loops also modulate various forms of cognitive and affective processing. Here we present evidence for a role of the cerebellum in premenstrual dysphoric disorder (PMDD), which is characterized by severe negative mood symptoms during the luteal phase of the menstrual cycle. Although a link between menstruation and cyclical dysphoria has long been recognized, neuroscientific investigations of this common disorder have only recently been explored. This article reviews functional and structural brain imaging studies of PMDD and the similar but less well defined condition of premenstrual syndrome (PMS). The most consistent findings are that women with premenstrual dysphoria exhibit greater relative activity than other women in the dorsolateral prefrontal cortex and posterior lobules VI and VII of the neocerebellum. Since both brain areas have been implicated in emotional processing and mood disorders, working memory and executive functions, this greater activity probably represents coactivation within a cerebro-cerebellar feedback loop regulating emotional and cognitive processing. Some of the evidence suggests that increased activity within this circuit may preserve cerebellar structure during aging, and possible mechanisms and implications of this finding are discussed.

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OBJECTIVE: The value of home telehealth self-monitoring with nurse oversight has been demonstrated; however, there is a dearth of objective documentation of patients' experiences with such a model. We used a mixed methods approach to examine the value of home telehealth monitoring with remote care nurse (RCN) support from the perspective of participants in our study. MATERIALS AND METHODS: Thirty-three patients who used remote technology to self-monitor their health at home participated in a semistructured interview. The instrument was designed to help identify facilitators and barriers and to evaluate patient satisfaction with and effectiveness of home telehealth self-monitoring. RESULTS: Overall, patients reported high levels of satisfaction with RCN support as they received efficient feedback, were better able to identify changes in their health status, and experienced enhanced accountability, self-efficacy, and motivation to make health behavior changes. The most frequently cited barriers related to malfunctioning equipment or trouble with Internet connections, forgetfulness, and feeling poorly. CONCLUSIONS: The results suggest that home telehealth self-monitoring with RCN support is effective in empowering patients to take a more active role in their healthcare and indirectly improve quality of life for those living with chronic illness.

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OBJECTIVE: The purpose of this study was to examine the relationships of identity development and identity distress to psychological adjustment within adolescents affected by psychological problems. METHOD: Participants included 88 adolescents (43.2% female) ranging from 11 to 20 years of age who were receiving services from a community mental health center. RESULTS: A high proportion of the participants (22.7%) met the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition Text Revision criteria for Identity Problem. Regression analyses found psychopathology symptom score was associated with identity distress, identity exploration, and identity commitment, while identity distress was only related to psychopathology symptom score and not the other two identity variables. CONCLUSIONS: Adolescents with a clinical diagnosis may report significant levels of identity distress. Given that the relationship between psychopathology and identity distress may be reciprocal, assessing for identity issues might be prudent when conducting clinical diagnostic interviews and useful in treatment planning.

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OBJECTIVE: This study is a continuation of a previous pilot project that demonstrated improved health outcomes and significant cost savings using home telehealth with nurse oversight in patients with end-stage renal disease undergoing chronic dialysis. We are reporting the results of a larger sample size over a 3-year study period to test the validity of our original observations. SUBJECTS AND METHODS: Ninety-nine patients were included in this study; 43 (18 females, 25 males) with a mean age of 58.6 years were enrolled in the remote technology (RT) group, and 56 (26 females, 30 males) with a mean age of 63.1 years were enrolled in the usual-care (UC) group. Health resource outcome measures included hospitalizations, emergency room (ER) visits, and number of days hospitalized. Economic analysis was conducted on hospital and ER charges. RESULTS: Hospitalizations (RT, 1.8; UC, 3.0), hospital days (RT, 11.6; UC, 25.0), and hospital and ER charges (RT, $66,000; UC, $157,000) were significantly lower in the RT group, as were hospital and ER charges per study day (RT, $159; UC, $317). CONCLUSIONS: The results support our previous findings, that is, home telehealth can contribute to improved health outcomes and cost of care in high-risk dialysis patients.

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Leptin affects eating behavior partly by altering the response of the brain to food-related stimuli. The effects of leptin on brain structure have been observed in the cerebellum, where leptin receptors are most densely expressed, but the function of leptin in the cerebellum remains unclear. We performed a nonrandomized, prospective interventional study of three adults with genetically mediated leptin deficiency. FMRI was recorded three times each year during years 5 and 6 of leptin replacement treatment. Session 1 of each year occurred after 10 months of continuous daily replacement, session 2 after 33-37 days without leptin, and session 3 at 14-23 days after daily replacement was restored. Statistical parametric mapping software (SPM5) was employed to contrast the fMRI blood oxygenation level-dependent response to images of high-calorie foods versus images of brick walls. Covariate analyses quantified the effects of the duration of leptin replacement and concomitant changes in body mass on the cerebral responses. Longer duration of replacement was associated with more activation by food images in a ventral portion of the posterior lobe of the cerebellum, while simultaneous decreases in body mass were associated with decreased activation in a more dorsal portion of the same lobe. These findings indicate that leptin replacement reversibly alters neural function within the posterior cerebellum and modulates plasticity-dependent brain physiology in response to food cues. The results suggest an underexplored role for the posterior cerebellum in the regulation of leptin-mediated processes related to food intake.

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OBJECTIVE: Premenstrual dysphoric disorder (PMDD) is characterized by severe, negative mood symptoms during the luteal phase of each menstrual cycle. We recently reported that women with PMDD show a greater increase in relative glucose metabolism in the posterior cerebellum from the follicular to the luteal phase, as compared with healthy women, and that the phase-related increase is proportional to PMDD symptom severity. We extended this work with a study of brain structure in PMDD. METHODS: High-resolution magnetic resonance imaging (MRI) scans were obtained from 12 women with PMDD and 13 healthy control subjects (whole-brain volume-corrected p<.05). Voxel-based morphometry was used to assess group differences in cerebral grey-matter volume (GMV), using a statistical criterion of p<.05, correcting for multiple comparisons in the whole-brain volume. RESULTS: PMDD subjects had greater GMV than controls in the posterior cerebellum but not in any other brain area. Age was negatively correlated with GMV within this region in healthy women, but not in women with PMDD. The group difference in GMV was significant for women over age 30(p=.0002) but not younger participants (p>.1). CONCLUSIONS: PMDD appears to be associated with reduced age-related loss in posterior cerebellar GMV. Although the mechanism underlying this finding is unclear, cumulative effects of symptom-related cerebellar activity may be involved.

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This chapter begins with a discussion of the unique experience of adolescents and emerging adults who grew up with globalization in China and how it has affected their sense of self. We then discuss the effects of globalization on identity development in general, with a special focus on the sociohistorical context of China. We also review and critique the psychological literature that has been conducted on identity within Chinese and Chinese American populations. Finally, we discuss the applicability of Western concepts of identity on a culture that does not necessarily share the same value structure.

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