The Patient-Reported Outcomes Measurement Information System (PROMIS) pediatric and parent-proxy short forms for anxiety: Psychometric properties in the Kids FACE FEARS sample

Association of mental health-related patient reported outcomes with blood pressure in adults and children with primary proteinuric glomerulopathies

INTRODUCTION

The prevalence of mental health disorders including anxiety and depression is increasing and is linked to hypertension in healthy individuals. However, the relationship of psychosocial patient-reported outcomes on blood pressure (BP) in primary proteinuric glomerulopathies is not well characterized. This study explored longitudinal relationships between psychosocial patient-reported outcomes and BP status among individuals with proteinuric glomerulopathies.

METHODS

An observational cohort study was performed using data from 745 adults and children enrolled in the Nephrotic Syndrome Study Network (NEPTUNE). General Estimating Equations for linear regression and binary logistic analysis for odds ratios were performed to analyze relationships between the exposures, longitudinal Patient-Reported Outcome Measurement Information System (PROMIS) measures and BP and hypertension status as outcomes.

RESULTS

In adults, more anxiety was longitudinally associated with higher systolic and hypertensive BP. In children, fatigue was longitudinally associated with increased odds of hypertensive BP regardless of the PROMIS report method. More stress, anxiety, and depression were longitudinally associated with higher systolic BP index, higher diastolic BP index, and increased odds of hypertensive BP index in children with parent-proxy patient-reported outcomes.

DISCUSSION/CONCLUSION

Chronically poor psychosocial patient-reported outcomes may be significantly associated with higher BP and hypertension in adults and children with primary proteinuric glomerulopathies. This interaction appears strong in children but should be interpreted with caution, as multiple confounders related to glomerular disease may influence both mental health and BP independently. That said, access to mental health resources may help control BP, and proper disease and BP management may improve overall mental health.

Psychometric properties of the GAD-7 and PROMIS-Anxiety-4a among youth with depression and suicidality: Results from the Texas youth depression and suicide research network

There is a tremendous need for brief, valid, and free assessments of anxiety in child mental healthcare. The goal of this study was to determine the psychometric properties of two such measures, the GAD-7 and PROMIS-Anxiety-4a, in 1000 children, adolescents, and young adults (8-20 years-old) with depression and/or suicidality. The GAD-7, the PROMIS-Anxiety-4a, and other validated assessments of anxiety, physical functioning, and psychiatric diagnoses were completed. Confirmatory factor analyses showed an acceptable fit for a single factor in both measures via all indices but the RMSEA. They demonstrated measurement invariance across pre-adolescents (8-12 years-old) and adolescents and emerging adults (13-20 years-old), though scalar invariance was not observed for the GAD-7. Both measures showed strong convergent validity, GAD-7: r = 0.68; PROMIS-Anxiety-4a: r = 0.75, divergent validity with a measure of physical function, GAD-7: r = -0.24; PROMIS-Anxiety-4a: r = -0.28, good internal consistency, ω = 0.89 for both, and high test-retest reliability, GAD-7: r = 0.69; PROMIS-Anxiety-4a: r = 0.71. Both measures also showed acceptable sensitivity and specificity in detecting the presence of any anxiety disorder, GAD-7 cut-off score of 10: AUC = 0.75; PROMIS-Anxiety-4a cutoff score of 12: AUC = 0.79. The GAD-7 correlated similarly with the Screen for Child Anxiety Related Disorders total score and generalized anxiety subscale, and also showed similar diagnostic sensitivity and specificity when used to detect the presence of any anxiety disorder vs. generalized anxiety disorder specifically. Results suggest that both of these brief, publicly available instruments are valid and reliable assessments of anxiety among youth in treatment for depression and/or suicidality.

Mental Health in the Youth Athlete

Though research is inconclusive in being able to determine if young athletes are more or less likely to suffer from mental health disorders compared with their non-athlete peers, there are important psychological considerations that are unique to the athletic population. This includes depression in the context of overtraining and burnout, performance anxiety, perfectionism, psychological sequalae of concussion, and injury as an independent risk factor for depression, anxiety, post-traumatic stress, and high-risk behaviors. Optimization of mental health care in youth athletes requires continued efforts to improve mental health literacy, decrease stigma, encourage help-seeking behaviors, and advance the routine implementation of effective screening practices.

Development of the Nighttime Parenting Scale: Differentiating nighttime versus general parenting practices and their impact on youth sleep health

OBJECTIVES

The current study provides a novel method of assessing the impact of nighttime parenting practices on youth sleep health during the sensitive transition from childhood to adolescence (ie., peri-puberty). Specifically, we aimed to advance the measurement of nighttime parenting by developing a conceptually driven questionnaire for use in research and clinical settings.

METHOD

A total of 625 parents (67.9% mothers) of peripubertal youth (age M=11.6, SD=1.31) were recruited online and completed self-report questionnaires. The sample was primarily White (67.4%), followed by 16.5% Black, 13.1% Latinx, and 9.6% Asian. Factor structure was examined through four empirically-driven stages (ie, exploratory factor analyses, confirmatory factor analyses, examining internal and test-retest reliability, and indices of validity). Furthermore, the current study sought to validate nighttime parenting as a unique construct by exploring associations with peripubertal youth sleep health.

RESULTS

A factor structure consisting of six dimensions of nighttime parenting was established (ie, nighttime supportiveness, hostility, physical control, limit-setting, media monitoring, and co-sleeping behaviors). Furthermore, the current measure demonstrated strong psychometric properties. Finally, the established dimensions were cross-sectionally associated with youth sleep health indices.

CONCLUSIONS

This study extends previous research by examining the influence of distinct domains of parenting practices that specifically occur at nighttime and how these differentially relate to youth sleep health. Results suggest that intervention and/or prevention programs targeting sleep should place emphasis on fostering positive parenting at nighttime as a strategy for creating an evening environment that is conducive to optimizing youth sleep health.