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Wu WW, Shiu CS, Lu FL, Tang CC, Jou ST, Chen JS, Liu YL, Tsai SY. Medical clowning influences the emotions of parents of children undergoing cancer treatment: A quasi-experimental study. J Pediatr Nurs 2023:S0882-5963(23)00093-3. [PMID: 37120387 DOI: 10.1016/j.pedn.2023.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 03/24/2023] [Accepted: 04/12/2023] [Indexed: 05/01/2023]
Abstract
BACKGROUND Medical clowning for children has been found to be effective at enhancing parents' psychological well-being during preoperative preparation, but has not been found during cancer treatment. This study aimed to examine whether and how medical clowning influenced the emotions of parents of children undergoing cancer treatment. METHODS In this quasi-experimental study, 96 parents of children receiving inpatient cancer treatment were recruited, from June 2018 through April 2020. A demographic questionnaire measuring characteristics of parent and dyadic child, Brief Symptom Rating Scale measuring psychological distress of the parent, and Mood Assessment Scale measuring emotional status of parent and child were administered 1 day before a clowning service. The day after the clowning service, the Mood Assessment Scale again collected emotional status for parent and child. Descriptive analysis, bivariate analysis, and structural equation modeling to fit the actor-partner, cross-lagged model were used. FINDINGS Parents experienced a low degree of psychological distress that called for emotional management. The indirect effect of medical clowning on parents' emotions through children's emotions was significant, as were the direct effect and total effect of medical clowning on parents' emotions. DISCUSSION Parents experienced psychological distress during their child's inpatient cancer treatment. Medical clowning can directly improve children's emotions and through this pathway indirectly improve their parents' emotions. APPLICATION TO PRACTICE There is need to monitor psychological distress and provide interventions for parents of children undergoing cancer treatment. Medical clowns should continue to serve parent-child dyads in pediatric oncology practice and become members of multidisciplinary health care teams.
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Affiliation(s)
- Wei-Wen Wu
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan; Adjunct Supervisor, Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan.
| | - Cheng-Shi Shiu
- Department of Social Work, National Taiwan University, Taipei, Taiwan
| | - Frank L Lu
- Department of Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chia-Chun Tang
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan; Adjunct Supervisor, Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan
| | - Shiann-Tang Jou
- Department of Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Jiann-Shiuh Chen
- Department of Pediatrics, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Yen-Lin Liu
- Department of Pediatrics, Taipei Medical University Hospital, Taipei, Taiwan
| | - Shao-Yu Tsai
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan; Adjunct Supervisor, Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan
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The Causes and Factors Associated with Infant Mortality Rate in Ethiopia: The Application of Structural Equation Modelling. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10020397. [PMID: 36832527 PMCID: PMC9955481 DOI: 10.3390/children10020397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 02/10/2023] [Accepted: 02/13/2023] [Indexed: 02/22/2023]
Abstract
Infant mortality rate is a proxy measure of population health. Previous studies on the infant mortality rate in Ethiopia did not consider measurement errors in the measured variables and had a one-directional effect; little emphasis was placed on testing multiple causal paths at the same time. We used structural equation modelling for a better understanding of the direct, indirect, and total effects among causal variables in a single model. A path analysis was part of an algorithm providing equations that were relating the variances and covariances of the indicators. From the results, the maternal mortality ratio (MMR) was significantly mediating the influence of out-of-pocket expenditure (OOP) on infant mortality rate (IMR), and the fertility rate (FR) was significantly mediating the influence of GDP to IMR (β = 1.168, p < 0.001). The GDP affects the IMR directly and indirectly while the OOP affects IMR indirectly. This study showed that there was a causal linkage between the World Bank Health and Population Variables for causing IMR in Ethiopia. The MMR and FR were found to be the intermediate indicators in this study. Through the indicators, FR had the highest standardised coefficients for increasing the IMR. We recommended that the existing interventions to reduce IMR be strengthened.
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Wang CP, Lu YC, Hung WC, Tsai IT, Chang YH, Hu DW, Hsu CC, Wu CC, Wei CT, Chung FM, Lee YJ. Inter-relationship of risk factors and pathways associated with chronic kidney disease in patients with type 2 diabetes mellitus: a structural equation modelling analysis. Public Health 2021; 190:135-144. [PMID: 33451823 DOI: 10.1016/j.puhe.2020.02.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 01/12/2020] [Accepted: 02/10/2020] [Indexed: 01/18/2023]
Abstract
OBJECTIVES Diabetes mellitus is the most common cause of chronic kidney disease (CKD); however, the inter-relationships and pathogenetic mechanisms among risk factors are still largely unknown. Structural equation modelling (SEM) was applied to test a hypothesis of causal pathways related to CKD in patients with type 2 diabetes mellitus (T2DM). STUDY DESIGN This is a prospective observational study. METHODS A total of 3395 patients with T2DM were enrolled in this study. A hypothesised SEM was applied to assess associations among demographic data, diabetic self-management behaviours, diabetes control, lifestyle, psycho-social, chronic inflammation factors, anthropometric and metabolic variables simultaneously and the risk of CKD. RESULTS Demographic data (including education, marital status and mini-mental state examination score) (-0.075), white blood cell count (0.084), high blood pressure (0.144), World Health Organisation (WHO) 5 well-being index (-0.082), diabetes control (0.099), triglyceride (0.091) and uric acid (0.282) levels had direct effects on the risk of CKD. The final model could explain 26% of the variability in baseline CKD status. In addition, the same direct and specific indirect factors at baseline CKD status analysis contributed to the risk of CKD at the 12-month follow-up. The final model could explain 31% of the variability in the risk of CKD at the 12-month follow-up. CONCLUSIONS This study investigates associations between factors obtained from real-world daily practice and CKD status simultaneously and delineates the potential pathways and inter-relationships of the risk factors that contribute to the development of CKD in patients with T2DM.
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Affiliation(s)
- C-P Wang
- Department of Internal Medicine, Division of Cardiology, E-Da Hospital, I-Shou University, Kaohsiung, 82445, Taiwan; School of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung, 82445, Taiwan
| | - Y-C Lu
- Department of Internal Medicine, Division of Endocrinology and Metabolism, E-Da Hospital, I-Shou University, Kaohsiung, 82445, Taiwan; School of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung, 82445, Taiwan
| | - W-C Hung
- Department of Internal Medicine, Division of Cardiology, E-Da Hospital, I-Shou University, Kaohsiung, 82445, Taiwan; The School of Chinese Medicine for Post Baccalaureate, College of Medicine, I-Shou University, Kaohsiung, 82445, Taiwan
| | - I-T Tsai
- Department of Emergency Medicine, E-Da Hospital, I-Shou University, Kaohsiung, 82445, Taiwan; School of Medicine, College of Medicine, I-Shou University, Kaohsiung, 82445, Taiwan
| | - Y-H Chang
- Lee's Endocrinologic Clinic, Pingtung, 90000, Taiwan
| | - D-W Hu
- Lee's Endocrinologic Clinic, Pingtung, 90000, Taiwan
| | - C-C Hsu
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung, 82445, Taiwan; The School of Chinese Medicine for Post Baccalaureate, College of Medicine, I-Shou University, Kaohsiung, 82445, Taiwan; Health Examination Center, E-Da Dachang Hospital, Kaohsiung, Taiwan
| | - C-C Wu
- Department of Internal Medicine, Division of Cardiology, E-Da Hospital, I-Shou University, Kaohsiung, 82445, Taiwan; The School of Chinese Medicine for Post Baccalaureate, College of Medicine, I-Shou University, Kaohsiung, 82445, Taiwan; Division of Cardiology, Department of Internal Medicine, E-Da Cancer Hospital, Kaohsiung, 82445, Taiwan
| | - C-T Wei
- Division of General Surgery, Department of Surgery, E-Da Hospital, I-Shou University, Kaohsiung, 82445, Taiwan
| | - F-M Chung
- Department of Internal Medicine, Division of Cardiology, E-Da Hospital, I-Shou University, Kaohsiung, 82445, Taiwan
| | - Y-J Lee
- Lee's Endocrinologic Clinic, Pingtung, 90000, Taiwan.
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Byrne ME, Shank LM, Altman DR, Swanson TN, Ramirez E, Moore NA, Rubin SG, LeMay-Russell S, Parker MN, Kaufman RE, Yang SB, Torres SL, Brady SM, Kelly NR, Tanofsky-Kraff M, Yanovski JA. Inhibitory control and negative affect in relation to food intake among youth. Appetite 2021; 156:104858. [PMID: 32891676 PMCID: PMC7669609 DOI: 10.1016/j.appet.2020.104858] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 09/01/2020] [Accepted: 09/01/2020] [Indexed: 12/12/2022]
Abstract
Negative affect and poor inhibitory control are related to disinhibited eating behaviors in youth and may contribute to the development and/or maintenance of obesity. Although few studies have jointly examined these constructs in youth, it has been theorized that poor inhibitory control may be driven by negative affect. If supported, impaired inhibitory control, driven by negative affect, could represent a modifiable neurocognitive treatment target for disinhibited eating. The current study examined whether inhibitory control mediates the relationship between negative affect and eating among youth. Youth (8-17 years) participated in a Food Go/No-Go neurocognitive task to measure inhibitory control as the percentage of commission errors. A composite negative affect score was created from self-report measures of anxiety and depression. A laboratory buffet meal modeled to simulate disinhibited eating was used to measure total and snack food intake. Cross-sectional mediation models with bias-corrected bootstrap confidence intervals (CI) were conducted using negative affect as the independent variable, inhibitory control as the mediator, and intake patterns as dependent variables. One-hundred-eighty-one youths (13.2 ± 2.7y; 55% female; BMIz 0.6 ± 1.0) were studied. Total Go/No-Go commission errors mediated the relationship between negative affect and total intake (95%CI = [0.3, 31.6]), but not snack intake (95%CI = [-2.5, 7.3]). Commission errors for Food-Go blocks significantly mediated the relationship between negative affect and total intake (95%CI = [7.7, 44.4]), but not snack intake (95%CI = [-3.4, 9.5]). Commission errors on Neutral-Go blocks did not significantly mediate any of these relationships. Negative affect may lead to poorer inhibitory control as well as a stronger approach tendency toward food, increasing the likelihood of engaging in disinhibited eating. Future research should determine if, in combination with approaches to reduce negative affect, improved inhibitory control could help prevent overeating in youths with depressive or anxiety symptoms.
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Affiliation(s)
- Meghan E Byrne
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), USA; Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), USA
| | - Lisa M Shank
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), USA; Department of Medicine, USU, USA; Military Cardiovascular Outcomes Research (MiCOR), Metis Foundation, USA
| | - Deborah R Altman
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), USA
| | - Taylor N Swanson
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), USA; Military Cardiovascular Outcomes Research (MiCOR), Metis Foundation, USA
| | - Eliana Ramirez
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), USA
| | - Nia A Moore
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), USA
| | - Sarah G Rubin
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), USA
| | - Sarah LeMay-Russell
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), USA; Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), USA
| | - Megan N Parker
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), USA; Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), USA
| | - Rachel E Kaufman
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), USA
| | | | | | - Sheila M Brady
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), USA
| | - Nichole R Kelly
- Department of Counseling Psychology and Human Services, Prevention Science Institute, University of Oregon, USA
| | - Marian Tanofsky-Kraff
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), USA; Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), USA; Department of Medicine, USU, USA; Military Cardiovascular Outcomes Research (MiCOR), Metis Foundation, USA.
| | - Jack A Yanovski
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), USA
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Byrne ME, Shomaker LB, Brady SM, Kozlosky M, Yanovski JA, Tanofsky-Kraff M. Associations between latent trait negative affect and patterns of food-intake among girls with loss-of-control eating. Int J Eat Disord 2020; 53:618-624. [PMID: 32107799 PMCID: PMC8190819 DOI: 10.1002/eat.23253] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Revised: 02/13/2020] [Accepted: 02/14/2020] [Indexed: 01/06/2023]
Abstract
OBJECTIVE Momentary negative affect (NA) has been shown to predict eating patterns in the laboratory, yet, more stable mood states have not been studied in relation to eating patterns in the laboratory among youth at high risk for binge-eating disorder and obesity. METHOD One-hundred-eight adolescent girls (14.5 ± 1.7 years) with BMI between the 75th-97th percentile who reported loss-of-control (LOC)-eating completed measures of trait anxiety and depressive symptoms. Food-intake patterns were measured from a laboratory test meal (9,385 kcal). Latent factor analysis of depressive symptoms and trait anxiety was used to compute latent trait NA. Multivariate general linear models predicted total energy, snacks, and macronutrient intake from trait NA, adjusting for age, race, height, lean-mass, and percentage fat-mass. RESULTS Trait NA was significantly positively related to total energy-intake, and, specifically, snacks, sweet snacks, and percentage sweet fats (ps ≤ .03), and negatively related to percentage protein consumed (p = .04). DISCUSSION Expanding on affect theory, trait NA may relate to palatable food-intake among girls with LOC-eating. Further data are needed to determine whether those with LOC-eating and trait NA are at heightened risk for the development of binge-eating disorder and obesity.
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Affiliation(s)
- Meghan E. Byrne
- Department of Medical and Clinical Psychology and Medicine, Uniformed Services University of the Health Sciences (USU), 4301 Jones Bridge Road, Bethesda, MD, 20814,Section on Growth and Obesity, Program in Endocrinology, Metabolism and Genetics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD, 20892,Henry M. Jackson Foundation for the Advancement of Military Medicine (HJF), 6720A Rockledge Drive #100, Bethesda, MD, 20817, USA
| | - Lauren B. Shomaker
- Department of Human Development and Family Studies, College of Health and Human Sciences, Colorado State University, Fort Collins, CO, 80523
| | - Sheila M. Brady
- Section on Growth and Obesity, Program in Endocrinology, Metabolism and Genetics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD, 20892
| | - Merel Kozlosky
- Nutrition Department, Clinical Center, NIH, 10 Center Drive, Bethesda, MD, 20892
| | - Jack A. Yanovski
- Section on Growth and Obesity, Program in Endocrinology, Metabolism and Genetics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD, 20892
| | - Marian Tanofsky-Kraff
- Department of Medical and Clinical Psychology and Medicine, Uniformed Services University of the Health Sciences (USU), 4301 Jones Bridge Road, Bethesda, MD, 20814,Section on Growth and Obesity, Program in Endocrinology, Metabolism and Genetics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, 10 Center Drive, Bethesda, MD, 20892
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Armstrong B. Commentary: Reflecting on Holmbeck (2002): Making Advanced Quantitative Methods Approachable in Pediatric Psychology. J Pediatr Psychol 2019; 44:813-815. [PMID: 31073606 PMCID: PMC6655387 DOI: 10.1093/jpepsy/jsz035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 03/15/2019] [Accepted: 04/17/2019] [Indexed: 11/13/2022] Open
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Miettunen J, Nordström T, Kaakinen M, Ahmed AO. Latent variable mixture modeling in psychiatric research--a review and application. Psychol Med 2016; 46:457-467. [PMID: 26526221 DOI: 10.1017/s0033291715002305] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Latent variable mixture modeling represents a flexible approach to investigating population heterogeneity by sorting cases into latent but non-arbitrary subgroups that are more homogeneous. The purpose of this selective review is to provide a non-technical introduction to mixture modeling in a cross-sectional context. Latent class analysis is used to classify individuals into homogeneous subgroups (latent classes). Factor mixture modeling represents a newer approach that represents a fusion of latent class analysis and factor analysis. Factor mixture models are adaptable to representing categorical and dimensional states of affairs. This article provides an overview of latent variable mixture models and illustrates the application of these methods by applying them to the study of the latent structure of psychotic experiences. The flexibility of latent variable mixture models makes them adaptable to the study of heterogeneity in complex psychiatric and psychological phenomena. They also allow researchers to address research questions that directly compare the viability of dimensional, categorical and hybrid conceptions of constructs.
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Affiliation(s)
- J Miettunen
- Center for Life Course Epidemiology and Systems Medicine,University of Oulu,Oulu,Finland
| | - T Nordström
- Center for Life Course Epidemiology and Systems Medicine,University of Oulu,Oulu,Finland
| | - M Kaakinen
- Center for Life Course Epidemiology and Systems Medicine,University of Oulu,Oulu,Finland
| | - A O Ahmed
- Department of Psychiatry,Weill Cornell Medical College - Westchester Division,White Plains, NY,USA
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Kaczynski K, Gambhir R, Caruso A, Lebel A. Depression as a mediator of the relation between family functioning and functional disability in youth with chronic headaches. Headache 2015; 56:491-500. [DOI: 10.1111/head.12709] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/27/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Karen Kaczynski
- Division of Pain Medicine, Department of Anesthesiology, Perioperative and Pain Medicine; Children's Hospital Boston and Harvard Medical School; Boston MA USA
- Department of Psychiatry; Children's Hospital Boston and Harvard Medical School; Boston MA USA
| | - Rupa Gambhir
- Division of Pain Medicine, Department of Anesthesiology, Perioperative and Pain Medicine; Children's Hospital Boston and Harvard Medical School; Boston MA USA
- Department of Psychiatry; Children's Hospital Boston and Harvard Medical School; Boston MA USA
| | - Alessandra Caruso
- Division of Pain Medicine, Department of Anesthesiology, Perioperative and Pain Medicine; Children's Hospital Boston and Harvard Medical School; Boston MA USA
| | - Alyssa Lebel
- Division of Pain Medicine, Department of Anesthesiology, Perioperative and Pain Medicine; Children's Hospital Boston and Harvard Medical School; Boston MA USA
- Department of Neurology; Children's Hospital Boston and Harvard Medical School; Boston MA USA
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Karazsia BT, Berlin KS. Adding practical tools to our toolbox: introduction to the special issue on quantitative methodologies. J Pediatr Psychol 2015; 39:121-3. [PMID: 24578377 DOI: 10.1093/jpepsy/jsu001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Bryan T Karazsia
- PhD, Department of Psychology, The College of Wooster, Wooster, OH 44691, USA.
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Berlin KS, Williams NA, Parra GR. An Introduction to Latent Variable Mixture Modeling (Part 1): Overview and Cross-Sectional Latent Class and Latent Profile Analyses. J Pediatr Psychol 2013; 39:174-87. [DOI: 10.1093/jpepsy/jst084] [Citation(s) in RCA: 420] [Impact Index Per Article: 38.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Berlin KS, Parra GR, Williams NA. An Introduction to Latent Variable Mixture Modeling (Part 2): Longitudinal Latent Class Growth Analysis and Growth Mixture Models. J Pediatr Psychol 2013; 39:188-203. [DOI: 10.1093/jpepsy/jst085] [Citation(s) in RCA: 224] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
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12
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Karazsia BT, Berlin KS, Armstrong B, Janicke DM, Darling KE. Integrating Mediation and Moderation to Advance Theory Development and Testing. J Pediatr Psychol 2013; 39:163-73. [DOI: 10.1093/jpepsy/jst080] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Carona C, Crespo C, Canavarro MC. Similarities amid the difference: caregiving burden and adaptation outcomes in dyads of parents and their children with and without cerebral palsy. RESEARCH IN DEVELOPMENTAL DISABILITIES 2013; 34:882-893. [PMID: 23291505 DOI: 10.1016/j.ridd.2012.12.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2012] [Revised: 11/30/2012] [Accepted: 12/04/2012] [Indexed: 06/01/2023]
Abstract
This study had two main objectives: first, to examine the direct and indirect effects, via social support, of caregiving burden on the adaptation outcomes of children/adolescents with cerebral palsy and their parents; and second, to assess the invariance of such models in clinical vs. healthy subsamples. Participants were 210 dyads of children/adolescents and one of their parents (total N=420), divided in 93 dyads of children/adolescents with cerebral palsy and 117 dyads of children/adolescents with no medical diagnosis. Data on caregiving burden, social support and adaptation outcomes were obtained through self-report questionnaires. Caregiving burden was linked to parents and their children's psychological maladjustment and quality of life both directly (except for children's quality of life) and indirectly through social support. Findings were invariant across clinical and healthy subsamples. Caregiving burden may influence adaptation outcomes of children/adolescents with CP and their parents both directly and via their social support perceptions. These patterns are similar to those observed in typically developing children/adolescents.
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Affiliation(s)
- C Carona
- The University of Coimbra, Portugal.
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14
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Gardiner L, Akintola A, Chen G, Catania JM, Vaidya V, Burghardt RC, Bonventre JV, Trzeciakowski J, Parrish AR. Structural equation modeling highlights the potential of Kim-1 as a biomarker for chronic kidney disease. Am J Nephrol 2012; 35:152-63. [PMID: 22269876 DOI: 10.1159/000335579] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2011] [Accepted: 12/03/2011] [Indexed: 01/16/2023]
Abstract
BACKGROUND Chronic kidney disease (CKD) is a major public health problem, and despite continued research in the field, there is still a need to identify both biomarkers of risk and progression, as well as potential therapeutic targets. Structural equation modeling (SEM) is a family of statistical techniques that has been utilized in the fields of sociology and psychology for many years; however, its utilization in the biological sciences is relatively novel. SEM's ability to investigate complex relationships in an efficient, single model could be utilized to understand the progression of CKD, as well as to develop a predictive model to assess kidney status in the patient. METHODS Fischer 344 rats were fed either an ad libitum diet or a calorically restricted diet, and a time-course study of kidney structure and function was performed. EQS, a SEM software package, was utilized to generate five CKD models of the Fisher 344 rat and identify relationships between measured variables and estimates of kidney damage and kidney function. RESULTS All models identified strong relationships between a biomarker for CKD, kidney injury molecule-1 (Kim-1) and kidney damage, in the Fischer 344 rat CKD model. Models also indicate a strong relationship between age and renal damage and dysfunction. CONCLUSION SEM can be used to model CKD and could be useful to examine biomarkers in CKD patients.
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Affiliation(s)
- Lesley Gardiner
- College of Medicine, Texas A&M Health Science Center, Bryan, TX, USA
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Barnard-Brak L, Brak V. Pharmacotherapy and academic achievement among children with attention-deficit/hyperactivity disorder. J Child Adolesc Psychopharmacol 2011; 21:597-603. [PMID: 22196315 DOI: 10.1089/cap.2010.0127] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
This study examined the association of pharmacological treatments and academic achievement among children with attention-deficit/hyperactivity disorder (ADHD). Results examining the association of pharmacological treatments and academic achievement among children with ADHD are mixed. Our objective was to examine this association using structural equation modeling (SEM) techniques, which may be considered more sophisticated and advanced over traditional regression techniques. To achieve the purpose, we employed a sample of children with ADHD derived from the Early Childhood Longitudinal Study-Kindergarten (ECLS-K) data. The ECLS-K provides a large, community-based, nationally representative sample of children to examine across time with respect to academic achievement outcomes. The present study reveals a statistically nonsignificant association between pharmacological treatment and academic achievement among children with ADHD. These results derived from a large, community-based, nationally representative sample, using SEM techniques, may be considered highly generalizable.
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The concept of bootstrapping of structural equation models with smaller samples: an illustration using mealtime rituals in diabetes management. J Dev Behav Pediatr 2011; 32:619-26. [PMID: 21900827 DOI: 10.1097/dbp.0b013e31822bc74f] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The objective of this study was to offer a practical demonstration of the use of bootstrapping in structural equation modeling (SEM) with smaller samples by evaluating family dinnertime rituals at the intersection between the family social environment and pediatric type 1 diabetes mellitus management. METHOD Participants were 77 children and adolescents aged 6 to 18 years and their mothers from a larger study of child and parental challenges related to managing the treatment regimen and correlates of adherence. SEM was used to test a model of maternal reports of the family social environment as exogenous variables with mealtime rituals and child hemoglobin A1c levels as endogenous variables. The bootstrapping procedure and the Bollen-Stine bootstrapped χ test were then applied to test the stability and appropriateness of this model. RESULTS Using SEM, the final model had robust goodness-of-fit indicators and revealed that the family social environment characteristics of control and cohesion were related to mealtime rituals, which was associated with hemoglobin A1c levels. The bootstrapping procedure indicated that the parameter estimates were very stable, thus lending greater credence to the model. The Bollen-Stine approach provided evidence that the entire hypothesized model was not significantly different from the model derived from bootstrapping. CONCLUSIONS This investigation offers a practical demonstration of the bootstrapping technique and the Bollen-Stine approach for testing models on smaller samples in SEM. These techniques may be used with relatively small samples, which are common in developmental/behavioral pediatrics and pediatric psychology research.
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Barile JP, Kuperminc GP, Weintraub ES, Mink JW, Thompson WW. Thimerosal exposure in early life and neuropsychological outcomes 7-10 years later. J Pediatr Psychol 2011; 37:106-18. [PMID: 21785120 DOI: 10.1093/jpepsy/jsr048] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE The authors used a public use data set to investigate associations between the receipt of thimerosal-containing vaccines and immune globulins early in life and neuropsychological outcomes assessed at 7-10 years. METHODS The data were originally created by evaluating 1,047 children ages 7-10 years and their biological mothers. This study developed seven latent neuropsychological factors and regressed them on a comprehensive set of covariates and thimerosal exposure variables. RESULTS The authors found no statistically significant associations between thimerosal exposure from vaccines early in life and six of the seven latent constructs. There was a small, but statistically significant association between early thimerosal exposure and the presence of tics in boys. CONCLUSIONS This finding should be interpreted with caution due to limitations in the measurement of tics and the limited biological plausibility regarding a causal relationship.
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Affiliation(s)
- John P Barile
- Department of Psychology, Georgia State University, USA.
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Kaczynski KJ, Simons LE, Claar RL. Anxiety, Coping, and Disability: A Test of Mediation in a Pediatric Chronic Pain Sample. J Pediatr Psychol 2011; 36:932-41. [DOI: 10.1093/jpepsy/jsr024] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Nelson TD, Aylward BS, Rausch JR. Dynamic p-technique for modeling patterns of data: applications to pediatric psychology research. J Pediatr Psychol 2011; 36:959-68. [PMID: 21486938 DOI: 10.1093/jpepsy/jsr023] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE Dynamic p-technique (DPT) is a potentially useful statistical method for examining relationships among dynamic constructs in a single individual or small group of individuals over time. The purpose of this article is to offer a nontechnical introduction to DPT. METHOD An overview of DPT analysis, with an emphasis on potential applications to pediatric psychology research, is provided. To illustrate how DPT might be applied, an example using simulated data is presented for daily pain and negative mood ratings. RESULTS The simulated example demonstrates the application of DPT to a relevant pediatric psychology research area. In addition, the potential application of DPT to the longitudinal study of adherence is presented. CONCLUSION Although it has not been utilized frequently within pediatric psychology, DPT could be particularly well-suited for research in this field because of its ability to powerfully model repeated observations from very small samples.
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Affiliation(s)
- Timothy D Nelson
- Department of Psychology, University of Nebraska-Lincoln, Lincoln, NE 68588-0308, USA.
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Zocca JM, Shomaker LB, Tanofsky-Kraff M, Columbo KM, Raciti GR, Brady SM, Crocker MK, Ali AH, Matheson BE, Yanovski SZ, Yanovski JA. Links between mothers' and children's disinhibited eating and children's adiposity. Appetite 2010; 56:324-31. [PMID: 21182882 DOI: 10.1016/j.appet.2010.12.014] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2010] [Revised: 11/30/2010] [Accepted: 12/13/2010] [Indexed: 02/06/2023]
Abstract
Few studies have examined relationships between parents' and children's specific disinhibited eating behaviors. We investigated links among mothers' and children's binge/loss of control eating, eating in the absence of hunger, and children's adiposity in 305 non-treatment-seeking youth, aged 8-17 years (13.62±2.65 years; 49.8% female) and their mothers. Youths' loss of control eating and eating in the absence of hunger were assessed by interview and self-report questionnaire. Children's adiposity was assessed with BMI-z and air displacement plethysmography. Maternal binge eating, eating in the absence of hunger and highest, non-pregnant BMI were self-reported. In structural equation models controlling for mothers' BMI, mothers' binge eating related to children's loss of control eating, and mothers' eating in the absence of hunger related to children's eating in the absence of hunger. Mothers' binge eating and children's eating in the absence of hunger were unrelated, as were mothers' eating in the absence of hunger and children's loss of control. Further, mothers' binge eating was indirectly related to children's adiposity through children's loss of control eating. Likewise, mothers' eating in the absence of hunger indirectly related to children's adiposity through children's eating in the absence of hunger. Mothers and children share similar, specific disinhibited eating styles.
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Affiliation(s)
- Jaclyn M Zocca
- Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, DHHS, CRC Rm 1-3330, 10 Center Dr MSC 1103, Bethesda, MD 20892, USA
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Elliott CA, Tanofsky-Kraff M, Shomaker LB, Columbo KM, Wolkoff LE, Ranzenhofer LM, Yanovski JA. An examination of the interpersonal model of loss of control eating in children and adolescents. Behav Res Ther 2010; 48:424-8. [PMID: 20074702 DOI: 10.1016/j.brat.2009.12.012] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2009] [Revised: 11/16/2009] [Accepted: 12/22/2009] [Indexed: 10/20/2022]
Abstract
The interpersonal model of binge eating disorder proposes that social problems lead to negative affect which, in turn, precipitates binge eating episodes. However, no study to date has examined this model among youth who report loss of control (LOC) eating. Participants were 219 non-treatment-seeking children and adolescent volunteers, age 8-17 years (13.1 +/- 2.8 y; 50% female). Children's social problems were assessed by parent report. Youth completed self-report questionnaires of negative affect that assessed depressive symptoms and anxiety. Participants were interviewed to determine the presence or absence of LOC eating in the month prior to assessment. Structural equation modeling analyses found that social problems were positively related to LOC eating presence (p = .02). Negative affect mediated the relationship between social problems and LOC eating (95% CI Product = .00247, .01336). These preliminary results suggest that the interpersonal model of binge eating may describe one possible pathway for the development of LOC eating among non-treatment-seeking youth.
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Affiliation(s)
- Camden A Elliott
- Unit on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, DHHS, USA
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Annett RD, Turner C, Brody JL, Sedillo D, Dalen J. Using structural equation modeling to understand child and parent perceptions of asthma quality of life. J Pediatr Psychol 2009; 35:870-82. [PMID: 20026568 DOI: 10.1093/jpepsy/jsp121] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
OBJECTIVE Using structural equation modeling, test a conceptual model of associations between constructs predicting parent and child asthma quality of life. METHODS Children with a confirmed asthma diagnosis and their parents completed measures of health status and independently reported on psychological functioning, family functioning, and quality of life. RESULTS Measurement and structural models for predicting parent and child quality of life provided a good fit of data to the conceptual model. Parent and child independent reports of quality of life are dependent upon family functioning and child psychological functioning. Long-term asthma symptom control is the only health status variable that impacts quality of life. CONCLUSIONS With minor modifications, both parent and child data fit the conceptual model. Child psychological functioning and long-term asthma control jointly contribute to quality of life outcomes. Findings suggest that both acute and long-term asthma health status outcomes have different determinants.
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Affiliation(s)
- Robert D Annett
- Department of Pediatrics, University of New Mexico, Albuquerque, NM 87131-0001, USA.
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Mellins CA, Elkington KS, Bauermeister JA, Brackis-Cott E, Dolezal C, McKay M, Wiznia A, Bamji M, Abrams EJ. Sexual and drug use behavior in perinatally HIV-infected youth: mental health and family influences. J Am Acad Child Adolesc Psychiatry 2009; 48:810-819. [PMID: 19564801 PMCID: PMC3033727 DOI: 10.1097/chi.0b013e3181a81346] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE As perinatally human immunodeficiency virus (HIV)-infected (PHIV+) youths enter adolescence, they are at high risk for poor behavioral and health outcomes. This study examines relations between youth mental health problems and sexual and substance use risk behavior, the impact of caregiver mental health and family functioning on youth mental health and risk behavior outcomes, and the role of youth HIV status in this process. METHOD Participants were recruited from four medical centers. Individual interviews were administered to 193 PHIV+ and 127 perinatally HIV exposed but uninfected (PHIV-) 9- to 16-year-old boys and girls and their primary caregivers. Participants were primarily African American and Latino. The interview assessed child sexual and drug risk behavior, child and caregiver mental health, and family functioning. RESULTS Exploratory latent-variable structural equation modeling revealed no differences in rates of sexual risk behavior or substance use between PHIV+ and PHIV- youths. However, adolescent mental health was significantly associated with sexual risk behavior and substance use. Caregiver mental health was associated with youth mental health and indirectly with sexual risk behavior and drug use through its impact on youth mental health. Family functioning did not significantly predict youth outcomes. CONCLUSIONS Over and above other key environmental factors and family functioning, youth and caregiver mental health problems are related to sex and drug use risk behaviors in PHIV+ and PHIV- youths. Given high rates of youth and caregiver mental health problems in this population, family-based mental health interventions may be a key component of HIV prevention programs for perinatally HIV-exposed youth.
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Affiliation(s)
- Claude A Mellins
- Drs. Mellins, Elkington, Brackis-Cott, and Dolezal are with the HIV Center for Clinical and Behavioral Studies, Columbia University and New York State Psychiatric Institute. Dr. Bauermeister is with the Department of Health Behavior and Health Education, University of Michigan. Dr. McKay is with the Mount Sinai School of Medicine. Dr. Wiznia is with the Jacobi Medical Center, Albert Einstein College of Medicine. Dr. Bamji is with the NY Medical College, and Dr. Abrams is with the Harlem Hospital and Columbia University.
| | - Katherine S Elkington
- Drs. Mellins, Elkington, Brackis-Cott, and Dolezal are with the HIV Center for Clinical and Behavioral Studies, Columbia University and New York State Psychiatric Institute. Dr. Bauermeister is with the Department of Health Behavior and Health Education, University of Michigan. Dr. McKay is with the Mount Sinai School of Medicine. Dr. Wiznia is with the Jacobi Medical Center, Albert Einstein College of Medicine. Dr. Bamji is with the NY Medical College, and Dr. Abrams is with the Harlem Hospital and Columbia University
| | - Jose A Bauermeister
- Drs. Mellins, Elkington, Brackis-Cott, and Dolezal are with the HIV Center for Clinical and Behavioral Studies, Columbia University and New York State Psychiatric Institute. Dr. Bauermeister is with the Department of Health Behavior and Health Education, University of Michigan. Dr. McKay is with the Mount Sinai School of Medicine. Dr. Wiznia is with the Jacobi Medical Center, Albert Einstein College of Medicine. Dr. Bamji is with the NY Medical College, and Dr. Abrams is with the Harlem Hospital and Columbia University
| | - Elizabeth Brackis-Cott
- Drs. Mellins, Elkington, Brackis-Cott, and Dolezal are with the HIV Center for Clinical and Behavioral Studies, Columbia University and New York State Psychiatric Institute. Dr. Bauermeister is with the Department of Health Behavior and Health Education, University of Michigan. Dr. McKay is with the Mount Sinai School of Medicine. Dr. Wiznia is with the Jacobi Medical Center, Albert Einstein College of Medicine. Dr. Bamji is with the NY Medical College, and Dr. Abrams is with the Harlem Hospital and Columbia University
| | - Curtis Dolezal
- Drs. Mellins, Elkington, Brackis-Cott, and Dolezal are with the HIV Center for Clinical and Behavioral Studies, Columbia University and New York State Psychiatric Institute. Dr. Bauermeister is with the Department of Health Behavior and Health Education, University of Michigan. Dr. McKay is with the Mount Sinai School of Medicine. Dr. Wiznia is with the Jacobi Medical Center, Albert Einstein College of Medicine. Dr. Bamji is with the NY Medical College, and Dr. Abrams is with the Harlem Hospital and Columbia University
| | - Mary McKay
- Drs. Mellins, Elkington, Brackis-Cott, and Dolezal are with the HIV Center for Clinical and Behavioral Studies, Columbia University and New York State Psychiatric Institute. Dr. Bauermeister is with the Department of Health Behavior and Health Education, University of Michigan. Dr. McKay is with the Mount Sinai School of Medicine. Dr. Wiznia is with the Jacobi Medical Center, Albert Einstein College of Medicine. Dr. Bamji is with the NY Medical College, and Dr. Abrams is with the Harlem Hospital and Columbia University
| | - Andrew Wiznia
- Drs. Mellins, Elkington, Brackis-Cott, and Dolezal are with the HIV Center for Clinical and Behavioral Studies, Columbia University and New York State Psychiatric Institute. Dr. Bauermeister is with the Department of Health Behavior and Health Education, University of Michigan. Dr. McKay is with the Mount Sinai School of Medicine. Dr. Wiznia is with the Jacobi Medical Center, Albert Einstein College of Medicine. Dr. Bamji is with the NY Medical College, and Dr. Abrams is with the Harlem Hospital and Columbia University
| | - Mahrukh Bamji
- Drs. Mellins, Elkington, Brackis-Cott, and Dolezal are with the HIV Center for Clinical and Behavioral Studies, Columbia University and New York State Psychiatric Institute. Dr. Bauermeister is with the Department of Health Behavior and Health Education, University of Michigan. Dr. McKay is with the Mount Sinai School of Medicine. Dr. Wiznia is with the Jacobi Medical Center, Albert Einstein College of Medicine. Dr. Bamji is with the NY Medical College, and Dr. Abrams is with the Harlem Hospital and Columbia University
| | - Elaine J Abrams
- Drs. Mellins, Elkington, Brackis-Cott, and Dolezal are with the HIV Center for Clinical and Behavioral Studies, Columbia University and New York State Psychiatric Institute. Dr. Bauermeister is with the Department of Health Behavior and Health Education, University of Michigan. Dr. McKay is with the Mount Sinai School of Medicine. Dr. Wiznia is with the Jacobi Medical Center, Albert Einstein College of Medicine. Dr. Bamji is with the NY Medical College, and Dr. Abrams is with the Harlem Hospital and Columbia University
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Shomaker LB, Furman W. Interpersonal influences on late adolescent girls' and boys' disordered eating. Eat Behav 2009; 10:97-106. [PMID: 19447351 PMCID: PMC2706397 DOI: 10.1016/j.eatbeh.2009.02.003] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2008] [Revised: 01/30/2009] [Accepted: 02/12/2009] [Indexed: 11/20/2022]
Abstract
Perceived socio-cultural pressure to be thin has an important impact on disordered eating during early and middle adolescence, but less is known about late adolescence. Most prospective studies included only girls, and less is known about the influence on boys. This study investigated interpersonal influences on changes in late adolescent boys' and girls' symptoms of disordered eating over one year. Participants were a community sample of late adolescents 16-19 years of age (N=199; 49.75% girls), their mothers, and friends. Structural equation modeling revealed that interpersonal pressure to be thin and criticism about appearance predicted increases in disordered eating over time. Late adolescents', mothers' and friends' reports of pressure were associated with disordered eating at Time 1 and Time 2. Further, adolescents' perceptions and friends' reports of pressure to be thin predicted changes in disordered eating over time. Findings underscore the significance of interpersonal relationships for disordered eating during late adolescence in both girls and boys.
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Affiliation(s)
- Lauren B Shomaker
- Department of Psychology, University of Denver, 2155 South Race Street, Denver, CO 80208, United States.
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Kaczynski KJ, Claar RL, Logan DE. Testing Gender as a Moderator of Associations Between Psychosocial Variables and Functional Disability in Children and Adolescents with Chronic Pain. J Pediatr Psychol 2008; 34:738-48. [DOI: 10.1093/jpepsy/jsn113] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Peshkin BN, DeMarco TA, Garber JE, Valdimarsdottir HB, Patenaude AF, Schneider KA, Schwartz MD, Tercyak KP. Brief assessment of parents' attitudes toward testing minor children for hereditary breast/ovarian cancer genes: development and validation of the Pediatric BRCA1/2 Testing Attitudes Scale (P-TAS). J Pediatr Psychol 2008; 34:627-38. [PMID: 18385162 DOI: 10.1093/jpepsy/jsn033] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE Predictive genetic testing for hereditary breast/ovarian cancer risk (BRCA1/2 testing) is not recommended for minor children due to its lack of immediate medical benefit and potential psychological risk. Yet, tested mothers are often interested in learning about their children's cancer risks via pediatric BRCA1/2 testing, raising a host of bioethical concerns. However, no reliable or valid tool exists to formally gauge parents' interest in such testing. The aim of this study was to develop and evaluate a new measure for use in genetic research and consultation, known as the Pediatric BRCA1/2 Testing Attitudes Scale (P-TAS). METHODS After pretest genetic counseling and provision of a blood sample for BRCA1/2 testing, the P-TAS was administered to 187 mothers of children between 8- and 21-years-old. The measure was also given to 96 of the mothers' nontested co-parents. Analyses of the factor structure and psychometric properties of the measure were performed in mothers and confirmed in their co-parents. RESULTS The two factors of the P-TAS, labeled Attitudes and Beliefs (Factor 1) and Decision Making and Communication (Factor 2), accounted for 62.9% of the variance and were reliable (Cronbach's coefficient alphas =.70 and .90, respectively); the structure and properties were largely confirmed among co-parents. Validity was indicated through its convergence with related constructs. CONCLUSIONS This new tool may be integrated into genetic counseling research to better assess parents' attitudes and interests in pediatric BRCA1/2 testing. Such information may help guide ongoing discussions about the appropriateness of testing in adolescent or young adult children.
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