Examining profiles of convergence and divergence in reports of parental warmth: Links to adolescent developmental problems

Parental warmth during the transition from childhood to adolescence is a key protective factor against a host of adolescent problems, including substance use, maladjustment, and diminished well-being. Moreover, adolescents and parents often disagree in their perceptions of parenting quality, and these discrepancies may confer risk for problem outcomes. The current study applies latent profile analysis to a sample of 687 mother-father-6th grade adolescent triads to identify patterns of adolescent-parent convergence and divergence in perceptions of parental warmth. Five profiles were identified, and associations with adolescent positive well-being, substance use, and maladjustment outcomes in 9th grade were assessed. Patterns of divergence in which adolescents had a pronounced negative perception of parental warmth compared to parents, as well as those wherein pronounced divergence was present in only one adolescent-parent dyad, were associated with diminished positive well-being compared to adolescents who had more positive perceptions of warmth than parents. Having more negative perceptions of warmth compared to parents was also associated with elevated risk for alcohol and marijuana initiation, but only when the divergence was pronounced rather than more moderate. These findings add nuance to findings from previous between-family investigations of informant discrepancies, calling for further family-centered methods for investigating multiple perspectives.

Association between Food Insecurity and Depressive Symptoms in College Students Before and During the COVID-19 Pandemic

Objectives

To examine the change in the relationship between food insecurity and risk of depression pre-COVID and during COVID periods in college students.

Methods

We conducted secondary data analysis of 1,004 undergraduate students from the Penn State College Relationships and Experiences (CORE) project. Students were surveyed in November 2019 (Wave 1) and followed up in May 2020 (Wave 2). A binary indicator of elevated risk for depression was created using data collected via the shortened Center for Epidemiologic Studies Depression Scale at both waves. Food insecurity was measured by 2-item Food Insecurity screen at both waves and was coded as a binary indicator. Cross-sectional analysis of each wave was conducted using logistic regression models to estimate elevated risk for depression as a function of food insecurity status. Longitudinal analysis was conducted to estimate elevated risk of depression at wave 2 as a function of the change in food insecurity status from wave 1 to wave 2. The models were adjusted for depression diagnosis at wave 1, living situation, gender, age, and race.

Results

At Wave 1, 28.2% of students were food insecure and 56.6% had elevated depression risk. Food insecurity was lower at wave 2 (14.3%) whereas proportion of elevated depression risk was slightly higher (63.4%). 26.4% of students changed from low risk of depression at Wave 1 to an elevated risk of depression at wave 2. Compared to the food secure referent, food insecure students were about 2 times more likely to have an elevated risk of depression at Wave 1 (OR = 2.30, 95%CI: 1.74, 3.8) and Wave 2 (OR = 2.10, 95%CI: 1.06, 4.42). Compared to those who stayed food secure, the students who changed from food insecure to food secure and those who remained food insecure were 2.08 (CI 1.05–4.30) times and 3.03 (1.23–8.34) times more likely to have elevated depression risk at wave 2 respectively.

Conclusions

College students who experienced food insecurity before the COVID pandemic were more likely to an elevated risk of depression before and during the COVID pandemic.

Funding Sources

The Pennsylvania State University National Institute on Drug Abuse (NIDA) K01 National Institute on Alcohol Abuse and Alcoholism (NIAAA) The Broadhurst Career Development Professorship for the Study of Health Promotion and Disease Prevention.

College Students' Sense of Belonging and Mental Health Amidst the COVID-19 Pandemic

PURPOSE

Social isolation, anxiety, and depression have significantly increased during the COVID-19 pandemic among college students. We examine a key protective factor-students' sense of belonging with their college-to understand (1) how belongingness varies overall and for key sociodemographic groups (first-generation, underrepresented racial/ethnic minority students, first-year students) amidst COVID-19 and (2) if feelings of belonging buffer students from adverse mental health in college.

METHODS

Longitudinal models and regression analysis was assessed using data from a longitudinal study of college students (N = 1,004) spanning (T1; Fall 2019) and amidst COVID-19 (T2; Spring 2020).

RESULTS

Despite reporting high levels of belonging pre- and post-COVID, consistent with past research, underrepresented racial/ethnic minority/first-generation students reported relatively lower sense of belonging compared to peers. Feelings of belonging buffered depressive symptoms and to a lesser extent anxiety amidst COVID among all students.

CONCLUSIONS

College students' sense of belonging continues to be an important predictor of mental health even amidst the pandemic, conveying the importance of an inclusive climate.

Depression and marijuana use disorder symptoms among current marijuana users

BACKGROUND

Depression is one of the most consistent risk factors implicated in both the course of escalating substance use behaviors and in the development of substance dependence symptoms, including those associated with marijuana use. In the present study, we evaluate if depression is associated with marijuana use disorder symptoms across the continuum of marijuana use frequency.

METHODS

Data were drawn from six annual surveys of the National Survey of Drug Use and Health to include adults who reported using marijuana at least once in the past 30days (N=28,557).

RESULTS

After statistical control for sociodemographic characteristics and substance use behaviors including marijuana use, alcohol use, smoking, and use of illicit substances other than marijuana, depression was positively and significantly associated with each of the marijuana use disorder symptoms as well as the symptom total score. Adult marijuana users with depression were consistently more likely to experience marijuana use disorder symptoms and a larger number of symptoms, with the magnitude and direction of the relationship generally consistent across all levels of marijuana use frequency from 1day used in the past month to daily marijuana use.

CONCLUSIONS

Depression is a consistent risk factor for marijuana use disorder symptoms over and above exposure to marijuana suggesting that depressed individuals may represent an important subgroup in need of targeted substance use intervention.

Heterogeneity of alcohol, tobacco, and other substance use behaviors in U.S. college students: A latent class analysis

PURPOSE

To identify subgroups of college students with distinct profiles of traditional and alternative types of tobacco, alcohol, and other substance use and to examine how demographic characteristics and academic and social activities are associated with subgroup membership.

METHODS

We used latent class analysis to characterize subgroups of individuals in their fourth-year of college based on their patterns of seven substance use behaviors: extreme heavy episodic drinking (HED), cigarette use, cigar/cigarillo/little cigar use, smokeless tobacco use, hookah use, marijuana use, and non-medical prescription drug use. Demographic characteristics and academic and social activities were then incorporated as predictors of these latent classes.

RESULTS

We identified five classes defined by unique behavior patterns: (1) Non/Low Users, (2) Non-Hookah Tobacco Users, (3) Extreme HED & Marijuana Users, (4) Hookah and Marijuana Users, and (5) Poly-Substance Users. Being male, older, and involved in sports were associated with greater odds of being in the Poly-Substance User class compared to the Low/No User class, and participating in an honors society and reporting more positive peer relationships were associated with being in the Hookah and Marijuana User class compared to the Low/No User class.

CONCLUSION

Our findings of unique characteristics in the subgroups identified suggest that college substance users are a heterogeneous population requiring different targeted interventions. Of particular concern are subgroups with high rates of alternative tobacco products, as perceived risks of use may be inaccurate and this is not currently a focus of college substance use prevention interventions.

Time-varying effects of a text-based smoking cessation intervention for urban adolescents

INTRODUCTION

Craving to smoke is understood as an important mechanism for continued smoking behavior. Identifying how smoking interventions operate on craving with particular populations is critical for advancing intervention science. This study's objective was to investigate the time-varying effect of a text-delivered smoking cessation intervention.

METHODS

Toward this end, we used ecological momentary assessment (EMA) data collected from a five-day, automated text-messaging smoking cessation randomized clinical trial with 200 urban adolescents. We employed a time-varying effect model (TVEM) to estimate the effects of stress (time-varying covariate) and baseline nicotine dependence level (time-invariant covariate) on craving over six months by treatment condition. The TVEM approach models behavioral change and associations of coefficients expressed dynamically and graphically represented as smooth functions of time.

RESULTS

Controlling for gender, age, and current smoking, differences in trajectories of craving between intervention and control conditions were apparent over the course of the study. During months 2 to 3, the association between stress and craving was significantly stronger among the control group, suggesting treatment dampens this association during this time period. The intervention also reduced the salience of baseline dependence among treatment adolescents, with craving being reduced steadily over time, while the control group increased craving over time.

CONCLUSIONS

These results provide insight into the time-varying nature of treatment effects for adolescents receiving a text-based smoking cessation intervention. The ability to specify when in the course of an intervention the effect is strongest is important in developing targeted and adaptive interventions that can adjust strategically with time.

STRUCTURE OF THE UNIVERSITY PERSONALITY INVENTORY FOR CHINESE COLLEGE STUDENTS

The University Personality Inventory, a mental health instrument for college students, is frequently used for screening in China. However, its unidimensionality has been questioned. This study examined its dimensions to provide more information about the specific mental problems for students at risk. Four subsamples were randomly created from a sample (N = 6,110; M age = 19.1 yr.) of students at a university in China. Principal component analysis with Promax rotation was applied on the first two subsamples to explore dimension of the inventory. Confirmatory factor analysis was conducted on the third subsample to verify the exploratory dimensions. Finally, the identified factors were compared to the Symptom Checklist-90 (SCL-90) to support validity, and sex differences were examined, based on the fourth subsample. Five factors were identified: Physical Symptoms, Cognitive Symptoms, Emotional Vulnerability, Social Avoidance, and Interpersonal Sensitivity, accounting for 60.3% of the variance. All the five factors were significantly correlated with the SCL-90. Women scored significantly higher than men on Cognitive Symptoms and Interpersonal Sensitivity.

Early lapses in a cessation attempt: lapse contexts, cessation success, and predictors of early lapse

INTRODUCTION

The great majority of smokers relapse when they make quit attempts. Therefore, understanding the process of relapse may guide the development of more effective smoking cessation or relapse prevention treatments. The goal of this research is to extend our understanding of the context of initial lapses that occur within 8 weeks of quitting by using more comprehensive assessments of context, a contemporary sample, and sophisticated analytic techniques.

METHODS

Participants from a randomized controlled smoking cessation trial completed baseline assessments of demographics and tobacco dependence, a daily smoking calendar to determine latency to lapse and relapse (7 consecutive days of smoking), and an assessment of initial lapse context (affect, location, activity, interpersonal, smoke exposure, and cigarette availability). Latent class analysis (LCA) was used to analyze the 6 early lapse (within the first 8 weeks; N = 551) context dimensions; logistic regression and Cox regression were used to relate context to cessation outcomes.

RESULTS

LCA revealed 5 distinct initial lapse context classes (talking, with friends, angry; social; alone; with spouse, angry; and with smoking spouse) that were differentially related to cessation outcome. The easy availability of cigarettes characterized almost 75% of lapses, but being with friends, drinking, and not being at home were associated with a lower likelihood of progression to relapse.

CONCLUSIONS

Early lapsing is highly related to ultimate relapse, and lapsing in frequently experienced contexts seemed most strongly linked with progression to full relapse.

Molecular aspects involved in swimming exercise training reducing anhedonia in a rat model of depression

Patients suffering from depression frequently display hyperactivity of the hypothalamic-pituitary-adrenal axis (HPA) resulting in elevated cortisol levels. One main symptom of this condition is anhedonia. There is evidence that exercise training can be used as a rehabilitative intervention in the treatment of depressive disorders. In this scenario, the aim of the present study was to assess the effect of an aerobic exercise training protocol on the depressive-like behavior, anhedonia, induced by repeated dexamethasone administration. The study was carried out on adult male Wistar rats randomly divided into four groups: the "control group" (C), "exercise group" (E), "dexamethasone group" (D) and the "dexamethasone plus exercise group" (DE). The exercise training consisted of swimming (1 h/d, 5 d/wk) for 3 weeks, with an overload of 5% of the rat body weight. Every day rats were injected with either dexamethasone (D/DE) or saline solution (C/E). Proper positive controls, using fluoxetine, were run in parallel. Decreased blood corticosterone levels, reduced adrenal cholesterol synthesis and adrenal weight (HPA disruption), reduced preference for sucrose consumption and increased immobility time (depressive-like behavior), marked hippocampal DNA oxidation, increased IL-10 and total brain-derived neurotrophic factor (BDNF; pro-plus mature-forms) and a severe loss of body mass characterized the dexamethasone-treated animals. Besides increasing testosterone blood concentrations, the swim training protected depressive rats from the anhedonic state, following the same profile as fluoxetine, and also from the dexamethasone-induced impaired neurochemistry. The data indicate that physical exercise could be a useful tool in preventing and treating depressive disorders.

Medical decision-making capacity in mild cognitive impairment: a 3-year longitudinal study

OBJECTIVE

To investigate longitudinal change in the medical decision-making capacity (MDC) of patients with amnestic mild cognitive impairment (MCI) under different consent standards.

METHODS

Eighty-eight healthy older controls and 116 patients with MCI were administered the Capacity to Consent to Treatment Instrument at baseline and at 1 to 3 (mean = 1.7) annual follow-up visits thereafter. Covariate-adjusted random coefficient regressions were used to examine differences in MDC trajectories across MCI and control participants, as well as to investigate the impact of conversion to Alzheimer disease on MCI patients' MDC trajectories.

RESULTS

At baseline, MCI patients performed significantly below controls only on the three clinically relevant standards of appreciation, reasoning, and understanding. Compared with controls, MCI patients experienced significant declines over time on understanding but not on any other consent standard. Conversion affected both the elevation (a decrease in performance) and slope (acceleration in subsequent rate of decline) of MCI patients' MDC trajectories on understanding. A trend emerged for conversion to be associated with a performance decrease on reasoning in the MCI group.

CONCLUSIONS

Medical decision-making capacity (MDC) decline in mild cognitive impairment (MCI) is a relatively slow but detectable process. Over a 3-year period, patients with amnestic MCI show progressive decline in the ability to understand consent information. This decline accelerates after conversion to Alzheimer disease (AD), reflecting increasing vulnerability to decisional impairment. Clinicians and researchers working with MCI patients should give particular attention to the informed consent process when conversion to AD is suspected or confirmed.

Medical decision-making capacity in patients with mild cognitive impairment

OBJECTIVES

To empirically assess the capacity of patients with amnestic mild cognitive impairment (MCI) to consent to medical treatment under different consent standards (Ss).

METHODS

Participants were 56 healthy controls, 60 patients with MCI, and 31 patients with mild Alzheimer disease (AD). Each participant was administered the Capacity to Consent to Treatment Instrument (CCTI) and a comprehensive neuropsychological battery. Group differences in performance on the CCTI and neuropsychological variables were examined. In addition, the capacity status (capable, marginally capable, or incapable) of each MCI participant on each CCTI standard was examined using cut scores derived from control performance.

RESULTS

Patients with MCI performed comparably to controls on minimal consent standards requiring merely expressing a treatment choice (S1) or making the reasonable treatment choice [S2], but significantly below controls on the three clinically relevant standards of appreciation (S3), reasoning (S4), and understanding (S5). In turn, the MCI group performed significantly better than the mild AD group on [S2], S4, and S5. Regarding capacity status, patients with MCI showed a progressive pattern of capacity compromise (marginally capable and incapable outcomes) related to stringency of consent standard.

CONCLUSIONS

Patients with amnestic mild cognitive impairment (MCI) demonstrate significant impairments on clinically relevant abilities associated with capacity to consent to treatment. In obtaining informed consent, clinicians and researchers working with patients with MCI must consider the likelihood that many of these patients may have impairments in consent capacity related to their amnestic disorder and related cognitive impairments.

[Prevention of ischemic colitis following aortic reconstruction: personal experience of the role of transmural oximetry in the decision for inferior mesenteric artery reimplantation]

BACKGROUND

The colonic ischemic necrosis is one of the most serious complication in the surgical reconstruction of abdominal aorta aneurysm (AAA) due to surgical inappropriate binding of the inferior mesenteric artery (IMA).

METHODS

A retrospective analyzed of a group of 118 infrarenal AAA surgically treated is presented.

RESULTS

The most common cause of ischemic colitis (75% of cases) is the surgical binding of an opened IMA or its failed reimplantation.

CONCLUSIONS

In this paper according to their personal experience and the literature data, the authors outline a diagnostic behaviour to select the patients needing the reimplantation of IMA; they suggest to complete the pre operative information with an instrumental evaluation during the surgical treatment.

Improvement of diabetic autonomic gustatory sweating by botulinum toxin type A

Fourteen diabetic subjects with gustatory sweating were treated by intracutaneous injections of botulinum toxin type A into the affected facial skin areas. In all subjects, sweating (measured by Minor starch iodine test) ceased within 4 days, with the maximal follow-up time lasting 24 weeks. This therapeutic approach, which could be used to reduce the severity of diabetic gustatory sweating, appears to be long lasting, adverse effect free, and minimally invasive.

Changes in children's self-competence and values: gender and domain differences across grades one through twelve

This study extended previous research on changes in children's self-beliefs by documenting domain-specific growth trajectories for 761 children across grades 1 through 12 in a longitudinal study of perceptions of self-competence and task values. Hierarchical Linear Modeling was used to (1) describe changes in beliefs across childhood and adolescence within the domains of mathematics, language arts, and sports; (2) examine the impact of changes in competence beliefs on changes in values over time in the same domains; and (3) describe gender differences in mean levels and trajectories of change in competence beliefs and values. The most striking finding across all domains was that self-perceptions of competence and subjective task values declined as children got older, although the extent and rate of decline varied across domains. For example, in language arts, competence beliefs declined rapidly during the elementary school years, but then leveled off or increased to some extent; whereas the decline in self-competence beliefs in sports accelerated during the high school years. Significant gender differences in beliefs were found in most domains; however, the gender differences in developmental trajectories appeared to be domain specific rather than global. Importantly, the gender differences between boys and girls did not systematically increase with age, as predicted by some socialization perspectives. Adding competence beliefs as an explanatory variable to the model for task values revealed that changes in competence beliefs accounted for much of the age-related decline in task values. In addition, competence beliefs accounted for most of the gender differences in task values for language arts and sports.

Clinical and molecular analysis of 11 Sicilian SCA2 families: influence of gender on age at onset

Autosomal dominant cerebellar ataxias (ADCAs) are a complex group of slowly progressive neurodegenerative disorders characterized by gait and stance ataxia, dysarthria and other symptoms of nervous system involvement. ADCA type I is the commonest form and is genetically heterogeneous; several loci have been identified. Spinocerebellar ataxia type 2 (SCA2) has been mapped to chromosome 12, with expanded cytosine-adenine-guanine (CAG) repeats being identified as the mutational cause of the disease. We investigated 15 families, all originating from mid-eastern Sicily, with ADCA type I; molecular studies performed in 12 families showed the SCA2 mutation to be present in 11 of them (91.6%) - the highest occurrence so far reported in the literature. The CAG repeat of the affected alleles varied between 34 and 44 repeats. Age at onset and repeat length revealed an inverse correlation. Mean age at onset was 37.32 +/- 16. 74 years, and occurred earlier in males than in females. There were no differences in mean CAG repeat units between the sexes. However, a higher instability of CAG repeats was observed for paternal transmission than for maternal transmission. Age at onset and anticipation were not related to parental transmission. Our data suggest that in SCA2 an unknown sex-linked factor may play a role in the modulation of toxic effects of the polyglutamine tract.

Body Polarity and Mineral Selectivity in the Demosponge Chondrosia reniformis

The skeleton of the common Mediterranean demosponge Chondrosia reniformis lacks endogenous spicules; but exogenous siliceous material is selectively incorporated into its collagenous ectosome, strengthening this layer. Nevertheless, the settling of sponge buds during asexual reproduction necessitates an active incorporation of the calcareous substratum through the sponge lower ectosome. This fact suggests the presence of a polarity in the sponge, with the lower surface selecting primarily carbonates, and the upper surface selecting exclusively silicates and quartz. Our observations under experimental conditions showed that the strong selectivity of the upper ectosome is realized only when the sponge is fixed to the substratum; if detached, the sponge incorporates both quartz and carbonates. In laboratory experiments, the incapacity of both kinds of ectosome to regenerate into a new complete sponge suggests that this polarity arises early in ontogeny.

Leukoaraiosis and lacunar infarcts in ischemic stroke: role of age and vascular risk factors

To assess the role that age and some vascular risk factors play in the pathogenesis of leukoaraiosis and lacunar infarcts in patients with ischemic stroke, we examined 71 consecutive patients who had undergone magnetic resonance imaging because of clinical suspicion of stroke. We collected data regarding hypertension, diabetes mellitus, cardiac diseases, hypercholesterolemia, and hematocrit, and compared patients with lacunar infarcts to those with cortical or subcortical nonlacunar lesions. Patients were then assigned to one of two age groups, Group A (< or = 66 years), or Group B (> 66 years). We found a significant correlation between the presence and severity of leukoaraiosis and the presence of lacunar infarcts in both groups. In Group A, however, lacunar infarcts were correlated to hematocrit, while in Group B they were correlated to a trend to hypertension. Leukoaraiosis was correlated to hypertension only in Group A. Although we noted a strong correlation between leukoaraiosis and lacunar infarcts suggesting a common small-vessel disease, our data indicate that different pathogenetic mechanisms are involved. We suggest that patients be grouped according to age in future studies on the role that risk factors play in the pathogenesis of leukoaraiosis and lacunar infarcts.

[Echo-Doppler, exercise test, NMR in the follow-up of surgically treated aortic coarctation]

Persistent hypertension is one of the causes of sudden death which sometimes happens in patients operated on for coarctation of the aorta. Seven patients operated on for coarctation of the aorta were examined using exercise testing (Treadmill-Bruce), Echo-Doppler and NMR. Pressure gradients between the right upper and lower limbs were compared with those of normal young people and evaluated using NMR. The authors conclude that the patients operated on have resting blood pressure and pressure gradients, both resting and during exercise, greater than normal. Some patients operated on, with normal resting blood pressure and a slight gradient, can develop hypertension during exercise and a significant pressure gradient. Significant gradients during exercise are correlated to isthmic obstruction which is visible on the NMR. Follow-up after surgical repair of coarctation of the aorta cannot exclude measurement of exercise pressure gradients. This gives more physiological information compared with pressure gradients measured at rest.

[The use of high-field magnetic resonance in the follow-up of patients with mechanic aortic valve prosthesis and composite aortic tubular prosthesis]

Eleven patients who had undergone cardiac surgery were studied by means of high-field MR imaging (1.5 T). Six patients had had aortic root and valve replaced with a Björk-Shiley (BS) composite tubular aortic graft prosthesis for acute dissection of ascending aorta. In the other 5 patients with rheumatic calcific aortic disease, the valve had been replaced with a BS prosthesis. As a whole, MRI studies were 14. Previous evaluations of magnetic field effects had seem carried out ex vivo on both BS valves and BS composite prostheses, on surgical ligation clips (Tantalium and Stainless) and on stainless wires for sternal closure. In 4 patients (2 BS composite grafts and 2 BS valves) MRI diagnosed chronic dissection of both arch and descending aorta. In 1 of them, with a BS valve, associated localized acute dissection of ascending aorta was observed. In 3 patients with BS composite grafts, MRI revealed pseudo-aneurysms (including a thrombosed one) at the graft level. In one case MRI was repeated 4 times and was very helpful in monitoring the pseudo-aneurysm. MRI showed pericardial hematoma in 2 patients with BS grafts and paravalvular abscess in a case with BS valve. In one patient with BS valve fast-imaging MR revealed severe aortic regurgitation. No adverse reactions were demonstrated on MR images of prosthetic implants. MRI artifacts were insignificant with the spin-echo technique, while the fast-imaging technique showed clear image distortion at the valve level.