On the joys of missing data

Substance Use and Healthcare Utilization Across the Pre-Exposure Prophylaxis (PrEP) Care Cascade among Black and Latino Men Who Have Sex with Men

Background: Despite the documented efficacy of pre-exposure prophylaxis (PrEP) for HIV prevention, large disparities in uptake and adherence exist among Black and Latino/Hispanic men who have sex with men (BLMSM). Limited data exists among BLMSM on the impact of substance use at different stages of the PrEP Care Cascade. We examined the ways substance (alcohol, cannabis, other drug) use is related to PrEP experiences across the PrEP Care Cascade (PrEP aware/no use; PrEP use/discontinuation; PrEP use/adherent).Methods: We utilized data from a national sample of 908 BLMSM (Mage = 25.17, range: 18-29), collected between February and October 2020.Results: We found that heavier alcohol use, more other drug (e.g., cocaine) use, more participant healthcare utilization, and higher number of partners across all measures of substance use were separately associated with a lower likelihood of being aware of PrEP. These same factors were also associated with a higher likelihood of PrEP adherence. Conversely, only cannabis use was associated with discontinuation of PrEP use.Conclusions: While we confirm some earlier findings (i.e., alcohol use is associated with both PrEP discontinuation and PrEP use), we newly identify cannabis as a barrier to the adherence of PrEP. Our findings highlight the need for improved PrEP interventions to increase awareness among BLMSM with substance use who are among the most at-risk for HIV infection.

Alcohol Use Motives and Cannabis Use among Young Adults: Between- and Within-Person Associations Based on Monthly Data from a Community Sample

Objective: Alcohol use motives may characterize types of drinking that have unique associations with cannabis use and illuminate psychological processes underlying cannabis use. This study examined how alcohol use motives, both on average across two years and in a particular month, were associated with any and frequent cannabis use. Method: A young adult community sample (n = 486; 54% female, age 18-23 at enrollment) who used alcohol and cannabis in the year prior to study enrollment provided two years of monthly data. Multilevel logistic regression models predicting any and frequent (10+ occasions) past-month cannabis use estimated both between- and within-person effects of alcohol use motives, controlling for frequency of alcohol use and demographic covariates. Results: Alcohol use frequency was positively associated with any cannabis use at the between- and within-person levels and frequent cannabis use at the within-person level. Across two years, individuals who had higher average coping drinking motives and lower average social and conformity drinking motives were more likely to use cannabis frequently. Further, between-person variation in social motives was negatively associated with any cannabis use. Within-person, months with greater enhancement and social motives were associated with higher probability of any cannabis use. Conclusions: Using alcohol for coping reasons, rather than other-focused social reasons, indicated greater risk for frequent cannabis use, although drinking for social and enhancement reasons in a particular month signaled slightly increased short-term probability of any cannabis use. Assessment of alcohol motives may help guide targeting and timing of prevention related to cannabis use.

Maternal History of Child Sexual Abuse and Maladaptive Outcomes in Sexually Abused Children: The Role of Maternal Mental Health

The effects of child sexual abuse (CSA) have been found to surpass generations as maternal history of CSA is associated with increased difficulties in sexually abused children. However, little is known about the mechanisms underlying this association. The present study aimed to test maternal mental health symptoms including psychological distress, post-traumatic stress disorder (PTSD) symptoms, and dissociation as mediators of the relationship between maternal CSA and children's internalizing, externalizing, and dissociation symptoms in a large sample of sexually abused children. A total of 997 sexually abused children aged 3-14 years old and their mothers were recruited at five specialized intervention centers offering services to sexually abused children and their families. The children were divided into two groups depending on their mothers' self-reported history of CSA. Mothers completed a series of questionnaires assessing their mental health and children's functioning. Maternal history of CSA was associated with increased maternal psychological distress, PTSD symptoms, and dissociation following children's disclosure of CSA. In turn, maternal psychological distress and maternal dissociation were associated with increased child internalizing, externalizing, and dissociation symptoms. Maternal PTSD symptoms were associated with child internalizing symptoms. Maternal mental health difficulties mediated the association between maternal CSA and sexually abused children's maladaptive outcomes. Clinicians should assess for possible history of CSA in mothers of sexually abused children and determine how best to support them to cope with the aftermaths of their child's disclosure and with their own traumatic past.

Stress development during emergency remote teaching in higher education

Higher education includes e-learning in addition to on-site learning. Still, the shift to Emergency Remote Teaching (ERT) as reaction to the Covid-19 pandemic in the summer semester 2020, presented a challenging situation for students. Cross-sectional studies pointed towards higher stress levels of students. However, only a few studies addressed the development of students' stress across several dimensions (joy, worry, tension, demands) within one semester. The current study analyzed trajectories of stress in ERT in relation to age, gender, digital readiness, and experience of loneliness, based on a sample of N = 2795 German students. Latent Growth Curve Models (LGCM) revealed a significant increase in demands, tension and worries and a decrease in joy during the summer term 2020. The development of tension and demands was influenced by age, gender, digital readiness, and loneliness. The decrease in joy and increase in worries could be primarily attributed to digital readiness and loneliness.

Change in measures of moral function following acute bouts of Marine Corps Martial Arts Training

The Marine Corps Martial Arts Program (MCMAP) was developed to prepare Marines for complex battlefield situations that include hand-to-hand combat and ethical decision making. The objective of this study was to quantify changes in ethical decision-making following MCMAP training. Fifty-five, active duty, newly enlisted U.S. Marines (Males: n = 37; age = 19 ± 1 years; height = 176 ± 7 cm; mass = 74 ± 7 kg; Females: n = 18; age = 20 ± 2 years; height = 164 ± 6 cm; mass = 61 ± 6 kg) volunteered for this investigation and were assessed three times over 6 weeks, with 3 weeks between each visit, using serial blood samples for cortisol, norepinephrine, and epinephrine collected before training and during recovery [Immediate Post (IP), 15, 30, 45 and 60 min]. The Moral Functioning Continuum was used to quantify moral function before training, IP, 30, and 60 min post. Moral intention exhibited an acute response to training with significantly impaired decision making immediately post training. Moreover, both moral intention and moral judgement worsened over the visits suggesting a chronic impairment related to time in training suggesting a functional change in ethical decision-making following acute bouts of MCMAP.

Reciprocal Influences among Marital Relationship, Parent-Adolescent Relationship, and Youth Depressive Symptoms

OBJECTIVE

Drawing on family systems framework, this study investigated the reciprocal prospective associations between marital relationship quality, parent-adolescent closeness and conflict, and adolescent depressive symptoms among families in Taiwan.

BACKGROUND

The family systems theory posits reciprocity between family subsystems. However, the direction of influences between marital relationship quality, parent-adolescent relationship quality and adolescent well-being may be more unidirectional in Chinese societies due to hierarchical family values.

METHOD

Data were from a longitudinal survey of 2,292 parent-youth dyads in the Taiwan Youth Project. Cross-lagged path models were used to test the bidirectional associations between marital relationship quality, parent-adolescent closeness and conflict, and adolescent depressive symptoms from ages 12 to 18.

RESULTS

Our primary hypothesis that marital relationship quality predicts parent-adolescent relationship quality, which then predicts adolescent depressive symptoms in a unidirectional manner was partially substantiated. Moreover, marital relationship quality directly predicted fewer depressive symptoms from middle to late adolescence and indirectly from early to late adolescence via parent-adolescent relationship quality in middle adolescence. We also found that child depressive symptoms predicted less parent-adolescent closeness, and more conflicts which predicted poorer marital relationship quality, particularly in early adolescence.

CONCLUSION

Extending the family systems theory, findings suggest that marital relationship quality plays a dominant role in the health and well-being of Taiwanese families, especially as adolescents mature. Results highlight the importance of testing theories in families from diverse cultures.

Early Maternal Employment And Children's School Readiness: Changing Associations Over Time?

This study assessed whether the links between early maternal employment and children's school readiness have changed over time. Research has examined mothers' labor force participation and its associations with children's well-being. As maternal employment has become more normative, these associations may have changed, particularly among subgroups of families. Data come from two large, longitudinal samples of children born in the U.S. in 1991 (N = 1042) and in 2001 (N = 7850). OLS regression models estimated changes between cohorts in the associations between early maternal employment and children's reading/language skills, math skills, and conduct problems at age 4 and school entry. Despite similar prevalence rates of maternal employment by 9 months between the 1991 and 2001 samples, there were differences in the demographic characteristics of mothers in each employment pattern over the decade. Examining associations between the early maternal employment patterns and children's school readiness, results revealed that full time employment by 9 months in comparison to non-employment shifted to having more positive associations with reading/language skills at age 4 and school entry from 1991 to 2001. However, full time maternal employment by 9 months was associated with children's higher conduct problems at school entry in 1991 and 2001, and by 2001, part time employment had similar repercussions. The results differed by family income. There have been small changes in the associations between early maternal employment and children's school readiness over time.

Parental Arrest and Child Behavior: Differential Role of Executive Functioning among Racial Subgroups

This study examines relations among parental arrest, child executive functioning (EF), and problem behaviors among youth who participated in the baseline assessment of the Adolescent Brain Cognitive Development (ABCD) study (N = 11,875). Participants ranged in age from 9 to 10 (M = 9.91) years, and approximately half were girls (47.9%). Results of regression analyses that controlled for sociodemographic risk factors indicated that children who experienced parental arrest exhibited more internalizing and externalizing behaviors than comparison youth, particularly when their mother vs. father had been arrested. Results of analyses that were disaggregated by child race further revealed that EF appeared to play a differential role among White (n = 5851) and Black (n = 1451) children. Among White children, EF was associated with fewer internalizing and externalizing behaviors regardless of whether or not a parent had been arrested. Among Black children, low levels of EF were associated with more internalizing behaviors in the context of parental arrest vs. no arrest, but high levels of EF did not appear to confer benefits. EF was not significantly related to externalizing behaviors among Black children. Taken together, results suggest that parental arrests have adverse implications for child well-being that warrant continued theoretical and empirical attention. Findings also suggest that, although EF may be broadly beneficial among White children, there appear to be constraints on the extent to which high EF benefits Black children, a finding that is discussed through the lens of racial stratification and that has important implications for future theory, research, and practice.

Pregnancy anxiety, placental corticotropin-releasing hormone and length of gestation

OBJECTIVE

High pregnancy anxiety is a consistent predictor of earlier labor and delivery. Placental corticotropin-releasing hormone (pCRH) predicts earlier delivery consistently and it has been identified as a biological mediator of the association between pregnancy anxiety and gestational length. However, studies have not examined whether changes in pregnancy anxiety are associated with earlier birth as mediated by changes in pCRH during pregnancy. Accordingly, this study tests whether linear changes in pregnancy anxiety are associated with length of gestation indirectly through nonlinear increases in pCRH over pregnancy.

METHODS

A sample of pregnant women (n=233) completed prenatal assessments in early pregnancy, second trimester, and third trimester that included a 4-item assessment of pregnancy anxiety and collection of blood samples assayed for pCRH using radioimmunoassay. Length of gestation was abstracted from medical records after birth.

RESULTS

Increases in pregnancy anxiety from early pregnancy to third trimester predicted shorted length of gestation, as did nonlinear increases in pCRH over pregnancy. However, there was no evidence of an indirect effect of changes in pregnancy anxiety on length of gestation via changes in pCRH.

CONCLUSIONS

These results indicate that linear changes in pregnancy anxiety and nonlinear changes in pCRH during pregnancy are independent risk factors for shortened gestational length. This study adds to a small but growing body of work on biopsychological processes in pregnancy and length of gestation. Modeling changes in psychological and biological processes during pregnancy could provide more insight into understanding risk for adverse pregnancy outcomes.

Adverse childhood experiences and past 30-day cannabis use among middle and high school students: The protective influence of families and schools

Exposure to adverse childhood experiences (ACEs) is a risk factor for adolescent cannabis use (CU). We explored whether family communication and school connectedness can offer direct protection (the compensatory model of resiliency) or moderating protection (the protective factors model of resiliency). Using cluster random sampling, a Youth Risk Behavior Survey (YRBS) was conducted with 5,341 middle school and 4,980 high school students in 2019. Generalized estimating equations were used to estimate whether family communication and school connectedness offered independent direct protection (multiple regression) or moderating protection (multiplicative interaction) in the relationship between ACEs and past 30-day CU. Adjusted prevalence ratios (APR) and 95% confidence intervals (95% CI) were calculated. There was a graded relationship between ACEs and past 30-day CU for all students that was particularly strong among middle school students: 1 ACE (APR = 2.37, 95% CI = 2.16, 2.62), 2 ACEs (APR = 2.89, 95% CI = 2.60, 3.23), 3 ACEs (APR = 5.30, 95% CI = 4.75, 5.90), 4 + ACEs (APR = 7.86, 95% CI = 7.13, 8.67). Results supported the compensatory model of resiliency with both family communication (middle school APR = 0.90, 95% CI = 0.88, 0.93; high school APR = 0.90, 95% CI = 0.87, 0.93) and school connectedness (middle school APR = 0.76, 95% CI = 0.72, 0.79; high school APR = 0.72, 95% CI = 0.68, 0.77) demonstrating a direct, independent protective relationship with past 30-day CU. There was no consistent evidence supporting the protective factors resiliency model.

Diagnostic accuracy of Spanish and English screeners with Spanish and English criterion measures for bilingual students in Grades 1 and 2

The purpose of this study was to examine the diagnostic accuracy of English and Spanish language screeners when predicting reading comprehension outcomes in both languages at the end of Grade 1 and Grade 2. Participants were 1221 Latino/a bilingual students in Grade 1 and 1004 in Grade 2 who were attending bilingual programs in the Pacific Northwest and in Texas. We used ROC curve analyses to calculate the area under the curve (AUC; A) for each measure. The decision thresholds we selected resulted in 71% of all comparisons having accuracy of at least 0.75. Letter naming, decoding, and oral reading fluency in Spanish were accurate in predicting reading risk on criterion measures in Spanish and in English in Grades 1 and 2 (A value of 0.75 or above). English screeners, however, only predicted reading risk on the English criterion measure, but not on the Spanish criterion measure, with a few exceptions. Implications for practice and future research are discussed.

Educational, psychosocial, and clinical impact of SARS-CoV-2 (COVID-19) pandemic on medical students in the United States

BACKGROUND

The coronavirus disease 2019 (COVID-19) pandemic altered education, exams, and residency applications for United States medical students.

AIM

To determine the specific impact of the pandemic on US medical students and its correlation to their anxiety levels.

METHODS

An 81-question survey was distributed via email, Facebook and social media groups using REDCap^TM. To investigate risk factors associated with elevated anxiety level, we dichotomized the 1-10 anxiety score into low (≤ 5) and high (≥ 6). This cut point represents the 25^th percentile. There were 90 (29%) shown as low anxiety and 219 (71%) as high anxiety. For descriptive analyses, we used contingency tables by anxiety categories for categorical measurements with chi square test, or mean ± STD for continuous measurements followed by t-test or Wilcoxson rank sum test depending on data normality. Least Absolute Shrinkage and Selection Operator was used to select important predictors for the final multivariate model. Hierarchical Poisson regression model was used to fit the final multivariate model by considering the nested data structure of students clustered within State.

RESULTS

397 medical students from 29 states were analyzed. Approximately half of respondents reported feeling depressed since the pandemic onset. 62% of participants rated 7 or higher out of 10 when asked about anxiety levels. Stressors correlated with higher anxiety scores included “concern about being unable to complete exams or rotations if contracting COVID-19” (RR 1.34; 95%CI: 1.05-1.72, P = 0.02) and the use of mental health services such as a “psychiatrist” (RR 1.18; 95%CI: 1.01-1.3, P = 0.04). However, those students living in cities that limited restaurant operations to exclusively takeout or delivery as the only measure of implementing social distancing (RR 0.64; 95%CI: 0.49-0.82, P < 0.01) and those who selected “does not apply” for financial assistance available if needed (RR 0.83; 95%CI: 0.66-0.98, P = 0.03) were less likely to have a high anxiety.

CONCLUSION

COVID-19 significantly impacted medical students in numerous ways. Medical student education and clinical readiness were reduced, and anxiety levels increased. It is vital that medical students receive support as they become physicians. Further research should be conducted on training medical students in telemedicine to better prepare students in the future for pandemic planning and virtual healthcare.

Life course trajectories of affective symptoms and their early life predictors

BACKGROUND

Life course trajectories of affective symptoms (depression and anxiety) are heterogenous. However, few studies have investigated the role of early life risk factors in the development of these trajectories. The present study aimed to: (1) derive latent trajectories of affective symptoms over a period of more than 50 years (ages 13-69), and (2) examine early life risk factors for associations with specific life course trajectories of affective symptoms.

METHOD

Participants are from the MRC National Survey of Health and Development (NSHD) (n = 5,362). Affective symptoms were measured prospectively at ages 13, 15, 36, 43, 53, 60-64 and 69. A latent variable modelling framework was implemented to model longitudinal profiles of affective symptoms. Twenty-four prospectively measured early life predictors were tested for associations with different symptom profiles using multinomial logistic regression.

RESULTS

Four life course profiles of affective symptoms were identified: (1) absence of symptoms (66.6% of the sample); (2) adolescent symptoms with good adult outcome (15.2%); (3) adult symptoms only (with no symptoms in adolescence and late life) (12.9%); (4) symptoms in adolescence and mid adulthood (5.2%). Of the 24 early life predictors observed, only four were associated with life course trajectories, with small effect sizes observed.

CONCLUSIONS

People differ in their life course trajectories of anxiety and depression symptoms and that these differences are not largely influenced by early life factors tested in this study.

Examining bereavement-related needs and outcomes among survivors of sudden loss: A latent profile analysis

OBJECTIVE

Recognizing important bereavement-related needs among sudden loss survivors (e.g., suicide, overdose)-a population that is burgeoning and at risk for deleterious outcomes-is a critical task as needs may reflect modifiable grief-related variables that can assist with post-loss adjustment.

METHODS

Latent profile analysis was used among 347 sudden loss survivors to (a) identify distinct patterns of needs among survivors of sudden loss, (b) assess predictors of such profiles, and (c) investigate differences in profiles in terms of bereavement outcomes.

RESULTS

Four classes of bereavement-related needs were identified: a low needs class, a moderate needs-spiritual class, a moderate needs-relational class, and a high needs (HN) class. Clear differences emerged between need classes with the HN class evidencing the greatest level of grief and mental health sequelae.

CONCLUSION

Tending to bereavement-related needs is critical, as they indicate the degree of distress and reflect modifiable therapeutic variables.

Effects of Transparency on Perceived Humanness: Implications for Rendering Skin Tones Using Optical See-Through Displays

Current optical see-through displays in the field of augmented reality are limited in their ability to display colors with low lightness in the hue, saturation, lightness (HSL) color space, causing such colors to appear transparent. This hardware limitation may add unintended bias into scenarios with virtual humans. Humans have varying skin tones including HSL colors with low lightness. When virtual humans are displayed with optical see-through devices, people with low lightness skin tones may be displayed semi-transparently while those with high lightness skin tones will be displayed more opaquely. For example, a Black avatar may appear semi-transparent in the same scene as a White avatar who will appear more opaque. We present an exploratory user study ( N=160) investigating whether differing opacity levels result in dehumanizing avatar and human faces. Results support that dehumanization occurs as opacity decreases. This suggests that in similar lighting, low lightness skin tones (e.g., Black faces) will be viewed as less human than high lightness skin tones (e.g., White faces). Additionally, the perceived emotionality of virtual human faces also predicts perceived humanness. Angry faces were seen overall as less human, and at lower opacity levels happy faces were seen as more human. Our results suggest that additional research is needed to understand the effects and interactions of emotionality and opacity on dehumanization. Further, we provide evidence that unintentional racial bias may be added when developing for optical see-through devices using virtual humans. We highlight the potential bias and discuss implications and directions for future research.

Self-critical perfectionism, dependency and entropy during cognitive behavioural therapy for depression

OBJECTIVES

This study examined whether 'personality vulnerability' (i.e., self-critical perfectionism or dependency) predicts the trajectory of change, as well as variability and instability (i.e., entropy) of symptoms, during cognitive behaviour therapy (CBT) for depression.

DESIGN

Study participants were outpatients (N = 312) experiencing a primary mood disorder. Participants received CBT for depression group sessions over 15 weeks. Self-report measures of self-critical perfectionism, dependency, and depression were collected longitudinally.

METHODS

A latent growth mixture modelling (LGMM) statistical approach was used to evaluate the presence of latent classes of individuals based on their longitudinal pattern of symptom change during CBT and to evaluate whether baseline self-critical perfectionism or dependency predicts class membership. A Latent Acceleration Score (LAS) model evaluated whether perfectionism or dependency led to variability in depression symptom change (e.g., velocity) by considering changes in velocity (e.g., acceleration and/or deceleration).

RESULTS

LGMM indicated the presence of two latent classes that represent symptom improvement (N = 239) or minimal symptom improvement over time (N = 73). Elevated baseline self-critical perfectionism, but not dependency, predicted a greater likelihood of membership in the class of participants who demonstrated minimal symptom improvement over time. The second analysis examined whether baseline self-critical perfectionism also predicts depression symptom variability and instability. The LAS perfectionism model demonstrated that perfectionism accelerates depression symptom change during the first seven sessions of treatment, then has a decelerating effect on depression symptom change.

CONCLUSIONS

Results indicated that higher baseline self-critical perfectionism predicted higher variability and instability in depression symptoms and variability in acceleration and deceleration, over the course of treatment.

Latent stability and change in subgroups of social anxiety and depressive symptoms in adolescence: A latent profile and transitional analysis

BACKGROUND

Social anxiety and depressive symptoms increase markedly during adolescence. Most research examining the emergence of these symptoms has used a variable-centered approach providing little information about how these symptoms group together in individuals over time.

METHOD

A person-centered approach utilizing latent profile and latent transitional analyses was applied to a large adolescent sample (N = 2742, M_age=13.65; SD=0.63; 47.9% girls). Subgroups differing in their expressions of social anxiety and depressive symptoms at each of four annual time points were identified and then change in membership of these groups was evaluated.

RESULTS

Four subgroups were identified: 1. Low Distress, 2. Socially Anxious, 3. Dysphoric, and 4. Comorbid. The low distress group was the largest and most stable, followed by the socially anxious group, who most commonly transitioned into the comorbid group. In contrast, the dysphoric group were most likely to remit and move to the low distress group. The comorbid group was the smallest and least stable, although once in this group, three quarters of adolescents remained in this group over time.

CONCLUSION

Early intervention is particularly imperative for socially anxious adolescents with or without comorbid depressive symptoms as they are the least likely to improve across the adolescent years.

Other-Oriented Perfectionism in Children and Adolescents: Development and Validation of the Other-Oriented Perfectionism Subscale-Junior Form (OOPjr)

Research on adults indicates other-oriented perfectionism (requiring perfection from others) is associated with various consequential outcomes independent of self-oriented perfectionism (requiring perfection of the self) and socially prescribed perfectionism (believing others require perfection of the self). However, historically, the most widely used and researched measure of trait perfectionism in children, the Child-Adolescent Perfectionism Scale (CAPS), has omitted other-oriented perfectionism. In the present study, we address this by reporting on the multisource development and validation of the first self-report measure of other-oriented perfectionism specifically intended for youths: the Other-Oriented Perfectionism Subscale-Junior Form (OOPjr). Children ( N = 107; Mage = 11.5, SD = 1.7) completed the OOPjr, CAPS, and measures of perfectionistic self-presentation, narcissism, social disconnection, depressive symptoms, and parental psychological control. Parents provided ratings of children’s self-oriented, socially prescribed, and other-oriented perfectionism. Psychometric analyses indicated the OOPjr is a homogenous and internally reliable scale that, when factor analyzed alongside the CAPS, displays measurement invariance across gender and replicates the three-factor solution found in adults. Furthermore, parent ratings of other-oriented perfectionism showed unique positive relationships with OOPjr scores, but not CAPS scores. Likewise, other-oriented perfectionism had independent positive relationships with narcissistic superiority and achievement-oriented parental psychological control, after controlling for self-oriented and socially prescribed perfectionism. Overall, our findings provide preliminary support for the use of the OOPjr as a measure of other-oriented perfectionism in youths.

Ego Control Mediates the Effect of Maltreatment on Child Depression

Maltreatment among school-aged children is associated with negative impacts on development and can contribute to the onset of psychological difficulties, including early depressive symptoms. Maltreatment can have devasting consequences, thus it is important to better understand the mechanisms contributing to children's psychological outcomes. Purpose: The objective of this study was to examine children's personality functioning (ego control and ego resiliency) as mediators of the association between substantiated maltreatment and depression. Methods: A total of 300 school-aged children were followed over the course of 3 years in the context of a summer camp (168 maltreated children; 132 non-maltreated children). Maltreatment status was determined through cases referred by the Monroe County Department of Social Services, New York. Ego control and ego resiliency at year 2 (T2), as measured by camp counselors using the California Child Q-Set, were tested as mediators. Children's depressive symptoms were self-reported using the Childhood Depression Inventory at year 3 (T3). A parallel mediation model was tested using Mplus. Results: Maltreatment was not directly associated with depression at either time point, but significantly predicted both mediators. Ego undercontrol significantly predicted increased depressive symptoms at T3, while there was no significant prediction by ego resiliency. Conclusions: These findings point to the longitudinal paths to early depressive symptoms in maltreated children and the mediating effect of children's ego control which could be a target for intervention.

Resident and Non-resident Father Involvement, Coparenting, and the Development of Children's Self-Regulation Among Families Facing Economic Hardship

Self-regulation, or the ability to effectively manage emotions and behavior, is a critical skill to develop in early childhood. Children living in a context of economic hardship are at an increased risk for developing self-regulation difficulties. However, few studies have comprehensively examined how multiple aspects of the caregiving environment, including fathers' parenting and coparenting quality, may contribute to child self-regulation. Thus, this study applied a family systems perspective to examine whether coparenting and resident and non-resident fathers' reports of parenting quantity and quality were associated with observations of children's self-regulation. Participants were drawn from the Embedded Developmental Study (n = 257) of the Three-City Study, a longitudinal study of children and families facing economic hardship. At Wave 1, when children were 2-4 years old, reports of parenting (i.e., quantity and quality) and coparenting (i.e., support) were obtained. At Wave 2, when children were 3-6 years old, children participated in a snack delay and gift wrap task, which assessed their self-regulation. Multi-group path analyses indicated that resident fathers' harsh parenting at Wave 1 predicted decreased levels of self-regulation at Wave 2. Non-resident fathers' reported hours of involvement at Wave 1 predicted greater levels of self-regulation at Wave 2. Additionally, supportive coparenting among families with a non-resident father predicted greater self-regulation. Supportive coparenting was not associated with child self-regulation in families with a resident father. The implications for research focused on facilitating positive father-child relationships in diverse family contexts are discussed.

A 1-year longitudinal study of the stress, sleep, and parenting of mothers of toddlers

OBJECTIVES

The present study, building on cross-sectional research showing links between mothers' sleep, stress, and parenting, used a longitudinal design to consider (1) the temporal direction of links between mothers' sleep and stress, (2) whether mother sleep deficits predict change in parenting across time, and (3) whether mother sleep deficits mediate the inverse association between stress and positive parenting.

DESIGN

The study used repeated measures of stress, mother sleep, and positive parenting at toddler ages 30, 36, and 42 months.

SETTING

Data were collected at 2 sites, one in the Midwest and one in the East.

PARTICIPANTS

Four hundred thirteen mother-toddler pairs were followed. Mothers were mostly married, college educated, and middle class, but there was also considerable variability between families.

MEASUREMENTS

Stress was measured via parenting hassles, CHAOS, and role overload scales. Mother sleep was measured via actigraphy. Positive parenting was observed during the bedtime routine and rated using the HOME scale and other items.

RESULTS

Mother stress and sleep were inextricably linked across toddlerhood, and worse sleep was predictive of less observed positive parenting, even when controlling for prior levels of stress and parenting.

CONCLUSIONS

Improving mothers' sleep may be important in efforts to improve their parenting.

Short-term pain trajectories in patients with knee osteoarthritis

AIM

It is unknown if pain in knee osteoarthritis (KOA) follows distinct patterns over the short term. Therefore, the aim of this study was to identify whether persons with a previous history of KOA pain fluctuations have distinct trajectories of pain over 90 days and to examine associations between baseline characteristics and pain trajectories.

METHOD

People with a previous history of KOA were selected from a web-based longitudinal study. Baseline variables were sex, age, being obese/overweight, years of KOA, knee injury, knee buckling, satisfactory Lubben Social Support Score, pain and stress scales, Intermittent Constant Osteoarthritis Pain Score (ICOAP), medication use, and physical activity. Participants completed a Knee Injury and Osteoarthritis Outcomes Score (KOOS) pain subscale (KOOS-p, rated 0 = extreme to 100 = no knee problems) at 10-day intervals for 90 days. Short-term KOOS-p trajectories were identified using latent growth mixture modeling and the baseline risk factors for these pain trajectories were examined.

RESULTS

Participants (n = 313) had a mean age of 62.2 (SD ± 8.1) years and and a body mass index of 29.8 (SD ± 6.6) kg/m² . The three-class latent growth mixture modeling quadratic model with best fit indices was chosen (based on lowest sample-size-adjusted Bayesian Information Criterion, high probability of belonging, interpretability). Three distinct pain trajectory clusters (over 90 days) were identified: low-moderate pain at baseline with large improvement (n = 11), minimal change in pain over 90 days (n = 248), and moderate-high pain with worsening (n = 46). Higher ICOAP (intermittent scale), perceived stress, negative affect score, and knee buckling at baseline were associated with a worse knee pain trajectory (P < 0.05).

CONCLUSIONS

Persons with KOA showed unique short-term pain trajectories over 90 days, with distinct characteristics at baseline associated with each trajectory.

Parents matter: Parent acceptance of school-based executive functions interventions relates to improved child outcomes

OBJECTIVES

School-based interventions with parent-training components might improve access among lower-income families to effective help for children with neurodevelopmental disorders. This potential might be realized, however, only if parents perceive the interventions as acceptable and therefore engage with treatment.

METHODS

Parents (N = 124) of 3rd-5th grade students diagnosed with Autism Spectrum Disorder or Attention-Deficit/Hyperactivity Disorder rated the acceptability of their child's treatment (one of two culturally responsive behavioral interventions). Parent engagement was measured through attendance at parent training sessions and the extent to which they read a corresponding workbook.

RESULTS

Education and income correlated inversely with parent perceptions of treatment acceptability. Acceptability correlated positively with engagement, more strongly among lower-income families. Acceptability had an indirect effect on treatment outcome, mediated by parent engagement.

CONCLUSIONS

Treatment providers should focus on strategies to increase parent acceptability, with particular attention to improving access for lower-income families.

Disruption Leads to Methodological and Analytic Innovation in Developmental Sciences: Recommendations for Remote Administration and Dealing With Messy Data

The COVID-19 pandemic has impacted data collection for longitudinal studies in developmental sciences to an immeasurable extent. Restrictions on conducting in-person standardized assessments have led to disruptive innovation, in which novel methods are applied to increase participant engagement. Here, we focus on remote administration of behavioral assessment. We argue that these innovations in remote assessment should become part of the new standard protocol in developmental sciences to facilitate data collection in populations that may be hard to reach or engage due to burdensome requirements (e.g., multiple in-person assessments). We present a series of adaptations to developmental assessments (e.g., Mullen) and a detailed discussion of data analytic approaches to be applied in the less-than-ideal circumstances encountered during the pandemic-related shutdown (i.e., missing or messy data). Ultimately, these remote approaches actually strengthen the ability to gain insight into developmental populations and foster pragmatic innovation that should result in enduring change.

In-Person and Cyber Dating Abuse: A Longitudinal Investigation

While studies have identified associations between cyber and in-person dating abuse, most research has relied on cross-sectional data, limiting the ability to determine temporality. This study tested the longitudinal associations between cyber and physical and psychological forms of in-person dating abuse. Data were from an ongoing longitudinal study following a group of high school students originally recruited in Southeast Texas, U.S., into their young adulthood. Three waves of data (Waves 4-6) were used, with each wave collected one year apart. At Wave 4, participants' age ranged from 16 years to 20 years (Mean = 18.1 years, Median = 18.0 years, SD = .78). The analytical sample consisted of 879 adolescents/young adults (59% female, 41% male; 32% Hispanics, 28% Black, 29% White, and 11% other) who completed the dating abuse questions. Cross-lagged panel analysis showed that dating abuse victimization and perpetration were predictive of subsequent dating abuse of the same type. Cyber dating abuse perpetration was found to predict subsequent physical dating abuse perpetration as well as physical dating abuse victimization, but not vice versa. Further, cyber dating abuse perpetration predicted psychological dating abuse victimization, but not vice versa. Cyber dating abuse victimization was not significantly associated with either physical or psychological dating abuse temporally. Overall, findings suggest that cyber dating abuse perpetration may be a risk marker for both physical and psychological forms of in-person dating abuse. Interventions may benefit from targeting cyber dating abuse perpetration as means to prevent in-person dating abuse.

Examining reciprocal associations between parent depressive symptoms and child internalizing symptoms on subsequent psychiatric disorders: An adoption study

INTRODUCTION

The dynamic interplay between parent depressive symptoms and child internalizing behavior over time is not well understood.

METHODS

We used data from a prospective parent-offspring adoption design (N = 561) to examine associations between adoptive parent depressive symptoms and child internalizing behavior when children were ages 18 months, 27 months, 4.5 years, and 6 years, and subsequent child psychiatric disorder symptoms when children were between the ages of 6-8 years. Models also accounted for the contributions of birth parent psychopathology, birth mother depressive symptoms during pregnancy, and infant negative emotionality. Bidirectional associations between adoptive parent depressive symptoms and child internalizing behavior were examined using a random-intercept cross-lagged panel model.

RESULTS

There was evidence for associations between child internalizing behavior and adoptive parent depressive symptoms over time, with mothers' depressive symptoms being a more salient risk factor for child internalizing behavior than fathers'. We found one significant cross-lagged association from adoptive mother depressive symptoms at child age 18 months to child internalizing behavior at age 27 months. Infant negative emotionality (i.e., emotional liability) at age 9 months predicted both child internalizing behavior and adoptive parent depressive symptoms.

CONCLUSION

Results suggest that postnatal maternal depressive symptoms confer specific risks for child internalizing behaviors in toddlerhood and childhood and depressive symptoms in childhood.

Changes in cerebral arterial pulsatility and hippocampal volume: a transcranial doppler ultrasonography study

The physiological mechanisms of age-related cognitive decline remain unclear, in no small part due to the lack of longitudinal studies. Extant longitudinal studies focused on gross neuroanatomy and diffusion properties of the brain. We present herein a longitudinal analysis of changes in arterial pulsatility - a proxy for arterial stiffness - in two major cerebral arteries, middle cerebral and vertebral. We found that pulsatility increased in some participants over a relatively short period and these increases were associated with hippocampal shrinkage. Higher baseline pulsatility was associated with lower scores on a test of fluid intelligence at follow-up. This is the first longitudinal evidence of an association between increase in cerebral arterial stiffness over time and regional shrinkage.

Suicide Risk in Emerging Adulthood: Associations with Screen Time over 10 years

Suicide rates have increased over the past decade, and screen media (and social media in particular) are often blamed for this marked increase. However, there is little longitudinal research on this topic. The current study examined the link between various types of screen media use over a 10-year period (from adolescence to emerging adulthood) to suicide risk in emerging adulthood. Participants included 500 adolescents (51% female) who were first surveyed in 2009, when they were an average of 13.82 years old (range 12-15 years). For girls, a high level of social media or television use in early adolescence followed by a marked increase over time was most predictive of suicide risk in emerging adulthood. Additionally, video game use that increased over time was also associated with a higher risk for developing suicide risk for girls. A passive sensing measurement was also included at the final wave of data collection to obtain a more accurate and complete picture of phone use in particular. The use of entertainment apps was risky for girls while reading apps were risky for boys. Additionally, video game use (for boys) was associated with suicide risk when cyberbullying was also high. Identifying nonnormative patterns of media during adolescence may be instructive in terms of suicide prevention efforts.

Examining patterns of postnatal feeding in relation to infant's weight during the first year

BACKGROUND

There is mixed evidence regarding specific infant feeding behaviors and later risk for overweight and obesity. We sought to detect underlying patterns in duration of breastfeeding, introduction of solid foods and sweetened beverages, in order to understand the relation to later weight.

METHODS

Patterns of postnatal feeding were examined among infants enrolled in the Infant Feeding Practices Study II (N = 3033). At monthly intervals, mothers reported on the duration of any and exclusive breastfeeding, age of solid food and sweetened beverage introduction, and reported infant weight at ages 9- and 12-months. Latent profile analysis was used to empirically derive patterns of postnatal feeding and examine associations with weight z-scores at 9 and 12 months.

RESULTS

Two profiles emerged: (1) Short breastfeeding duration and early introduction to solid foods and sweetened beverages (Short BF/Early Introduction; 53%) and (2) longer breastfeeding duration and later introduction to solid foods and sweetened beverages (Longer BF/Later Introduction; 43%). Infants in the Shorter BF/Early Introduction profile had significantly greater weight z-scores at 9 (M = 0.18) and 12 months (M = 0.26), compared to those in the Longer BF/Later Introduction profile (M = -0.21; M = -0.17, respectively).

CONCLUSIONS

Overall, shorter BF duration and earlier food and sweetened beverage introduction is associated with higher weight z-scores at 9 and 12 months. Early intervention should aim to promote breastfeeding and later introduction of solids and discourage consumption of sweetened beverages. These postnatal patterns of feeding behaviors provides important context to inform targeted interventions aimed at reducing risk for later obesity.

The effect of classroom aggression-related peer group norms on students' short-term trajectories of aggression

Using a four-wave/seven-month longitudinal design with a sample of 1595 preadolescents (53% boys, 47% girls, M_age  = 10.2 years) from 63 fourth-, fifth- and sixth- grade classrooms in nine mixed-sex schools in Bogotá, Colombia, we examined whether growth trajectories of measures of overt and relational aggression varied as a function of classroom norms for aggression. Multilevel growth mixture modeling revealed (a) distinct trajectories of overt and relational aggression for boys and girls and (b) that norm salience (i.e., the process by which a group norm is made salient via the punishments or reinforcements to the behavior within the group) was a better predictor of associations with trajectories of overt and relational aggression than were perceived injunctive norms (i.e., the perceived standards of what is approved or disapproved in a social context). In classrooms where popular or accepted children were perceived by their peers as aggressive, more boys followed an increasing trajectory of overt and relational aggression than a low-stable trajectory, and more girls followed a high-stable trajectory of relational aggression than a low-stable trajectory. These findings are discussed in terms of the practical implications for the design of educational interventions aimed at preventing aggression in classroom settings.

Presentation and outcomes of orbital cellulitis caused by Group F Streptococcus

PURPOSE:

To compare the presentation and outcomes of patients with orbital cellulitis requiring surgical intervention caused by the Group F Streptococcus (GFS) versus other bacteria. We hypothesize that patients with GFS infections have a more severe presentation and worse clinical outcomes compared to infections by other bacteria.

METHODS:

After Institutional Review Board approval at a large academic institutional center, 70 patients with culture-positive orbital cellulitis who required surgical intervention were identified. Clinical examinations before and after surgery as well as preoperative imaging with computed tomography and/or magnetic resonance imaging were reviewed. The study measures were preoperative and postoperative vision, motility, involved sinus disease, complications, and total hospital length of stay. Multiple imputation was used for missing data. Characteristics of patients were compared using Chi-square and Wilcoxon rank-sum.

RESULTS:

Nineteen patients (27%) had positive cultures for GFS and 51 patients (73%) had positive cultures for other bacterial species. There was no significant difference in visual acuity, motility, or inflammatory markers in patients with GFS compared to other patients. Patients with GFS were noted to have more sinus involvement on presentation compared to patients with other bacterial infections (P = 0.007).

CONCLUSION:

GFS associated orbital cellulitis is associated with significantly more sinus involvement, but has similar outcomes as orbital cellulitis from other bacterial species.

Sex differences in social communication behaviors in toddlers with suspected autism spectrum disorder as assessed by the ADOS-2 toddler module

LAY ABSTRACT

When toddlers are suspected of autism spectrum disorder (ASD), the gold-standard assessment technique is with the Autism Diagnostic Observation Schedule, 2nd edition (ADOS-2) Toddler Module, a behavioral observation system. ASD is a neurodevelopmental condition more frequently diagnosed in toddler boys than in toddler girls. There is some evidence that the ADOS-2 assesses behaviors that are more characteristic of boys with ASD than girls. Thus, it is possible that focusing on these behaviors contributes at least in part to why more boys are diagnosed than girls. Specifically, girls may show more social skills than boys during the ADOS-2 assessment due to their socialization histories, which may lead to missed diagnoses of ASD in toddler girls. The current study examined eight social behaviors assessed by the ADOS-2 in a sample of toddlers with suspected ASD to see if they contributed differently to the total score of those items. Examination of those items suggested that those social communication behaviors work the same for boys and girls with suspected ASD, which was inconsistent with hypotheses. However, examination of particular items raises the possibility of examining creative/imaginative play as an area for future research.

Parental influence on urban adolescents' physical activity experience

As important socializing agents of adolescents, parents may substantially influence adolescents' physical activity but their roles in adolescents' physical activity experience have not been sufficiently studied. Furthermore, there is a dearth of research on potential mechanisms through which parents may promote adolescents' positive physical activity experience. Using a longitudinal sample of 464 urban and primarily Hispanic and African American adolescents, this study examined the impact of parental support on adolescents' physical activity experience. Results of structural equation modeling showed that after controlling for adolescents' gender, body mass index, and perceived overall health, parental support positively affected adolescents' restructuring ability (i.e., ability to construct meaningful and satisfying activities during unpleasant experiences) and intrinsic motivation (i.e., activity participation driven by inherent interest and enjoyment) in physical activity, which in turn positively affected adolescents' physical activity experience. No significant gender differences were found in these relationships. Theoretical and practical implications are discussed.

Improved Random Forest Algorithm Based on Decision Paths for Fault Diagnosis of Chemical Process with Incomplete Data

Fault detection and diagnosis (FDD) has received considerable attention with the advent of big data. Many data-driven FDD procedures have been proposed, but most of them may not be accurate when data missing occurs. Therefore, this paper proposes an improved random forest (RF) based on decision paths, named DPRF, utilizing correction coefficients to compensate for the influence of incomplete data. In this DPRF model, intact training samples are firstly used to grow all the decision trees in the RF. Then, for each test sample that possibly contains missing values, the decision paths and the corresponding nodes importance scores are obtained, so that for each tree in the RF, the reliability score for the sample can be inferred. Thus, the prediction results of each decision tree for the sample will be assigned to certain reliability scores. The final prediction result is obtained according to the majority voting law, combining both the predicting results and the corresponding reliability scores. To prove the feasibility and effectiveness of the proposed method, the Tennessee Eastman (TE) process is tested. Compared with other FDD methods, the proposed DPRF model shows better performance on incomplete data.

Workplace Cognitive Failure among Nurses during the COVID-19 Pandemic

Numerous studies provide evidence of the physical and emotional strain experienced by nurses during the COVID-19 pandemic. However, little is known regarding the impact of this occupational strain on nurses’ cognitive function at work. The aim of this study was to identify factors associated with workplace cognitive failure in a sample of U.S. nurses during the COVID-19 pandemic. An online questionnaire was administered in May 2020 to Michigan nurses statewide via three nursing organizations (n = 695 respondents). Path analysis was conducted to test the parallel effects of frequency of contact with COVID patients and personal protective equipment (PPE) supply on workplace cognitive failure scores. Mediation effects of stress, sleep quality, secondary trauma, and work-related exhaustion were examined for each exposure. Results revealed significant indirect effects of all mediators except sleep quality of contact with COVID patients (cumulative indirect effect = 1.30, z = 6.33, p < 0.001) and PPE (cumulative indirect effect = −2.10, z = −5.22, p < 0.001) on cognitive failure. However, 58% of the PPE effect was direct. To reduce the risk of cognitive failure, healthcare organizations need to provide nurses with protective equipment and work environments that allow nurses to strengthen their resilience to extreme working conditions.

Implementing family-based behavioral treatment in the pediatric primary care setting: Design of the PLAN study

Family-based behavioral treatment (FBT) is an evidence-based treatment for pediatric obesity. FBT has primarily been implemented in specialty clinics, with highly trained interventionists. The goal of this study is to assess effectiveness of FBT implemented in pediatric primary care settings using newly trained interventionists who might implement FBT in pediatric practices. The goal is to randomize 528 families with a child with overweight/obesity (≥85th BMI percentile) and parent with overweight/obesity (BMI ≥ 25) across four sites (Buffalo and Rochester, New York; Columbus, Ohio; St. Louis, Missouri) to FBT or usual care and obtain assessments at 6-month intervals over 24 months of treatment. FBT is implemented using a mastery model, which provides quantity of treatment tailored to family progress and following the United States Preventive Services Task Force recommendations for effective dose and duration of treatment. The primary outcome of the trial is change in relative weight for children, and secondarily, for parents and siblings who are overweight/obese. Between group differences in the tendency to prefer small immediate rewards over larger, delayed rewards (delay discounting) and how this is related to treatment outcome is also evaluated. Challenges in translation of group-based interventions to individualized treatments in primary care settings, and in study implementation that arose due to the COVID-19 pandemic are discussed. It is hypothesized that the FBT intervention will be associated with better changes in relative weight for children, parents, and siblings than usual care. The results of this study can inform future dissemination and implementation of FBT into primary care settings.

Who declines to respond to the reactions to race module?: findings from the South Carolina Behavioral Risk Factor Surveillance System, 2016-2017

Background

The inclusion of self-reported differential treatment by race/ethnicity in population-based public health surveillance and monitoring systems may provide an opportunity to address long-standing health inequalities. While there is a growing trend towards decreasing response rates and selective non-response in health surveys, research examining the magnitude of non-response related to self-reported discrimination warrants greater attention. This study examined the distribution of sociodemographic variables among respondents and non-respondents to the South Carolina Behavioral Risk Factor Surveillance System (SC-BRFSS) Reactions to Race module (6-question optional module capturing reports of race-based treatment).

Methods

Using data from SC-BRFSS (2016, 2017), we examined patterns of non-response to the Reactions to Race module and individual items in the module. Logistic regression models were employed to examine sociodemographic factors associated with non-response and weighted to account for complex sampling design.

Results

Among 21,847 respondents, 15.3% were non-responders. Significant differences in RTRM non-response were observed by key sociodemographic variables (e.g., age, race/ethnicity, labor market participation, and health insurance status). Individuals who were younger, Hispanic, homemakers/students, unreported income, and uninsured were over-represented among non-respondents. In adjusted analyses, Hispanics and individuals with unreported income were more likely to be non-responders in RTRM and across item, while retirees were less likely to be non-responders. Heterogeneity in levels of non-responses were observed across RTRM questions, with the highest level of non-response for questions assessing differential treatment in work (54.8%) and healthcare settings (26.9%).

Conclusions

Non-responders differed from responders according to some key sociodemographic variables, which could contribute to the underestimation of self-reported discrimination and race-related differential treatment and health outcomes. While we advocate for the use of population-based measures of self-reported racial discrimination to monitor and track state-level progress towards health equity, future efforts to estimate, assess, and address non-response variations by sociodemographic factors are warranted to improve understanding of lived experiences impacted by race-based differential treatment.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-11748-y.

Do older manual workers benefit in vitality after retirement? Findings from a 3-year follow-up panel study

Vitality is the feeling of physical and mental aliveness. Vitality benefits individual, organizational and societal well-being. However, we know much less about the dynamics in the levels of vitality and its' precursors. This study investigates the effects of retirement on vitality and how this effect differs between manual and non-manual workers and by baseline levels of vitality. We used two waves of the NIDI Pension Panel Survey, collected in the Netherlands in 2015 and 2018. Data from 4156 older workers (N = 4156), of whom 1934 (46.5%) retired between waves, were analysed. Vitality is assessed in three ways, as: (1) a composite measure of vitality, and its subcomponents (2) energy and (3) fatigue. Conditional Change OLS Regression models demonstrated that retirement is associated with improved vitality and decreased fatigue. Older workers who retire from manual work at wave 1 experienced the largest gains in vitality and highest declines in fatigue at wave 2, compared to those who remained employed. Retirement was more advantageous for older workers who experienced poor vitality and high fatigue at wave 1. No such effects were found for energy. Older workers in manual work, those experiencing low vitality and high fatigue at wave 1, may benefit most from early retirement. Since opportunities for early retirement are highly restrictive, it is essential to provide these groups of workers with effective work accommodations and interventions that may not only improve their vitality and quality of working life, but also extend their participation in the labour market.

Maternal mindfulness during pregnancy predicts newborn neurobehavior

Newborn neurobehavioral competencies portend a young child's abilities to modulate their arousal and attention in response to dynamic environmental cues. Although evidence suggests prenatal contributions to newborn neurobehavioral differences, no study to date has examined wellness-promoting traits, such as a pregnant woman's mindfulness, in this association. We examined whether a mother's mindfulness while pregnant related to neurobehavioral outcomes in her neonate, as well as whether maternal mindfulness moderated the link between prenatal maternal emotion dysregulation and newborn neurobehavior. Mothers (N = 162) reported on their mindfulness and emotion dysregulation while pregnant. Newborn arousal and attention were assessed at least 24 h after birth (M = 3.8 days, SD = 8.3) using the NICU Network Neurobehavioral Scale (NNNS). Highly mindful pregnant women reported lower levels of emotion dysregulation. Newborns of highly mindful mothers exhibited higher levels of arousal (e.g., excitability, motor activity) but did not differ in regards to attention at birth. Maternal emotion dysregulation while pregnant was associated with blunted newborn attention, but only among mothers who were less mindful. Our findings suggest that a mother's mindfulness while pregnant may influence her fetus' neurobehavioral development in ways that are evident at birth.