1
|
Trajectories of insomnia following bereavement. Sleep Med 2024; 114:159-166. [PMID: 38194898 DOI: 10.1016/j.sleep.2023.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 11/17/2023] [Accepted: 12/14/2023] [Indexed: 01/11/2024]
Abstract
BACKGROUND Insomnia symptoms are common following bereavement and may exacerbate severe and protracted grief reactions, such as prolonged grief disorder (PGD). However, typical trajectories of insomnia symptoms and risk factors for having a more chronic insomnia trajectory following bereavement are yet unknown. METHOD In the current investigation, 220 recently bereaved (≤6 months post-loss) participants, completed questionnaires assessing sociodemographic and loss-related characteristics, rumination, experiential avoidance and symptoms of (prolonged) grief and depression, on three time-points (6 months apart). We applied growth mixture models to investigate the typical trajectories of insomnia symptoms following bereavement. RESULTS Three insomnia trajectory classes emerged, characterized by a resilient (47 %), recovering (43 %), and a chronic trajectory (10 %). Baseline depression symptoms best predicted the type of insomnia trajectory. At one-year follow-up, 9 %, 27 %, and 60 % of participants met the criteria for probable PGD within the resilient, recovering and chronic trajectory, respectively. A parallel process model showed that temporal changes in insomnia symptoms were strongly related to changes in prolonged grief symptoms. CONCLUSION The results suggest, that targeting insomnia symptoms in the treatment of PGD, particularly with comorbid depression, may be a viable option.
Collapse
|
2
|
Workload transition rate matters: Evidence from growth curve modeling. APPLIED ERGONOMICS 2023; 106:103885. [PMID: 36084577 DOI: 10.1016/j.apergo.2022.103885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 08/05/2022] [Accepted: 08/17/2022] [Indexed: 06/15/2023]
Abstract
This research examined three specific gaps in the workload transition literature: (1) the impact of workload transition rate, (2) the applicability of current theoretical explanations, and (3) the variability of performance overall and over time. Sixty Naval flight students multitasked in an unmanned aerial vehicle control testbed and workload transitioned at three rates: slow, medium, or fast. Response time and accuracy were analyzed via growth curve modeling. Slow transitions had the largest decline in performance over time. Medium transitions had some of the slowest, but most accurate and consistent performance. Fast transitions had some of the fastest, but least accurate performance. However, all performance trends significantly varied, suggesting multiple theoretical explanations may apply and performance may also depend on the individual. Design guidance on how to maximize performance goals with transition rate is provided, but future research needs to study the theoretical explanations and impact of individual differences further.
Collapse
|
3
|
Scan-based eye tracking measures are predictive of workload transition performance. APPLIED ERGONOMICS 2022; 105:103829. [PMID: 35930898 DOI: 10.1016/j.apergo.2022.103829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 06/06/2022] [Accepted: 06/08/2022] [Indexed: 06/15/2023]
Abstract
Given there is no unifying theory or design guidance for workload transitions, this work investigated how visual attention allocation patterns could inform both topics, by understanding if scan-based eye tracking metrics could predict workload transition performance trends in a context-relevant domain. The eye movements of sixty Naval flight students were tracked as workload transitioned at a slow, medium, and fast pace in an unmanned aerial vehicle testbed. Four scan-based metrics were significant predictors across the different growth curve models of response time and accuracy. Stationary gaze entropy (a measure of how dispersed visual attention transitions are across tasks) was predictive across all three transition rates. The other three predictive scan-based metrics captured different aspects of visual attention, including its spread, directness, and duration. The findings specify several missing details in both theory and design guidance, which is unprecedented, and serves as a basis of future workload transition research.
Collapse
|
4
|
Abstract
BACKGROUND Governments have implemented a range of measures focused on changing citizens' behaviors to lower the transmission of COVID-19. While international data shows that compliance did decline from the start of the pandemic, average trends could mask considerable heterogeneity in compliance behaviors. PURPOSE To explore trajectories of compliance with COVID-19 guidelines. METHODS We used longitudinal data on self-reported compliance from 50,851 adults in the COVID-19 Social Study collected across two waves of the pandemic in the UK (April 01, 2020-February 22, 2021). We modeled typical compliance trajectories using latent class growth analysis (LCGA) and used multinomial logistic regression to examine whether individual personality and demographic characteristics were related to compliance trajectories. RESULTS We selected a four-class LCGA solution. Most individuals maintained high levels of compliance and reported similar levels of compliance across the first and second waves. Approximately 15% of participants had decreasing levels of compliance across the pandemic, reporting noticeably lower levels of compliance in the second wave. Individuals with declining compliance levels were younger on average, in better physical health, had lower empathy and conscientiousness and greater general willingness to take risks. CONCLUSIONS While a minority, not all individuals have maintained high compliance across the pandemic. Decreasing compliance is related to several psychological traits. The results suggest that targeting of behavior change messages later in the pandemic may be needed to increase compliance.
Collapse
|
5
|
Intensive Stuttering Therapy with Telepractice Follow-Up: Longitudinal Outcomes. Folia Phoniatr Logop 2021; 74:254-270. [PMID: 34583350 DOI: 10.1159/000519866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 09/19/2021] [Indexed: 11/19/2022] Open
Abstract
PURPOSE This study estimated the treatment outcomes of a behavioral stuttering therapy program that blended a combination of intensive face-to-face therapy with telepractice-based follow-up therapy. METHOD A total of 17 participants (mean age = 22 years) who stutter participated in the program, preceded by an extended baseline period. The participants completed a series of assessments conducted over multiple time points, spanning a total of 42 weeks. Growth curve modeling was used to analyze the changes participants experienced in the frequency of stuttering, stuttering severity, communication attitudes, and quality of life. RESULTS The participants demonstrated stability throughout the extended baseline period, and experienced positive outcomes from the intensive program and the gains in communication attitudes and quality of life were largely maintained with weekly follow-up telepractice sessions. However, stuttering frequency and severity increased when the telepractice follow-up session frequency transitioned to a biweekly basis. Neither gender nor age group predicted the treatment outcomes for frequency or severity of stuttering. Gender-based differences were found for the treatment outcomes of specific self-report measures, with male participants having demonstrated a greater proportional decline on their standard scores, relative to female participants. Outcomes were similar for both adolescents and adults. CONCLUSIONS Participants attending the intensive stuttering therapy program experienced positive and significant changes in their speech, attitudes toward communication, and overall quality of life, which were maintained over time with structured, weekly telepractice follow-up sessions.
Collapse
|
6
|
Trajectories of learning approaches during a full medical curriculum: impact on clinical learning outcomes. BMC MEDICAL EDUCATION 2021; 21:370. [PMID: 34233677 PMCID: PMC8262035 DOI: 10.1186/s12909-021-02809-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 06/24/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND No consensus exists on whether medical students develop towards more deep (DA) or surface learning approaches (SA) during medical training and how this impacts learning outcomes. We investigated whether subgroups with different trajectories of learning approaches in a medical students' population show different long-term learning outcomes. METHODS Person-oriented growth curve analyses on a prospective cohort of 269 medical students (Mage=21years, 59 % females) traced subgroups according to their longitudinal DA/SA profile across academic years 1, 2, 3 and 5. Post-hoc analyses tested differences in academic performance between subgroups throughout the 6-year curriculum until the national high-stakes licensing exam certifying the undergraduate medical training. RESULTS Two longitudinal trajectories emerged: surface-oriented (n = 157; 58 %), with higher and increasing levels of SA and lower and decreasing levels of DA; and deep-oriented (n = 112; 42 %), with lower and stable levels of SA and higher but slightly decreasing levels of DA. Post hoc analyses showed that from the beginning of clinical training, deep-oriented students diverged towards better learning outcomes in comparison with surface-oriented students. CONCLUSIONS Medical students follow different trajectories of learning approaches during a 6-year medical curriculum. Deep-oriented students are likely to achieve better clinical learning outcomes than surface-oriented students.
Collapse
|
7
|
Auditory neurophysiological development in early childhood: A growth curve modeling approach. Clin Neurophysiol 2021; 132:2110-2122. [PMID: 34284246 DOI: 10.1016/j.clinph.2021.05.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2018] [Revised: 04/12/2021] [Accepted: 05/24/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE During early childhood, the development of communication skills, such as language and speech perception, relies in part on auditory system maturation. Because auditory behavioral tests engage cognition, mapping auditory maturation in the absence of cognitive influence remains a challenge. Furthermore, longitudinal investigations that capture auditory maturation within and between individuals in this age group are scarce. The goal of this study is to longitudinally measure auditory system maturation in early childhood using an objective approach. METHODS We collected frequency-following responses (FFR) to speech in 175 children, ages 3-8 years, annually for up to five years. The FFR is an objective measure of sound encoding that predominantly reflects auditory midbrain activity. Eliciting FFRs to speech provides rich details of various aspects of sound processing, namely, neural timing, spectral coding, and response stability. We used growth curve modeling to answer three questions: 1) does sound encoding change across childhood? 2) are there individual differences in sound encoding? and 3) are there individual differences in the development of sound encoding? RESULTS Subcortical auditory maturation develops linearly from 3-8 years. With age, FFRs became faster, more robust, and more consistent. Individual differences were evident in each aspect of sound processing, while individual differences in rates of change were observed for spectral coding alone. CONCLUSIONS By using an objective measure and a longitudinal approach, these results suggest subcortical auditory development continues throughout childhood, and that different facets of auditory processing follow distinct developmental trajectories. SIGNIFICANCE The present findings improve our understanding of auditory system development in typically-developing children, opening the door for future investigations of disordered sound processing in clinical populations.
Collapse
|
8
|
Longitudinal patterns of cocaine use among patients receiving injectable hydromorphone or diacetylmorphine for the treatment of opioid use disorder: A growth curve modeling approach. Drug Alcohol Depend 2021; 218:108333. [PMID: 33268225 DOI: 10.1016/j.drugalcdep.2020.108333] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 09/22/2020] [Accepted: 09/23/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND AIMS Cocaine use is prevalent among people receiving injectable opioid agonist treatment. Investigations of cocaine use in this population have been descriptive and the potential heterogeneity existing in patterns of use have not been characterized. As such, among patients receiving injectable opioid agonist treatment, this study aimed to: 1) quantify intra- and inter-individual variation in cocaine use over 24-months and; 2) determine how predictors of interest explained this variation. METHODS Participants were patients receiving injectable opioid agonist treatment for opioid use disorder. Study visits were completed at baseline prior to receiving treatment, and 3,6,9,12,18, and 24 months after baseline. A multi-level regression approach to growth curve modeling was employed to estimate and explain intra- (within-person) and inter-individual (between-person) variation in cocaine use. RESULTS Significant intra and inter-individual variation in cocaine use was identified over 24-months. Treatment engagement was on average associated with reductions in the prior month number of days of cocaine use (range: 0-30)(Estimate (standard error): -0.05(0.02), p = 0.003). On average, men reported less cocaine use compared to women (Estimate (standard error): -5.91(1.57), p=<0.001), and participants reporting ever regularly using cocaine at baseline reported more cocaine use over 24-months compared to participants reporting never regularly using cocaine (Estimate (standard error): 4.72 (1.91), p = 0.013). CONCLUSIONS Significant reductions in cocaine use were observed and significant heterogeneity in patterns of cocaine use was identified. These heterogeneous cocaine use profiles suggest that an individualized approach to care will be critical in responding to patients' cocaine use in injectable opioid agonist treatment.
Collapse
|
9
|
Application of multiple-group latent growth model to determine the effect of shift work on body mass index among petrochemical industries staff. Med J Islam Repub Iran 2020; 33:109. [PMID: 31934569 PMCID: PMC6946924 DOI: 10.34171/mjiri.33.109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Indexed: 11/18/2022] Open
Abstract
Background: Shift work can be defined as work activity scheduled in which employees work outside standard daytime hours. Some reports have shown that shift work is associated with several health problems. The main objective of this research was to explore the effect of shift work on body mass index (BMI) over time among Iranian petroleum industry staff. Methods: This longitudinal study sample was consisted of 3,686 (1,872 day workers and 1,814 shift workers) petrochemical industries staff in Mahshahr, southwest of Iran, from 2012 to 2015. The weight and height of these staff were measured using standard techniques and equipment. Multiple-group latent growth curve modeling was used to determine the effect of shift working on BMI trajectories over this period of time via Mplus software, version 6.0. Results: The mean (±SD) age of the shift workers and day workers were 38.96 (±8.36) and 43.33 (±8.35) years, respectively. Findings from the modeling approach showed that the slope of BMI in shift workers on average was 0.14 kg/m2 greater than the day workers in years under study (p<0.001). Conclusion: The findings of the current study suggest that shift work can be considered as a potential risk indicator for higher weight gain in petrochemical staff. Hence, health policy-makers should organize health screening programs and periodical checkups to find high-risk staff and control unhealthy lifestyle factors in these industries.
Collapse
|
10
|
Anxiety and Depression During Childhood and Adolescence: Testing Theoretical Models of Continuity and Discontinuity. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2019; 46:1295-1308. [PMID: 29256025 DOI: 10.1007/s10802-017-0370-x] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
The present study sought to clarify the trajectory (i.e., continuous vs. discontinuous) and expression (i.e., homotypic vs. heterotypic) of anxiety and depressive symptoms across childhood and adolescence. We utilized a state-of-the-science analytic approach to simultaneously test theoretical models that describe the development of internalizing symptoms in youth. In a sample of 636 children (53% female; M age = 7.04; SD age = 0.35) self-report measures of anxiety and depression were completed annually by youth through their freshman year of high school. For both anxiety and depression, a piecewise growth curve model provided the best fit for the data, with symptoms decreasing until age 12 (the "developmental knot") and then increasing into early adolescence. The trajectory of anxiety symptoms was best described by a discontinuous homotypic pattern in which childhood anxiety predicted adolescent anxiety. For depression, two distinct pathways were discovered: A discontinuous homotypic pathway in which childhood depression predicted adolescent depression and a discontinuous heterotypic pathway in which childhood anxiety predicted adolescent depression. Analytical, methodological, and clinical implications of these findings are discussed.
Collapse
|
11
|
Abstract
Growth curve modeling is a popular methodological tool due to its flexibility in simultaneously analyzing both within-person effects (e.g., assessing change over time for one person) and between-person effects (e.g., comparing differences in the change trajectories across people). This paper is a practical exposure to fitting growth curve models in the hierarchical Bayesian framework. First the mathematical formulation of growth curve models is provided. Then we give step-by-step guidelines on how to fit these models in the hierarchical Bayesian framework with corresponding computer scripts (JAGS and R). To illustrate the Bayesian GCM approach, we analyze a data set from a longitudinal study of marital relationship quality. We provide our computer code and example data set so that the reader can have hands-on experience fitting the growth curve model.
Collapse
|
12
|
Time-specific Errors in Growth Curve Modeling: Type-1 Error Inflation and a Possible Solution with Mixed-Effects Models. MULTIVARIATE BEHAVIORAL RESEARCH 2018; 53:876-897. [PMID: 30693803 DOI: 10.1080/00273171.2018.1504273] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Growth curve modeling (GCM) has been one of the most popular statistical methods to examine participants' growth trajectories using longitudinal data. In spite of the popularity of GCM, little attention has been paid to the possible influence of time-specific errors, which influence all participants at each timepoint. In this article, we demonstrate that the failure to take into account such time-specific errors in GCM produces considerable inflation of type-1 error rates in statistical tests of fixed effects (e.g., coefficients for the linear and quadratic terms). We propose a GCM that appropriately incorporates time-specific errors using mixed-effects models to address the problem. We also provide an applied example to illustrate that GCM with and without time-specific errors would lead to different substantive conclusions about the true growth trajectories. Comparisons with other models in longitudinal data analysis and potential issues of model misspecification are discussed.
Collapse
|
13
|
Changes in trauma admission rates and mechanisms during recession and recovery: evidence from the Detroit metropolitan area. Int J Public Health 2018; 63:847-854. [PMID: 29546441 DOI: 10.1007/s00038-018-1087-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Revised: 02/15/2018] [Accepted: 03/05/2018] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVES Although individual socioeconomic status has been linked with risk of traumatic injury, there has been relatively little research into the question of how economic changes may impact trauma admission rates in neighborhoods with different socioeconomic backgrounds. METHODS This study pairs ZIP code-level data on trauma admissions with county-level data on unemployment to assess differences in the type of changes experienced in more and less affluent neighborhoods of the Detroit metropolitan area between 2006 and 2014. RESULTS Conditional linear growth curve modeling results indicate that trauma admission rates decreased during the "great recession" of 2008-2010 in neighborhoods with the highest unemployment levels, but increased during the same period of time in neighborhoods with lower unemployment. Consequently, citywide disparities in trauma incidence decreased during the recession and widened again as the economy began to improve. CONCLUSION Trauma risks and demand for trauma care may shift geographically in relation to broader economic changes. Health care policy and planning should consider these dynamics when anticipating changing demands and needs for efforts at prevention.
Collapse
|
14
|
Trends in self-efficacy to quit and smoking urges among homeless smokers participating in a smoking cessation RCT. Addict Behav 2018; 78:43-50. [PMID: 29125976 DOI: 10.1016/j.addbeh.2017.10.025] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Revised: 10/24/2017] [Accepted: 10/27/2017] [Indexed: 12/11/2022]
Abstract
INTRODUCTION In the U.S., approximately 73% of homeless adults smoke cigarettes and they experience difficulty quitting. Homeless smokers report low self-efficacy to quit and that smoking urges are a barrier to quitting. Self-efficacy to quit and smoking urges are dynamic and change throughout smoking cessation treatment. This study examines changes in self-efficacy to quit and smoking urges throughout a smoking cessation intervention among the homeless and identifies predictors of change in these characteristics. METHODS Homeless smokers (n=430) participating in a smoking cessation randomized controlled trial in the U.S. completed surveys at baseline, and weeks 1, 2, 4, 6, 8, and 26 on demographic and smoking characteristics (i.e., confidence to quit, self-efficacy to refrain from smoking, and smoking urges). A growth curve analysis was conducted by modeling change in the smoking characteristics over time and examining the variability in the change in smoking characteristics by demographic characteristics and treatment group. RESULTS Among the full sample, self-efficacy to refrain from smoking increased linearly over time, confidence to quit increased until the midpoint of treatment but subsequently decreased, and smoking urges decreased until the midpoint of treatment but subsequently increased. There were race differences in these trajectories. Racial minorities experienced significantly greater increases in self-efficacy to refrain from smoking than Whites and Blacks had higher confidence to quit than Whites. CONCLUSIONS White participants experienced less increase in self-efficacy to refrain from smoking and lower confidence to quit and therefore may be a good target for efforts to increase self-efficacy to quit as part of homeless-targeted smoking cessation interventions. Sustaining high confidence to quit and low smoking urges throughout treatment could be key to promoting higher cessation rates among the homeless.
Collapse
|
15
|
Abstract
The design of longitudinal data collection is an essential component of any study of change. A well-designed study will maximize the efficiency of statistical tests and minimize the cost of available resources (e.g., budget). Two families of designs have been used to collect longitudinal data: complete data (CD) and planned missing (PM) designs. This article proposes a systematic and flexible procedure named SEEDMC (SEarch for Efficient Designs using Monte Carlo Simulation) to search for efficient CD and PM designs for growth-curve modeling under budget constraints. This procedure allows researchers to identify efficient designs for multiple effects separately and simultaneously, and designs that are robust to MCAR attrition. SEEDMC is applied to identify efficient designs for key change parameters in linear and quadratic growth models. The identified efficient designs are summarized and the strengths and possible extensions of SEEDMC are discussed.
Collapse
|
16
|
Behavioral activation versus physical activity via the internet: A randomized controlled trial. J Affect Disord 2017; 215:85-93. [PMID: 28319696 DOI: 10.1016/j.jad.2017.03.018] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Revised: 02/06/2017] [Accepted: 03/05/2017] [Indexed: 01/09/2023]
Abstract
BACKGROUND A major problem today is that only about fifty percent of those affected by depression seeks help. One way to reach more sufferers would be by offering easily accessible internet based treatments. The purpose of this study was to compare/evaluate four therapist supported internet administered treatments. METHOD/RESULTS Two hundred eighty six participants were included. The treatment period lasted twelve weeks, consisting of the following treatments: 1) physical activity without treatment rational, 2) physical activity with treatment rational, 3) behavioral activation without treatment rational and 4) behavioral activation with treatment rational. All groups (including a control-group) showed a significant decrease in depressive symptoms. When the treatment groups were pooled and compared to the control group, there were significant differences from pretest to posttest (Hedges gav treatment =1.01, control group =0.47). This held true also when each of the four treatment groups was compared to the control group, with one exception: Physical activity without treatment rationale. LIMITATIONS The differences between how many modules the participants completed could indicate that there are other factors than the treatments that caused the symptom reduction, however, the dose-response analysis did not detect any significant differences on account of modules completed. CONCLUSIONS The results support the positive effects of internet administered treatments for depression, and highlights the importance of psychoeducation, which tends to affect both the treatment outcome and the probability of remaining in treatment. These aspects need to be considered when developing and conducting new treatments for depression, since they would increase the likelihood of positive treatment outcomes.
Collapse
|
17
|
Therapeutic relationship in the treatment of geriatric depression with executive dysfunction. J Affect Disord 2017; 214:130-137. [PMID: 28288407 PMCID: PMC5390484 DOI: 10.1016/j.jad.2017.03.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Revised: 01/15/2017] [Accepted: 03/05/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND The effects of therapeutic relationship (TR) in elder mental health are understudied. A greater understanding of TR in geriatric psychotherapy is particularly needed for treating late-life depression with executive dysfunction, which predicts poor response to antidepressant medication and presents unique clinical challenges. METHODS Participants were older patients (N = 220) with major depression and executive dysfunction who received 12 weeks of problem-solving therapy or supportive therapy in a randomized control trial. Multilevel growth curve modeling and latent change scores were used to analyze TR dimensions of Understanding and Accepting at the patient level (individual patient ratings, N = 194) and therapist level (ratings of each therapist averaged across participants, N = 10). RESULTS TR predicted reduction of depression in both treatment groups, while treatment×TR interactions were not significant. Patients treated by therapists with higher average Understanding (patient and therapist level) and Accepting (therapist level) ratings had greater decreases in depression. The patient level×therapist level interaction for Understanding approached statistical significance (p=.065), suggesting a synergistic effect on treatment outcome. Together, Understanding and Accepting predicted 21% of variance in depression level changes. LIMITATIONS TR was not assessed throughout the course of treatment (only after the first therapy session and at post-treatment) and did not include ratings from an objective evaluator. CONCLUSIONS Assessment of patient's experience of the TR and of therapist ability to foster Understanding and Accepting can play a significant role in the delivery of geriatric psychosocial interventions.
Collapse
|
18
|
Test-retest, retest, and retest: Growth curve models of repeat testing with Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT). J Clin Exp Neuropsychol 2016; 38:869-74. [PMID: 27266563 PMCID: PMC4962874 DOI: 10.1080/13803395.2016.1168781] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Computerized neuropsychological testing has become an important tool in the identification and management of sports-related concussions; however, the psychometric effect of repeat testing has not been studied extensively beyond test-retest statistics. The current study analyzed data from Division I collegiate athletes who completed Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) baseline assessments at four sequential time points that varied over the course of their athletic careers. Administrations were part of a larger National Institutes of Health (NIH) study. Growth curve modeling showed that the two memory composite scores increased significantly with successive administrations: Change in Verbal Memory was best represented with a quadratic model, while a linear model best fit Visual Memory. Visual Motor Speed and Reaction Time composites showed no significant linear or quadratic growth. The results demonstrate the effect of repeated test administrations for memory composite scores, while speed composites were not significantly impacted by repeat testing. Acceptable test-retest reliability was demonstrated for all four composites as well.
Collapse
|
19
|
Differential treatment response trajectories in individuals with subclinical and clinical PTSD. J Anxiety Disord 2016; 38:95-101. [PMID: 26874291 PMCID: PMC5097342 DOI: 10.1016/j.janxdis.2016.01.006] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Revised: 01/04/2016] [Accepted: 01/15/2016] [Indexed: 10/22/2022]
Abstract
Subclinical presentations of posttraumatic stress disorder (PTSD), wherein patients are one or two symptom criteria short of the full disorder, are prevalent and associated with levels of distress and impaired functioning approximating that of full PTSD. Nonetheless, research examining treatment efficacy for this group is in the nascent stage. The purpose of the present study was to examine whether the subclinical PTSD group would: (1) show a greater reduction in PTSD symptoms at pre and post treatment in response to an exposure based treatment and (2) show a greater rate of change over the course of treatment, when compared to the full criteria PTSD group. We also examined whether differences would emerge when examining PTSD symptom clusters. Consistent with predictions, the subclinical PTSD group demonstrated a greater reduction in PTSD symptoms at post-treatment (29%) than those with a PTSD diagnosis (14%). Further, the groups had different treatment trajectories, with the subclinical PTSD group showing a marginally greater rate of change during the course of treatment. Findings also varied by symptom cluster with the subclinical group showing a greater rate of change in the intrusions, hypervigilance, and avoidance symptom clusters. There was not a significant between group difference in the numbing symptom cluster. This study provides preliminary evidence that treating PTSD symptoms at the subclinical level may result in a larger, and more rapid symptom reduction, and thus has implications supporting treatment earlier in the developmental trajectory of the disorder.
Collapse
|
20
|
The effects of the Green House nursing home model on ADL function trajectory: A retrospective longitudinal study. Int J Nurs Stud 2015; 53:238-47. [PMID: 26260709 DOI: 10.1016/j.ijnurstu.2015.07.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Revised: 07/16/2015] [Accepted: 07/17/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Growing attention in the past few decades has focused on improving care quality and quality of life for nursing home residents. Many traditional nursing homes have attempted to transform themselves to become more homelike emphasizing individualized care. This trend is referred to as nursing home culture change in the U.S. A promising culture change nursing home model, the Green House nursing home model, has shown positive psychological outcomes. However, little is known about whether the Green House nursing home model has positive effects on physical function compared to traditional nursing homes. OBJECTIVES To examine the longitudinal effects of the Green House nursing home model by comparing change patterns of activities of daily living function over time between Green House home residents and traditional nursing home residents. DESIGN A retrospective longitudinal study. SETTINGS Four Green House organizations (nine Green House units and four traditional units). PARTICIPANTS A total of 242 residents (93 Green House residents and 149 traditional home residents) who had stayed in the nursing home at least 6 months from admission. METHODS The outcome was activities of daily living function, and the main independent variable was the facility type in which the resident stayed: a Green House or traditional unit. Age, gender, comorbidity score, cognitive function, and depressive symptoms at baseline were controlled. All of these measures were from a minimum dataset. Growth curve modeling and growth mixture modeling were employed in this study for longitudinal analyses. RESULTS The mean activities of daily living function showed deterioration over time, and the rates of deterioration between Green House and traditional home residents were not different over time. Four different activities of daily living function trajectories were identified for 18 months, but there was no statistical difference in the likelihood of being in one of the four trajectory classes between the two groups. CONCLUSIONS Although Green House nursing homes are considered to represent an innovative model changing the nursing home environment into more person-centered, this study did not demonstrate significant differences in activities of daily living function changes for residents in the Green House nursing homes compared to traditional nursing homes. Given that the Green House model continues to evolve as it is being implemented and variations within and across Green House homes are identified, large-scale longitudinal studies are needed to provide further relevant information on the effects of the Green House model.
Collapse
|
21
|
Patterns of women׳s mood after delivery: a growth curve analysis. J Affect Disord 2015; 174:201-8. [PMID: 25514193 DOI: 10.1016/j.jad.2014.11.022] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Accepted: 11/13/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND The course and predictors of women׳s mood following childbirth have informed clinically significant phenomena, such as postpartum depression (PPD), with some contradictory findings due to methodological limitations. It is important to further investigate mood during this unique period of time to inform assessment and improve interventions. METHODS Recently delivered mothers (n=216) recruited from the maternity unit at a University hospital completed sociodemographic questions and the Daily Experiences Questionnaire (DEQ), a measure of Negative Affect (NA) and Positive Affect (PA), for 10 consecutive days. The Structured Clinical Interview for DSM-IV was administered to assess postpartum depression diagnosis. RESULTS Growth curve modeling (GCM) techniques revealed average trends in mood following delivery. NA changed in a curvilinear fashion with a peak at day 5. PA declined rapidly during the days immediately following delivery and then stabilized. Women diagnosed with PPD experienced higher overall levels of NA and lower levels of PA from delivery to 10 days postpartum. Patterns of mood varied as a function of neuroticism and several well-established sociodemographic variables. LIMITATIONS Small sample size and relatively few ethnic minority participants may affect generalizability of the findings. CONCLUSIONS NA changed in a pattern consistent with the "peaking phenomenon". Well-established risk factors of the blues had significant associations with mood from delivery to day 10. Increased understanding into the nature of NA and PA in the early postpartum, and its role in identifying women susceptible to experiencing PPD, can inform screening and therapeutic interventions for PPD.
Collapse
|
22
|
Growth curve analyses of the relationship between early maternal age and children's mathematics and reading performance. SOCIAL SCIENCE RESEARCH 2015; 50:343-366. [PMID: 25592941 DOI: 10.1016/j.ssresearch.2014.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2013] [Revised: 08/17/2014] [Accepted: 09/10/2014] [Indexed: 06/04/2023]
Abstract
Regarding the methods used to examine the early maternal age-child academic outcomes relationship, the extant literature has tended to examine change using statistical analyses that fail to appreciate that individuals vary in their rates of growth. Of the one study I have been able to find that employs a true growth model to estimate this relationship, the authors only controlled for characteristics of the maternal household after family formation; confounding background factors of mothers that might select them into early childbearing, a possible source of bias, were ignored. The authors' findings nonetheless suggested an inverse relationship between early maternal age, i.e., a first birth between the ages of 13 and 17, and Canadian adolescents' mean math performance at age 10. Early maternal age was not related to the linear slope of age. To elucidate whether the early maternal age-child academic outcomes association, treated in a growth context, is consistent with this finding, the present study built on it using US data and explored children's mathematics and reading trajectories from age 5 on. Its unique contribution is that it further explicitly controlled for maternal background factors and employed a three-level growth model with repeated measures of children nested within their mothers. Though the strength of the relationship varied between mean initial academic performance and mean academic growth, results confirmed that early maternal age was negatively related to children's mathematics and reading achievement, net of post-teen first birth child-specific and maternal household factors. Once maternal background factors were included, there was no statistically significant relationship between early maternal age and either children's mean initial mathematics and reading scores or their mean mathematics and reading growth.
Collapse
|
23
|
Course of depression and anxiety symptoms during the transition to parenthood for female adolescents with histories of victimization. CHILD ABUSE & NEGLECT 2014; 38:1160-1170. [PMID: 24862921 DOI: 10.1016/j.chiabu.2014.04.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Revised: 04/01/2014] [Accepted: 04/11/2014] [Indexed: 06/03/2023]
Abstract
The aim of the current study was to increase understanding of how victimization history impacts the longitudinal course of depression and anxiety in a sample of 55 adolescents emerging into parenthood. Adolescents were interviewed about their victimization experiences during their second trimester of pregnancy, and interviews were subsequently classified according the Maltreatment Classification Scale (Barnett, Manly, & Cicchetti, 1993). Adolescents reported on their symptoms of depression and anxiety prenatally and 6 and 12 months postpartum. Growth curve modeling revealed that, on average, there was a steady linear decline in depression and anxiety symptoms across the transition to parenthood, with a rate of change of 25% and 20%, respectively, from the prenatal assessment to 12 months postpartum. Sexual abuse history attenuated the likelihood of a decrease in depressive symptoms over time. Neglect history was associated with higher prenatal levels of anxiety, as well as a steeper decline in anxiety symptoms over time. Future research is needed to determine the role of poly-victimization in predicting the onset and change of depression and anxiety symptoms. Findings from the current study have the potential to aid in the design of preventative and intervention efforts to reduce risks of mental health difficulties in adolescent parents.
Collapse
|
24
|
Abstract
OBJECTIVES This paper examines age-related changes in subjective well-being (SWB) in later life using multiple measures that cover eudemonic, evaluative, and affective dimensions of well-being. METHOD Using data from 5 waves of respondents aged 50 and older from the English Longitudinal Study of Ageing (2002-11), we fit multilevel linear growth curve models to examine the cohort differences and individual aging effects on quality of life, depressive symptomatology, and life satisfaction. RESULTS Older cohorts are shown to have equivalent or better SWB than younger cohorts for each well-being measure. Nonetheless, individual aging effects for each well-being measure were observed with deterioration in well-being being greatest in older cohorts, even when adjusting for age-related changes in later life, including widowhood, retirement, and declining health. DISCUSSION The results suggest that although older cohorts enjoy higher levels of SWB than their younger counterparts when under similar circumstances, they experience sharper declines, especially in the very oldest cohorts. The findings demonstrate the importance of separating out cohort differences and aging effects and also of taking into account the multidimensionality of SWB to determine the point at which age deterioration begins to occur across different measures.
Collapse
|