The Association Between Child Abuse and Aggressive Behavior: A Three-Level Meta-Analysis

Child abuse is considered to be an essential factor in the development of aggressive behavior. The intensity of the positive relations between child abuse and aggressive behavior differed considerably among researches despite the fact that abundant studies have observed this relation. According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) approach, a three-level meta-analysis was employed to obtain reliable estimates for the sizes of effects and investigate some potential moderators of the relation between child abuse and aggressive behavior. The present study obtained 51 studies (30,566 participants; 680 effect sizes) through performing the detailed literature search. It was found that child abuse was positively associated with aggressive behavior in the current study. In addition, the present meta-analysis observed significant moderating effects for type of child abuse, culture, measurement of child abuse, and publication year in the association between child abuse and aggressive behavior. This study suggests that child abuse is a predictor for the development of aggressive behavior in humans. Moreover, child abuse is an important aspect for consideration in efforts toward strengthening of interventions targeting individuals' aggressive behavior.

The Association Between Child Abuse and Internet Addiction: A Three-Level Meta-Analysis

Child abuse is an important factor for Internet addiction. Despite numerous researches had observed there was a positive correlation between child abuse and Internet addiction, the strength of this association differed considerably in the previous studies. This study aims to obtain reliable estimates for effect sizes and investigate the potential moderator of the association between child abuse and Internet addiction. Thirty-one studies reported the association between child abuse and Internet addiction (273 effect sizes and 55,585 participants) through a systematic literature search. Based on Preferred Reporting Items for Systematic Review and Meta-Analysis approach, a three-level model was employed to conduct a three-level meta-analysis. The current meta-analysis found that child abuse was significantly positively correlated with Internet addiction. Besides, the study found that the type of child abuse and publication year had significant moderating effects on the association between child abuse and Internet addiction. This study suggested child abuse was a risk factor for Internet addiction. Moreover, child abuse is an essential factor should be considered when strengthening interventions for individuals' Internet addiction.

The moderating role of work-to-family spillover in the association between nurses' work values and work engagement: A cross-sectional study

AIM

Although researchers have emphasized the importance of enhancing work engagement in nurses to ensure work-related well-being, the underlying mechanisms of the influencing factors of work engagement remain unclear. This study aimed to elucidate whether work-to-family spillover moderates the relationship between nurses' work values and work engagement.

METHODS

In total, 2600 nurses from 52 hospitals in the Tohoku region of Japan were recruited, and 1587 nurses participated. The questionnaire included items on demographic characteristics, the Nurses' Work Values Scale, the Japanese version of the Work-life Balance Scale, and the Work Engagement Scale. Data were analyzed using hierarchical multiple regression.

RESULTS

The interaction terms of negative work-to-family spillover with extrinsic work values and prestige work values were significantly associated with work engagement. The interaction terms of nurses' work values and positive work-to-family spillovers did not show a significant association.

CONCLUSIONS

Nurses who emphasized extrinsic work values and those who did not emphasize prestige work values had the lowest work engagement in settings with high negative work-to-family spillover. To ensure nurses' work-related well-being and engagement, nursing managers could provide support for nurses in tackling work-related negative events, so that these do not carry over to family settings.

The relationship between parenting styles and adolescent problematic Internet use: A three-level meta-analysis

Background and aims

Problematic Internet use (PIU) has become a global public health problem. It has been suggested that parenting style is associated with adolescent PIU. However, the evidence in favor of this view is mixed. Based on the PRISMA method, the present study employed three-level meta-analysis approach to investigate the relationship between these two variables and further explore potential moderators.

Methods

After a systematic search for published articles, 35 studies were included, reporting 171 effect sizes (N = 40,587).

Results

The results showed that positive parenting styles were significantly negatively related to PIU. This association was moderated by gender, age, publication year, and measurements of PIU, but was not by culture and measurements of parenting styles. Negative parenting styles were significantly positively related to PIU, which was moderated by publication year, culture, and sub-types of negative parenting, but not by gender, age, and measurements of both parenting styles and PIU. In addition, the correlation of PIU with negative parenting styles was stronger than that with positive parenting styles.

Discussion and Conclusions

The present results demonstrated that parenting styles, especially punitive parenting styles, should be attached to more important when treating adolescent PIU.

Women's behaviours towards cervical cancer screening in the COVID-19 pandemic: A moderated-mediation-model based on Information-Motivation-Behavioural Skills

AIMS

(1) To establish a predictive model based on the Information-Motivation-Behavioural Skills model, which can analyse the factors affecting the behaviours of women towards cervical cancer screening in the COVID-19 pandemic, and (2) to test the mediating effects of behavioural skills in the model, and (3) to test the moderated mediation effect of age.

DESIGN

A cross-sectional study was conducted among 354 women aged 30-65 between May and August 2021 in Turkey.

METHODS

Data were collected by using an online survey. The direct and indirect effects were tested in the structural equation model and the moderated-mediation effect was tested in the PROCESS macro.

RESULTS

Behavioural skills mediate the effect of motivation on cervical cancer screening behaviours. In addition, age has a moderated mediation effect on this mediation effect.

CONCLUSION

Our study revealed that as women's motivation for cervical cancer screening increased, their behavioural skills also increased. It can be stated that middle-aged and older women with higher behavioural skills are more likely to have screening during the pandemic and to comply with national recommendations.

IMPACT

This study is the first quantitative study to test the impact of the components of the Information-Motivation-Behavioural Skills model on cervical cancer screening during the COVID-19 pandemic. In addition, the results reveal the mediating effect of behavioural skills in the relationship between motivation and cervical cancer scanning behaviour and the moderated mediation effect of age. Our results can provide insight for nurses into how to triage women with delayed cervical cancer screening, how to build screening capacity, and how intervention strategies should be developed to improve compliance with cervical cancer screening and follow-up recommendations in women at risk during and after the pandemic.

Child Sexual Abuse and Problems Reported by Survivors of CSA: A Meta-Review

A systematic meta-review of reviews and meta-analyses on problems reported by survivors of Child Sexual Abuse (CSA) was conducted. The aim was to comprise a comprehensive overview of 1) problems reported by survivors of CSA, and 2) variables moderating these relations. Two raters independently conducted a search through PubMed, PsychINFO, Campbell Library, Cochrane Library and Web of Science. Twenty-five reviews and meta-analyses reporting on 53 problems related to CSA were analyzed. All fell into five domains: medical, psychological, sexual, repeated (self-)harm, and a final category of other problems. Thirty-six of all problems (68%) were consistently and significantly more commonly reported by CSA survivors as compared to individuals without a history of CSA. Most moderator analyses did not significantly influence these relationships. In conclusion, CSA is associated with various problems across different domains and overall, these problems are prevalent independent of specific characteristics of and circumstances surrounding the abuse.

The Association between Parental Attachment and Youth Suicidal Ideation: A Three-Level Meta-analysis

Youth suicidal ideation is regarded as a serious psychological problem that hinders their mental health development. Parental attachment is considered a critical factor linked with youth suicidal ideation, but existing findings are still inconsistent. The present study was based on the PRISMA method; it employed a three-level meta-analysis to obtain reliable estimates of effect size and examined a range of moderators (sample, publication, outcome). Through the retrieval of articles published before November 2020, a systematic search yielded 31 independent studies (N = 12848) from which 109 effect sizes could be extracted. The present meta-analysis revealed a significant negative correlation between parental attachment and youth suicidal ideation (r = -0.108, p < 0.001), implying that youths show a higher level of suicidal ideation when they experienced lower quality of parental attachment. Moreover, the overall association was influenced by different parental attachment patterns. More specifically, youth suicidal ideation was more strongly associated with parental alienation (r = 0.501, p < 0.001) than with parental communication (r = -0.173, p < 0.001). The moderator analyses also showed that the type of instrument used was a significant moderator of the association between parental attachment and youth suicidal ideation. The strength of the overall association was significantly stronger when measured with the IPPA (Inventory of Parent and Peer Attachment) (r = -0.181, p = 0.003) than with the ECR (Experiences in Close Relationships) (r = 0.085, p = 0.003). These results indicate that assessing parental attachment is important in strengthening interventions that target suicidal ideation among youths.HIGHLIGHTSOur analysis revealed a significant negative association between parental attachment and youth.Specifically, the presence of a secure relationship with parents, as perceived by the youth, brings forth feelings of appreciation, acceptance, safety, and confidence, that predispose the individual to seek help in a more consistent manner and to resist to maladjusted behavior when faced with adversity. However, a low quality of attachment produces cognitions associated with perceived burdensomeness and failed belongingness, which increase a youth's vulnerability to suicidal ideation.The parental attachment pattern showed a significant moderating effect on the association between parental attachment and youth suicidal ideation.Regarding the association between parental attachment and youth suicidal ideation, we observed that the manner in which parental attachment is measured is another moderating effect.

Assessing Real-Time Moderation for Developing Adaptive Mobile Health Interventions for Medical Interns: Micro-Randomized Trial

Background

Individuals in stressful work environments often experience mental health issues, such as depression. Reducing depression rates is difficult because of persistently stressful work environments and inadequate time or resources to access traditional mental health care services. Mobile health (mHealth) interventions provide an opportunity to deliver real-time interventions in the real world. In addition, the delivery times of interventions can be based on real-time data collected with a mobile device. To date, data and analyses informing the timing of delivery of mHealth interventions are generally lacking.

Objective

This study aimed to investigate when to provide mHealth interventions to individuals in stressful work environments to improve their behavior and mental health. The mHealth interventions targeted 3 categories of behavior: mood, activity, and sleep. The interventions aimed to improve 3 different outcomes: weekly mood (assessed through a daily survey), weekly step count, and weekly sleep time. We explored when these interventions were most effective, based on previous mood, step, and sleep scores.

Methods

We conducted a 6-month micro-randomized trial on 1565 medical interns. Medical internship, during the first year of physician residency training, is highly stressful, resulting in depression rates several folds higher than those of the general population. Every week, interns were randomly assigned to receive push notifications related to a particular category (mood, activity, sleep, or no notifications). Every day, we collected interns’ daily mood valence, sleep, and step data. We assessed the causal effect moderation by the previous week’s mood, steps, and sleep. Specifically, we examined changes in the effect of notifications containing mood, activity, and sleep messages based on the previous week’s mood, step, and sleep scores. Moderation was assessed with a weighted and centered least-squares estimator.

Results

We found that the previous week’s mood negatively moderated the effect of notifications on the current week’s mood with an estimated moderation of −0.052 (P=.001). That is, notifications had a better impact on mood when the studied interns had a low mood in the previous week. Similarly, we found that the previous week’s step count negatively moderated the effect of activity notifications on the current week’s step count, with an estimated moderation of −0.039 (P=.01) and that the previous week’s sleep negatively moderated the effect of sleep notifications on the current week’s sleep with an estimated moderation of −0.075 (P<.001). For all three of these moderators, we estimated that the treatment effect was positive (beneficial) when the moderator was low, and negative (harmful) when the moderator was high.

Conclusions

These findings suggest that an individual’s current state meaningfully influences their receptivity to mHealth interventions for mental health. Timing interventions to match an individual’s state may be critical to maximizing the efficacy of interventions.

Trial Registration

ClinicalTrials.gov NCT03972293; http://clinicaltrials.gov/ct2/show/NCT03972293

Health indicators as moderators of occupational commitment and nurses' intention to leave

AIM

This study examined the hypothesis that health indicators moderate the relationship between occupational commitment and intention to leave among nurses, using a large sample in Japan.

METHODS

A self-administered questionnaire was distributed to all registered nurses (N = 11,171) working in group hospitals in western Japan in 2014. The questionnaire evaluated intention to leave, occupational commitment, psychological distress, cumulative fatigue, and demographic variables. After a preliminary analysis of the bivariate and multivariate associations between variables and intention to leave, we tested the interactions between occupational commitment and health indicators on intention to leave.

RESULTS

Of the 5,768 returned questionnaires, data from 5,505 (49.3%) participants were analyzed. Participants' mean age was 36.27 years (SD = 10.37). Most (95.14%) were women. According to a generalized estimating equation, the interaction of continuance occupational commitment and cumulative fatigue was significantly related to intention to leave (b = -0.0055). Additionally, the interaction of affective occupational commitment and psychological distress was significantly related to intention to leave (b = 0.0079).

CONCLUSIONS

This study clarified that the relationship between occupational commitment and intention to leave was robust for nurses in good health. Interventions aimed at reducing fatigue and improving psychological distress should be implemented to prevent the protective effects of occupational commitment on nurses' intention to leave from being compromised.

Social and Non-social Mechanisms of Inequity Aversion in Non-human Animals

Research over the last decades has shown that humans and other animals reveal behavioral and emotional responses to unequal reward distributions between themselves and other conspecifics. However, cross-species findings about the mechanisms underlying such inequity aversion are heterogeneous, and there is an ongoing discussion if inequity aversion represents a truly social phenomenon or if it is driven by non-social aspects of the task. There is not even general consensus whether inequity aversion exists in non-human animals at all. In this review article, we discuss variables that were found to affect inequity averse behavior in animals and examine mechanistic and evolutionary theories of inequity aversion. We review a range of moderator variables and focus especially on the comparison of social vs. non-social explanations of inequity aversion. Particular emphasis is placed on the importance of considering the experimental design when interpreting behavior in inequity aversion tasks: the tasks used to probe inequity aversion are often based on impunity-game-like designs in which animals are faced with unfair reward distributions, and they can choose to accept the unfair offer, or reject it, leaving them with no reward. We compare inequity-averse behavior in such impunity-game-like designs with behavior in less common choice-based designs in which animals actively choose between fair and unfair rewards distributions. This review concludes with a discussion of the different mechanistic explanations of inequity aversion, especially in light of the particular features of the different task designs, and we give suggestions on experimental requirements to understand the “true nature” of inequity aversion.

A Reduction in Pain Intensity Is More Strongly Associated With Improved Physical Functioning in Frustration Tolerant Individuals: A Longitudinal Moderation Study in Chronic Pain Patients

OBJECTIVE

The onset and chronification of pain often has devastating consequences on the physical and mental functioning of individuals. Medical interventions are quite efficacious in reducing pain levels. However, changes in physical and mental health status after medical interventions are not proportional. In the past decades, rational/irrational beliefs, especially catastrophizing, have contributed to a better understanding of the pain experience. This study explores whether pain reduction efforts are more beneficial for individuals scoring high in rational thinking (moderation).

METHODS

The study design was longitudinal. Patients were assessed twice, 2 weeks prior to the start of medical treatment at the pain clinic and 6 months after. A total of 163 patients with heterogeneous pain (mostly low back and neck pain) participated in the study. Their mean age was 58.74 years (SD = 14.28) and 61.3% were female.

RESULTS

Overall, there was a reduction in pain intensity (t = 4.25, p < 0.001, d = 0.32). An improvement in physical functioning (t = 4.02, p < 0.001, d = 0.19), but not mental health (t = -0.66, p = 0.511, d = 0.11) was also observed. In the regression analyses, a decrease in pain intensity was moderately associated with improved physical health (β = 0.87, t = 4.96, p < 0.001, R 2 change = 0.177). This association was found to be moderated by frustration tolerance (β = -0.49, t = -2.80, p = 0.006, R 2 change = 0.039). Specifically, post hoc analyses indicated that changes in pain intensity only correlated with changes in physical health when patients reported high frustration tolerance levels (r = 0.47, p = 0.006, M = 7, n = 32), but not when patients were intolerant to frustration (r = 0.28, p = 0.078, M = 17, n = 41).

CONCLUSION

The results suggest that frustration tolerance may render adaptive by facilitating the positive effect that a reduction in pain intensity has on physical health status. The study findings are discussed in the context of personalized therapy with an emphasis on how to maximize the effectiveness of current interventions for pain.

Differences in the placebo response in duloxetine and venlafaxine trials

OBJECTIVE

Our analysis aimed at comparing the placebo effect sizes from randomized controlled trials (RCTs) of two widely prescribed antidepressants, namely duloxetine and venlafaxine, and at analysing a potential influence of the investigated drugs on the placebo response.

METHOD

We conducted a comprehensive systematic review and meta-analysis of placebo-controlled, double-blind RCTs, which examined the efficacy of duloxetine and venlafaxine in the acute treatment of major depressive disorder.

RESULTS

We included 71 studies (29 duloxetine trials and 43 venlafaxine trials; one study provided data for the duloxetine and the venlafaxine data set). The placebo effect sizes, defined as pre-postscore change divided by baseline standard deviation, differed significantly between venlafaxine and duloxetine studies (-2.51 vs. -2.09; test for subgroup differences P = 0.028; high heterogeneity). The analysis of effect modifiers and the metaregression analyses confirmed the drug, next to baseline depression severity and publication status, as the most influential independent predictor.

CONCLUSION

Our analyses show a significant difference in the placebo response between venlafaxine and duloxetine trials and suggest that the investigated drug has an influence on the placebo response that is not related to baseline severity, changes over the years or other variables we included.

Subgroup effects of occupational therapy-based intervention for people with advanced cancer

Background: Many people with advanced cancer have decreased ability to perform activities of daily living (ADL). We recently performed a randomized, controlled trial (RCT) assessing the efficacy of an occupational therapy-based program, the 'Cancer Home-Life Intervention' in people with advanced cancer (N = 242) and found no overall effects on ADL ability. However, heterogeneity of treatment effect may disguise subgroup differences.Objective: To investigate whether subgroups of people with advanced cancer gain positive effects from the 'Cancer Home-Life Intervention' on ADL ability.Material and method: An exploratory subgroup analysis including 191 participants from a RCT. The outcome was ADL motor ability measured by the Assessment of Motor and Process Skills (AMPS). Subgroups were defined by age, gender, years of education, type of primary tumor, functional level, and activity problems.Results: The 'Cancer Home-Life Intervention' had no statistically significant effect in the six subgroups. Modifying effects of age (0.30 [95% CI: -0.05 to 0.64]) and gender (0.23 [95% CI: -0.11 to 0.57]) were not found.Conclusion: There were no subgroup effects of the 'Cancer Home-Life Intervention'on ADL motor ability. Some indications suggest greater effects for those aged below 69 years; however, this result should be interpreted with caution.

Coupled latent differential equation with moderators: simulation and application

Latent differential equations (LDE) use differential equations to analyze time series data. Because of the recent development of this technique, some issues critical to running an LDE model remain. In this article, the authors provide solutions to some of these issues and recommend a step-by-step procedure demonstrated on a set of empirical data, which models the interaction between ovarian hormone cycles and emotional eating. Results indicated that emotional eating is self-regulated. For instance, when people do more emotional eating than normal, they will subsequently tend to decrease their emotional eating behavior. In addition, a sudden increase will produce a stronger tendency to decrease than will a slow increase. We also found that emotional eating is coupled with the cycle of the ovarian hormone estradiol, and the peak of emotional eating occurs after the peak of estradiol. The self-reported average level of negative affect moderates the frequency of eating regulation and the coupling strength between eating and estradiol. Thus, people with a higher average level of negative affect tend to fluctuate faster in emotional eating, and their eating behavior is more strongly coupled with the hormone estradiol. Permutation tests on these empirical data supported the reliability of using LDE models to detect self-regulation and a coupling effect between two regulatory behaviors.

Does a depression intervention result in improved outcomes for patients presenting with physical symptoms?

OBJECTIVE

To investigate the effects of exclusively physical presentation of depression on 1). depression management and outcomes under usual care conditions, and 2). the impact of an intervention to improve management and outcomes.

DESIGN AND SETTING

Secondary analysis of a depression intervention trial in 12 community-based primary care practices.

PARTICIPANTS

Two hundred adults beginning a new treatment episode for depression.

MEASUREMENTS

Presenting complaint and physician depression query at index visit; antidepressant use, completion of adequate antidepressant trial, change in depressive symptoms, and physical and emotional role functioning at 6 months.

MAIN RESULTS

Sixty-six percent of depressed patients presented exclusively with physical symptoms. Under usual care conditions, psychological presenters were more likely than physical presenters to complete an adequate trial of antidepressant treatment but experienced equivalent improvements in depressive severity and role functioning. In patients presenting exclusively with physical symptoms, the intervention significantly improved physician query (40.8% vs 18.0%; P =.06), receipt of any antidepressant (63.0% vs 20.1%; P =.001), and an adequate antidepressant trial (34.9% vs 5.9%; P =.004), but did not significantly improve depression severity or role functioning. In patients presenting with psychological symptoms, the intervention significantly improved receipt of any antidepressant (79.9% vs 38.0%; P =.01) and an adequate antidepressant trial (46.0% vs 23.8%; P =.004), and also improved depression severity and physical and emotional role functioning.

CONCLUSIONS

Our results suggest that there is a differential intervention effect by presentation style at the index visit. Thus, current interventions should be targeted at psychological presenters and new approaches should be developed for physical presenters.