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OBJECTIVE: This study describes trajectories of cognitive aging among American Indian/Alaskan Native (AI/AN) adults with and without HIV and the role of immunosenescence longitudinally. METHOD: We characterized trajectories of cognitive aging in a sample of 333 AI/AN and 309 non-Hispanic White (NHW) adults who were followed longitudinally for up to 20 years by the HIV Neurobehavioral Research Program (HNRP) across six U.S. research sites. We used growth curve modeling with autoregressive Lag-1 structures and heterogeneous residual variances to assess the role of ethnoracial identity and HIV grouping upon decline in trajectories of cognitive aging. RESULTS: HIV- AI/AN adults demonstrated earlier and steeper decline in normative trajectories of cognitive aging on tasks of processing speed, timed tasks of attention/working memory, executive function, and psychomotor speed in comparison to HIV- NHW adults. Accentuated trajectories of cognitive aging were evident in both HIV+ and HIV+ immunosuppressed groups in comparison to HIV- peers and were primarily driven by the role of immunosenescence. CONCLUSIONS: AI/AN disparities in trajectories of cognitive aging are evident and are likely explained by the interplay of biopsychosociocultural factors, including immunosenescence. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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The menopausal transition (MT) is associated with an increased risk for many disorders including neurological and mental disorders. Brain imaging studies in living humans show changes in brain metabolism and structure that may contribute to the MT-associated brain disease risk. Although deficits in ovarian hormones have been implicated, cellular and molecular studies of the brain undergoing MT are currently lacking, mostly due to a difficulty in studying MT in postmortem human brain. To enable this research, we explored 39 candidate biomarkers for menopausal status in 42 pre-, peri-, and post-menopausal subjects across three postmortem tissues: blood, the hypothalamus, and pituitary gland. We identified thirteen significant and seven strongest menopausal biomarkers across the three tissues. Using these biomarkers, we generated multi-tissue and tissue-specific composite measures that allow the postmortem identification of the menopausal status across different age ranges, including the "perimenopausal", 45-55-year-old group. Our findings enable the study of cellular and molecular mechanisms underlying increased neuropsychiatric risk during the MT, opening the path for hormone status-informed, precision medicine approach in women's mental health.
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Schools and friendships represent important but distinct contexts for adolescent identity development. However, research has yet to explore the long-term interplay between these factors on ethnic/racial identity (ERI). This study included a sample of 640 adolescents from 9 public high schools in a diverse United States metropolis (Mage = 14.50, SD = 0.67; 44% Asian, 20% Black, 36% Latinx; female = 68%, male = 32%, non-binary = 0%). Latent growth curve modeling was conducted to investigate longitudinal associations in friendship ethnic/racial composition and ERI exploration. From the 9th-11th grades, same-race friends and ERI exploration increased linearly whereas friendship ethnic/racial diversity decreased linearly. Adolescents attending more ethnically/racially diverse schools maintained more ethnically/racially diverse friends over time but did not differ in changes in ERI exploration compared to adolescents in less diverse schools. There was no association between the rates at which adolescents' friendship ethnic/racial composition and ERI changed over time. More ethnically/racially diverse friends in the 9th-grade predicted faster increases in subsequent ERI exploration. The findings highlight important differences in the roles of friendship and school contexts on ERI, suggesting that friendship ethnic/racial diversity, but not school ethnic/racial diversity, facilitated ERI exploration over time. School ethnic/racial diversity did facilitate a slower decline in friendship ethnic/racial diversity, emphasizing the importance of school integration.
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OBJECTIVE: The purpose of the study was to investigate the association between discrimination by multiple sources (ie, teachers, students, and other adults) and early adolescents' behavioral problems (ie, internalizing, externalizing, and attention problems), also considering the protective role of parental warmth in the association. METHOD: Cross-sectional analyses were conducted with 3,245 early adolescents of color obtained from the Adolescent Brain Cognitive Development Study (ABCD Study) at year 1 follow-up (Y1), a large and diverse sample of children (mean age = 9.48 years) in the United States. Racially-ethnically minoritized adolescents reported sources of discrimination, parental warmth, and symptoms of psychopathology. Regression with interaction terms was conducted to investigate the associations among sources of discrimination, parental warmth, and behavioral problems among racially-ethnically minority adolescents. Sensitivity analyses were conducted to examine (1) race/ethnicity and sex/gender variations; (2) whether the associations between different sources of discrimination and behavioral problems were reliably different; and (3) effects of discrimination, parental warmth, and their interplay at Y1 in predicting adolescents' behavioral problems at year 2 follow-up. RESULTS: Early adolescents experiencing interpersonal racial-ethnic discrimination by multiple sources, including teachers, students, and other adults, reported higher levels of attention, internalizing, and externalizing problems. Parental warmth was protective for the association between interpersonal racial-ethnic discrimination and early adolescents' behavioral problems. CONCLUSION: Experiencing interpersonal racial-ethnic discrimination from teachers, peers, and other adults is related to heightened attention, internalizing, and externalizing problems among racially-ethnically minoritized early adolescents. Parental warmth may reduce the risk of developing behavioral problems among early adolescents who experience interpersonal racial-ethnic discrimination from students, teachers, and other adults outside of school. DIVERSITY & INCLUSION STATEMENT: We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. We worked to ensure sex and gender balance in the recruitment of human participants. We worked to ensure that the study questionnaires were prepared in an inclusive way. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/or gender groups in science. One or more of the authors of this paper received support from a program designed to increase minority representation in science. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group. While citing references scientifically relevant for this work, we also actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our reference list. We actively worked to promote sex and gender balance in our author group. While citing references scientifically relevant for this work, we also actively worked to promote sex and gender balance in our reference list.
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PURPOSE: The study aimed to investigate longitudinal, bidirectional associations between discrimination due to multiple reasons (race/ethnicity, sexual orientation, weight; termed multiple discrimination) and substance use (SU) intention in late childhood. These associations were compared across youth with no, single, and multiple (i.e., intersecting) marginalized identities based on race/ethnicity, sexual orientation, and overweight status. METHODS: Data were drawn from a national sample of youth in the Adolescent Brain Cognitive Development study (N = 8,530; 9-12 years old). Youth reported both their experiences of multiple discrimination (the number of forms of discrimination youth experienced) and SU intention at one-year and two-year follow-ups. Theoretically relevant covariates were included. RESULTS: Compared to non-marginalized youth (n = 2,689) and youth with single marginalized identities (n = 3,399), youth with intersecting marginalized identities (n = 2,442) reported the highest SU intention and multiple discrimination across waves. Only for this last group, multiple discrimination predicted stronger SU intention subsequently (ß = 0.07, 95% confidence interval [0.02, 0.11]), whereas stronger SU intention predicted lower levels of multiple discrimination over time (ß = -0.06, 95% confidence interval [-0.09, -0.02]). Sensitivity analyses yielded similar patterns with some nuances among subgroups of youth with varying intersecting marginalized identities. DISCUSSION: Multiple discrimination predicted stronger SU intention over time in late childhood, particularly among youth with intersecting marginalized identities. Policies and practices should consider addressing multiple discrimination to reduce SU disparities among diverse youth.
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Intenção , Transtornos Relacionados ao Uso de Substâncias , Humanos , Masculino , Feminino , Criança , Transtornos Relacionados ao Uso de Substâncias/psicologia , Estudos Longitudinais , Adolescente , Desenvolvimento do Adolescente , Comportamento Sexual/psicologia , Estados UnidosRESUMO
OBJECTIVE: Irritability, typically defined as a proneness to anger, particularly in response to frustration, falls at the intersection of emotion and disruptive behavior. Despite well-defined translational models, there are few convergent findings regarding the pathophysiology of irritability. Most studies utilize computer-based tasks to examine neural responses to frustration, with little work examining stress-related responding to frustration in social contexts. The present study is the first to utilize the novel Frustration Social Stressor for Adolescents (FSS-A) to examine associations between adolescent irritability and psychological and physiological responses to frustration. METHOD: The FSS-A was completed by a predominantly male, racially, ethnically, and socioeconomically diverse sample of 64 12- to 17-year-olds, who were originally recruited as children with varying levels of irritability. Current irritability was assessed using the Multidimensional Assessment Profiles-Temper Loss scale (MAP-TL-Youth). Adolescents rated state anger and anxiety before and after the FSS-A, and usable salivary cortisol data were collected from 43 participants. RESULTS: Higher MAP-TL-Youth scores were associated with greater increases in anger during the FSS-A, but not increases in anxiety, or alterations in cortisol. Pre-task state anger negatively predicted the slope of the rise in cortisol observed in anticipation of the FSS-A. CONCLUSIONS: Results provide support for unique associations between adolescent irritability and anger during, and in anticipation of, frustrating social interactions. Such findings lay a foundation for future work aimed at informing physiological models and intervention targets.
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Ira , Ansiedade , Frustração , Hidrocortisona , Humor Irritável , Saliva , Humanos , Adolescente , Masculino , Feminino , Humor Irritável/fisiologia , Ira/fisiologia , Hidrocortisona/análise , Hidrocortisona/metabolismo , Saliva/química , Ansiedade/psicologia , Criança , Estresse Psicológico/psicologiaRESUMO
PURPOSE: This study sought to examine whether the daily associations between ethnic/racial discrimination and stress responses served as mediators linking ethnic/racial identity (ERI), adolescent sleep health, and somatic symptoms. METHODS: Data were drawn from 279 adolescents of color (69% female; 24% African Americans; 31% Asian Americans; 41% Latinx; and 4% unknown ethnicity/race; Mage = 14.31 years, SD = 0.65). Adolescents first completed an online survey about ERI exploration and commitment; and then 14-day diaries on ethnic/racial discrimination and stress responses (i.e., rumination and problem-solving coping), and finally, a post-diary survey about sleep and somatic health over the past two weeks. This study adopts slope-as-mediator mediation modeling, a novel approach highlighting the role of daily-level experiences in developmental processes by examining the day-to-day association between two variables as an explanatory mechanism. RESULTS: The daily associations between ethnic/racial discrimination and two stress responses significantly mediated the link between ERI exploration and adolescents' subsequent sleep and somatic health. For ERI commitment, only the mediating pathway of the association between ethnic/racial discrimination and problem-solving coping was significant. DISCUSSION: Daily responses to ethnic/racial discrimination, both adaptively and maladaptively, could in part explain the association between ERI exploration and adolescent health. Active participation in cultural activities may increase adaptive responses to ethnic/racial discrimination; meanwhile, uncertainty about ERI may lead to maladaptive reactions such as rumination. For ERI commitment, only problem-solving coping with ethnic/racial discrimination mediated the links to health outcomes, an observation possibly explained by the benefits of holding a strong sense of commitment to ERI.
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Nível de Saúde , Racismo , Sono , Identificação Social , Adolescente , Feminino , Humanos , Masculino , Negro ou Afro-Americano , Etnicidade , Asiático , Hispânico ou LatinoRESUMO
Early-life stress and ovarian hormones contribute to increased female vulnerability to cocaine addiction. Here, we reveal molecular substrates in the reward area, the nucleus accumbens, through which these female-specific factors affect immediate and conditioning responses to cocaine. We find shared involvement of X chromosome inactivation-related and estrogen signaling-related gene regulation in enhanced conditioning responses following early-life stress and during the low-estrogenic state in females. Low-estrogenic females respond to acute cocaine by opening neuronal chromatin enriched for the sites of ΔFosB, a transcription factor implicated in chronic cocaine response and addiction. Conversely, high-estrogenic females respond to cocaine by preferential chromatin closing, providing a mechanism for limiting cocaine-driven chromatin and synaptic plasticity. We find that physiological estrogen withdrawal, early-life stress, and absence of one X chromosome all nullify the protective effect of a high-estrogenic state on cocaine conditioning in females. Our findings offer a molecular framework to enable understanding of sex-specific neuronal mechanisms underlying cocaine use disorder.
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Experiências Adversas da Infância , Cocaína , Masculino , Feminino , Humanos , Cocaína/farmacologia , Núcleo Accumbens , Cromatina , Estrogênios/farmacologiaRESUMO
Many currently available effect size measures for mediation have limitations when the predictor is nominal with three or more categories. The mediation effect size measure υ was adopted for this situation. A simulation study was conducted to investigate the performance of its estimators. We manipulated several factors in data generation (number of groups, sample size per group, and effect sizes of paths) and effect size estimation [different R-squared (R 2) shrinkage estimators]. Results showed that the Olkin-Pratt extended adjusted R 2 estimator had the least bias and the smallest MSE in estimating υ across conditions. We also applied different estimators of υ in a real data example. Recommendations and guidelines were provided about the use of this estimator.
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OBJECTIVE: This cross-sectional study investigates the independent and interactive effects of depression and socioeconomic status (SES) on neurocognition in a diverse sample of people with HIV (PWH). METHOD: The sample of 119 PWH (71% Latinx, 27% female) completed comprehensive neurocognitive and psychosocial evaluations and were separated into two groups: those with a history of depression diagnosis (n = 47) and those without (n = 72). RESULTS: The results of regression analyses indicated that lifetime depression was not associated with lower SES nor with worse neurocognitive performance on any neurocognitive outcome. However, a significant main effect of SES was observed on the Hopkins Verbal Learning Test (total), indicating that higher SES was associated with better verbal learning performance (B= .11, SE = .05, p< .02). Lastly, the results revealed an interactive effect of lifetime depression and SES, such that individuals with depression and higher SES performed better on tests of attention/working memory (i.e., WAIS-III Letter-Number Sequencing, B= .08, SE = .04, p< .02; Paced Auditory Serial Addition Test, B= .39, SE = .16, p< .02). CONCLUSIONS: Depression and SES appear to play an important role in the neurocognitive performance of PWH. Specifically, higher SES appears to have a protective effect on attention/working memory among PWH only if they have co-morbid history of lifetime depression.
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Infecções por HIV , Classe Social , Humanos , Feminino , Masculino , Estudos Transversais , Aprendizagem Verbal , Memória de Curto Prazo , Infecções por HIV/complicações , Infecções por HIV/epidemiologiaRESUMO
BACKGROUND: Ovarian hormone fluctuations over the rodent estrous cycle and the human menstrual cycle are known to significantly impact brain physiology and disease risk, yet this variable is largely ignored in preclinical neuroscience research, clinical studies, and psychiatric practice. METHODS: To assess the importance of the estrous cycle information for the analysis of sex differences in neuroscience research, we re-analyzed our previously published data with or without the estrous cycle information, giving a side-by-side comparison of the analyses of behavior, brain structure, gene expression, and 3D genome organization in female and male mice. We also examined and compared the variance of female and male groups across all neurobehavioral measures. RESULTS: We show that accounting for the estrous cycle significantly increases the resolution of the neuroscience studies and allows for: (a) identification of masked sex differences; (b) mechanistic insight(s) into the identified sex differences, across different neurobehavioral outcomes, from behavior to molecular phenotypes. We confirm previous findings that female data from either mixed- or staged-female groups are, on average, not more variable than that of males. However, we show that female variability is not, at all, predictive of whether the estrous cycle plays an important role in regulating the outcome of interest. CONCLUSIONS: We argue that "bringing back" the estrous cycle variable to the main stage is important in order to enhance the resolution and quality of the data, to advance the health of women and other menstruators, and to make research more gender-inclusive. We strongly encourage the neuroscience community to incorporate the estrous cycle information in their study design and data analysis, whenever possible, and we debunk some myths that tend to de-emphasize the importance and discourage the inclusion of this critically important biological variable. Highlights Ovarian hormone fluctuation impacts brain physiology and is a major psychiatric risk factor, yet this variable has been overlooked in neuroscience research and psychiatric practice. From rodent behavior to gene regulation, accounting for the estrous cycle increases the resolution of the neuroscience data, allowing identification and mechanistic insight(s) into sex differences. Female variability does not equal (and is not predictive of) the estrous cycle effect and should not be used as a proxy for the effects of ovarian hormones on the outcome of interest. Neuroscience researchers are advised to incorporate the estrous cycle information in their studies to foster more equitable, female- and gender-inclusive research. Studies of the ovarian cycle are especially important for improving women's mental health.
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Ciclo Estral , Caracteres Sexuais , Feminino , Camundongos , Masculino , Humanos , Animais , Ciclo Estral/metabolismo , Ciclo Menstrual , HormôniosRESUMO
OBJECTIVE: In patients with cancer across the illness trajectory, treatment decisions are often influenced by one's perception of their prognosis (i.e., curability of disease, life expectancy, quality of life). However, research on how patients understand their prognosis (i.e., prognostic understanding) has been limited by simplistic measurement tools that fail to capture the complexity of the construct. This study describes the initial development of a measure of prognostic understanding: the Prognostic Understanding Perceptions Scale (PUPS) for use in patients with advanced cancer. METHOD: An initial pool of 16 candidate items were developed through semi-structured interviews with 15 experts (oncology, psycho-oncology and palliative care professionals) and 30 advanced cancer patients. We investigated the dimensionality, internal item structure, item difficulty and item discrimination of the item pool using exploratory factor analysis (EFA), classical test theory (CTT) and item response theory (IRT) analyses. Convergent and divergent validity were based on correlations between PUPS, terminal illness acknowledgement, and self-report measures of depression, anxiety, hopelessness, and death acceptance. RESULTS: The final measure was comprised of nine items encompassing three factors (perceived curability, illness trajectory, treatment options), yielding strong psychometric properties. CONCLUSION: These results provide preliminarily support for PUPS as a multifaceted measure of prognostic understanding developed for use in patients with advanced cancer. Preliminary findings also highlight the potential utility of the PUPS for clinical settings, as a means of enhancing communication between patients and physicians.
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Neoplasias , Qualidade de Vida , Análise Fatorial , Humanos , Neoplasias/terapia , Cuidados Paliativos , Psicometria/métodos , Reprodutibilidade dos Testes , Inquéritos e QuestionáriosRESUMO
BACKGROUND: Obsessive-compulsive disorder (OCD) is an often disabling and chronic condition that is normally assessed using diagnostic interviews or lengthy self-report questionnaires. This makes routine screening in general health settings impractical, and as a result OCD is often under-(or mis-)recognized. The present study reports on the development of an ultra-brief version of the Obsessive-Compulsive Inventory-Child Version (OCI-CV) which may be administered routinely as a screener for pediatric OCD. METHOD: A total of 489 youth diagnosed with OCD, 259 non-clinical controls, and 299 youth with other disorders completed the OCI-CV and other indices of psychopathology. Using item analyses, we extracted five items and examined the measure's factor structure, sensitivity and specificity, and convergent and discriminant validity. RESULTS: We extracted five items that assess different dimensions of OCD (washing, checking, ordering, obsessing, neutralizing/counting), termed the OCI-CV-5. Results revealed that the measure possesses good to excellent psychometric properties, and a cutoff off (≥2) yielded optimal sensitivity and specificity. LIMITATIONS: Participants were predominantly White. In addition, more research is needed to examine the OCI-CV-5's test-retest reliability and sensitivity to treatment. CONCLUSIONS: The OCI-CV-5 shows promise as an ultra-brief self-report screener for identifying OCD in youth when in-depth assessment is unfeasible.
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Transtorno Obsessivo-Compulsivo , Adolescente , Criança , Humanos , Transtorno Obsessivo-Compulsivo/diagnóstico , Escalas de Graduação Psiquiátrica , Psicometria/métodos , Reprodutibilidade dos Testes , Inquéritos e QuestionáriosRESUMO
Ethnic/racial discrimination is associated with negative psychosocial outcomes, and this study considered sleep disturbance as a mediating pathway. Employing a combination of daily diary and biannual surveys, multilevel structural equation models estimated the indirect effects of sleep/wake concerns on negative, anxious, and positive mood, rumination, and somatic symptoms. In a sample of 350 urban Asian (74% Chinese, 8% Korean, 4% Indian, 1% Filipinx, 1% Vietnamese, and 12% other), Black, and Latinx (25% Dominican, 24% South American, 22% Mexican, 15% Puerto Rican, 5% Central American, and 9% other) youth (M = 14.27 years, 69% female, 77% U.S. born, 76% monoethnic/racial, data collected from 2015 to 2018), there was evidence for sleep disturbances mediating the impact of ethnic/racial discrimination on adjustment. Nighttime disturbance, daytime dysfunction, and daytime sleepiness evidenced partial or full mediation for daily- and person-level outcomes (υ = 0.1%-17.9%). Reciprocal associations between sleep disturbances and negative mood and rumination were also observed.
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Racismo , Transtornos do Sono-Vigília , Adolescente , Etnicidade , Feminino , Humanos , Masculino , Saúde Mental , Racismo/psicologia , Sono , Transtornos do Sono-Vigília/psicologiaRESUMO
BACKGROUND: The Obsessive-Compulsive Inventory-Children's Version (OCI-CV) was developed to assess obsessive-compulsive symptoms in youth. Recent changes in the Diagnostic and Statistical Manual (DSM-5) exclude hoarding from inclusion in the diagnosis of obsessive-compulsive disorder (OCD). Accordingly, the present study examined the reliability, validity, factorial structure, and diagnostic sensitivity of a revised version of the scale - the OCI-CV-R- that excludes items assessing hoarding. METHODS: Participant were 1047 youth, including 489 meeting DSM criteria for primary OCD, 298 clinical controls, and 260 nonclinical controls, who completed the OCI-CV and measures of obsessive-compulsive symptom severity, depression, and anxiety at various treatment and research centers. RESULTS: Findings support a five-factor structure (doubting/checking, obsessing, washing, ordering, and neutralizing), with a higher order factor. Factorial invariance was found for older (12-17 years) and younger (7-11 years) children. Internal consistency of the OCI-CV-R was acceptable, and discriminant and convergent validity were adequate and akin to that of its progenitor. Diagnostic sensitivity and specificity were found for a total score of 8 and higher. CONCLUSION: It is recommended that the OCI-CV-R replace the former version, and that this measure serve as part of a comprehensive clinical assessment of youth with OCD. Recommendations for further research with ethnically and racially diverse samples, as well as the need to establish benchmark scores are discussed.
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Transtorno Obsessivo-Compulsivo , Adolescente , Ansiedade , Humanos , Transtorno Obsessivo-Compulsivo/diagnóstico , Escalas de Graduação Psiquiátrica , Psicometria , Reprodutibilidade dos Testes , Inquéritos e QuestionáriosRESUMO
Adopting the constructs of exposure, reactivity, and recovery, from stress and coping frameworks, this study investigated three models of discrimination, adjustment, and ethnic/racial identity among 76 African American, 145 Asian American, and 129 Latinx adolescents who were majority United States-born. The sample includes adolescents sampled from public schools in a large urban area in the northeastern United States, 62% female and with an average age of 14.3 years. Multilevel analyses support an exposure effect (Model 1) where a higher level of ethnic/racial identity (ERI) commitment was associated with a 28% reduction in experiencing discrimination stress. The negative effects of discrimination were attenuated by ERI commitment and centrality/private regard, while effects were exacerbated by ERI exploration (Model 2). Two approaches investigated next-day and longer-term recovery from discrimination (Model 3). With the exception of positive mood and anxiety, the data support recovery from discrimination stress. Discrimination is discussed in the development and maintenance of health disparities. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Racismo , Identificação Social , Adaptação Psicológica , Adolescente , Negro ou Afro-Americano , Asiático , Etnicidade , Feminino , Humanos , Masculino , Estados UnidosRESUMO
This study examines how everyday discrimination is associated with 6-day trajectories of sleep/wake problems, operationalized as sleep disturbance and daytime dysfunction, among 350 diverse adolescents (Mage = 14.27, SD = 0.61, 69% female; 22% African American, 41% Asian American, 37% Latinx; 24% multiethnic/racial; across participating schools, 72% of students eligible for free/reduced price lunch) in the Northeastern United States. Adolescents encountering discrimination experienced changes in sleep/wake problem trajectories (i.e., significant increases in same-day sleep/wake problems), whereas adolescents reporting no discrimination experienced no changes in trajectories (Cohen's ds = .51-.55). Multiethnic/racial (compared to monoethnic/racial) adolescents experiencing everyday discrimination reported greater same-day sleep/wake problems, yet steeper decreases in sleep/wake problems suggesting stronger impact coupled with faster return to baseline levels.
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Racismo , Transtornos do Sono-Vigília , Adolescente , Negro ou Afro-Americano , Asiático , Feminino , Humanos , Masculino , SonoRESUMO
BACKGROUND: Hypertension (HTN) and HIV are salient risk factors for cerebral small vessel disease and neurocognitive (NC) impairment, yet the effects of HTN on NC performance in persons living with HIV remain poorly understood. This is the first study to examine the longitudinal associations between blood pressure (BP), HTN, and pulse pressure (PP) with NC performance in persons living with HIV. SETTING: New York City. METHODS: Analysis of medical, NC, and virologic data from 485 HIV+ participants was collected by the Manhattan HIV Brain Bank, a prospective, observational, longitudinal study of neuroHIV. A series of multilevel linear growth curve models with random intercepts and slopes were estimated for BP, HTN status, and PP to predict the change in NC performance. RESULTS: The baseline prevalence of HTN was 23%. Longitudinal changes in diastolic and systolic pressure were associated with a 10.5-second and 4-second increase in the Grooved Pegboard Test nondominant hand performance, respectively. A longitudinal change in diastolic BP was also associated with a 0.3-point decline in correct categories and 3-point increase in perseverative responses and total errors on the Wisconsin Card Sorting Test. Increasing odds of prevalent and/or incident HTN were associated with a 0.1-point decrease in correct categories and a 0.8-point increase in total errors on the Wisconsin Card Sorting Test. There was no association between PP and NC performance. CONCLUSIONS: The results indicate linear longitudinal relations for BP and HTN with poorer NC test performance, particularly in psychomotor and executive functions in persons with HIV.
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Terapia Antirretroviral de Alta Atividade/efeitos adversos , Pressão Sanguínea/fisiologia , Infecções por HIV/tratamento farmacológico , Hipertensão/complicações , Transtornos Neurocognitivos/etiologia , Adulto , Feminino , Infecções por HIV/complicações , Humanos , Hipertensão/epidemiologia , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Transtornos Neurocognitivos/epidemiologia , Estudos ProspectivosRESUMO
Unfair treatment based on race is an unfortunate reality. While there is increasing interest in mapping the daily and longer-term impact of discrimination in psychology, studies that examine the psychometric properties of indicators spanning these timeframes are limited. Item response analysis examined the measurement characteristics of two daily measures of ethnic/racial discrimination: (a) the six-item Racial/Ethnic Discrimination Index (REDI), and (b) the modified five-item Everyday Discrimination Scale (EDS; Williams et al., Journal of Health Psychology, 1997, 2, 335). This study investigated whether the two scales can be appropriately adapted to access adolescents' daily-level ethnic/racial discrimination experiences. Both measures were administered for 14 consecutive days in a sample of 350 adolescents attending public schools in a large, urban area. Results suggest that the REDI has high loading and high difficulty. All REDI items functioned similarly at daily and person levels, suggesting that any single REDI item measured on a single day is sufficient for measuring daily ethnic/racial discrimination experiences. The EDS also shows high loading and high difficulty. However, EDS items functioned differently at the daily and person levels. REDI items were invariant across gender and race/ethnicity (African Americans, Asians, and Latinx). Recommendations for measuring daily ethnic/racial discrimination are discussed. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Etnicidade/psicologia , Testes Psicológicos , Racismo/psicologia , Adolescente , Feminino , Humanos , Estudos Longitudinais , Masculino , Análise Multinível , Psicometria , Racismo/estatística & dados numéricos , Reprodutibilidade dos Testes , Estados UnidosRESUMO
People living with HIV (PLWH) report higher rates of cannabis use than the general population, a trend likely to continue in light of recent policy changes and the reported therapeutic benefits of cannabis for PLWH. Therefore, it is important to better understand cannabis-associated effects on neurocognition, especially as PLWH are at heightened risk for neurocognitive impairment. This study aimed to elucidate the effects of a past cannabis use disorder on current neurocognition in a diverse sample of PLWH. This cross-sectional study included 138 PLWH (age M(SD) = 47.28(8.06); education M(SD) = 12.64(2.73); 73% Male; 71% Latinx) who underwent neuropsychological, DSM-diagnostic, and urine toxicology evaluations. One-way ANCOVAs were conducted to examine effects of a past cannabis use disorder (CUD+) on tests of attention/working memory, processing speed, executive functioning, verbal fluency, learning, memory, and motor ability. Compared to the past CUD- group, the past CUD+ group performed significantly better on tests of processing speed, visual learning and memory, and motor ability (p's < .05). Findings suggest PLWH with past cannabis use have similar or better neurocognition across domains compared to PLWH without past use.