Patterns of Co-occurring Developmental Failures in Adolescence: Socioeconomic and Genetic Antecedents and Health Outcomes in Adulthood.

This study investigates (1) conjoint latent classes of adolescent co-occurring developmental problems (obesity, depressive symptoms, and low educational attainment), (2) socioeconomic and genetic influences on these classes of adolescents' problem trajectories, and (3) physical health consequences of those latent classes. Data from the National Longitudinal Study of Adolescent to Adult Health (Add Health; N = 9,107; mean age = 15.5 years; Female = 52.9 per cent) were used to identify classes of early socioeconomic adversity and conjoint trajectory groups of co-occurring developmental problems. Profiles of social antecedents, genetic endowments (polygenic scores), and physical health outcomes in young adulthood were compared across identified four conjoint trajectory risk groups (overall high-risk, overall low-risk, BMI-risk or obesity, low education-risk). The results showed that youth with overall high-risk and BMI/education-specific risk trajectory groups were more likely to be Black or Hispanic, reported more adverse socioeconomic characteristics and genetic endowment, and averaged significantly poorer physical health in young adulthood compared with youth in the overall low-risk problem trajectory group. Less pronounced differences emerged between the high-risk and problem-specific-risk groups. The findings highlight heterogeneity in adolescent co-occurring developmental problems. Adolescent heterogeneous problem co-development is associated with background socioeconomic and genetic characteristics and physical health in young adulthood.

Long-Term Physical Health Consequences of Financial and Marital Stress in Middle-Aged Couples.

OBJECTIVE: To examine psychological health as a mechanism linking economic pressure and marital instability in the early middle years to poor physical health in later life. BACKGROUND: Although previous research suggests that sustained stressful marital experience may lead to mental and physical health problems, little is known about how contextual factors, such as economic pressure, impact marital outcomes, and how changes in marital attributes influence health outcomes in a longitudinal and dyadic context. METHOD: Utilizing an actor-partner interdependence model within a latent growth curve approach and prospective data from couples in enduring marriages, we examined the associations between family economic pressure, marital instability, and mental health over their early middle years (1989-1994) and subsequent physical health in later adulthood (2015). Analyses assessed a couple-level pathway and an individual pathway involving within-spouse and between-spouse effects. RESULTS: During the middle years, family financial difficulties were linked to reduced marital stability, which was associated with increased mental health challenges. The findings also reinforced the salient role of psychological distress for subsequent physical health outcomes as husbands' and wives' anxiety symptoms over their early middle years contributed to declines in their physical health outcomes in later adulthood. A partner effect was noted between husbands' anxiety and wives' physical health. CONCLUSION: For couples, experiences of financial and marital stress in their early middle years can have long-lasting detrimental impacts on their physical health in later adulthood.

The Contribution of Stressful Marital Interactions to Loneliness and Health across Mid-life and Later Adulthood.

Although past research has noted longitudinal, and sometimes bi-directional, associations between marital interactions, loneliness, and physical health, previous work has not identified long-term associations and differential associations over life-course stages (i.e., mid-life and later adulthood). Utilizing a life-course stress process perspective and a sample of 250 couples in enduring marriages over 17 years (2001-2017), a structural equation model within a dyadic framework assessed the unique influences of stressful marital interactions on loneliness and physical health and the variation in bi-directional influences of loneliness and physical health over time. Marital interactions were relatively stable across life stages, yet marital interactions appear to influence loneliness and physical health. Notable distinctions were evident across life stages (from mid-life to later adulthood and then within later adulthood). Findings are discussed with an emphasis on the implications for health promotion and prevention programs targeting couples' quality of life in later years.

Sex and Body Circumferences Associated with Serum Leptin in African American Adults.

Objective: Cardiovascular disease (CVD) continues to be a leading cause of death for U.S. adults, especially African Americans (AA). Yet, few studies have examined a comprehensive set of metabolic health and health behavior factors related to CVD risk in this population. This study investigated the relationship between serum leptin and anthropometries (body mass index [BMI], circumferences [waist-WC, hip-HC, and waist/hip ratio W/H]), metabolic health (systolic and diastolic blood pressure [BP], serum lipids, glucose, and C-reactive protein [CRP]), and health behaviors (hours of sleep, physical activity) in midlife and older AAs. Materials and Methods: Participants (n = 89, ≥45 years of age) were AAs in six churches in North Florida enrolled in a broader church-based longitudinal study. Anthropometric measurements, serum analyses, and self-reported items. Results: Serum leptin was positively correlated with gender (being female) (r = 0.623, p < 0.001), BMI log transformed (r = 0.469, p < 0.001), WC (r = 0.440, p < 0.001), HC (r = 0.658, p < 0.001), use of BP medication (r = 0.216, p < 0.05), and serum CRP (r = 0.277, p < 0.01). Correlations by sex showed significant relationships for both men and women between leptin and BMI log transformed, WC, and HC. The final multiple regression model [R2 = 0.758, F(4, 66) = 55.871, p < 0.001] showed that 75.8% of the variance in leptin was explained by being female (ß = 0.65, p < 0.001), WC (ß = 0.26, p < 0.02), and HC (ß = 0.28, p < 0.01). Conclusions: Findings more specifically delineate the variables associated with serum leptin in AAs, particularly WC and HC, and suggest greater attention to possible risk for leptin resistance in AA females. Clinical Trial Registration: This study is registered at www.clinicaltrials.gov NCT03339050.

The biopsychosocial associations between marital hostility and physical health of middle-aged couples.

The aim of the current study was to investigate bio-psycho-behavioral associations between marital distress and the physical health of couples, with two different aspects of physical health outcomes receiving attention: physical illness and physical functional impairments over the middle years. Using an actor-partner interdependence model within a longitudinal approach and data from married heterosexual couples in enduring marriages (N = 370 dyads), we examined the mediating pathways which reflected biopsychosocial processes and addressed how trajectories spousal hostility may contribute to husbands' and wives' later health. The results indicated that hostile marital interactions in the early middle years could wear down couples' regulatory systems through greater psychological distress, more health-risk behaviors, and a higher body mass index (BMI), which in turn increased vulnerability to later physical health problems for both husbands and wives. For both husbands and wives, their evolved psychological distress influenced by both their own and their spouse's perceived spousal hostile behaviors, supported the stress-related dyadic process in the couples. The findings also emphasized the salient role of psychological distress in leading not only to an increased risk of physical illness directly but also to a higher risk of physical impairment through increased levels of BMI for both husbands and wives. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Modeling Latent Change Score Analysis and Extensions in Mplus: A Practical Guide for Researchers.

Many developmental and life course researchers are interested in modeling dynamic developmental processes. Latent change score (LCS) modeling is a potentially powerful modeling technique that can be used to assess complex life course processes, as well as the direction of longitudinal bivariate associations. Advances in modeling software, like Mplus, as well as widening adoption of software by researchers has made LCS modeling simpler. Thus, in the present paper, we provide 1) a theoretical overview of LCS analysis, 2) information on the interpretation of these models, 3) a practical guid7e for estimating these models in Mplus (including example syntax), 4) illustrative examples of LCS analysis, and 5) potential caveats for researchers.

Aging Together in Enduring Couple Relationships: A Life Course Systems Perspective.

This article introduces and demonstrates the use of an integrated life course systems perspective to advance the study of the aging processes of couples in enduring relationships. This objective is accomplished by bridging the life course and systems perspectives to conceptualize the couple as a functioning system and to locate couple dynamics within a longitudinal life course context in order to identify multilevel relational mechanisms that explain partners' aging outcomes in their broader socioeconomic and longitudinal context. Informed by this integrated theoretical perspective, testable hypotheses related to aging processes are derived, and analytical methodologies that can advance the research on couple aging processes are demonstrated. Identifying these relationship-health processes and contextual considerations provides insight into leverage points for the development and implementation of prevention and intervention efforts to facilitate positive aging outcomes. Directions for further theoretical and analytical advances in the area of couple aging are discussed.

Psychological Resources, Constructive Conflict Management Behaviors, and Depressive Symptoms: A Dyadic Analysis.

This study investigated the longitudinal associations between mastery, conflict management behaviors, and depressive symptoms using an actor-partner interdependence model with 371 middle-aged couples over a span of 24 years. Results indicated that for both husbands and wives, individuals who possessed higher levels of mastery generally displayed more constructive conflict management behaviors during marital conflicts in middle years. In turn, individuals with more constructive behaviors averaged fewer depressive symptoms in their later adulthood. A partner effect was also noted, as individuals' constructive behaviors were linked to their spouse's depressive symptoms. This finding emphasizes the importance of utilizing a dyadic context to understand intra-individual and inter-individual (or crossover) influences between husbands and wives in enduring marriages. A better understanding of how couples affect each other's mental health can inform the development and implementation of health promotion interventions and prevention efforts targeting middle-aged couples.

Este estudio investigó las asociaciones longitudinales entre el control, las conductas de manejo de conflictos y los síntomas depresivos usando un modelo de interdependencia actor-pareja con 371 parejas de mediana edad durante un periodo de 24 años. Los resultados indicaron que tanto en el caso de los esposos como en el de las esposas, las personas que tuvieron niveles más altos de control generalmente demostraron conductas más constructivas de manejo de conflictos durante los conflictos conyugales en la mediana edad. A su vez, las personas con más conductas constructivas promediaron menos síntomas depresivos en su tercera edad. También se observó un efecto de pareja, ya que las conductas constructivas de las personas estuvieron asociadas con los síntomas depresivos de su cónyuge. Este resultado enfatiza la importancia de utilizar un contexto diádico para comprender las influencias intraindividuales e interindividuales (o cruces) entre los esposos y las esposas en los matrimonios duraderos. Una mejor comprensión de cómo las parejas influyen mutuamente en su salud mental puede contribuir al desarrollo y la implementación de intervenciones de promoción de la salud y de esfuerzos de prevención dirigidos a las parejas en la mediana edad.

Health for Hearts United Longitudinal Trial: Improving Dietary Behaviors in Older African Americans.

INTRODUCTION: Church-based interventions have been shown to improve the dietary health of underserved populations, yet few studies have examined sustainability of health behavior change over time. This paper examines dietary outcomes over a 24-month period (baseline and 6, 18, and 24 months) for fruit and vegetable and fat consumption behaviors of African-American participants in the Health for Hearts United church-based intervention in North Florida. STUDY DESIGN: This quasi-experimental, longitudinal trial was conducted from 2009 to 2012. Data were analyzed in 2018. SETTING/PARTICIPANTS: Six churches in a 2-county area (3 treatment, 3 comparison) were selected for the study using community-based participatory research approaches. Participants were African-American adults (aged ≥45 years; n=211 at baseline) randomly selected from the churches, stratified by age and sex. INTERVENTION: Health for Hearts United intervention was developed by the 3 treatment churches. The 18-month intervention was implemented in 3 6-month phases, framed around 3 conceptual components, which included 4 types of programs and 4 key messages. MAIN OUTCOME MEASURES: Fruit and vegetable consumption was assessed using a single item (fruit and vegetable intake) and the National Cancer Institute Fruit and Vegetable Screener. Fat consumption was determined using a single item (fat intake) and the National Cancer Institute Fat Screener. Background characteristics included age, sex, educational level, and marital status. RESULTS: Significant time effects only were found for daily fruit and vegetable intake (p<0.001), fat intake (p<0.001), and the Fat Screener (p<0.001) with dietary improvements in both treatment and comparison groups across the intervention phases. Fruit and Vegetable Screener results showed that time (p<0.001) and the interaction between time and treatment (p<0.01) were significant, with increases in fruit and vegetable consumption over time for both the treatment and comparison groups and with the increase differing between groups. Post hoc analysis revealed that the treatment group had greater increases in fruit and vegetable consumption than the comparison group between Phases 1 and 3 (p=0.03). CONCLUSIONS: Dietary behaviors of mid-life and older African Americans can be improved and sustained over 24 months using a church-based heart health intervention, with similar improvements noted for both comparison and treatment participants. TRIAL REGISTRATION: This study is registered at www.clinicaltrials.govNCT03339050.

Life Course Patterns of Concurrent Trajectories of BMI and Affective Symptoms of Rural Mothers: Socioeconomic Antecedents and Disease Outcomes in Later Life.

OBJECTIVES: The current study, using prospective data over 25 years (1991-2015), concurrently investigates patterns of body mass index (BMI) and affective symptom trajectories in middle-aged mothers and the socioeconomic antecedents and disease outcomes of these patterns. METHOD: Growth mixture modeling was used to identify latent classes of conjoint health risk trajectories (BMI, depressive symptoms, and anxiety symptoms) from 1991 to 2001. For each latent class, we identified mean trajectories of each health risk. Then, analyses were conducted identifying how these conjoint health risk classes were associated with respondents' socioeconomic background profiles in 1991 and subsequent chronic health problems in 2015. RESULTS: Socioeconomic background profiles were significantly associated with initially high-risk trajectories. There was a statistically significant association between membership in certain classes of conjoint trajectories and physical health outcomes in later years. Consistent patterns of association with changes in different health outcomes including onset of diseases were observed when classes of conjoint risk trajectories are examined. DISCUSSION: The identification of members of various conjoint risk trajectory groups provides a potentially useful prognostic tool for early preventive intervention efforts, treatment, and policy formation. Such interventions should promote and develop resiliency factors, thereby aiding in the redirection of middle-aged women's adverse risk trajectories.

Role of Calcium and Low-Fat Dairy Foods in Weight-Loss Outcomes Revisited: Results from the Randomized Trial of Effects on Bone and Body Composition in Overweight/Obese Postmenopausal Women.

Several studies have investigated the possibility of dairy foods and calcium (Ca) mediating weight and body composition, but a consensus has not been reached. We aimed to investigate weight-loss-related outcomes during intervention with low-fat dairy foods or Ca + vitamin D supplements, both as complements to hypocaloric diets. Overweight/obese Caucasian, early-postmenopausal women (n = 135) were recruited for a 6 month energy-restricted weight loss study complemented with either low-fat dairy foods (D; 4-5 servings/day), or Ca + vitamin D supplements (S); both to amount a total of ~1500 mg/day and 600 IU/day of Ca and vitamin D, respectively, or placebo pills (C). Bone mineral density (BMD) and lean and fat tissue were measured by Lunar iDXA. Serum and urinary markers of bone turnover were analyzed. Diet and physical activity were assessed with 3-day records. Participants on average lost ~4%, ~3%, and ~2% of body weight, fat, and lean tissue, respectively. The significantly better outcomes were noticed in participants in the D group regarding body composition (fat loss/lean tissue preservation) and in participants in the S group regarding the BMD outcomes, compared to those in the C group. Therefore, increasing low-fat dairy foods to 4-5 servings/day and/or increasing Ca & vitamin D intake by supplements (in those who are at the borderline dietary intake) may be beneficial for weight loss/maintenance and may lead to more favorable bone and body composition outcomes in postmenopausal women during moderate weight loss.

The Impact of Family Economic Strain On Work-Family Conflict, Marital Support, Marital Quality, and Marital Stability During the Middle Years.

Over the past few decades, US families have been faced with several economic recessions. The regularity and severity of these economic crises lends to the importance of having an understanding of how these events affect families. The present study investigates the effects of family economic strain on marital quality and marital stability through individual and dyadic models, incorporating work-family conflict and marital support as mediators. The study analyzed secondary data from the Iowa Youth and Families Project (IYFP) and Midlife Transition Project (MTP) collected from 370 middle-aged married couples across a 12-year time period that encompassed the US early 1990s recession and the recession of 2001, which occurred between the years 1989 and 2001. The results support the hypotheses that the impact of economic strain upon marital quality and marital stability is mitigated through a positive perception of work-family conflict and marital support. Implications for future research and for financial practice are discussed.

Lower life satisfaction, active coping and cardiovascular disease risk factors in older African Americans: outcomes of a longitudinal church-based intervention.

This study examined lower life satisfaction, active coping and cardiovascular disease risk factors (diastolic and systolic blood pressure, body mass index, and circumferences) in older African Americans over the phases of an 18-month church-based intervention, using a quasi-experimental design. Participants (n = 89) were 45 years of age and older from six churches (three treatment, three comparison) in North Florida. Lower life satisfaction had a persistent unfavorable effect on weight variables. Active coping showed a direct beneficial effect on selected weight variables. However, active coping was adversely associated with blood pressure, and did not moderate the association between lower life satisfaction and cardiovascular risk factors. The intervention had a beneficial moderating influence on the association between lower life satisfaction and weight variables and on the association between active coping and these variables. Yet, this pattern did not hold for the association between active coping and blood pressure. The relationship of lower life satisfaction and selected cardiovascular risk factors and the positive effect of active coping were established, but findings regarding blood pressure suggest further study is needed.

The decade-long effect of work insecurity on husbands' and wives' midlife health mediated by anxiety: A dyadic analysis.

Although the detrimental physical health effects of work insecurity have been noted in previous research, less is known about the mediating processes, such as anxiety symptoms, that link work insecurity to physical health. Even less research has explored these effects at specific life stages and how these effects may impact significant others, even though the impact of this stress may vary across the life course and the mutual influences between married partners may cause dyadic effects stemming from partners' work insecurity. To fill these gaps, the current study incorporates theories that emphasize the stress-work connection, such as stress appraisal theory (Lazarus, 1999) and resource conservation theory (Hobfoll, 1989), into a neurobiological stress-health perspective. This study uses a sample of 330 consistently married, dual-earner husbands and wives who provided data at multiple time points over a 10-year period from 1991 to 2001. Results from a model including growth curves of work insecurity and anxiety symptoms when respondents were in their early middle years and reports of physical illness in their later middle years generally supported the hypothesized model. Both the level and rate of change in work insecurity were related to the change in anxiety symptoms over time. Similarly, the level and rate of change in anxiety symptoms from 1991 to 1994 were linked to subsequent illness years later in 2001. There was only partial support for the existence of partner effects. Findings are discussed as they relate to previous research as well as policy and clinical implications. (PsycINFO Database Record

Application of Latent Growth Curve Analysis with Categorical Responses in Social Behavioral Research.

Latent growth modeling allows social behavioral researchers to investigate within-person change and between-person differences in within-person change. Typically, conventional latent growth curve models are applied to continuous variables, where the residuals are assumed to be normally distributed, whereas categorical variables (i.e., binary and ordinal variables), which do not hold to normal distribution assumptions, have been rarely used. This article describes the latent growth curve model with categorical variables, and illustrates applications using Mplus software that are applicable to social behavioral research. The illustrations use marital instability data from the Iowa Youth and Family Project. We close with recommendations for the specification and parameterization of growth models that use both logit and probit link functions.

Mediational pathways connecting secondary education and age at marriage to maternal mortality: A comparison between developing and developed countries.

While studies have shown that maternal mortality rates have been improving worldwide, rates are still high across developing nations. In general, poor health of women is associated with higher maternal mortality rates in developing countries. Understanding country-level risk factors can inform intervention and prevention efforts that could bring high maternal mortality rates down. Specifically, the authors were interested in investigating whether: (1) secondary education participation (SEP) or age at marriage (AM) of women were related to maternal mortality rates, and (2) adolescent birth rate and contraceptive use (CU) acted as mediators of this association. The authors add to the literature with this current article by showing the relation of SEP and AM to maternal mortality rates globally (both directly and indirectly through mediators) and then by comparing differences between developed and developing/least developed countries. Path analysis was used to test the hypothesized model using country level longitudinal data from 2000 to 2010 obtained from United Nations publications, World Health Organization materials, and World Bank development reports. Findings include a significant correlation between SEP and AM for developing countries; for developed countries the relation was not significant. As well, SEP in developing countries was associated with increased CU. Women in developing countries who finish school before marriage may have important social capital gains.

Developmental Growth Trajectories of Self-Esteem in Adolescence: Associations with Child Neglect and Drug Use and Abuse in Young Adulthood.

Neglectful rearing is linked with young adults' substance use and abuse, though the developmental mechanisms that underlie this association are unclear. The present study examines links between self-esteem growth during adolescence, childhood supervisory versus physical neglect severity, and substance use and abuse in young adulthood. A sample of youth was obtained from the Add Health study (N = 8738; 55.4 %-Female; 20 %-African American, 14.7 %-Hispanic). Growth mixture modeling analyses supported declining, ascending, and stable high self-esteem trajectories. The declining and ascending trajectories reported greater neglect and alcohol abuse (but not use) as well as cannabis use and abuse. The findings suggest that compromised development of self-esteem underlies associations between neglect and substance use and abuse. Preventive interventions may benefit from targeting self-esteem among neglected youth.

The Socioeconomic Pathways Leading to Romantic Relationship Outcomes: A Genetically Informed Early Life Course Investigation.

The present study tests a multilevel comprehensive model incorporating both life course processes and genetic influences leading to young adults' romantic relationship quality using data from 1,560 adolescents over 13 years in the nationally representative Add Health sample. Results provided evidence of a socioeconomic mediating pathway linking early family and community contexts to young adults' romantic relationship quality, and novel evidence for both direct and interactive genetic associations that relate to these mediating pathways. A cumulative genetic index showed (a) direct associations with young adults' socioeconomic attainment and (b) interactions with community adversity and mothers' marital stability on young adults' achieved socioeconomic context and relationship quality.

Early socioeconomic adversity, youth positive development, and young adults' cardio-metabolic disease risk.

OBJECTIVE: Recent research suggests that psychosocial resources, including self-esteem, personality, and educational attainment, may be mechanisms explaining the socioeconomic variation in health risks. However, less research has examined this possibility over the early life course. METHOD: A nationally representative sample of 12,424 respondents with data collected over a 13-year period from National Longitudinal Study of Adolescent to Adult Health (Add Health) was examined. This study utilized a cumulative measure of early socioeconomic adversity capturing multiple dimensions of adversity to test resource focused models in a structural equation framework estimating the influence of early adversity on young adults' (ages 25-34) risk for cardio-metabolic disease, as measured by metabolic and cardiovascular bio-markers, through psychosocial resources (i.e., self-esteem, personality, and educational attainment). Lastly, potential model differences by sex and race/ethnicity were examined. RESULTS: The findings showed that early adversity contributed to young adults' cardio-metabolic disease risk directly. Additionally, early adversity increased young adults' cardio-metabolic disease risk indirectly through its' negative influence on the development of youths' psychosocial resources: self-esteem, positive personality, and educational attainment. The association between psychosocial resources and young adults' cardio-metabolic disease risk differed for men and women and across racial/ethnic groups. CONCLUSIONS: These findings contribute valuable knowledge to existing research by elucidating how early adversity exerts an enduring long-term influence on young adults' cardio-metabolic disease risk directly and indirectly through psychosocial resources. Furthermore, this information suggests that effective intervention and prevention programs should focus on early adversity and the development of youths' psychosocial resources.

Stress and resource pathways connecting early socioeconomic adversity to young adults' physical health risk.

Although research has established the impact of early stress, including stressful life contexts, and early resources, such as educational attainment, on various adolescent health outcomes, previous research has not adequately investigated "integrative models" incorporating both stress and resource mediational pathways to explain how early socioeconomic adversity impacts physical health outcomes, particularly in early life stages. Data on early childhood/adolescent stress and socioeconomic resources as well as biomarkers indicating physical health status in young adulthood were collected from 11,798 respondents (54 % female) over a 13-year period from youth participating in the National Study of Adolescent Health (Add Health). Physical health risk in young adulthood was measured using a composite index of nine regulatory biomarkers of cardiovascular and metabolic systems. Heterogeneity in stress and socioeconomic resource pathways was assessed using latent class analysis to identify clusters, or classes, of stress and socioeconomic resource trajectories. The influence of early socioeconomic adversity on young adults' physical health risk, as measured by biomarkers, was estimated, and the role of stress and socioeconomic resource trajectory classes as linking mechanisms was assessed. There was evidence for the influence of early socioeconomic adversity on young adults' physical health risk directly and indirectly through stress and socioeconomic resource trajectory classes over the early life course. These findings suggest that health models should be broadened to incorporate both stress and resource experiences simultaneously. Furthermore, these findings have prevention and intervention implications, including the importance of early socioeconomic adversity and key intervention points for "turning" the trajectories of at-risk youth.