Does Parental Mental Health Moderate the Association between Parenting Stress and Child Externalizing Behaviors Among Autistic Children?

Parents of autistic children experience significant parenting stress, which is prospectively associated with increases in child externalizing behaviors. However, family factors that place specific families at risk for experiencing the negative impacts of parenting stress on child externalizing behaviors have not been identified. The present study examined whether parental mental health moderates the association between parenting stress and child externalizing behaviors. Parents of 501 autistic children (Mage=5.16yrs) completed the Parenting Stress Index and Eyberg Child Behavior Inventory. Parents reported whether they had ever been diagnosed with a mental health disorder. Parenting stress, parental internalizing diagnosis, and parental externalizing diagnosis all independently predicted child externalizing behavior. However, parenting stress did not interact with any category of parental mental health diagnoses to predict child externalizing. Results implicate high levels of parenting stress as a risk factor for increased child behavior problems among autistic children across parental mental health statuses. Interventions aimed at reducing parenting stress may improve parent outcomes and prevent the development of child externalizing behaviors among families of autistic children.

Personalized Depression Prevention Reduces Dependent Stressors Among Adolescents: Results from a Randomized Controlled Trial.

OBJECTIVE: Depression and stressors both increase during adolescence. The stress generation model posits that depression symptoms and associated impairment contribute to the generation of dependent stressors. Adolescent depression prevention programs have been shown to reduce the risk of depression. Recently, risk-informed personalization approaches have been adopted to enhance the efficacy of depression prevention, and preliminary evidence supports the beneficial effects of personalized prevention on depression symptoms. Given the close association between depression and stress, we examined the hypothesis that personalized depression prevention programs would reduce adolescents' experience of dependent stressors (interpersonal and non-interpersonal) over longitudinal follow-up. METHOD: The present study included 204 adolescents (56% girls, 29% racial minority) who were randomized to receive either a cognitive-behavioral or an interpersonal prevention program. Youth were categorized as high or low on cognitive and interpersonal risk using a previously established risk classification system. Half of the adolescents received a prevention program that matched their risk profile (e.g., high cognitive risk randomized to cognitive-behavioral prevention); half received a mismatched program (e.g., high interpersonal risk randomized to cognitive-behavioral prevention). Exposure to dependent and independent stressors was assessed repeatedly over an 18-month follow-up period. RESULTS: Matched adolescents reported fewer dependent stressors during the post-intervention follow-up period (d = .46, p = .002) and from baseline through 18-months post-intervention (d = .35, p = .02) compared to mismatched youth. As expected, there were no differences between matched and mismatched youth on the experience of independent stressors. CONCLUSIONS: These findings further highlight the potential of personalized approaches to depression prevention and demonstrate benefits that go beyond depression symptom reduction.

Controlled human exposure to diesel exhaust: results illuminate health effects of traffic-related air pollution and inform future directions.

Air pollution is an issue of increasing interest due to its globally relevant impacts on morbidity and mortality. Controlled human exposure (CHE) studies are often employed to investigate the impacts of pollution on human health, with diesel exhaust (DE) commonly used as a surrogate of traffic related air pollution (TRAP). This paper will review the results derived from 104 publications of CHE to DE (CHE-DE) with respect to health outcomes. CHE-DE studies have provided mechanistic evidence supporting TRAP's detrimental effects on related to the cardiovascular system (e.g., vasomotor dysfunction, inhibition of fibrinolysis, and impaired cardiac function) and respiratory system (e.g., airway inflammation, increased airway responsiveness, and clinical symptoms of asthma). Oxidative stress is thought to be the primary mechanism of TRAP-induced effects and has been supported by several CHE-DE studies. A historical limitation of some air pollution research is consideration of TRAP (or its components) in isolation, limiting insight into the interactions between TRAP and other environmental factors often encountered in tandem. CHE-DE studies can help to shed light on complex conditions, and several have included co-exposure to common elements such as allergens, ozone, and activity level. The ability of filters to mitigate the adverse effects of DE, by limiting exposure to the particulate fraction of polluted aerosols, has also been examined. While various biomarkers of DE exposure have been evaluated in CHE-DE studies, a definitive such endpoint has yet to be identified. In spite of the above advantages, this paradigm for TRAP is constrained to acute exposures and can only be indirectly applied to chronic exposures, despite the critical real-world impact of living long-term with TRAP. Those with significant medical conditions are often excluded from CHE-DE studies and so results derived from healthy individuals may not apply to more susceptible populations whose further study is needed to avoid potentially misleading conclusions. In spite of limitations, the contributions of CHE-DE studies have greatly advanced current understanding of the health impacts associated with TRAP exposure, especially regarding mechanisms therein, with important implications for regulation and policy.

Controlled human exposure to diesel exhaust: a method for understanding health effects of traffic-related air pollution.

Diesel exhaust (DE) is a major component of air pollution in urban centers. Controlled human exposure (CHE) experiments are commonly used to investigate the acute effects of DE inhalation specifically and also as a paradigm for investigating responses to traffic-related air pollution (TRAP) more generally. Given the critical role this model plays in our understanding of TRAP's health effects mechanistically and in support of associated policy and regulation, we review the methodology of CHE to DE (CHE-DE) in detail to distill critical elements so that the results of these studies can be understood in context. From 104 eligible publications, we identified 79 CHE-DE studies and extracted information on DE generation, exposure session characteristics, pollutant and particulate composition of exposures, and participant demographics. Virtually all studies had a crossover design, and most studies involved a single DE exposure per participant. Exposure sessions were typically 1 or 2 h in duration, with participants alternating between exercise and rest. Most CHE-DE targeted a PM concentration of 300 µg/m3. There was a wide range in commonly measured co-pollutants including nitrogen oxides, carbon monoxide, and total organic compounds. Reporting of detailed parameters of aerosol composition, including particle diameter, was inconsistent between studies, and older studies from a given lab were often cited in lieu of repeating measurements for new experiments. There was a male predominance in participants, and over half of studies involved healthy participants only. Other populations studied include those with asthma, atopy, or metabolic syndrome. Standardization in reporting exposure conditions, potentially using current versions of engines with modern emissions control technology, will allow for more valid comparisons between studies of CHE-DE, while recognizing that diesel engines in much of the world remain old and heterogeneous. Inclusion of female participants as well as populations more susceptible to TRAP will broaden the applicability of results from CHE-DE studies.

Short-changing the future: The systemic gap between psychology internship stipends and living wages.

Introduction: Providing doctoral internship stipends below living wages may harm interns, the clinical services they provide, and the field of health service psychology as a whole. This study evaluated the extent to which doctoral psychology internship stipends from the 2021-2022 training year for APA-accredited, APPIC-member programs in the US are consistent with living wages in the geographic region where sites are located. Methods: We obtained data reflecting internship sites' geographic location and stipends for the 2021-2022 academic year. Using the Massachusetts Institute of Technology Living Wage Calculator, we computed a living wage for the county in which each internship site is located. Descriptive statistics, discrepancies, ratios, and correlations were calculated to reflect the associations between internship sites' stipends and their local living wages. Results: The average internship stipend was $31,783, which was lower than the average living wage by $2,091. Stipends ranged widely, from a low of $15,000 to a high of $94,595-reflecting a six-fold difference in wages. Although internship sites in higher cost of living areas paid higher stipends, over two-thirds (67.0%) of sites did not pay a stipend that equaled or exceeded a living wage. Ninety-eight sites (15.3%) had deficits of over $10,000 when comparing their stipends to local living wages, with $33,240 as the highest deficit. Discussion: Eliminating obstacles to educating health service psychologists by decreasing the financial burden of training will likely have subsequent critical benefits towards bridging the workforce gap between mental healthcare service needs and available providers, ultimately leading to improved population health.

Co-occurring Stress Trajectories and the Longitudinal Coupling of Internalizing Symptoms in Parent-Adolescent Dyads.

Stress is one candidate mechanism posited to contribute to the intergenerational risk of psychopathology. However, the ways in which parent and child stress are related across adolescence, and the role that co-occurring parent and child stress may exert regarding bidirectional risk for internalizing symptoms, are not well understood. Using repeated measures data spanning 3-years, this study investigated (1) the extent to which trajectories of parent and child stress are related during adolescence, and (2) whether co-occurring parent and child stress trajectories mediate prospective, bidirectional associations between parent depression symptoms and child internalizing symptoms (depression, physical and social anxiety). Participants included 618 parent-adolescent dyads (age 8-16; 57% girls; 89% mothers). Parent depressive symptoms and child symptoms of depression, social anxiety, and physical anxiety were assessed via self-report questionnaire at baseline and 36 months later. Parent and child stress were assessed via self-report questionnaire every three months between 3- and 33-months (11 total assessments). Latent growth curve model (LGCM) analysis found that parent and child stress trajectories were positively related across development. Prospective LGCM mediation analysis showed that higher youth stress at 3-months partially mediated prospective relations between parental depressive symptoms at baseline and youth depressive, as well as physical and social anxiety symptoms at 36-months. Parent and child stress reinforce each other across adolescence and may lead to increased risk for psychopathology. Increases in child stress represent an important factor conferring transdiagnostic risk for internalizing among children of depressed parents.

Tumor-derived GCSF Alters Tumor and Systemic Immune System Cell Subset Composition and Signaling.

While immunotherapies such as immune checkpoint blockade and adoptive T-cell therapy improve survival for a subset of human malignancies, many patients fail to respond. Phagocytes including dendritic cells (DC), monocytes, and macrophages (MF) orchestrate innate and adaptive immune responses against tumors. However, tumor-derived factors may limit immunotherapy effectiveness by altering phagocyte signal transduction, development, and activity. Using Cytometry by Time-of-Flight, we found that tumor-derived GCSF altered myeloid cell distribution both locally and systemically. We distinguished a large number of GCSF-induced immune cell subset and signal transduction pathway perturbations in tumor-bearing mice, including a prominent increase in immature neutrophil/myeloid-derived suppressor cell (Neut/MDSC) subsets and tumor-resident PD-L1+ Neut/MDSCs. GCSF expression was also linked to distinct tumor-associated MF populations, decreased conventional DCs, and splenomegaly characterized by increased splenic progenitors with diminished DC differentiation potential. GCSF-dependent dysregulation of DC development was recapitulated in bone marrow cultures in vitro, using medium derived from GCSF-expressing tumor cell cultures. Importantly, tumor-derived GCSF impaired T-cell adoptive cell therapy effectiveness and was associated with increased tumor volume and diminished survival of mice with mammary cancer. Treatment with neutralizing anti-GCSF antibodies reduced colonic and circulatory Neut/MDSCs, normalized colonic immune cell composition and diminished tumor burden in a spontaneous model of mouse colon cancer. Analysis of human colorectal cancer patient gene expression data revealed a significant correlation between survival and low GCSF and Neut/MDSC gene expression. Our data suggest that normalizing GCSF bioactivity may improve immunotherapy in cancers associated with GCSF overexpression. Significance: Tumor-derived GCSF leads to systemic immune population changes. GCSF blockade restores immune populations, improves immunotherapy, and reduces tumor size, paralleling human colorectal cancer data. GCSF inhibition may synergize with current immunotherapies to treat GCSF-secreting tumors.

Stress Mediates the Within-Person Longitudinal Associations Between Depression and Different Anxiety Syndromes in Youth.

Depressive symptoms predict within-person change in physical symptoms of anxiety and social anxiety symptoms; however, potential mediators of these within-person associations remain understudied. The current study examined whether overall stress, interpersonal stress, and achievement stress mediate the associations between depressive symptoms and physical, social, and separation anxiety symptoms for girls and boys in a sample of 680 community youth aged 8-18 (M = 11.8, SD = 2.4; 55% female) using a random intercept cross-lagged panel model (RI-CLPM). Participants completed measures of anxiety symptoms, depression symptoms, and stress (Adolescent Life Events Questionnaire) every 3 months for 3 years (13 total assessments). Overall and interpersonal stress partly mediated the longitudinal, within-person associations between depression symptoms and physical symptoms of anxiety and between depression symptoms and social anxiety symptoms. Stress did not mediate the longitudinal associations between depression and separation anxiety symptoms. Multigroup models indicated that total stress mediated the associations between depression and physical symptoms of anxiety, and between depression and social anxiety for girls but not for boys. Results support the role of stress as a mediator of the association between depression and anxiety symptoms and suggest that, as youth experience depression-related impairment, they may generate additional stressors, which increase their symptoms of physical and social anxiety.

The relationship between stressful events, emotion dysregulation, and anxiety symptoms among youth: longitudinal support for stress causation but not stress generation.

INTRODUCTION: There is a clear bi-directional link between stressful events and depressive symptoms in adolescence, but the directionality of this link for anxiety symptoms remains underexamined. We critically evaluate the longitudinal relationship between stressors and anxiety among youth. Specifically, we examine whether stressors predict anxiety symptoms over a 1.5-year period (stress causation), and whether anxiety symptoms predict stressors over this period (stress generation). We examine potential influencing factors, including stressor type (independent vs. dependent) and emotion dysregulation (nonacceptance; goal-directed difficulty). METHODS: Social, separation, and physical anxiety symptoms, and frequency and stressor type, were assessed every 3 months for 1.5 years among community youth (n = 528, ages 8-17). Baseline emotion dysregulation was assessed. Time-lagged analyses evaluated the bi-directional relationship of stress and anxiety over time, controlling for previous anxiety and depression. RESULTS: Interpersonal stressors predicted subsequent physical and social anxiety symptoms, but anxiety did not predict subsequent stressors. Both nonacceptance and goal-directed difficulties predicted subsequent anxiety symptoms and stressors, but did not moderate the relationship. CONCLUSION: The findings supported the stress causation model for youth anxiety, but not the stress generation model. Nonacceptance and goal-directed difficulty predicted greater subsequent anxiety symptoms and stressors. We discuss implications for prevention and intervention.

Evaluation of the ratio of collagen type III to collagen type I in periurethral tissues of sexually intact and neutered female dogs.

OBJECTIVE: To determine the ratio of collagen type III to collagen type I in the periurethral tissues of sexually intact and neutered female dogs. ANIMALS: 8 neutered and 34 sexually intact female dogs. PROCEDURES: Tissues were obtained from female dogs euthanized for non-urinary tract-related reasons. Indirect immunofluorescent antibody detection of type I and collagen type III was performed by use of confocal microscopy on 2 periurethral samples from each dog, and the ratios of collagen type III to type I area fraction and total area were determined. RESULTS: No significant differences were detected in the collagen ratios of periurethral tissues between sexually intact and neutered female dogs. CONCLUSIONS AND CLINICAL RELEVANCE: In contrast to differences in periurethral collagen content found between pre- and postmenopausal women, such differences may not occur in dogs. This implies that changes in pelvic organ support structures may not play an important role in urinary incontinence in neutered female dogs. Further evaluation is needed to determine the role of age on collagen and pelvic organ support structures in the pathogenesis of canine urinary incontinence.

Longitudinal patterning of depression repeatedly assessed across time among youth: Different trajectories in self-report questionnaires and diagnostic interviews.

Developmental epidemiological work shows that rates of depression as assessed by diagnostic interviews increase from childhood through early adulthood. It could be assumed that the trajectory of depression as assessed by self-report questionnaire measures would be characterized by a similar pattern. We aimed to evaluate this assumption and more clearly establish the longitudinal trajectory of depression in youth, when repeatedly assessed over time with a self-report questionnaire and with a diagnostic interview. Participants were 679 youth ages 7-16 years at baseline (Mage = 11.8, SD = 2.4, 56% girls). They completed the Children's Depression Inventory (CDI) every 3 months for 3 years (13 time points) and were interviewed every 6 months using the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS) to ascertain onset of depression diagnosis. A series of growth curve models was fit to the CDI and K-SADS data. A piecewise model characterized growth in depression as assessed by the CDI, with an initial negative linear slope (b = -0.64) spanning the first 3 assessments, and a positive quadratic second slope (b = 0.015; linear component: b = -0.22) spanning the remaining 10 assessments. Depression, as assessed by the K-SADS, grew continuously over time (a positive linear slope, b = 0.23). Findings illustrate differences between longitudinal trajectories of depression when assessed repeatedly by self-report questionnaire and diagnostic interview. Implications for research designed to study longitudinal depression trajectories are discussed. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Co-Occurring Trajectories of Depression and Social Anxiety in Childhood and Adolescence: Interactive Effects of Positive Emotionality and Domains of Chronic Interpersonal Stress.

Deficits in positive emotionality (PE) have been implicated in the etiology of both social anxiety and depression; however, factors that contribute to divergent social anxiety and depression outcomes among youth low in PE remain unknown. Extant research suggests that parent-child stress and peer stress demonstrate differential patterns of associations with social anxiety and depression. Thus, the present study examined prospective interactive effects of PE and chronic parent-child and peer stress on simultaneously developing trajectories of social anxiety and depression symptoms among 543 boys and girls (age 8-16 at baseline, M[SD] = 11.94[2.32] 55.6% female). Parents reported on youth PE at baseline. Domains of chronic interpersonal (parent-child and peer) stress occurring between baseline and 18-months were assessed via child-report by trained interviews using the Youth Life Stress Interview (Rudolph and Flynn Development and Psychopathology, 19(2), 497-521, 2007). Youth completed self-report measures of depression and social anxiety every three months from 18- to 36- months (7 assessments). Conditional bivariate latent growth curve models indicated that main effects of parent-child stress, but not peer stress, predicted trajectories of depression in boys and girls. In girls, high levels of chronic interpersonal stress in both domains predicted stable, elevated trajectories of social anxiety symptoms regardless of PE. In boys, PE contributed to a pattern of differential susceptibility whereby boys high in PE were particularly susceptible to the effects of chronic interpersonal stress, for better or worse.

Temporal dynamics and longitudinal co-occurrence of depression and different anxiety syndromes in youth: Evidence for reciprocal patterns in a 3-year prospective study.

BACKGROUND: Depression is highly comorbid with anxiety in youth. It is frequently reported that anxiety precedes depression; however, evidence surrounding the temporal precedence of anxiety over depression is mixed. Many studies of anxiety-depression co-occurrence lump distinct forms of anxiety, obscuring information regarding trajectories of specific anxiety syndromes. This study sought to more accurately describe the development of anxiety and depression over time by moving beyond the question of temporal precedence to investigate a developmentally dynamic model of anxiety-depression co-occurrence. METHODS: A community sample of 665 youth (M= 11.8, SD= 2.4; 55% female) completed repeated self-report measures of depression and anxiety (social, physical, and separation anxiety) over a 3-year longitudinal study. Prospective associations between distinct syndromes of anxiety with depression were analyzed using an autoregressive cross-lagged path model over four time points. RESULTS: Physical symptoms and depression symptoms reciprocally predicted each other, above and beyond the stability of either domain. Social anxiety and depression symptoms similarly predicted each other in a systematic pattern. LIMITATIONS: Our study is limited in its generalizability to other forms of anxiety, like worry. Additional research is needed to determine whether similar patterns exist in clinical populations, and whether these processes maintain symptoms once they reach diagnostic levels. CONCLUSIONS: The development of syndromes of depression, physical, and social anxiety during childhood and adolescence occurs in a predictable, systematic reciprocal pattern, rather than sequentially and unidirectionally (i.e., anxiety syndromes precede depression). Results are clinically useful for predicting risk for disorder, and demonstrate the necessity of tracking symptom levels across domains.

Mindfulness buffers retaliatory responses to injustice: A regulatory approach.

We investigate the role of mindfulness as a regulatory factor by examining whether it mitigates the relationship between justice and retaliation. Drawing on theories of self-regulation, we integrate work on justice with emerging frameworks that identify mindfulness as an important work-related regulatory variable (Glomb, Duffy, Bono, & Yang, 2011). Specifically, we identify the role of mindfulness as a buffer of the ruminative thoughts and negative emotions that link injustice to retaliation. We test mediated moderation hypotheses in 2 samples. In Sample 1, two behavioral measures of retaliation are assessed in an experiment that manipulated both injustice and mindfulness. In Sample 2, we generalize our model to the field, examining employee responses regarding experiences with workplace injustice and retaliation. Results of both studies converge to support the proposed mediated moderation model that mindfulness buffers the effect of injustice on rumination and negative emotions, thus reducing retaliation. Our findings contribute to the broader literatures on self-regulation, organizational justice, and retaliation.

Short-distance walking speed tests in people with Parkinson disease: reliability, responsiveness, and validity.

PURPOSE: The aims of this study were to determine test-retest reliability and responsiveness of short-distance walking speed tests for persons with Parkinson disease (PD). Discriminant and convergent validity of walking speed tests were also examined. METHODS: Eighty-eight participants with PD (mean age, 66 years) with mild to moderate severity (stages 1-4 on the Hoehn and Yahr Scale) were tested on medications. Measures of activity included the comfortable and fast 10-m walk tests (CWT, FWT), 6-min walk test (6MWT), mini balance evaluations systems test (mini-BEST Test), fear of falling (FoF), and the Activity-Specific Balance Confidence Scale (ABC). The mobility subsection of the PD quality of life-39 (PDQ39-M) served as a participation-based measure. RESULTS: Test-retest reliability was high for both walking speed measures (CWT, ICC(2,1) = 0.98; FWT, ICC(2,1) = 0.99). Minimal detectable change (MDC(95)) for the CWT and FWT was 0.09 m/s and 0.13 m/s respectively. Participants at Hoehn & Yahr levels 3/4 demonstrated significantly slower walking speed with the CWT and FWT than participants at Hoehn & Yahr levels 1 and 2 (P < .01). The CWT and FWT were both significantly (P ≤ .002) correlated with all activity and participation-based measures. CONCLUSIONS: Short-distance walking speed tests are clinically useful measures for persons with PD. The CWT and FWT are highly reliable and responsive to change in persons with PD. Short distance walking speed can be used to discriminate differences in gait function between persons with mild and moderate PD severity. The CWT and FWT had moderate to strong associations with other activity and participation based measures demonstrating convergent validity.

Eruptive post-chemotherapy in situ melanomas and dysplastic nevi.

A 22-year-old white man without a personal or family history of atypical nevi had received chemotherapy for pre-B-cell acute lymphocytic leukemia at age 17 that included L-asparaginase, prednisone, methotrexate, mercaptopurine, daunorubicin, and cytoxan. Two to three months after completing maintenance chemotherapy, the patient reports he developed many moles, which remained stable for approximately 2 years. Upon examination, two dark, atypical appearing plaques with irregular borders and numerous pink papules of varying shapes and sizes were noted on his chest, back, and abdomen. Histology of specimens of both types of lesions revealed three moderately atypical compound dysplastic melanocytic nevi and three in situ melanomas. The lesions with only features of dysplastic nevi exhibited dermal fibrosis, cytologic atypia, junctional shoulders, lentiginous spread, and focal pigmentation. The lesions with in situ melanomas in addition demonstrated pagetoid spread, extension down adnexal structures, and more severe cytologic atypia. Malignant melanoma has been associated with chronic immunosuppression, and benign nevi have been reported to erupt after chemotherapy. We report an occurrence of multiple eruptive dysplastic nevi and in situ melanomas appearing shortly after completion of chemotherapy.