Pursuing genetic testing for children with autism spectrum disorders: What do parents think?

The American Academy of Pediatrics, the American College of Medical Genetics and Genomics, and the American Academy of Neurology recommend genetic testing, as a genetic evaluation tool, for children diagnosed with autism spectrum disorders (ASD). Despite the potential benefits, the utilization of genetic testing is low. We proposed an integrated theoretical framework to examine parents' intention and associated psychosocial factors in pursuing genetic testing for their children with ASD. Recruiting primarily from the Interactive Autism Network, a nationwide sample of 411 parents of children with ASD who had never pursued genetic testing for their children completed our theory-based online survey. Data were analyzed using structural equation modeling. About half of the parents were willing to pursue genetic testing for their children with ASD. Findings of the structural equation modeling suggested a good model fit between our integrated theoretical framework and survey data. Parents' intention was significantly and positively associated with their attitudes toward genetic testing, subjective norm, and self-efficacy in having their children tested. This study serves as an initial window to understand parental intention to pursue genetic testing for their children with ASD. Our findings can help physicians and genetic counselors understand, educate, counsel, and support parents' decision-making about having their children with ASD genetically tested. Furthermore, our study can also assist physicians and genetic counselors in developing theory- and evidence-based patient education materials to enhance genetic testing knowledge among parents of children with ASD.

Development and evaluation of a genomics training program for community health workers in Texas.

PURPOSE: Genomics services have the potential to reduce incidence and mortality of diseases by providing individualized, family health history (FHH)-based prevention strategies to clients. These services may benefit from the involvement of community health workers (CHWs) in the provision of FHH-based genomics education and services, as CHWs are frontline public health workers and lay health educators, who share similar ethnicities, languages, socioeconomic statuses, and life experiences with the communities they serve. We developed, implemented, and evaluated the FHH-based genomics training program for CHWs. METHODS: This theory- and evidence-based FHH-focused genomics curriculum was developed by an interdisciplinary team. Full-day workshops in English and Spanish were delivered to 145 Texas CHWs (91.6% were Hispanic/black). Preworkshop, postworkshop, and 3-month follow-up data were collected. RESULTS: CHWs significantly improved their attitudes, intention, self-efficacy, and knowledge regarding adopting FHH-based genomics into their practice after the workshops. At 3-month follow-up, these scores remained higher, and there was a significant increase in CHWs' genomics practices. CONCLUSION: This FHH-based genomics training successfully educated Texas CHWs, and the outcomes were promising. Dissemination of training to CHWs in and outside of Texas is needed to promote better access to and delivery of personalized genomics services for the lay and underserved communities.

Acceptance and Commitment Therapy for Co-Occurring Posttraumatic Stress Disorder and Alcohol Use Disorders in Veterans: Pilot Treatment Outcomes.

Posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) frequently co-occur and are associated with worse outcomes together than either disorder alone. A lack of consensus regarding recommendations for treating PTSD-AUD exists, and treatment dropout is a persistent problem. Acceptance and Commitment Therapy (ACT), a transdiagnostic, mindfulness- and acceptance-based form of behavior therapy, has potential as a treatment option for PTSD-AUD. In this uncontrolled pilot study, we examined ACT for PTSD-AUD in 43 veterans; 29 (67%) completed the outpatient individual therapy protocol (i.e., ≥ 10 of 12 sessions). Clinician-assessed and self-reported PTSD symptoms were reduced at posttreatment, ds = 0.79 and 0.96, respectively. Self-reported symptoms of PTSD remained lower at 3-month follow-up, d = 0.88. There were reductions on all alcohol-related outcomes (clinician-assessed and self-reported symptoms, total drinks, and heavy drinking days) at posttreatment and 3-month follow-up, dmean = 0.91 (d range: 0.65-1.30). Quality of life increased at posttreatment and follow-up, ds = 0.55-0.56. Functional disability improved marginally at posttreatment, d = 0.35; this effect became significant by follow-up, d = 0.52. Fewer depressive symptoms were reported at posttreatment, d = 0.50, and follow-up, d = 0.44. Individuals experiencing suicidal ideation reported significant reductions by follow-up. Consistent with the ACT theoretical model, these improvements were associated with more between-session mindfulness practice and reductions in experiential avoidance and psychological inflexibility. Recommendations for adapting ACT to address PTSD-AUD include assigning frequent between-session mindfulness practice and initiating values clarification work and values-based behavior assignments early in treatment.

Resilience and Traumatic Brain Injury Among Iraq/Afghanistan War Veterans: Differential Patterns of Adjustment and Quality of Life.

OBJECTIVE: We examined the degree to which a resilient personality prototype predicted adjustment among war Veterans with and without a traumatic brain injury (TBI) while covarying the level of combat exposure. METHOD: A total of 127 war Veterans (107 men, 20 women; average age = 37 years) participated. Personality prototypes were derived from the Multidimensional Personality Questionnaire (Patrick, Curtain, & Tellegen, 2002). Measures were administered at baseline, and a subset was administered at 4- and 8-month follow-ups. RESULTS: Veterans with resilient personalities reported less sleep disturbance, more health-promoting behaviors, psychological flexibility, and emotional distress tolerance than Veterans with undercontrolled or overcontrolled prototypes. Path models revealed that resilience significantly predicted posttraumatic stress disorder (PTSD), depression, quality of life, and social support over time. TBI had unique and consistent effects only on PTSD. CONCLUSION: Personality characteristics influence distress and quality of life among war Veterans with and without TBI. Implications for assessment, interventions, and research are discussed.

Effects of Extracurricular Participation During Middle School on Academic Motivation and Achievement at Grade 9.

We investigated the effect of participating in two domains of extracurricular activities (sports and performance arts/clubs) in Grades 7 and 8 on Grade 9 academic motivation and letter grades, above baseline performance. Participants were 483 students (55% male; 33% Euro-American, 25% African American, and 39% Latino). Propensity score weighting controlled for potential confounders in all analyses. Delayed (Grade 8 only) and continuous participation (Grades 7 and 8) in sports predicted competence beliefs and valuing education; delayed and continuous participation in performance arts/clubs predicted teacher-rated engagement and letter grades. Benefits of participation were similar across gender and ethnicity; however, Latino youth were least likely to participate in extracurricular activities. Implications for reducing ethnic and income disparities in educational attainment are discussed.

Estimating Standardized Effect Sizes for Two- and Three-Level Partially Nested Data.

Although previous research has discussed an effect size estimator for partially nested cluster randomized designs, the existing estimator (a) is not efficient when used with primary data, (b) can be biased when the homogeneity of variance assumption is violated, and (c) has not yet been empirically evaluated for its finite sample properties. The present paper addresses these limitations by proposing an alternative maximum likelihood estimator for obtaining standardized mean difference effect size and the corresponding sampling variance for partially nested data, as well as the variants that do not make an assumption of homogeneity of variance. The typical estimator, denoted as d (dW with pooled SD and dC with control arm SD), requires input of summary statistics such as observed means, variances, and the intraclass correlation, and is useful for meta-analyses and secondary data analyses; the newly proposed estimator [Formula: see text] ([Formula: see text] and [Formula: see text]) takes parameter estimates from a correctly specified multilevel model as input and is mainly of interest to researchers doing primary research. The simulation results showed that the two methods (d and [Formula: see text]) produced unbiased point and variance estimates for effect size. As expected, in general, [Formula: see text] was more efficient than d with unequal cluster sizes, especially with large average cluster size and large intraclass correlation. Furthermore, under heterogeneous variances, [Formula: see text] demonstrated a greater relative efficiency with small sample size for the unclustered control arm. Real data examples, one from a youth preventive program and one from an eating disorder intervention, were used to demonstrate the methods presented. In addition, we extend the discussion to a scenario with a three-level treatment arm and an unclustered control arm, and illustrate the procedures for effect size estimation using a hypothetical example of multiple therapy groups of clients clustered within therapists.

Indirect Effects of Extracurricular Participation on Academic Adjustment Via Perceived Friends' Prosocial Norms.

Students who participate in extracurricular activities in middle school exhibit higher levels of academic motivation and achievement, including graduation from high school. However, the mechanisms responsible for these beneficial effects are poorly understood. Guided by the bioecological models of development, this study tested the indirect effects of participation in grade 8 in school sports or performance arts and clubs on grade 9 academic achievement, academic competence beliefs, and school belonging, via adolescents' perceptions of their friends' prosocial norms. Participants were 495 (45 % female) ethnically diverse students (mean age at grade 8 = 13.9 years; SD = .58) who were recruited into a longitudinal study on the basis of below average literacy in grade 1. Using weighted propensity score analyses to control for potential confounders, results of longitudinal SEM found indirect effect of participation in sports, but not of participation in performance arts and clubs, on grade 9 outcomes noted above. Implications of findings for improving educational attainment of at-risk youth are discussed.

Detecting Misspecified Multilevel Structural Equation Models with Common Fit Indices: A Monte Carlo Study.

This study investigated the sensitivity of common fit indices (i.e., RMSEA, CFI, TLI, SRMR-W, and SRMR-B) for detecting misspecified multilevel SEMs. The design factors for the Monte Carlo study were numbers of groups in between-group models (100, 150, and 300), group size (10, 20, 30, and 60), intra-class correlation (low, medium, and high), and the types of model misspecification (Simple and Complex). The simulation results showed that CFI, TLI, and RMSEA could only identify the misspecification in the within-group model. Additionally, CFI, TLI, and RMSEA were more sensitive to misspecification in pattern coefficients while SRMR-W was more sensitive to misspecification in factor covariance. Moreover, TLI outperformed both CFI and RMSEA in terms of the hit rates of detecting the within-group misspecification in factor covariance. On the other hand, SRMR-B was the only fit index sensitive to misspecification in the between-group model and more sensitive to misspecification in factor covariance than misspecification in pattern coefficients. Finally, we found that the influence of ICC on the performance of targeted fit indices was trivial.

Effectiveness of a Web-based genomics training for health educators in Texas.

PURPOSE: With advanced genomic developments, better prevention strategies are available via personalized genomic services. Because there is a shortage of genetic professionals, and primary-care providers are overwhelmed with routine practice, involving health educators--whose expertise includes educating the general public and promoting healthy behavior--to provide basic genomics education may facilitate better services. We developed the first evidence- and theory-based family health history Web-based training for Texas health educators. This report presents its evaluation results. METHODS: Approximately one-third of Texas health educators holding (Master) Certified Health Education Specialist designation (~40% were racial/ethnic minorities) participated in the family health history Web-based training. Attitudes, self-efficacy, intention, knowledge, and practice were assessed at baseline, immediately after training, and 3 months posttraining. Qualitative data were collected to provide additional evaluation findings. RESULTS: Participants significantly improved their attitudes, knowledge, intention, and self-efficacy regarding family health history education, immediately posttraining and after 3 months. The number of participants practicing family health history was significantly increased. Participants' overall assessment of the program was positive. CONCLUSION: This family health history Web-based training successfully increased the number of genomically competent and culturally diverse Texas health educators. Ongoing efforts are needed to sustain and expand this education as well as to disseminate it to all health educators in the United States.

Differential Growth Trajectories for Achievement Among Children Retained in First Grade: A Growth Mixture Model.

The authors investigated the differential effect of retention on the development of academic achievement from grade one to five on children retained in first grade over six years. Growth Mixture Model (GMM) analyses supported the existence of two distinct trajectory groups of retained children for both reading and math among 125 ethnically and linguistically diverse retained children. For each achievement domain, a low intercept/higher growth group (Class 1) and a high intercept/slower growth group (Class 2) were identified. Furthermore, Class 1 children were found to score lower on several measures of learning related skills (LRS) variables and were characterized by having poorer self-regulation and less prosocial behaviors, compared to the other group. Findings suggest that some children appear to benefit more from retention, in terms of higher reading and math growth, than others. Study findings have implications for selecting children into retention intervention and early intervention.

A Parallel Process Growth Curve Analysis of Teacher-Student Relationships and Academic Achievement.

Teacher-student relationships (TSR) have been a key focus of study for developmental and educational psychology researchers interested in improving proximal and distal academic outcomes for children and youth. Although prior empirical work suggests some degree of association between TSR and achievement, the co-development of TSR and achievement during elementary grades remains unclear with most findings limited to reading and mathematics achievement. The current study used parallel process growth curve models (PPGCMs) to examine the longitudinal growth trajectories of teacher-student closeness and conflict, and science, reading, and mathematics achievement simultaneously for children followed from kindergarten to third grade in the Early Childhood Longitudinal Study, Kindergarten Class of 2010-2011 (N = 13,490). Findings from the final PPGCM showed teacher-student closeness in kindergarten was positively associated with science, reading and mathematics achievement in kindergarten (r = 0.234 to 0.277) and the linear growth of achievement through third grade (r = 0.068 to 0.156). Teacher-student conflict in kindergarten was negatively associated with science, reading, and mathematics achievement in kindergarten (r = -0.099 to -0.203) and the linear growth of achievement through third grade (r = -0.081 to -0.135). Child biological sex, family socioeconomic status, and child racial and ethnic identity predicted TSR and achievement developmental trends. Implications of the findings and future directions for research are discussed.

Parallel processing modeling in longitudinal designs: An example predicting trajectories of distress and life satisfaction.

PURPOSE: Parallel process modeling (PPM) can be used to analyze co-occurring relationships between health and psychological variables over time. A demonstration is provided using data obtained from the British Household Panel Survey (years 2005, 2006, 2007, and 2008), examining predictors of ongoing changes in their distress and life satisfaction of a subsample from the survey. RESEARCH METHOD: In the 2005 survey, data were available from 7,970 participants based on the following demographic variables: gender, age, ever registered as disabled, and ever experienced any strokes (before or at 2005). Time-varying variables included distress and life satisfaction collected yearly from 2005 to 2008. Time-invariant variables included age (65 or older), gender, disability condition, and stroke survivor status. RESULTS: Steps of fitting the PPM are presented. Four distinct distress trajectory groups-chronic, recovery, delayed, and resilient-were identified from the PPM estimates. Resilient and recovery groups showed a positive trend in life satisfaction. The delayed distress and chronic groups had a slight decrease in satisfaction. The time-invariant covariates only significantly predicted baseline levels of distress and satisfaction (i.e., their intercepts). CONCLUSIONS: PPM is a relatively simple and powerful tool for simultaneously studying relations between multiple processes. A step-by-step approach on decomposing the significant predictive relation from the change of distress to the change of satisfaction is presented. Properly decomposing any significant growth factor regressed on another growth factor is necessary to fully comprehend the intricate relationships within the results. Practical implications and additional methodological information about fitting PPM are discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Resilience and distress among young adults with chronic health conditions: A longitudinal study.

OBJECTIVES: To test the beneficial associations of a resilient personality prototype among emerging adults with chronic health conditions (CHC) over an 8-year period. DESIGN: Longitudinal, prospective observation study. METHODS: Data obtained from emerging adults in the Add Health project with a CHC and completed study measures at two time points (286 men, 459 women) were examined. Cluster analysis was used to identify a resilient personality prototype at the first time point, as defined in the Block model of personality. Differences between those with a resilient and non-resilient prototype were examined. A structural equation model (SEM) tested the association of a resilience prototype with positive affect, perceived control and family relationships in predicting distress over time. RESULTS: A resilient personality profile was identified (n = 256). These individuals reported higher positive affect, greater perceived control and less distress at both measurement occasions than those without this profile (n = 489). Women reported more distress than men. SEM revealed the relationship of a resilient prototype to distress was explained by its beneficial association with positive affect and perceived control at the first assessment, and through its beneficial association with perceived control 8 years later. Gender independently predicted distress. CONCLUSIONS: A resilient personality prototype appears to operate through its beneficial association with perceived control to prospectively predict distress reported by emerging adults with CHC. The self-regulatory properties theoretically associated with a resilient personality prototype may function through perceptions of control which, in turn, prevent prolonged experiences of distress. Clinical implications are considered.

Are College Students Interested in Family Health History Education? A Large Needs Assessment Survey Study.

Family health history (FHH) is an essential foundation for personalized disease prevention. As the incidence of early-onset chronic diseases is increasing among college students, it is important to provide them with the education required to learn about their FHH. This study aimed to assess college students' interest in receiving FHH education, preferred topics, and desired learning methods. We invited college students to complete an online survey from a large research-intensive university. A total of 2276 college students completed the survey. Nearly half of the participants self-identified as non-Hispanic white (45.5%). Slightly more than half of the sample (53.9%) were not interested in receiving FHH education mainly due to low prioritization. Among those who expressed interest in obtaining FHH education, the three most desired learning topics were the ability to interpret FHH information (76.1%), the application of FHH in disease prevention (72.0%), and FHH information collection strategies (63.6%). Computer-based learning (51.1%) was the most preferred educational method. Moreover, females, older individuals, those who have FHH in first-degree relatives, and participants who were members of racial and ethnic groups showed greater interests in receiving FHH education (ps < 0.05). Strategies to promote college students' awareness, collection, and use of FHH are needed.

Dynamics of teacher-student relationships: stability and change across elementary school and the influence on children's academic success.

This study modeled teacher-student relationship trajectories throughout elementary school to predict gains in achievement in an ethnic-diverse sample of 657 academically at-risk students (mean age = 6.57 years, SD = .39). Teacher reports of warmth and conflict were collected in Grades 1-5. Achievement was tested in Grades 1 and 6. For conflict, low-stable (normative), low-increasing, high-declining, and high-stable trajectories were found. For warmth, high-declining (normative) and low-increasing patterns were found. Children with early behavioral, academic, or social risks were underrepresented in the normative trajectory groups. Chronic conflict was most strongly associated with underachievement. Rising conflict but not declining Conflict coincided with underachievement. The probability of school failure increased as a function of the timing and length of time children were exposed to relational adversity.

Indirect Effects of Child Reports of Teacher-Student Relationship on Achievement.

The effect of student-reported teacher-student relationship quality (TSRQ) on academic motivation and achievement was investigated among a sample of 690 academically at risk elementary students (52.8% male). Measures of TSRQ, achievement, and motivation were collected annually for 3 consecutive years, beginning when participants were in grade 2 (24.8%) or grade 3 (74.6%). Child-reported conflict was stable across the 3 years, whereas warmth declined. Boys and African American students reported greater conflict than did girls and Caucasian and Hispanic students. Girls and African American students reported higher warmth than boys and non-African American students. Using path analysis, the authors tested the hypothesis that measures of student motivation in Year 2 mediated the effects of conflict and warmth in Year 1 on reading and math achievement in Year 3. Child-perceived conflict predicted cross-year changes in teacher-rated behavioral engagement, which, in turn, predicted cross-year changes in reading and math achievement. Math competence beliefs also mediated the effect of child- perceived warmth on math achievement. Effects controlled for stability of measures across time, the within-wave association between measures, and baseline measures of IQ and economic adversity. Implications of findings for improving the academic achievement of students at-risk for school failure are discussed.

An important component to investigating STEM persistence: the development and validation of the science identity (SciID) scale.

Background: Science, technology, engineering, and mathematics (STEM) influence almost every aspect of our daily lives. However, despite the high demand for STEM occupational talent, the STEM pipeline continues leaking, with less than one-sixth of high school students pursuing STEM majors and only 50% of entering STEM college majors matriculating into STEM fields. Science identity has been identified as the most powerful predictor of high school students pursuing an undergraduate STEM major as reported by Chang (Machine learning approach to predicting STEM college major choice, American Educational Research Association (AERA), San Francisco, 2020). Though the construct is gaining lots of attention, it remains largely ill-defined, not operationalized at the high school level, and not based upon traditional identity theory. The purpose of this study was to develop a valid and reliable instrument that measures high school students' science identity, the Science Identity (SciID) Scale. Results: Subject experts and a small group of high school students provided content validation for the proposed scale. Exploratory factor analysis revealed an optimal two-factor solution, reflecting the traditional two-dimensions of identity theory: Exploration and Commitment. Cronbach's alpha revealed good internal consistency for both factors. Finally, structural equation modeling confirmed the convergent validity of the instrument with the external variables of science achievement and science career interest. Furthermore, the divergent validity between science identity and science self-concept was also confirmed. Conclusions: Initial results indicate that the SciID Scale is a valid and reliable instrument that accurately measures a high school student's standing on this construct. The soundness of this instrument will enable policy makers and practitioners to design more effective intervention programs aimed at cultivating high school students' science identity.

Factors Influencing Family Health History Collection among Young Adults: A Structural Equation Modeling.

Family health history (FHH) can serve as an entry point for preventive medicine by providing risk estimations for many common health conditions. College is a critical time for young adults to begin to understand the value of FHH collection, and to establish healthy behaviors to prevent FHH-related diseases. This study seeks to develop an integrated theoretical framework to examine FHH collection behavior and associated factors among college students. A sample of 2670 college students with an average age of 21.1 years completed a web-based survey. Less than half (49.8%) reported actively seeking FHH information from their family members. Respondents' knowledge about FHH were generally low. Structural equation modeling findings suggested an adequate model fit between our survey data and the proposed integrated theoretical framework. Respondents who were members of racial/ethnic minority groups exhibited higher levels of anxiety and intention to obtain FHH information but had lower confidence in their ability to gather FHH information than non-Hispanic White respondents. Therefore, educational programs designed to enhance the level of young adults' FHH knowledge, efficacy, and behavior in FHH collection, and change subjective norms are critically needed in the future, especially for these who are members of racial/ethnic minority groups.

Chinese Americans' Family History of Colorectal Cancer Communication With Primary Care Physicians.

BACKGROUND: Colorectal cancer (CRC) is the third most common cancer for Chinese Americans. Family history (FH) plays an important role in clinical practice for CRC prevention. Nevertheless, Chinese Americans' FH of CRC communication with primary care physicians (PCPs) are still unknown. AIMS: This study examined Chinese Americans' behavior and the underlying psychological factors for FH of CRC communication with PCPs. METHOD: A total number of 742 Chinese Americans completed a survey developed based on the health belief model, the theory of planned behavior, and the social cognitive theory. Data were analyzed using structural equation modeling. RESULTS: Majority of the Chinese American participants (75.3%) had never discussed FH of CRC with their PCPs. Lack of inquiries from the PCPs was the main barrier. Structural equation modeling results suggested a good model fit between our theoretical model and the survey data (comparative fit index [CFI] = .946, root mean square error of approximation [RMSEA] = .070, and standardized root mean square residual [SRMR] = .020). Participants' FH of CRC communication with PCPs was positively associated with their intention (ß = .30, p < .001), which was positively correlated to attitudes (ß = .29, p < .001) and self-efficacy in discussing FH of CRC with PCPs (ß = .57, p < .001). Their attitudes were positively associated with perceived susceptibility to CRC (ß = .08, p < .05) and the perceived benefits of communicating FH of CRC (ß = .52, p < .001). CONCLUSIONS: Given that most Chinese Americans in this study did not communicate their FH of CRC with their PCPs, it is important to promote such behavior among Chinese Americans. Our structural equation modeling findings can guide future interventions and education for this underserved racial/ethnic minority group.

Multilevel modeling: current and future applications in personality research.

Traditional statistical analyses can be compromised when data are collected from groups or multiple observations are collected from individuals. We present an introduction to multilevel models designed to address dependency in data. We review current use of multilevel modeling in 3 personality journals showing use concentrated in the 2 areas of experience sampling and longitudinal growth. Using an empirical example, we illustrate specification and interpretation of the results of series of models as predictor variables are introduced at Levels 1 and 2. Attention is given to possible trends and cycles in longitudinal data and to different forms of centering. We consider issues that may arise in estimation, model comparison, model evaluation, and data evaluation (outliers), highlighting similarities to and differences from standard regression approaches. Finally, we consider newer developments, including 3-level models, cross-classified models, nonstandard (limited) dependent variables, multilevel structural equation modeling, and nonlinear growth. Multilevel approaches both address traditional problems of dependency in data and provide personality researchers with the opportunity to ask new questions of their data.