Self-reported cognitive function mediates the relationship between employment status and cognitive functioning in persons with multiple sclerosis.

BACKGROUND: Cognitive impairment (CI) is common in people with MS (PwMS). Evidence is lacking for the self-reported CI's mediation effect on employment status and objective cognitive performance. Self-reported CI was found to be unreliable and seemed to be more associated with depression rather than formal cognitive performance. We hypothesized that the link between subjective and objective assessments of cognitive functions, mood, and employment status may be more complex in PwMS than previously reported. OBJECTIVE: The aims of this study are the following: (Romero-Pinel et al., 2022) to determine whether employment status could affect performance in cognitive function testing and (Rao et al., 1991) whether their relationship may be mediated by self-reported CI; and (Deluca et al., 2013) to determine whether self-reported depression interacts with self-reported CI in influencing performance in various cognitive domains in PwMS. METHODOLOGY: A retrospective study was performed involving PwMS who completed the self-report Multiple Sclerosis Neuropsychological Questionnaire (MSNQ), Hospital Anxiety and Depression Scale-depression scale (HADS-D), Minimal Assessment of Cognitive Function in MS (MACFIMS) and had data regarding employment status. Included PwMS were classified as employed or unemployed. A structural equation modeling (SEM) approach was taken due to the advantage of examining multiple cognitive outcomes simultaneously while accounting for shared associations. First, a latent factor of memory and executive functioning modeled the error-free associations between both factors and a processing speed task (SDMT). Next, the model tested for the indirect effect of self-reported cognition (MSNQ) on employment status differences in each outcome (memory, speed, and executive functioning). Finally, we tested interactions between MSNQ and HADS-D on each of the outcomes. RESULTS: We included 590 PwMS: 72.5% female, mean age 44.2 years (SD = 10.5), mean disease duration 8.6 years (SD 9.0). The majority (n = 455, 77.1%) had relapsing MS; 357 (60.5%) were employed. About half (n = 301, 51%) did not report CI on the MSNQ; of those, 213 (70.8%) were employed. The mean MSNQ for employed PwMS was 24.5 (SD = 10.7) and 29.8 (SD = 11.2) for unemployed PwMS. Employed PwMS had significantly better memory (ß = .16, p < .05), executive functioning (ß = .25, p < .05), and processing speed (ß = .22, p < .05). MSNQ partially indirectly mediated the effect of employment status on memory (Δß = .03, p < .05) and executive functioning (Δß = .03, p < .05) and processing speed (Δß = .04, p < .05), indicating that self-report CI partially explains the influence of employment status on these cognitive domains. The association between MSNQ with both memory and executive functioning was moderated by depression, meaning that in PwMS with high HADS-D scores, MSNQ was more strongly related to worse memory and executive functioning. The final model was an acceptable fit to the data (χ2(87) = 465.07, p < .05; CFI = .90, RMSEA = .08, 90% CI [.06, .09], SRMR = .05) explaining 41.20%, 38.50% and 33.40% of the variability in memory, executive functioning, and processing speed, respectively. CONCLUSION: Self-reported CI partially explains the associations between employment status and objective cognitive assessment in PwMS. Depression may moderate the relationship between self-reported cognitive assessment and objective cognitive performance. Thus, employment status and mood may guide the interpretation of self-reported CI.

Photobiomodulation therapy combined with static magnetic field is better than placebo in patients with fibromyalgia: a randomized placebo-controlled trial.

BACKGROUND: Fibromyalgia is a syndrome characterized by generalized chronic pain and tenderness in specific areas. Photobiomodulation therapy (PBMT) using low-level laser therapy and/or light emitting diode therapy is an electrophysical agent that can be used alone or together with a static magnetic field (PBMT-sMF) to promote analgesia in several health conditions. Little evidence exists regarding the effects of using PBMT and PBMT-sMF in patients with fibromyalgia; this evidence is conflicting. AIM: We aimed to investigate the effects of using PBMT-sMF versus a placebo on reduction of the degree-of-pain rating, impact of fibromyalgia, pain intensity, and satisfaction with treatment in patients with fibromyalgia. DESIGN: A prospectively registered, monocentric, randomized placebo-controlled trial, with blinding of patients, therapists, and assessors, was performed. SETTING: The study was conducted at the Laboratory of Phototherapy and Innovative Technologies in Health (LaPIT) in Brazil, between March and October 2020. POPULATION: Ninety female patients with fibromyalgia were randomized to undergo either PBMT-sMF (N.=45) or placebo (N.=45) treatment. METHODS: Patients from both groups received nine treatment sessions, three times a week, for 3 weeks. Clinical outcomes were collected at baseline, the end of treatment, and at the follow-up appointment 4 weeks post-treatment. The primary outcome was the degree-of-pain rating, measured by the reduction of the tender point count. RESULTS: A decrease in the degree-of-pain rating was observed in patients allocated to the PBMT-sMF group, decreasing the number of tender points when compared to placebo group at the end of treatment (P<0.0001) and at the follow-up assessment (P<0.0001). Patients did not report any adverse events. CONCLUSIONS: PBMT-sMF is superior to placebo, supporting its use in patients with fibromyalgia. CLINICAL REHABILITATION IMPACT: PBMT-sMF might be considered an important adjuvant to the treatment regimens of patients with fibromyalgia.

Change over time in interactions between unfamiliar toddlers.

The frequency and length of games, conflicts, and contingency sequences that took place between toddlers as they got to know one another were studied using archival data. The sample consisted of 28 unfamiliar 20- and 30-month-old toddlers (predominantly White, 16 males) who met separately with each of two other toddlers for 18 play dates. The frequency of games increased over time, while the frequency of conflict and contingency sequences decreased. The length of games increased over time while the length of conflicts and contingency sequences were stable. Age and language ability predicted changes in frequency and length of the different types of sequences. Thus, toddlers engage in less structured interactions when they first meet; their interactions become increasingly more organized and positive as the relationship evolves.

Positive and negative actions early in the relationship predict later interactions among toddlers.

Very little is known about the role of early interactions in the development of peer relationships among toddlers. The present study examined whether behaviors early in the formation of toddler relationships predict interactions later in their relationships. Twenty-eight unfamiliar 20- and 30-month-old toddlers from a predominately European background met separately with each of two other toddlers for 18 playdates. Both positive and negative behaviors at the beginning of the relationship predicted a higher frequency of games later in the relationship. Positive behaviors at the beginning of the relationship predicted fewer conflicts later in the relationship. Negative behaviors at the beginning predicted more conflicts later in the relationship. These findings suggest that toddlers' behaviors, when they initially meet, underlie the pathway in which their relationship develops.

Contextual variations in associations between measures of aggression and withdrawal and functioning with peers: A replication study.

Data from 790 older school-age (Mage = 10.2 years, SD = 1.2 years) girls (N = 427) and boys from Barranquilla, Colombia (N = 449) and Montréal, Canada (N = 331) were used to replicate findings reported by Valdivia et al. (2005). This prior study revealed contextual variations in the association between two measures of social behavior, specifically aggression and withdrawal, and two measures of effective functioning with peers, specifically sociometric preference and friendship. The Montréal participants were primarily from families with European backgrounds. The ethnicity of the participants from Barranquilla can be described as Latinx/Caribbean. Multilevel analyses provided evidence of replication of place differences only for the associations between measures of aggression and sociometric preference. Stronger negative associations were observed between (a) measures of aggression and sociometric preference, (b) measures of withdrawal and sociometric preference, and (c) withdrawal and friendship in peer groups that were high in collectivism. These findings are interpreted as largely replicating the deep structure of the findings from the Valdivia et al. study. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Indirect effects of HPA axis dysregulation in the association between peer victimization and depressed affect during early adolescence.

OBJECTIVE: Previous research has identified a link between peer victimization and depressive symptoms during adolescence. The goal of the current study is to examine the possible indirect effects of HPA axis dysregulation in the link between adolescent peer victimization and depressive symptoms. METHOD: A total of 113 boys (n = 61) and girls (n = 52) participants from grade 5 (M age = 10.31 years) and grade 6 (M age = 11.33 years) who were predominantly European-Canadian completed self-report measures of peer victimization and depressed affect as well as, measures of salivary cortisol and self-reports of negative experiences collected in conjunction with one another five times per day over the course of four school days. RESULTS: Multi-level structural equation modeling found that peer victimization was indirectly associated with depressive symptoms via blunted cortisol reactivity (i.e. increases in cortisol in response to a negative event) but only at high rates of chronic peer victimization. CONCLUSION: The findings suggest that future studies should focus on HPA axis dysregulation for better understand the development, as well as the stability of depression over time and that interventions targeting peer victimization may want to put a special focus on those who are chronically experiencing peer victimization over time.

Gender minoritized students and academic engagement in Brazilian adolescents: Risk and protective factors.

Gender minoritized students experience unique challenges in their school environments that may have consequences for their educational outcomes, including academic engagement. The goal of the current study was to understand the association between gender identity and academic engagement among adolescents attending public high schools in Paraná, Brazil (N = 10,828). In particular, student perceptions of student-teacher relationships, school rule fairness and clarity, school-wide academic engagement, and peer victimization were examined as four facilitator/barrier factors that may account for lower levels of academic engagement for gender minoritized students as compared to their cisgender peers, and these processes were tested for differences across race/ethnicity. Public high school students (ages 12-18 years) completed an in-class survey assessing their gender identities, perceptions of the school environment, and academic engagement. Gender minoritized students reported significantly lower levels of academic engagement as compared to their cisgender peers. They also reported less clear and fair school rules, lower levels of school-wide academic engagement, and higher levels of victimization. These facilitator/barrier variables partially accounted for the lower levels of academic engagement reported by gender minoritized students. No significant differences were observed for gender identity according to race/ethnicity. These findings suggest that facilitators/barriers that account for academic engagement for students in general partially explain gender identity-related disparities, and the implications for school psychologists are discussed.

Reducing mental illness stigma: What types of images are most effective?

Public stigma against mental illness is a barrier to treatment and recovery. Research into the design of anti-stigma messages has focused heavily on text; there is limited information on what types of images are most persuasive in eliciting anti-stigma outcomes. This is important to study because the type of image used to depict an illness can influence how the illness is perceived, which in turn can affect how people with the illness are treated. Through an online experiment with 162 American adults, this study investigated whether mental illness narratives about depression illustrated with photographs are more effective than those illustrated with cartoons at reducing stigma. It was found that the illustrated narratives, whether with photo or cartoon, produced more anti-stigma effects than the text-only narrative (control). Further, the photographic narrative was more effective than the cartoon narrative in eliciting closeness to the story protagonist and willingness to donate to mental health services. The study's findings indicate that images should be used in anti-stigma messages on depression; further, regarding image type, photographs should be considered over cartoons as they are more effective in eliciting certain anti-stigma outcomes.Implications for PracticeThis study suggests that images have strong anti-stigma effects and that photographs are sometimes more persuasive than cartoons. These findings can inform best-practice guidelines for designing anti-stigma messages, created and disseminated by organisations such as the United States' National Alliance on Mental Illness and Mental Health America. Images in these messages should be selected carefully as they can influence how people with mental illness are perceived and treated.

Bullying Victimization and Friendship as Influences on Sleep Difficulty among Brazilian Adolescents.

Bullying victimization is associated with poor health-related outcomes, including sleeping problems. The present study aimed to investigate the impact of bullying victimization on sleep difficulty, and the moderating effect of the number of close friends on this association, also exploring differences across genders. The study was based on a nationally-representative survey on adolescent health conducted in Brazilian schools, involving a total of 109,104 participants, enrolled at the 9th year in 2012. The measures used in the analysis included socio-demographic characteristics, bullying victimization, sleep difficulty, and number of close friends. In the multilevel models, reporting more peer victimization was associated with more sleep difficulties (b = .18, t = 50.17, p < .05), with girls reporting more sleep difficulties in association with peer victimization than boys. Reporting having more friends was inversely linked to sleep difficulties (b = -.08, t = -15.26, p < .05), and the association between peer victimization and sleep difficulties was significantly buffered by the number of friends. Moreover, in a three way interaction, there was a marginally significant difference in the effect of friends on the link between victimization and sleep difficulties between boys and girls (b = .02, t = 1.86, p = .06), with the buffering effect of friendships being negligible among girls as opposed to boys. The results indicate a significant association between bullying victimization and sleep difficulties, which seems to be more pronounced among girls, also suggesting that the number of close friends may buffer this association, mainly for boys.

Self-Continuity Moderates the Association Between Sexual-Minority Status Based Discrimination and Depressive Symptoms.

Self-continuity, or how an individual understands their sense of self as persisting from past to present and present to future, is an important aspect of the self-concept that is linked to mental health outcomes. This self-concept construct may be particularly pertinent for sexual minority populations, as living in a heterosexist environment may prove detrimental for the development of self-continuity. The current study examined self-continuity among sexual minority and heterosexual community college and university students (N = 292). Compared to their heterosexual peers, sexual minority participants reported lower levels of self-continuity. Self-continuity moderated the associations between victimization due to gender nonconformity and victimization due to sexual minority status and depressive symptoms, such that higher levels of self-continuity were protective among individuals who were experiencing higher levels of victimization due to gender nonconformity or sexual minority status. Findings will be discussed in terms of their implications for identity development among emerging adults.