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1.
Arch Womens Ment Health ; 27(2): 285-292, 2024 Apr.
Article in English | MEDLINE | ID: mdl-37991597

ABSTRACT

Maternal HPA axis dysregulation during early pregnancy can negatively affect maternal functioning. However, findings are mixed regarding how intimate partner violence (IPV), a common traumatic stressor, impacts HPA axis regulation during pregnancy. Interactions between IPV and mental health symptoms as they influence cortisol production are rarely examined, especially among pregnant women. Therefore, this study examined the impact of IPV, mental health symptoms, and their interactions on the maternal HPA axis during early pregnancy; 255 pregnant women, oversampled for experiences of IPV, completed a laboratory stressor and measures of depressive and post-traumatic stress symptoms (PTSS) at 15-18 weeks of pregnancy. Participants provided saliva samples following the Trier Social Stress Test that were assayed for cortisol; the area under the curve with respect to ground (AUCg) was computed as a measure of cortisol reactivity. The interactive effects of IPV, depressive symptoms, and PTSS on AUCg were significant, but the main effects were not. At low levels of depressive symptoms, the association between IPV and AUCg was negative; at moderate levels of depressive symptoms, it was not significant, and at high levels, it was positive. At low and moderate levels of PTSS, the effects of IPV on cortisol AUCg were not significant, but at high levels, the association was positive. IPV during early pregnancy was associated with both hyperactive and blunted stress reactivity, depending on the type and severity of mental health symptoms. These patterns of dysregulation of the HPA axis may have differential effects both for women's functioning throughout pregnancy as well as for the offspring.


Subject(s)
Intimate Partner Violence , Mental Health , Humans , Female , Pregnancy , Hydrocortisone , Hypothalamo-Hypophyseal System , Stress, Psychological/psychology , Pituitary-Adrenal System , Intimate Partner Violence/psychology , Mothers/psychology
2.
Appetite ; 187: 106589, 2023 08 01.
Article in English | MEDLINE | ID: mdl-37146651

ABSTRACT

The early postpartum period is a sensitive time for understanding women's high-risk eating (i.e., eating behavior associated with negative health outcomes) given potential long-term eating behavior implications for infants. Food addiction and dietary restraint are two high-risk eating phenotypes associated with long-term negative health outcomes that have been theoretically linked. Yet, no research has considered how much these constructs overlap during the early postpartum period. The present study sought to characterize these two high-risk eating phenotypes in postpartum women to examine whether these are distinct constructs with specific etiologies and to inform future targets of intervention. Women (N = 277) in the early postpartum period reported on high-risk eating, childhood trauma exposure, depression symptoms, and pre-pregnancy weight. Women's height was measured and pre-pregnancy BMI was calculated. We conducted bivariate correlations and path analysis to characterize the relationship between food addiction and dietary restraint, controlling for pre-pregnancy BMI. Results showed that food addiction and dietary restraint were not significantly associated and that women's childhood trauma exposure and postpartum depression were associated with food addiction but not dietary restraint. Sequential mediation revealed that higher levels of childhood trauma exposure were associated with worse postpartum depression and, in turn, greater food addiction during the early postpartum period. Findings suggest that food addiction and dietary restraint have distinct psychosocial predictors and etiological pathways, which suggests important construct validity differences between the two high-risk eating phenotypes. Interventions seeking to address food addiction in postpartum women and mitigate the impact of this high-risk eating phenotype on the next generation may benefit from treating postpartum depression, especially in women with histories of childhood trauma exposure.


Subject(s)
Adverse Childhood Experiences , Depression, Postpartum , Food Addiction , Pregnancy , Humans , Female , Depression, Postpartum/psychology , Postpartum Period/psychology , Diet , Feeding Behavior
3.
Arch Womens Ment Health ; 25(5): 943-956, 2022 10.
Article in English | MEDLINE | ID: mdl-35962855

ABSTRACT

Our primary objective was to document COVID-19 induced changes to perinatal care across the USA and examine the implication of these changes for maternal mental health. We performed an observational cross-sectional study with convenience sampling using direct patient reports from 1918 postpartum and 3868 pregnant individuals collected between April 2020 and December 2020 from 10 states across the USA. We leverage a subgroup of these participants who gave birth prior to March 2020 to estimate the pre-pandemic prevalence of specific birthing practices as a comparison. Our primary analyses describe the prevalence and timing of perinatal care changes, compare perinatal care changes depending on when and where individuals gave birth, and assess the linkage between perinatal care alterations and maternal anxiety and depressive symptoms. Seventy-eight percent of pregnant participants and 63% of postpartum participants reported at least one change to their perinatal care between March and August 2020. However, the prevalence and nature of specific perinatal care changes occurred unevenly over time and across geographic locations. The separation of infants and mothers immediately after birth and the cancelation of prenatal visits were associated with worsened depression and anxiety symptoms in mothers after controlling for sociodemographic factors, mental health history, number of pregnancy complications, and general stress about the COVID-19 pandemic. Our analyses reveal widespread changes to perinatal care across the US that fluctuated depending on where and when individuals gave birth. Disruptions to perinatal care may also exacerbate mental health concerns, so focused treatments that can mitigate the negative psychiatric sequelae of interrupted care are warranted.


Subject(s)
COVID-19 , Anxiety/epidemiology , Anxiety/etiology , COVID-19/epidemiology , Child , Cross-Sectional Studies , Depression/epidemiology , Depression/etiology , Female , Humans , Infant , Infant, Newborn , Mental Health , Pandemics , Perinatal Care , Pregnancy
4.
Fam Process ; 61(4): 1437-1455, 2022 12.
Article in English | MEDLINE | ID: mdl-34908160

ABSTRACT

Parent-Child Interactions (PCI) is a home visit parenting intervention designed to promote positive parenting and deter punitive approaches to child behavior management. With attention to the importance of providing efficacious interventions for families from diverse backgrounds, this study used a subsample from a larger randomized controlled trial (RCT) to examine the efficacy of PCI intervention among Latinx participants. PCI was offered to 170 at-risk Latinx mother-child dyads, of whom the majority were primarily Spanish speaking. Dyads were randomly assigned to an intervention or a wait-list control condition. Path analysis modeling was used to examine parenting outcomes as a mediator of program efficacy between group assignment and children's long-term functioning. Results suggest that Latinx parent and child functioning benefited from PCI intervention 6 months following intervention. Specifically, model results indicated significant indirect effects of the PCI intervention on (1) cooperative child behavior and (2) children's externalizing behaviors 6-months posttreatment via parenting at post test, with mother-child dyads assigned to the treatment condition, relative to the control, demonstrating better functioning 6-months posttreatment. Overall, findings contribute to increased understanding of parenting intervention implementation among Latinx families. Recommendations for future study are discussed.


Interacciones entre padres e hijos (Parent-Child Interactions, PCI) es una intervención en la crianza con visitas a los hogares diseñada para promover la crianza positiva y desalentar los métodos correctivos de manejo del comportamiento infantil. Con atención a la importancia de ofrecer intervenciones eficaces para las familias de distintos orígenes, en este estudio se utilize una submuestra de un ensayo controlado aleatorizado más grande para analizar la eficacia de una intervención de PCI entre participantes latinas. Se ofreció la PCI a 170 díadas de madres e hijas latinas en riesgo, de las cuales la mayoría eran principalmente hispanohablantes. Las díadas se asignaron aleatoriamente a un grupo de intervención o de control en lista de espera. Se utilizó el modelo de análisis de ruta para analizar los resultados de la crianza como mediadora de la eficacia del programa entre la distribución a los grupos y el funcionamiento a largo plazo de las niñas. Los resultados sugieren que el funcionamiento de las madres latinas y las niñas se benefició de la intervención de PCI seis meses después de la intervención. Específicamente, los resultados del modelo indicaron efectos indirectos significativos de la intervención de PCI en (1) el comportamiento cooperativo de las niñas y (2) las conductas de exteriorización de las niñas seis meses después del tratamiento mediante la crianza en la evaluación posterior, donde las díadas madre e hija asignadas al grupo de tratamiento, respecto del de control, demostraron un major funcionamiento seis meses después del tratamiento. En general, los resultados contribuyen a una mayor comprensión de la implementación de intervenciones en la crianza entre las familias latinas. Se comentan las recomendaciones para futuros estudios.


Subject(s)
Mothers , Parents , Humans , Female
5.
J Soc Pers Relat ; 39(4): 908-930, 2022 Apr.
Article in English | MEDLINE | ID: mdl-36713971

ABSTRACT

This study examined trajectories of new parents' perceptions of conflictual coparenting and predictors thereof. Partners in 182 dual-earner different-gender U.S. couples reported their prenatal marital conflict and individual characteristics (conflictual coparenting in the family of origin, parenting self-efficacy expectations, and parenting role beliefs) during the third trimester of pregnancy, their infant's characteristics (negative affectivity and gender) at 3 months postpartum, and their perceptions of undermining coparenting and exposure to conflict at 3, 6, and 9 months postpartum. Results of latent growth curve models indicated that new parents' perceptions of undermining, but not exposure to conflict, increased similarly from 3 to 9 months. Fathers perceived higher initial undermining than mothers, but there were no gender differences in exposure to conflict. For mothers, greater prenatal marital conflict and greater infant negative affectivity were associated with elevated levels of perceived undermining and exposure to conflict. For fathers, more egalitarian role beliefs were associated with lower undermining and less exposure to conflict, whereas greater prenatal marital conflict, higher conflictual coparenting in the family of origin, and greater infant negative affectivity were associated with greater exposure to conflict. Fathers also perceived greater undermining and exposure to conflict when mothers reported higher prenatal marital conflict, whereas mothers' greater conflictual coparenting in the family of origin was related to fathers' lower exposure to conflict. These findings provide valuable information to strengthen programs focused on improving coparenting.

6.
Eur J Pediatr ; 180(11): 3399-3404, 2021 Nov.
Article in English | MEDLINE | ID: mdl-33987684

ABSTRACT

Small airway disease, characterised by ventilation heterogeneity (VH), is present in a subgroup of patients with asthma. Ventilation heterogeneity can be measured using multiple breath washout testing. Few studies have been reported in children. We studied the relationship between VH, asthma severity, and spirometry in a cross-sectional observational cohort study involving children with stable mild-moderate and severe asthma by GINA classification and a group of healthy controls. Thirty-seven participants aged 5-16 years completed multiple breath nitrogen washout (MBNW) testing (seven controls, seven mild-moderate asthma, 23 severe asthma). The lung clearance index (LCI) was normal in control and mild-moderate asthmatics. LCI was abnormal in 5/23 (21%) of severe asthmatics. The LCI negatively correlated with FEV1 z-score.Conclusion: VH is present in asthmatic children and appears to be more common in severe asthma. The LCI was significantly higher in the cohort of children with severe asthma, despite no difference in FEV1 between the groups. This supports previous evidence that LCI is a more sensitive marker of airway disease than FEV1. MBNW shows potential as a useful tool to assess children with severe asthma and may help inform clinical decisions. What is Known: • Increased ventilation heterogeneity is present in some children with asthma • Spirometry is not sensitive enough to detect small airway involvement in asthma What is New • Lung clearance index is abnormal in a significant subgroup of children with severe asthma but rarely in children with mild-moderate asthma • Our data suggests that LCI monitoring should be considered in children with severe asthma.


Subject(s)
Asthma , Asthma/diagnosis , Child , Cross-Sectional Studies , Humans , Lung , Respiratory Function Tests , Spirometry
7.
Infant Ment Health J ; 42(3): 315-330, 2021 05.
Article in English | MEDLINE | ID: mdl-33570212

ABSTRACT

Parentification occurs when children are unfairly charged with fulfilling parental instrumental and emotional needs. Parentification is associated with risk to evaluative self cognitions from childhood to emerging adulthood, but this association has not yet been studied among parents. The transition to parenthood is typically characterized by declines in self-esteem, suggesting it is a critical period for understanding the risk parentification history poses to evaluative self-cognitions and evaluative cognitions about children. The present study addresses these gaps using longitudinal data (N = 374 first-time mothers) to examine the influence of maternal parentification history domains (emotional and instrumental caregiving, role unfairness) on trajectories of maternal evaluative cognitions about the self (self-esteem, parenting self-efficacy) and about the child (difficult child temperament, dissatisfaction with child contributions to relationships) in early parenthood. A spillover model was also examined such that evaluative cognitions about the self were examined as potential mediators between parentification history and evaluative cognitions about children. Results support associations between the role unfairness domain of parentification and each domain of maternal evaluative cognitions and a significant indirect effect of unfairness on risk to maternal evaluative cognitions about child contributions via parenting self-efficacy. Implications for mother-child relationships and processes of intergenerational transmission of parentification are discussed.


La parentalización ocurre cuando a los niños se les hace asumir injustamente las necesidades instrumentales y emocionales de los padres. Se asocia la parentalización con el riesgo de auto cognición evaluativa de la niñez al naciente estado de adultez, pero esta asociación no ha sido aún estudiada entre los padres. La transición a la condición de ser padres se caracteriza típicamente por las bajas en la auto estima, lo cual sugiere que se trata de un período crítico para comprender el riesgo que el historial de la parentalización presenta para la auto cognición evaluativa y las cogniciones evaluativas sobre los niños. El presente estudio trata de estos vacíos usando datos longitudinales (N = 374 madres primerizas) para examinar la influencia de los campos del historial de la parentalización materna (el cuidado emocional e instrumental, el papel de lo que es injusto) sobre las trayectorias de las cogniciones evaluativas maternas acerca de ellas mismas (auto estima, auto efectividad en la crianza) y acerca del niño (el difícil temperamento del niño, la insatisfacción con las contribuciones del niño a las relaciones) en la temprana etapa de la maternidad. Se examinó un modelo de efectos secundarios de tal manera que se examinaron las cogniciones evaluativas acerca del yo como posibles factores de mediación entre el historial de parentalización y las cogniciones evaluativas acerca de los niños. Los resultados apoyan las asociaciones entre el papel del ámbito de lo injusto de la parentalización y cada ámbito de cogniciones evaluativas maternas y un efecto indirecto significativo de lo injusto sobre el riesgo de cogniciones evaluativas maternas sobre las contribuciones del niño por medio de la auto efectividad de la crianza. Se discuten las implicaciones de las relaciones madre-niño y los procesos de transmisión intergeneracional de la parentalización.


La parentification prend place lorsque on exige injustement des enfants qu'ils remplissent les besoins instrumentaux et émotionnels parentaux. La parentification est liée au risque d'auto-cognitions évaluatives de l'enfance au début de l'âge adulte, mais cette association n'a pas encore été étudiée chez les parents. La transition à la parenté est typiquement caractérisée par des déclins dans la confiance, suggérant que c'est une période critique pour comprendre l'histoire de risque que la parentification pose aux auto-cognitions évaluative et aux cognitions évaluatives sur les enfants. Cette étude porte sur ces écarts en utilisant des données longitudinales (N = 374 mères dont c'était la première grossesse) afin d'examiner l'influence des domaines de l'histoire de la parentification maternelle (soins émotionnels et instrumentaux, injustice du rôle) sur des trajectoires de cognition évaluative maternelle sur le moi (confiance en soi, auto-efficacité de parentage) et sur l'enfant (tempérament difficile de l'enfant, insatisfaction avec les contributions de l'enfant à la relation) au début de la parenté. Un modèle de débordement a aussi été examiné de telle manière que les cognitions évaluatives sur le self ont été examinées en tant que médiatrices potentielles entre l'histoire de parentification et les cognitions évaluatives sur les enfants. Les résultats soutiennent les liens entre le domaine de parentification de l'injustice du rôle et chaque domaine de cognitions évaluatives maternelles et un effet indirect important de l'injustice sur le risque aux cognitions évaluatives maternelles sur les contributions de l'enfant au travers de l'auto-efficacité de parentage. Les implications pour les relations mère-enfant et les processus de transmission intergénérationnelle de la parentification sont discutés.


Subject(s)
Mother-Child Relations , Parenting , Adult , Child , Cognition , Female , Humans , Mothers , Parents
8.
Health Commun ; 35(3): 281-288, 2020 03.
Article in English | MEDLINE | ID: mdl-30592228

ABSTRACT

Effectively caring for a child with type-1 diabetes (T1D) can be extremely demanding and stressful for the entire family. The difficulties of caring for a child with T1D impact the psychological and physical well-being of the parents. Interventions aimed at reducing stress and increasing coping may improve parental outcomes. This project sought to develop a resource to be used as a preliminary intervention step for these parents. This research was conducted in two parts. Part 1 includes three stages of formative evaluation, including a focus group, interviews, and a survey with parents to examine the current landscape of diabetes websites as a resource. Using data from Part 1, Part 2 of the study included the identification of a theory to guide the design of a website, the development of the website, and an 8-week pilot study of the website with parents with a child with T1D. Significant improvements were found in diabetes knowledge and caregivers' satisfaction of life. No changes were found in social support, self-efficacy, or quality of life. Overall, the data show that the parents were generally satisfied with the website. Through this work, researchers were able to develop a deeper understanding of the needs of parents caring for a child with T1D to develop the initial component of a larger intervention.


Subject(s)
Diabetes Mellitus, Type 1/therapy , Internet , Parents , Adaptation, Psychological , Child , Feedback , Humans , Needs Assessment , Pilot Projects , Quality of Life , Self Efficacy , Social Support
10.
Child Psychiatry Hum Dev ; 50(4): 681-691, 2019 08.
Article in English | MEDLINE | ID: mdl-30783812

ABSTRACT

The present study examined the influence of mothers' and fathers' depressive symptoms on children's early literacy skills. Home learning-related parenting (HLE) was examined as a mediator of these associations. Families (N = 465) were recruited through preschools. Results indicate an actor effect of fathers', but not mothers', depressive symptoms on HLE parenting such that fathers who reported more depressive symptoms engaged in fewer HLE activities. A partner effect of fathers' depressive symptoms on HLE parenting indicated that higher levels of fathers' depressive symptoms were associated with lower levels of mothers' home learning activities. Finally, fathers' depressive symptoms negatively related to children's early literacy skills indirectly through mothers' HLE parenting. Findings highlight a process of negative effect of parent depressive symptoms on children's early literacy and emphasize including both mothers and fathers in future research concerned with the influence of parents' depressive symptoms on children's development.


Subject(s)
Depression , Family Health , Literacy/psychology , Maternal Behavior/psychology , Parenting/psychology , Paternal Behavior/psychology , Adult , Child, Preschool , Depression/diagnosis , Depression/psychology , Female , Humans , Learning , Male , Parent-Child Relations
11.
Multivariate Behav Res ; 53(2): 172-189, 2018.
Article in English | MEDLINE | ID: mdl-29300105

ABSTRACT

Latent change score models (LCS) are conceptually powerful tools for analyzing longitudinal data (McArdle & Hamagami, 2001). However, applications of these models typically include constraints on key parameters over time. Although practically useful, strict invariance over time in these parameters is unlikely in real data. This study investigates the robustness of LCS when invariance over time is incorrectly imposed on key change-related parameters. Monte Carlo simulation methods were used to explore the impact of misspecification on parameter estimation, predicted trajectories of change, and model fit in the dual change score model, the foundational LCS. When constraints were incorrectly applied, several parameters, most notably the slope (i.e., constant change) factor mean and autoproportion coefficient, were severely and consistently biased, as were regression paths to the slope factor when external predictors of change were included. Standard fit indices indicated that the misspecified models fit well, partly because mean level trajectories over time were accurately captured. Loosening constraint improved the accuracy of parameter estimates, but estimates were more unstable, and models frequently failed to converge. Results suggest that potentially common sources of misspecification in LCS can produce distorted impressions of developmental processes, and that identifying and rectifying the situation is a challenge.


Subject(s)
Longitudinal Studies , Models, Statistical , Monte Carlo Method , Bias , Humans
12.
J Exp Child Psychol ; 143: 65-84, 2016 Mar.
Article in English | MEDLINE | ID: mdl-26630033

ABSTRACT

Mother-child reminiscing, the process by which mothers and their children discuss past events and emotional experiences, has been robustly linked with child outcomes, including autobiographical memory. To advance previous work linking elaborative maternal reminiscing with child autobiographical memory specificity, the ability to generate and retrieve specific memories from one's past, it is essential to make distinctions among aspects of elaboration and to consider how maternal risk factors may influence the reminiscing context. The current study evaluated (a) an interaction between emotional and structural elaboration predicting child autobiographical memory specificity and (b) the potential moderating role of maternal adult attachment. Participants consisted of 95 preschool-aged children and their mothers. The sample was predominantly low income and racially diverse. Dyads completed a reminiscing task that was coded for emotional and structural elaboration. Mothers completed the Experiences in Close Relationships questionnaire (ECR-R) to assess attachment-related avoidance and anxiety, and children completed the Autobiographical Memory Test-Preschool Version (AMT-PV) to assess memory specificity. Results indicated that the association between structural reminiscing and child memory specificity was moderated by emotional elements of reminiscing. At high levels of emotional elaboration, mothers with high levels of structural elaboration had children with more specific memory than mothers with low levels of structural elaboration. Moreover, emotional elaboration (a) predicted less specific child memory without high structural support and (b) negatively predicted child specificity at high levels of maternal attachment avoidance and anxiety, a profile associated with fearful avoidance. Future directions and implications are discussed.


Subject(s)
Emotions , Memory, Episodic , Mother-Child Relations , Mothers/psychology , Object Attachment , Adult , Child , Child, Preschool , Female , Humans , Male , Middle Aged , Midwestern United States , Surveys and Questionnaires , Young Adult
13.
Dev Psychopathol ; 27(4 Pt 2): 1515-26, 2015 Nov.
Article in English | MEDLINE | ID: mdl-26535941

ABSTRACT

Theoretical and empirical evidence suggest that the way in which parents discuss everyday emotional experiences with their young children (i.e., elaborative reminiscing) has significant implications for child cognitive and socioemotional functioning, and that maltreating parents have a particularly difficult time in engaging in this type of dialogue. This dyadic interactional exchange, therefore, has the potential to be an important process variable linking child maltreatment to developmental outcomes at multiple levels of analysis. The current investigation evaluated the role of maternal elaborative reminiscing in associations between maltreatment and child cognitive, emotional, and physiological functioning. Participants included 43 maltreated and 49 nonmaltreated children (aged 3-6) and their mothers. Dyads participated in a joint reminiscing task about four past emotional events, and children participated in assessments of receptive language and emotion knowledge. Child salivary cortisol was also collected from children three times a day (waking, midday, and bedtime) on 2 consecutive days to assess daily levels and diurnal decline. Results indicated that maltreating mothers engaged in significantly less elaborative reminiscing than did nonmaltreating mothers. Maternal elaborative reminiscing mediated associations between child maltreatment and child receptive language and child emotion knowledge. In addition, there was support for an indirect pathway between child maltreatment and child cortisol diurnal decline through maternal elaborative reminiscing. Directions for future research are discussed, and potential clinical implications are addressed.


Subject(s)
Child Abuse/psychology , Child Development/physiology , Emotions/physiology , Hydrocortisone/metabolism , Mother-Child Relations/psychology , Mothers/psychology , Verbal Behavior/physiology , Adult , Child , Child, Preschool , Female , Humans , Male , Memory, Episodic , Mental Recall
14.
J Allergy Clin Immunol Pract ; 11(9): 2715-2723, 2023 09.
Article in English | MEDLINE | ID: mdl-37245734

ABSTRACT

BACKGROUND: Biologic therapies such as mepolizumab and benralizumab offer treatment options for severe eosinophilic asthma (SEA), although long-term real-world data on their use are limited. OBJECTIVES: To evaluate the impact of benralizumab and mepolizumab treatment among biologic-naive patients with SEA over 36 months and describe the incidence of super-response at 12 and 36 months, identifying potential predictive factors. METHODS: We conducted a retrospective, single-center study of patients with SEA who were given mepolizumab or benralizumab from May 2017 to December 2019, and who completed 36 months of therapy. Baseline demographics, comorbidities, and medication use were described. Data on clinical outcomes, including maintenance oral corticosteroid (OCS) use, annual exacerbation rate (AER), mini Asthma Quality of Life Questionnaire, Asthma Control Questionnaire (ACQ-6), and eosinophil count were collected at baseline and at 12 and 36 months. Super-response was evaluated at 12 and 36 months. RESULTS: A total of 81 patients were included. Maintenance OCS use significantly improved from baseline (5.3 mg/d) to 12 months (2.4 mg/d, P < .0001) and 36 months (0.6 mg/d; P < .0001). Annual exacerbation rate decreased from baseline (5.8) to 12 months (0.9; P < .0001) and 36 months (1.2; P < .0001). Mini Asthma Quality of Life Questionnaire, ACQ-6, and eosinophil count significantly improved from baseline to 12 and 36 months. Twenty-nine patients demonstrated super-response at 12 months. Compared with those without a super-response, these patients had better baseline AER (4.7 vs 6.5; P = .009), mini Asthma Quality of Life Questionnaire (3.41 vs 2.54; P = .002), and ACQ-6 (3.38 vs 4.06; P = .03) scores. Most maintained a super-response up to 36 months. CONCLUSIONS: Mepolizumab and benralizumab are associated with significant improvements in OCS use, AER, and asthma control in real-world cohorts for up to 36 months, providing insight into long-term use for SEA.


Subject(s)
Anti-Asthmatic Agents , Asthma , Biological Products , Pulmonary Eosinophilia , Humans , Anti-Asthmatic Agents/therapeutic use , Quality of Life , Retrospective Studies , Asthma/drug therapy , Asthma/etiology , Pulmonary Eosinophilia/drug therapy , Adrenal Cortex Hormones/therapeutic use , Biological Products/therapeutic use
15.
Psychol Methods ; 28(2): 339-358, 2023 Apr.
Article in English | MEDLINE | ID: mdl-37166933

ABSTRACT

Empirical studies often demonstrate multiple causal mechanisms potentially involving simultaneous or causally related mediators. However, researchers often use simple mediation models to understand the processes because they do not or cannot measure other theoretically relevant mediators. In such cases, another potentially relevant but unobserved mediator potentially confounds the observed mediator, thereby biasing the estimated direct and indirect effects associated with the observed mediator and threatening corresponding inferences. Additionally, researchers may not know the extent to which their measures are reliable, and accordingly, measurement error may bias estimated effects and mislead statistical inferences. Given these threats, we explore how the omission of an unobserved mediator and/or using variables with measurement error biases estimates and affects inferences associated with the observed mediator. Then, building off Frank's impact threshold for a confounding variable (ITCV), we propose a correlation-based sensitivity analysis. Lastly, we provide an R package ConMed to assess the robustness of mediation inferences given the omission of an unobserved, confounding mediator and/or measurement error. (PsycInfo Database Record (c) 2023 APA, all rights reserved).


Subject(s)
Models, Statistical , Humans , Causality , Confounding Factors, Epidemiologic , Bias
16.
Psychol Violence ; 13(5): 396-404, 2023 Sep.
Article in English | MEDLINE | ID: mdl-37928622

ABSTRACT

Objective: Intimate partner violence (IPV) during pregnancy is associated with negative physical and mental health consequences for both mothers and infants. Economic hardship is often exacerbated during pregnancy and is associated with increased rates of IPV in non-pregnant samples. However, temporal associations between economic hardship and IPV victimization have not been well characterized during pregnancy. The present study used data collected at the weekly level to examine the interindividual and intraindividual effects of economic hardship on IPV victimization during pregnancy and determine whether longitudinal changes in IPV across pregnancy vary based on level of economic hardship. Method: Two hundred ninety-four women reported on weekly experiences of IPV and economic hardship (i.e., food insecurity and other money problems) during weeks 17-40 of pregnancy. Participants were oversampled for low income and IPV exposure. Binary logistic multilevel models were used to test study hypotheses. Results: Greater economic hardship on average during pregnancy predicted increased odds of IPV victimization. Within-person increases in economic hardship also predicted increased odds of IPV victimization in the same week. Although IPV victimization tended to decrease on average over the course of pregnancy, there was a significant time by economic hardship interaction such that IPV decreased more gradually for women reporting high levels of economic hardship. Conclusions: The present study examined weekly patterns of IPV victimization across pregnancy in a low-income community sample. Results suggest that policies aimed at increasing families' economic security during the perinatal period may reduce the individual and societal burden of IPV.

17.
Appl Dev Sci ; 27(1): 1-17, 2023.
Article in English | MEDLINE | ID: mdl-36704361

ABSTRACT

Developmental researchers face considerable challenges regarding maximizing data collection and reducing participant attrition. In this article, we use our experiences implementing our study on the effects of timing of prenatal stress on maternal and infant outcomes during the COVID-19 pandemic as a framework to discuss the difficulties and solutions for these challenges, including the development of two types of virtual assessments. Specific information regarding use of virtual platforms, confidentiality, engaging children during video conferencing, and modifying the major assessments of our research are discussed. Feasibility data are presented, and data analytic challenges regarding statistical inference are outlined. Finally, we conclude with some of the unintended positive consequences for our research that resulted from making these modifications to our original methods.

18.
J Clin Child Adolesc Psychol ; 41(4): 491-8, 2012.
Article in English | MEDLINE | ID: mdl-22432507

ABSTRACT

Prior research has established the independent associations of depressive symptoms and childhood trauma to overgeneral memory (OGM); the present study addresses the potentially interactive effects between these two risk factors on OGM. In addition, the current study comprehensively evaluates whether executive functions (EF) mediate the relation between depressive symptoms and/or abuse to OGM in a child and adolescent sample. OGM was assessed among an inpatient-psychiatric sample of 49 youth (ages 7-17) with, and without, child abuse histories and depressive symptomatology. EF was assessed with standardized neuropsychological measures of verbal fluency, inhibition, and cognitive flexibility. There was a significant interaction of depressive symptoms and abuse in predicting OGM; the effect of depression on OGM was less pronounced among youth with abuse histories, who had elevated OGM at both low and high depressive symptoms relative to those with no abuse and low depressive symptoms. Among the EF measures, only category fluency was associated with OGM. An additive, rather than mediational, model was supported, whereby category fluency accounted for a significant proportion of variance in OGM above child abuse and depressive symptoms. The meaning of these findings for models of OGM and clinical practice are emphasized.


Subject(s)
Child Abuse/psychology , Depression/psychology , Executive Function , Memory , Adolescent , Child , Female , Humans , Male , Neuropsychological Tests , Psychiatric Status Rating Scales
19.
J Adult Dev ; 29(1): 40-52, 2022 Mar.
Article in English | MEDLINE | ID: mdl-35342275

ABSTRACT

Highly satisfying social relationships make us happy and healthy-they fill us with joy and a sense of meaning and purpose. But do all the relationships in our lives contribute equally to our well-being and do some people benefit more from certain relationships? The current study examined associations between the satisfaction of specific relationships within a family (i.e., with parents, siblings) and adjustment (i.e., life satisfaction and depressive symptoms) among 572 emerging adults aged 18-25 (M age = 19.95, SD = 1.42; 77.4% female). Overall, relationship satisfaction with mothers and fathers was associated with better adjustment. Attachment anxiety and avoidance moderated associations between relationship-specific satisfaction and adjustment. We discuss the findings in the context of the shifting of attachment functions during emerging adulthood and the dynamic nature of close relationships across the lifespan.

20.
Sci Rep ; 12(1): 1209, 2022 01 24.
Article in English | MEDLINE | ID: mdl-35075202

ABSTRACT

The impact of COVID-19-related stress on perinatal women is of heightened public health concern given the established intergenerational impact of maternal stress-exposure on infants and fetuses. There is urgent need to characterize the coping styles associated with adverse psychosocial outcomes in perinatal women during the COVID-19 pandemic to help mitigate the potential for lasting sequelae on both mothers and infants. This study uses a data-driven approach to identify the patterns of behavioral coping strategies that associate with maternal psychosocial distress during the COVID-19 pandemic in a large multicenter sample of pregnant women (N = 2876) and postpartum women (N = 1536). Data was collected from 9 states across the United States from March to October 2020. Women reported behaviors they were engaging in to manage pandemic-related stress, symptoms of depression, anxiety and global psychological distress, as well as changes in energy levels, sleep quality and stress levels. Using latent profile analysis, we identified four behavioral phenotypes of coping strategies. Critically, phenotypes with high levels of passive coping strategies (increased screen time, social media, and intake of comfort foods) were associated with elevated symptoms of depression, anxiety, and global psychological distress, as well as worsening stress and energy levels, relative to other coping phenotypes. In contrast, phenotypes with high levels of active coping strategies (social support, and self-care) were associated with greater resiliency relative to other phenotypes. The identification of these widespread coping phenotypes reveals novel behavioral patterns associated with risk and resiliency to pandemic-related stress in perinatal women. These findings may contribute to early identification of women at risk for poor long-term outcomes and indicate malleable targets for interventions aimed at mitigating lasting sequelae on women and children during the COVID-19 pandemic.


Subject(s)
Anxiety , COVID-19 , Pandemics , Postpartum Period/psychology , Pregnancy Complications , Psychological Distress , SARS-CoV-2 , Adaptation, Psychological , Adult , Anxiety/epidemiology , Anxiety/psychology , COVID-19/epidemiology , COVID-19/psychology , Female , Humans , Pregnancy , Pregnancy Complications/epidemiology , Pregnancy Complications/psychology
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