The Role of Resilience in the Impact of Family Economic Adversity on Youth Emotional Distress over Time.

Previous research has highlighted the enduring negative impact of family economic adversity on youth emotional well-being. However, the longitudinal mechanism underlying the link between economic adversity and emotional distress is less explored. The present study examined the longitudinal pathway of parent economic adversity, and parent and adolescent emotional distress at age 16, parental support at age 21, youth self-esteem and mastery at age 23, and adult emotional distress at age 27. Data came from the Family Transitions Project (N = 441, 57% female), a 30-year study of families from the rural Midwest. Structural equation models revealed that economic adversity exerted a long-term negative influence on adult emotional well-being through parent and adolescent emotional distress and youth self-esteem and mastery. Additionally, parental support was associated with adult emotional distress through youth self-esteem and mastery. The current study advances our understanding of youth emotional well-being by suggesting a longitudinal family process and resilience pathways from adolescence to early adulthood.

Digitally Enabled Peer Support Intervention to Address Loneliness and Mental Health: Prospective Cohort Analysis.

BACKGROUND: Social isolation and loneliness affect 61% of US adults and are associated with significant increases in excessive mental and physical morbidity and mortality. Annual health care spending is US $1643 higher for socially isolated individuals than for those not socially isolated. OBJECTIVE: We prospectively evaluated the effects of participation with a digitally enabled peer support intervention on loneliness, depression, anxiety, and health-related quality of life among adults with loneliness. METHODS: Adults aged 18 years and older living in Colorado were recruited to participate in a peer support program via social media campaigns. The intervention included peer support, group coaching, the ability to become a peer helper, and referral to other behavioral health resources. Participants were asked to complete surveys at baseline, 30, 60, and 90 days, which included questions from the validated University of California, Los Angeles Loneliness Scale, Patient Health Questionnaire 2-Item Scale, General Anxiety Disorder 7-Item Scale, and a 2-item measure assessing unhealthy days due to physical condition and mental condition. A growth curve modeling procedure using multilevel regression analyses was conducted to test for linear changes in the outcome variables from baseline to the end of the intervention. RESULTS: In total, 815 ethnically and socially diverse participants completed registration (mean age 38, SD 12.7; range 18-70 years; female: n=310, 38%; White: n=438, 53.7%; Hispanic: n=133, 16.3%; Black: n=51, 6.3%; n=263, 56.1% had a high social vulnerability score). Participants most commonly joined the following peer communities: loneliness (n=220, 27%), building self-esteem (n=187, 23%), coping with depression (n=179, 22%), and anxiety (n=114, 14%). Program engagement was high, with 90% (n=733) engaged with the platform at 60 days and 86% (n=701) at 90 days. There was a statistically (P<.001 for all outcomes) and clinically significant improvement in all clinical outcomes of interest: a 14.6% (mean 6.47) decrease in loneliness at 90 days; a 50.1% (mean 1.89) decline in depression symptoms at 90 days; a 29% (mean 1.42) reduction in anxiety symptoms at 90 days; and a 13% (mean 21.35) improvement in health-related quality of life at 90 days. Based on changes in health-related quality of life, we estimated a reduction in annual medical costs of US $615 per participant. The program was successful in referring participants to behavioral health educational resources, with 27% (n=217) of participants accessing a resource about how to best support those experiencing psychological distress and 15% (n=45) of women accessing a program about the risks of excessive alcohol use. CONCLUSIONS: Our results suggest that a digitally enabled peer support program can be effective in addressing loneliness, depression, anxiety, and health-related quality of life among a diverse population of adults with loneliness. Moreover, it holds promise as a tool for identifying and referring members to relevant behavioral health resources.

Factor analysis of the Cognitive Abilities Screening Instrument: Kuakini Honolulu-Asia Aging Study.

OBJECTIVE: The Cognitive Abilities Screening Instrument (CASI) is a screening test of global cognitive function used in research and clinical settings. However, the CASI was developed using face validity and has not been investigated via empirical tests such as factor analyses. Thus, we aimed to develop and test a parsimonious conceptualization of the CASI rooted in cognitive aging literature reflective of crystallized and fluid abilities. DESIGN: Secondary data analysis implementing confirmatory factor analyses where we tested the proposed two-factor solution, an alternate one-factor solution, and conducted a χ2 difference test to determine which model had a significantly better fit. SETTING: N/A. PARTICIPANTS: Data came from 3,491 men from the Kuakini Honolulu-Asia Aging Study. MEASUREMENTS: The Cognitive Abilities Screening Instrument. RESULTS: Findings demonstrated that both models fit the data; however, the two-factor model had a significantly better fit than the one-factor model. Criterion validity tests indicated that participant age was negatively associated with both factors and that education was positively associated with both factors. Further tests demonstrated that fluid abilities were significantly and negatively associated with a later-life dementia diagnosis. CONCLUSIONS: We encourage investigators to use the two-factor model of the CASI as it could shed light on underlying cognitive processes, which may be more informative than using a global measure of cognition.

Dealing with loss in the face of disasters and crises: Integrating interpersonal theories of couple adaptation and functioning.

The COVID-19 pandemic has highlighted the significant and varied losses that couples can experience during times of global and regional disasters and crises. What factors determine how couples navigate their close relationships during times of loss? In this paper, we elaborate and extend on one of the most influential frameworks in relationship science-the Vulnerability Stress Adaptation Model (VSAM, Karney and Bradbury, 1995)-to enhance the model's power to explain relationships during loss-themed disasters/crises. We do so by elaborating on attachment theory and integrating interdependence theory (emphasizing partner similarities and differences). Our elaboration and extension to the VSAM provides a comprehensive framework to guide future research and inform practice and policy in supporting relationships during and beyond loss-themed disasters/crises.

Bidirectional Associations Between Depressive and Anxiety Symptoms and Loneliness During the COVID-19 Pandemic: Dynamic Panel Models With Fixed Effects.

Background: Understanding the direction and magnitude of mental health-loneliness associations across time is important to understand how best to prevent and treat mental health and loneliness. This study used weekly data collected over 8 weeks throughout the COVID-19 pandemic to expand previous findings and using dynamic panel models with fixed effects which account for all time-invariant confounding and reverse causation. Methods: Prospective data on a convenience and snowball sample from all 50 US states and the District of Colombia (n = 2,361 with ≥2 responses, 63.8% female; 76% retention rate) were collected weekly via online survey at nine consecutive timepoints (April 3-June 3, 2020). Anxiety and depressive symptoms and loneliness were assessed at each timepoint and participants reported the COVID-19 containment strategies they were following. Dynamic panel models with fixed effects examined bidirectional associations between anxiety and depressive symptoms and loneliness, and associations of COVID-19 containment strategies with these outcomes. Results: Depressive symptoms were associated with small increases in both anxiety symptoms (ß = 0.065, 95% CI = 0.022-0.109; p = 0.004) and loneliness (ß = 0.019, 0.008-0.030; p = 0.001) at the subsequent timepoint. Anxiety symptoms were associated with a small subsequent increase in loneliness (ß = 0.014, 0.003-0.025; p = 0.015) but not depressive symptoms (ß = 0.025, -0.020-0.070; p = 0.281). Loneliness was strongly associated with subsequent increases in both depressive (ß = 0.309, 0.159-0.459; p < 0.001) and anxiety (ß = 0.301, 0.165-0.436; p < 0.001) symptoms. Compared to social distancing, adhering to stay-at-home orders or quarantining were not associated with anxiety and depressive symptoms or loneliness (both p ≥ 0.095). Conclusions: High loneliness may be a key risk factor for the development of future anxiety or depressive symptoms, underscoring the need to combat or prevent loneliness both throughout and beyond the COVID-19 pandemic. COVID-19 containment strategies were not associated with mental health, indicating that other factors may explain previous reports of mental health deterioration throughout the pandemic.

The Impact of Distal Influences and Proximal Resources on the Mental Health of African American Older Adults: Findings From the Georgia Centenarian Study.

BACKGROUND AND OBJECTIVES: Over the years, a large amount of research has been devoted to the investigation of factors that led to mental health outcomes in older adults. For African American older adults, their lived experiences place them at high risk for mental health problems. The purpose of this study was to examine the impact of early life influences (i.e., education, childhood life events, and childhood financial well-being) and present psychosocial resources (i.e., individual, financial, and social) on current mental health outcomes in a sample of African American older adults in their 60s, 80s, and 100s. RESEARCH DESIGN AND METHODS: Using data from the Georgia Centenarian Study, 125 participants were interviewed about their mental health, resources, and early life influences. RESULTS: A structural equation model was tested and resulted in a good fit. Results indicated that the more social resources African American older adults had available, the lower the number of depressive symptoms they reported. African Americans with higher levels of financial well-being during childhood reported higher self-rated mental health. Older adults had higher levels of financial resources. Level of education showed a positive relationship with financial resources. Indirect effects of distal influences on health outcomes via current resources were not found. DISCUSSION AND IMPLICATIONS: The findings are of direct practical relevance and can be used to more readily identify older African Americans who may be susceptible to poorer mental health outcomes based upon the impact of their unique distal and proximal psychosocial resources.

Loneliness in the United States: A 2018 National Panel Survey of Demographic, Structural, Cognitive, and Behavioral Characteristics.

PURPOSE: To inform health behavior intervention design, we sought to quantify loneliness and its correlates, including social media use, among adults in the United States. DESIGN: Cross-sectional research panel questionnaire. SETTING: Responses were gathered from individuals in all 50 states surveyed via Internet from February 2018 to March 2018. PARTICIPANTS: A total of 20 096 US panel respondents aged 18+. MEASURES: The University of California at Los Angeles (UCLA) Loneliness Scale (theoretical score range = 20-80) was administered along with demographic, structural, cognitive, and behavioral items. ANALYSIS: After calibrating the sample to population norms, we conducted multivariable linear regression analysis. RESULTS: The overall mean survey-weighted loneliness score was 44.03 (standard error = 0.09). Social support (standardized ß [sß] = -0.19) and meaningful daily interactions (sß = -0.14) had the strongest associations with lower loneliness, along with reporting good relationships, family life, physical and mental health, friendships, greater age, being in a couple, and balancing one's daily time. Social anxiety was most strongly associated with greater loneliness (sß = +0.20), followed by self-reported social media overuse (sß = +0.05) and daily use of text-based social media (sß = +0.03). CONCLUSION: Our findings confirm that loneliness decreases with age, and that being in a relationship as well as everyday behavioral factors in people's control are most strongly related to loneliness. Population health promotion efforts to reduce loneliness should focus on improving social support, decreasing social anxiety, and promoting healthy daily behaviors.

Neighborhood racial discrimination and the development of major depression.

This study examined the impact of neighborhood racial discrimination on the development of major depressive disorder (MDD) in a sample of African American women. Participants were 499 women from Georgia and Iowa with no history of MDD who were followed for 9 to 11 years. Several neighborhood characteristics (community social disorder, community cohesion, and community racism) and individual characteristics (negative life events, financial strain, personal outlook, religious involvement, relationship quality, negative affectivity, and individual experiences of racism) were employed as predictors of whether or not the women met criteria for MDD during this period of time. In a multilevel logistic regression analysis, neighborhood-level discrimination as well as individual-level variables including the number of negative life events, financial strain, and negative affectivity were found to be significant predictors of developing MDD. Analyses of cross-level interactions indicated that the effects of neighborhood-level discrimination were moderated by the quality of individuals' relationships, such that better relationships with others served to lessen the effect of neighborhood discrimination on depression. Implications of these findings for understanding the negative effects of racial discrimination are discussed. (PsycINFO Database Record

United and Divided by Stress: How Stressors Differentially Influence Social Support in African American Couples Over Time.

The factors that allow people to be good support providers in relationships are not fully understood. We examined how support providers' stressful experiences (financial strain and racial discrimination) differentially influence their supportiveness, using longitudinal data from two samples of African American couples. Among couples that provided observational data ( N = 163 couples), providers who experienced high chronic financial strain behaved less supportively toward their partners, while those who experienced frequent racial discrimination behaved more supportively over a 2-year period. In a second sample of 213 couples over a 3-year period, support providers who experienced financial strain were perceived by their partners as slightly less supportive, while providers who experienced frequent racial discrimination were perceived by their partners as more supportive. Findings suggest that supportiveness in relationships may be differentially shaped by the specific stresses and strains that partners face.

Autonomy promotion, responsiveness, and emotion regulation promote effective social support in times of stress.

Adult attachment theory provides guidance for providing optimal social support in intimate relationships. According to attachment theory, facilitating autonomy (secure base support) sometimes is more important than providing nurturance (safe haven support). In addition, it is important that couples celebrate one another's triumphs and successes (another form of secure base support). A key construct that explains the development of attachment is responsiveness to the individual's needs. Support that is delivered in a responsive manner (i.e., that leads the individual to feel understood, validated, and cared for) is more likely to enhance the relationship and less likely to damage self-esteem than assistance that is not responsive. A responsive exchange is more likely if emotion dysregulation can be prevented. Attachment theory offers explanations for why people vary in their effectiveness at emotion regulation. Appropriate emotion regulation is more likely if disclosures of current difficulties can be made in a way that is not defensive or accusatory, an ability that varies as a function of attachment orientation. Attachment theory also offers guidance regarding the optimal forms of social support for specific individuals. All these insights from adult attachment theory can be integrated into interventions to help couples become more effective support providers.

The Longitudinal Impact of NFL PLAY 60 Programming on Youth Aerobic Capacity and BMI.

INTRODUCTION: The NFL PLAY 60 campaign has actively promoted physical activity and healthy eating in youth through programs such as the PLAY 60 Challenge and Fuel Up to PLAY 60. The purpose of the study was to evaluate the impact of NFL PLAY 60 programming on longitudinal trajectories of youth aerobic capacity and BMI. STUDY DESIGN: Data were from the NFL PLAY 60 FitnessGram Partnership Project, a large participatory research project designed to promote physical activity and healthy eating among Kindergarten through 12th grade children and adolescents. SETTING/PARTICIPANTS: The programming was led by teachers in school settings across 32 NFL franchise markets. A range of 50,000-100,000 students from 497 schools completed FitnessGram assessments annually starting in 2011 and continuing through 2015. The analysis was conducted in 2015. INTERVENTION: Adoption of NFL PLAY 60 programming was encouraged but not required and the program implementation was evaluated each year. The adoption was evaluated through self-reported annual survey. MAIN OUTCOME MEASURES: School assessments of aerobic capacity and BMI were evaluated using FitnessGram standards to calculate the percentage of students meeting the Healthy Fitness Zone for each test. Growth curve modeling was used to estimate the longitudinal trajectories. RESULTS: About 19% of schools were classified as programming schools. Annual improvements in aerobic capacity were significantly greater in schools that participated in the programs for both girls (3.0%, p<0.01) and boys (2.9%, p<0.01) compared with non-programming schools. The annual improvements in BMI Healthy Fitness Zone achievement were also higher in girls (1.3%, p<0.05) and in boys (1.2%, p<0.05) from schools that participated in the programs versus non-participating schools. Schools that implemented the programs for the entire 4-year period tended to have better improvements in aerobic capacity than schools enrolled for only 2 or 3 years (p<0.05). CONCLUSIONS: The results of these longitudinal analyses support the utility of the NFL PLAY 60 physical activity promotion programs for improving youth aerobic capacity and potentially helping to reverse the prevalence of overweight/obesity. However, the overall program adoption rate is low.

Financial strain, inflammatory factors, and haemoglobin A1c levels in African American women.

OBJECTIVE: Type 2 diabetes disproportionately affects African American women, a population exposed to high levels of stress, including financial strain (Centers for Disease Control & Prevention, 2011, http://www.cdc.gov/diabetes/pubs/pdf/ndfs_2011.pdf). We tested a mediational model in which chronic financial strain among African American women contributes to elevated serum inflammation markers, which, in turn, lead to increased haemoglobin A1C (HbA1c) levels and risk for type 2 diabetes. METHODS: We assessed level of financial strain four times over a 10-year period and tested its effect on two serum inflammation markers, C-reactive protein (CRP) and soluble interleukin-6 receptor (sIL-6R) in year 11 of the study. We tested the inflammation markers as mediators in the association between chronic financial strain and HbA1c, an index of average blood glucose level over several months. DESIGN: Data were from 312 non-diabetic African American women from the Family and Community Health Study (FACHS; Cutrona et al., 2000, J. Pers. Soc. Psychol., 79, 1088). RESULTS: Chronic financial strain predicted circulating sIL-6R after controlling for age, BMI, health behaviours, and physical health measures. In turn, sIL-6R significantly predicted HbA1c levels. The path between chronic financial strain and HbA1c was significantly mediated by sIL-6R. Contrary to prediction, CRP was not predicted by chronic financial strain. CONCLUSIONS: Results support the role of inflammatory factors in mediating the effects of psychosocial stressors on risk for type 2 diabetes. Findings have implications for interventions that boost economic security and foster effective coping as well as medical interventions that reduce serum inflammation to prevent the onset of type 2 diabetes.

Moderating influences of baseline activity levels in school physical activity programming for children: the Ready for Recess project.

BACKGROUND: A limitation of traditional outcome studies from behavioral interventions is the lack of attention given to evaluating the influence of moderating variables. This study examined possible moderation effect of baseline activity levels on physical activity change as a result of the Ready for Recess intervention. METHODS: Ready for Recess (August 2009-September 2010) was a controlled trial with twelve schools randomly assigned to one of four conditions: control group, staff supervision, equipment availability, and the combination of staff supervision and equipment availability. A total of 393 children (181 boys and 212 girls) from grades 3 through 6 (8-11 years old) were asked to wear an Actigraph monitor during school time on 4-5 days of the week. Assessments were conducted at baseline (before intervention) and post intervention (after intervention). RESULTS: Initial MVPA moderated the effect of Staff supervision (ß = -0.47%; p < .05), but not Equipment alone and Staff + Equipment (p > .05). Participants in the Staff condition that were 1 standard deviation (SD) below the mean for baseline MVPA (classified as "low active") had lower MVPA levels at post-intervention when compared with their low active peers in the control condition (Mean diff = -10.8 ± 2.9%; p = .005). High active individuals (+1SD above the mean) in the Equipment treatment also had lower MVPA values at post-intervention when compared with their highly active peers in the control group (Mean diff = -9.5 ± 2.9%; p = .009). CONCLUSIONS: These results indicate that changes in MVPA levels at post-intervention were reduced in highly active participants when recess staff supervision was provided. In this study, initial MVPA moderated the effect of Staff supervision on children's MVPA after 6 months of intervention. Staff training should include how to work with inactive youth but also how to assure that active children remain active.

The Effects of General Social Support and Social Support for Racial Discrimination on African American Women's Well-Being.

The present longitudinal study examined the role of general and tailored social support in mitigating the deleterious impact of racial discrimination on depressive symptoms and optimism in a large sample of African American women. Participants were 590 African American women who completed measures assessing racial discrimination, general social support, tailored social support for racial discrimination, depressive symptoms, and optimism at two time points (2001-2002 and 2003-2004). Our results indicated that higher levels of general and tailored social support predicted optimism one year later; changes in both types of support also predicted changes in optimism over time. Although initial levels of neither measure of social support predicted depressive symptoms over time, changes in tailored support predicted changes in depressive symptoms. We also sought to determine whether general and tailored social support "buffer" or diminish the negative effects of racial discrimination on depressive symptoms and optimism. Our results revealed a classic buffering effect of tailored social support, but not general support on depressive symptoms for women experiencing high levels of discrimination.

Assessing change in a personality profile.

We tested the validity of 6 methods (mean difference, variance difference, bivariate, profile agreement, pattern similarity, and intraclass) to assess change in a personality profile. During their first 2 months of college, 372 students completed reactive and spontaneous measures of their personality. Eight weeks later, 300 returned to complete a second set of the same measures and noted change in their spontaneous personality list. Sixty participants returned during their second semester to complete a third set of assessments. The bivariate and intraclass change coefficients showed consistent convergent, discriminant, and concurrent validity across time points. Recommendations and caveats for using these coefficients are discussed.

Experiential self-focus writing as a facilitator of processing an interpersonal hurt.

OBJECTIVES: This study examined the effects of experiential self-focus writing on changes in psychological outcomes (i.e., unforgiveness and negative affect) after an interpersonal hurt and the buffering effects of experiential self-focus writing on the association between anger rumination and these psychological outcomes. DESIGN: A sample of 182 college students who had experienced interpersonal hurt were randomly assigned to either the experiential self-focus writing condition, in which participants wrote about their feelings and experiences related to the hurt, or to a control writing condition in which they wrote about a recent neutral event. RESULTS: Latent growth curve analyses indicated that changes in unforgiveness over time did not differ between the experiential self-focus writing and the control writing conditions. However, relative to the control writing condition, negative affect decreased faster during writing and increased more slowly at follow-ups in the experiential self-focus writing condition. CONCLUSIONS: The results supported the hypothesis that negative affect resulting from an interpersonal hurt would significantly decrease over time among participants in the experiential self-focus writing group compared with the control group. Implications of experiential self-focus writing for interpersonal hurt and directions for future studies are discussed.

Is loneliness the same as being alone?

The cognitive discrepancy model predicts that loneliness occurs when individuals perceive a difference between their desired and actual levels of social involvement. Using data from a sample of high school sophomore students, the present investigation was designed to go beyond previous research that has tested this model by examining the predicted nonlinear relationships between desired and actual social contact and feelings of loneliness. Analyses indicated that support for the cognitive discrepancy model of loneliness was found only for measures of close friendships. Specifically, the discrepancy between the students' ideal number and actual number of close friends was found to be related in a nonlinear fashion to feelings of satisfaction with close friendships and loneliness after control for the number of close friends. Implications of these findings for theoretical models of loneliness are discussed.

Cancer distress reduction with a couple-based skills training: a randomized controlled trial.

BACKGROUND: There are few interventions for couples facing cancer. PURPOSE: This study aims to investigate the utility of providing dyadic skills to these couples. METHODS: Woman recently diagnosed with breast or gynecological cancer and their partners were randomly assigned to either a couple-skills intervention (Side by Side) or to cancer education (Couples Control Program). Assessments with self-report and behavioral observation of both partners were conducted four times over 16 months. RESULTS: Multilevel analyses of data from 72 participating couples suggest that females receiving Side by Side showed larger reductions in fear of progression, and couples reported less avoidance in dealing with the cancer, more posttraumatic growth, and better relationship skills relative to the Couples Control Program. All differences favoring Side by Side disappeared by 16 months after the diagnosis. CONCLUSION: Short-term changes in functioning may be improved by enhancing couples' dyadic skills during acute medical treatment of the disease.

Predicting relationship stability among midlife African American couples.

OBJECTIVE: This study examined predictors of relationship stability over 5 years among heterosexual cohabiting and married African American couples raising an elementary-school-age child. The vulnerability-stress-adaptation model of relationships (Karney & Bradbury, 1995) guided the investigation. Contextual variables were conceptualized as important determinants of education and income, which in turn influence family structure, stress, and relationship quality and stability. Religiosity was tested as a resource variable that enhances relationship stability. METHOD: Couples (N = 207) were drawn from the Family and Community Health Study. Variables assessed at Wave 1 (education, income, religiosity, biological vs. stepfamily status, marital status, financial strain, and relationship quality) were used to predict relationship stability 5 years later. RESULTS: Higher levels of education were associated with higher income, lower financial strain, and family structures that research has shown to be more stable (marriage rather than cohabitation and biological-family rather than stepfamily status; Bumpass & Lu, 2000). These variables, in turn, influenced relationship quality and stability. Religiosity, an important resource in the lives of African Americans, promoted relationship stability through its association with marriage, biological-family status, and women's relationship quality. CONCLUSIONS: Enhancing the stability of African American couples' relationships will require changes in societal conditions that limit opportunities for education and income and weaken relationship bonds. Programs to assist couples with blended families are needed, and incorporation of spirituality into culturally sensitive relationship interventions for African American couples may also prove beneficial.