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1.
J Speech Lang Hear Res ; 67(5): 1530-1547, 2024 May 07.
Artículo en Inglés | MEDLINE | ID: mdl-38592972

RESUMEN

PURPOSE: The word learning of preschool-age children with developmental language disorder (DLD) is improved when spaced retrieval practice is incorporated into the learning sessions. In this preregistered study, we compared two types of spacing-an expanding retrieval practice schedule and an equally spaced schedule-to determine if one of these approaches yields better word learning outcomes for the children. METHOD: Fourteen children with DLD aged 4-5 years and 14 same-age children with typical language development (TD) learned eight novel nouns over two sessions. Spacing for half of the novel words was expanded gradually during learning; for the remaining novel words, greater spacing remained at the same level throughout learning. Immediately after the second session and 1 week later, the children's recall of the words was tested. RESULTS: The children with TD recalled more novel words than the children with DLD, although this difference could be accounted for by differences in the children's standardized receptive vocabulary test scores. The two groups were similar in their ability to retain the words over 1 week. Initially, the shorter spacing in the expanding schedule resulted in greater retrieval success than the corresponding (longer spaced) retrieval trials in the equally spaced schedule. These early shorter spaced trials also seemed to benefit retrieval of the trials with greater spacing that immediately followed. However, as the learning period progressed, the accuracy levels for the two conditions converged and were likewise similar during final testing. CONCLUSION: We need a greater understanding of how and when short spacing can be helpful to children's word learning, with the recognition that early gains might give a misleading picture of the benefits that short spacing can provide to longer term retention. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.25537696.


Asunto(s)
Trastornos del Desarrollo del Lenguaje , Recuerdo Mental , Aprendizaje Verbal , Vocabulario , Humanos , Trastornos del Desarrollo del Lenguaje/psicología , Trastornos del Desarrollo del Lenguaje/terapia , Preescolar , Femenino , Masculino , Pruebas del Lenguaje , Lenguaje Infantil , Práctica Psicológica
2.
PLoS One ; 19(3): e0295007, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38498486

RESUMEN

Multiple adjustment difficulties have been associated with children's exposure to recent parental wartime military deployments, but long-term consequences have not yet been systematically studied. This investigation will assess direct and indirect relationships between exposures to parental deployments early in life and later youth adjustment. Parents' psychological health and family processes will be examined as mediators, and parents' and children's vulnerability and support will be examined as moderators. Archival data will be combined with new data gathered from two children and up to two parents in families where children will be aged 11 to 16 at the first data collection and will have experienced at least one parental deployment, for at least one child prior to age 6. Data are being gathered via telephone interviews and web-based surveys conducted twice one year apart. Outcomes are indicators of children's social-emotional development, behavior, and academic performance. Notable features of this study include oversampling of female service members, inclusion of siblings, and inclusion of families of both veterans and currently serving members. This study has potentially important implications for schools, community organizations and health care providers serving current and future cohorts of military and veteran families.


Asunto(s)
Padre , Personal Militar , Masculino , Niño , Adolescente , Humanos , Femenino , Padre/psicología , Madres/psicología , Padres/psicología , Emociones
3.
J Speech Lang Hear Res ; 66(7): 2278-2295, 2023 07 12.
Artículo en Inglés | MEDLINE | ID: mdl-37390495

RESUMEN

PURPOSE: People who stutter often experience significant adverse impact related to stuttering. However, it is unclear how adverse impact develops in children who stutter (CWS) and whether there are protective factors that may mitigate its development. This study examined the relationship between resilience, a potentially protective factor, and stuttering's adverse impact in CWS. Resilience comprises external factors, such as family support and access to resources as well as personal attributes, making it a comprehensive protective factor to explore. METHOD: One hundred forty-eight CWS aged 5-18 years completed the age-appropriate version of the Child and Youth Resilience Measure (CYRM) and the Overall Assessment of the Speaker's Experience of Stuttering. Parents completed a caregiver version of the CYRM and a behavioral checklist for their child. The adverse impact of stuttering was modeled as a function of resilience (external, personal, and total), controlling for child age and behavioral checklist score. We also estimated correlations between child-report and parent-report CYRM measures to assess rater agreement. RESULTS: Children reporting greater external, personal, or total resilience were more likely to experience lower degrees of adverse impact related to their stuttering. We documented stronger correlations between younger child and parent ratings of resilience and weaker correlations between older child and parent ratings. CONCLUSIONS: These results yield valuable insight into the variability of adverse impact experienced by CWS and offer empirical support for strength-based speech therapy approaches. We discuss the factors that contribute to a child's resilience and provide practical suggestions for how clinicians can incorporate resilience-building strategies into intervention for children experiencing significant adverse impact from their stuttering. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.23582172.


Asunto(s)
Tartamudeo , Adolescente , Humanos , Niño , Padres
4.
J Speech Lang Hear Res ; 66(4): 1309-1333, 2023 04 12.
Artículo en Inglés | MEDLINE | ID: mdl-36898133

RESUMEN

PURPOSE: Children with developmental language disorder (DLD) have well-documented verb learning difficulties. In this study, we asked whether the inclusion of retrieval practice during the learning period would facilitate these children's verb learning relative to a similar procedure that provided no retrieval opportunities. METHOD: Eleven children with DLD (M age = 60.09 months) and 12 children with typical language development (TD; M age = 59.92 months) learned four novel verbs in a repeated spaced retrieval (RSR) condition and four novel verbs in a repeated study (RS) condition. The words in the two conditions were heard an equal number of times, in the context of video-recorded actors performing novel actions. RESULTS: Recall testing immediately after the learning period and 1 week later revealed greater recall for novel verbs in the RSR condition than for novel verbs in the RS condition. This was true for both groups, and for immediate as well as 1-week testing. The RSR advantage remained when children had to recall the novel verbs while watching new actors perform the novel actions. However, when tested in contexts requiring the children to inflect the novel verbs with -ing for the first time, the children with DLD were much less likely to do so than their peers with TD. Even words in the RSR condition were only inconsistently inflected. CONCLUSIONS: Retrieval practice provides benefits to verb learning-an important finding given the challenges that verbs present to children with DLD. However, these benefits do not appear to automatically translate to the process of adding inflections to newly learned verbs but rather appear to be limited to the operations of learning the verbs' phonetic forms and mapping these forms onto associated actions.


Asunto(s)
Lenguaje Infantil , Trastornos del Desarrollo del Lenguaje , Humanos , Niño , Preescolar , Desarrollo del Lenguaje , Aprendizaje Verbal , Aprendizaje
5.
J Speech Lang Hear Res ; 65(7): 2571-2585, 2022 07 18.
Artículo en Inglés | MEDLINE | ID: mdl-35858262

RESUMEN

PURPOSE: In our earlier study, we found that overall accuracy on nonword repetition (NWR) lacked the specificity to differentiate among groups of children who stutter (CWS) with and without concomitant speech sound and/or language disorders and children who do not stutter (CWNS). The aim of this study was to determine whether NWR error characteristics distinguish these groups of children with different speech sound production and language abilities yielding insight into the deficits underlying poorer performance. METHOD: Participants were 141 children (88 CWS, 53 CWNS). CWS were divided into subgroups based on the presence or absence of concomitant speech sound and language disorders. Children completed an NWR task composed of one- to four-syllable nonwords. Error types included omissions, substitutions, and migrations. Error location was documented across the syllables of the longest, four-syllable nonwords and within each syllable (onset, nucleus, and coda) for all nonwords. RESULTS: We found that error patterns characterized groups' NWR performance. Specifically, CWS groups made more errors on syllable onsets, more errors on the first and fourth syllable of the four-syllable nonwords, and more substitution errors than CWNS. CWS with concomitant speech sound and/or language disorders made more omission errors than CWNS and CWS with typical speech sound and language abilities. CWS with both a speech sound and language disorder made more migration errors than all other groups. CONCLUSIONS: Using a data-driven framework derived from prior empirical investigations of NWR errors, this study demonstrated that error characteristics enhance the specificity of NWR by distinguishing groups of CWS with and without concomitant speech sound and language deficits. These error patterns also provide a window into the processes underlying NWR performance in CWS.


Asunto(s)
Trastornos del Lenguaje , Tartamudeo , Estudios de Casos y Controles , Niño , Humanos , Fonética , Habla , Medición de la Producción del Habla
6.
J Aging Health ; 34(6-8): 775-785, 2022 10.
Artículo en Inglés | MEDLINE | ID: mdl-35100880

RESUMEN

Objectives. The purpose of this study was to examine the psychometric properties of modified versions of the Behavioral Regulation in Exercise Questionnaire and Exercise Identity Scale for use with adults ages ≥55 years to measure regulatory styles and identity related to physical activity. Methods. Participants [Mage = 66.29 years (SD = 7.06)] answered an online questionnaire twice across a four-week timescale. We assessed measurement invariance and convergent and divergent validity based on relations between regulatory styles, identity, and physical activity. Results. Both measures were invariant across gender and time, and findings support the convergent and divergent validity of the scales. Notably, a two-factor model of identity representing role identity and physical activity beliefs provided the best fit, and physical activity beliefs was more strongly related to introjected regulation. Discussion. Taken together, there is evidence that these modified scales are suitable for use with adults ages ≥55 years.


Asunto(s)
Ejercicio Físico , Identidad de Género , Anciano , Humanos , Psicometría/métodos , Reproducibilidad de los Resultados , Encuestas y Cuestionarios
7.
Child Abuse Negl ; 126: 105508, 2022 04.
Artículo en Inglés | MEDLINE | ID: mdl-35123282

RESUMEN

BACKGROUND: Childhood maltreatment types can co-occur and are associated with increased substance use during adolescence and early adulthood. There is also a strong genetic basis for substance use which interacts with environmental factors (e.g., childhood maltreatment) to influence substance use phenotype. OBJECTIVE: This research aimed to identify childhood maltreatment sub-groups based on type and chronicity, and their association with substance use change from adolescence to early adulthood, while accounting for the influence of substance use polygenic risk (i.e., genetic risk based on the combined effects of multiple genes). PARTICIPANTS: We used a sample of unrelated European-origin Americans with genetic and childhood maltreatment data (n = 2,664) from the National Longitudinal Study of Adolescent to Adult Health. METHODS: Latent profile analysis was used for sub-group identification and direct and interaction effects were tested for longitudinal trajectories of substance use utilizing generalized estimating equations. RESULTS: Three sub-groups with co-occurring childhood maltreatment exposures were identified: a high sexual abuse sub-group, a high physical abuse sub-group, and a normative sub-group (with low maltreatment exposure). At high polygenic risk, the high physical abuse sub-group had faster increases in substance use over time. In comparison, the high sexual abuse sub-group had faster progression in substance use only at low and medium polygenic risk. CONCLUSIONS: Findings provide initial evidence for biological and environmental differences among maltreatment sub-groups on trajectories of substance use.


Asunto(s)
Maltrato a los Niños , Trastornos Relacionados con Sustancias , Adolescente , Adulto , Niño , Humanos , Estudios Longitudinales , Abuso Físico , Factores de Riesgo , Trastornos Relacionados con Sustancias/epidemiología , Trastornos Relacionados con Sustancias/genética
8.
Z Kinder Jugendpsychiatr Psychother ; 50(5): 346-356, 2022 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-34668761

RESUMEN

Objective: Interparental conflict has long been acknowledged as a major risk factor for the well-being of children. Empirical studies reveal clear associations between children's maladjustment and frequent destructive conflicts between their parents (van Eldik et al., 2020). Existing research suggests that interparental conflict spills over from the couple to the coparental relationship, undermining parents' skills to cooperate and their parenting competencies. This study addresses the effects of interparental conflict on the behavioral and emotional problems of toddlers. Methods: The analyses were based on longitudinal data from the German Family Panel pairfam. The sample comprised information on N = 828 anchor participants (59.9 % female) and their 3- to 5-year-old children. Results: As expected, the effects of interparental conflict on children's behavioral and emotional problems were mediated by coparenting problems and in part also by negative parenting. Further analyses comparing mothers and fathers revealed a stronger direct path of interparental conflict on coparenting for mothers. Conclusions: The findings provide support for the significance of the interparental relationship and coparenting quality for child development, even in this young age group, and point to the importance of early prevention.


Asunto(s)
Conflicto Familiar , Responsabilidad Parental , Niño , Crianza del Niño/psicología , Preescolar , Conflicto Familiar/psicología , Femenino , Alemania , Humanos , Masculino , Responsabilidad Parental/psicología , Padres/psicología
9.
Mil Psychol ; 34(1): 110-120, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-38536278

RESUMEN

Informed by life course theory, we estimated depression symptom trajectories for couples throughout a deployment cycle using data from a longitudinal study of National Guard couples (n= 339). One-third of couples served as a comparison group by participating in data collection after their deployments were canceled. We proposed that 1) service members and partners would display multiple trajectories of depression symptoms that differ as a function of role (i.e., service member or at-home partner) and exposure to deployment; 2) trajectory patterns would be associated with indicators of human capital; 3) service members' and partners' depression symptoms would be linked to each other. We found that depressive symptom trajectories varied by exposure to deployment and role, and that higher levels of human capital were mostly associated with lower depressive symptoms, although we did not find support for partner interdependence. Results were considered in the context of life course theory and emotional cycles of deployment.

10.
J Neurodev Disord ; 13(1): 20, 2021 05 15.
Artículo en Inglés | MEDLINE | ID: mdl-33992071

RESUMEN

BACKGROUND: Many children with developmental language disorders (DLD) have well-documented weaknesses in vocabulary. In recent years, investigators have explored the nature of these weaknesses through the use of novel word learning paradigms. These studies have begun to uncover specific areas of difficulty and have provided hints about possible intervention strategies that might help these children learn words more accurately and efficiently. Among the studies of this type are those that incorporate repeated spaced retrieval activities in the learning procedures. METHODS: In this study, we examined the data from four of these studies that employed the same types of participants (4- and 5-year-old children with DLD and same-age children with typical language development), research design, and outcome measures. The studies differed primarily in the type of learning condition that was being compared to a spaced retrieval condition. A mixed-effects modeling framework was used, enabling the data from the four studies and different outcome measures to be aggregated. RESULTS: Across the studies, more words in the repeated spaced retrieval condition were recalled than those in the comparison conditions. This was true regardless of outcome measure. Children with typical language development recalled more words than the children with DLD. Both groups benefited from spaced retrieval, though effects were larger for the group with DLD. Children recalled words as accurately 1 week after learning as they did at the 5-min mark; the two groups were essentially identical in this respect. CONCLUSIONS: Overall, the findings support the continued refinement of these types of repeated spaced retrieval procedures, as they may have potential to serve as effective approaches to intervention.


Asunto(s)
Trastornos del Desarrollo del Lenguaje , Aprendizaje Verbal , Niño , Preescolar , Humanos , Desarrollo del Lenguaje , Recuerdo Mental , Vocabulario
11.
Gait Posture ; 85: 285-289, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-33636457

RESUMEN

BACKGROUND: Walking at a brisk pace is widely recommended to promote health. When partners walk together, walking activity is increased and maintained due to enhanced social support and accountability, but at least one person must adjust their gait speed. Decreased gait speed could compromise health benefits, which may be especially relevant for the aging population. RESEARCH QUESTION: Do adults change gait speed when walking with their romantic partner, relative to walking alone, and is the change in speed affected by age or pathway conditions? METHODS: Participants were 141 individuals from 72 romantic couples; age range 25-79 years. The three couple conditions were walking alone, walking with their partner, and walking while holding hands with their partner. The two pathway conditions were clear pathway and pathway with obstacles. Gait speed was modeled as a function of the couple conditions, pathway conditions, and covariates (gender, age, relationship duration, and physical activity) using mixed-effects (3-level) regression. RESULTS: In both pathway conditions, both partners reduced speed when walking together (p < 0.001), and reduced speed further while holding hands (p < 0.001), when compared to walking alone. These effects were unchanged when covariates were included in the model. Further, speed was slower on the obstructed pathway for all participants, but the magnitude of slowing was greater with increasing age (p < 0.001) and in females (p=0.03). SIGNIFICANCE: Across the adult lifespan, when walking together, both partners decreased gait speed by a clinically meaningful amount (≥0.05 m/s). While walking with a partner may increase walking activity due to social support, reduced speed when walking together may unintentionally reduce health benefits and gait quality in both partners. Future research should identify how health is impacted by the trade-off between increased walking activity and reduced gait speed when romantic partners walk together.


Asunto(s)
Envejecimiento/fisiología , Esposos , Velocidad al Caminar/fisiología , Adulto , Factores de Edad , Anciano , Entorno Construido , Femenino , Marcha , Humanos , Masculino , Persona de Mediana Edad
12.
PLoS One ; 16(1): e0245053, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33471812

RESUMEN

BACKGROUND: Understanding patterns of multimorbidity in the US older adult population and their relationship with mortality is important for reducing healthcare utilization and improving health. Previous investigations measured multimorbidity as counts of conditions rather than specific combination of conditions. METHODS: This cross-sectional study with longitudinal mortality follow-up employed latent class analysis (LCA) to develop clinically meaningful subgroups of participants aged 50 and older with different combinations of 13 chronic conditions from the National Health Interview Survey 2002-2014. Mortality linkage with National Death Index was performed through December 2015 for 166,126 participants. Survival analyses were conducted to assess the relationships between LCA classes and all-cause mortality and cause specific mortalities. RESULTS: LCA identified five multimorbidity groups with primary characteristics: "healthy" (51.5%), "age-associated chronic conditions" (33.6%), "respiratory conditions" (7.3%), "cognitively impaired" (4.3%) and "complex cardiometabolic" (3.2%). Covariate-adjusted survival analysis indicated "complex cardiometabolic" class had the highest mortality with a Hazard Ratio (HR) of 5.30, 99.5% CI [4.52, 6.22]; followed by "cognitively impaired" class (3.34 [2.93, 3.81]); "respiratory condition" class (2.14 [1.87, 2.46]); and "age-associated chronic conditions" class (1.81 [1.66, 1.98]). Patterns of multimorbidity classes were strongly associated with the primary underlying cause of death. The "cognitively impaired" class reported similar number of conditions compared to the "respiratory condition" class but had significantly higher mortality (3.8 vs 3.7 conditions, HR = 1.56 [1.32, 1.85]). CONCLUSION: We demonstrated that LCA method is effective in classifying clinically meaningful multimorbidity subgroup. Specific combinations of conditions including cognitive impairment and depressive symptoms have a substantial detrimental impact on the mortality of older adults. The numbers of chronic conditions experienced by older adults is not always proportional to mortality risk. Our findings provide valuable information for identifying high risk older adults with multimorbidity to facilitate early intervention to treat chronic conditions and reduce mortality.


Asunto(s)
Enfermedades Cardiovasculares/epidemiología , Enfermedad Crónica/epidemiología , Disfunción Cognitiva/epidemiología , Trastorno Depresivo/epidemiología , Diabetes Mellitus/epidemiología , Anciano , Anciano de 80 o más Años , Enfermedades Cardiovasculares/mortalidad , Enfermedad Crónica/mortalidad , Disfunción Cognitiva/mortalidad , Estudios Transversales , Trastorno Depresivo/mortalidad , Diabetes Mellitus/mortalidad , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Multimorbilidad , Tasa de Supervivencia , Estados Unidos
13.
Innov Aging ; 5(4): igab041, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34988294

RESUMEN

BACKGROUND AND OBJECTIVES: Enjoyment of and satisfaction with physical activity have been proposed as two actionable mechanisms to promote sustained engagement in physical activity. An accurate understanding of how, why, and for whom these two mechanisms work (or not) in response to a particular intervention strategy is contingent on having suitable measures for the population of interest. This study aims to determine whether the Physical Activity Enjoyment Scale-8 and a novel approach to the measurement of satisfaction with physical activity are suitable for use among older adults (M age = 66.25 years; range = 55-91 years). RESEARCH DESIGN AND METHODS: Participants answered an online questionnaire twice across 4 weeks. Measurement invariance was assessed within a structural equation modeling framework; convergent validity was assessed by correlating the latent variables enjoyment and satisfaction with each other and with physical activity behavior. RESULTS: Both measures were invariant between gender and across time. Enjoyment and satisfaction were related to each other (r = 0.72) and to physical activity (r = 0.48 and 0.64, respectively). DISCUSSION AND IMPLICATIONS: Results support the suitability of these measures as tools to assess enjoyment of and satisfaction with physical activity among older adults.

14.
J Speech Lang Hear Res ; 63(8): 2763-2776, 2020 08 10.
Artículo en Inglés | MEDLINE | ID: mdl-32692599

RESUMEN

Purpose Children with developmental language disorder (DLD) often have difficulty with word learning. Recent studies have shown that incorporating retrieval practice provides a significant benefit to this learning. However, we have not yet discovered the best balance between the amount of retrieval and the amount of study (hearing the word in the presence of the referent) that is provided. In this investigation, we compared a word learning procedure using more retrieval and less study with a procedure that used more study and less retrieval. Method Participants were 13 children with DLD and 13 same-age peers with typical language development (TD). Both groups ranged in age from 4 to 6 years. The children learned two sets of novel words, with each set taught in two sessions. During an initial criterion period, the children had the opportunity to retrieve all of the words. Following this period, the words were either retrieved without further study or studied without additional retrieval. Recall and recognition testing immediately followed the second learning session and was repeated 1 week later. Testing assessed the children's retention of both the word forms and their meanings. Results Better recall both immediately after learning and after 1 week was seen for the more retrieval/less study condition. This was seen for both groups of children for word form recall and for children with DLD for meaning. Group differences were not found. Conclusion This study served as a stringent test of the benefits of retrieval to children's word learning. Continued retrieval after initial retrieval practice appeared to be helpful even when further study was discontinued and when the comparison study condition had also provided retrieval practice in the initial stages. Further refinement of retrieval procedures might lead to the development of useful clinical tools to promote word learning.


Asunto(s)
Trastornos del Desarrollo del Lenguaje , Niño , Preescolar , Humanos , Desarrollo del Lenguaje , Pruebas del Lenguaje , Recuerdo Mental , Aprendizaje Verbal
15.
Prev Med ; 136: 106102, 2020 07.
Artículo en Inglés | MEDLINE | ID: mdl-32360766

RESUMEN

This study aims to identify chronic disease patterns and their relationship to health-related quality of life (HRQL) in the US population. This cross-sectional study used data from 86,745 participants aged 18 years and older of the Medical Expenditure Panel Survey (MEPS) 2010-2015, we employed latent class analysis (LCA) to identify subgroups of participants with different combinations of 23 chronic conditions which had medical utilization during the past 12 months. Derived chronic condition latent classes were used to predict the 12-Item Short Form Survey physical component score (PCS), mental component score (MCS) in addition to overall HRQL (SF-6D) while controlling for covariates. LCA identified five unique multi-morbidity groups: "healthy" (62.5%), "vascular risk" (18.9%), "anxiety" (12.2%), "heart disease" (2.9%), and "severely-impaired" (3.5%). Covariate-adjusted mean SF-6D scores varied significantly among classes: healthy (0.85), vascular risk (0.77), anxiety (0.67), heart disease group (0.65), and severely-impaired (0.56). The anxiety group, proportionately younger and female, had high PCS (46.3) but low MCS (41.9). The heart disease group, although older and in poor physical health (PCS = 33.2), had higher MCS scores (46.9). Our results demonstrate multi-morbidity significantly impacts HRQL. The relationship between physical and mental health functioning varied across different multi-morbidity groups, and the discordance was more pronounced in younger ages and females. Our research also identified an older age group that was mentally robust and maintained a strong HRQL. Findings can inform the development of targeted interventions to improve physical and mental health functioning in vulnerable populations.


Asunto(s)
Estado de Salud , Calidad de Vida , Anciano , Enfermedad Crónica , Estudios Transversales , Femenino , Humanos , Encuestas y Cuestionarios
16.
JAMA Ophthalmol ; 138(4): 387-394, 2020 04 01.
Artículo en Inglés | MEDLINE | ID: mdl-32105300

RESUMEN

Importance: Visual impairment and visual disorders often co-occur with other chronic conditions. Understanding patterns of multimorbidity is important for reducing health care use and improving health outcomes. Objective: To identify chronic condition patterns and their association with visual impairment and health care use in a nationally representative sample. Design, Setting, and Participants: This cross-sectional study used National Health Interview Survey data for 387 780 individuals aged 18 years and older, representative of the civilian noninstitutionalized US population, from January 1, 2002, to December 31, 2014. Statistical analysis was performed from June to November 2018. Exposures: Participants were classified in subgroups with different combinations of self-reported chronic conditions using latent class analysis. Main Outcomes and Measures: Self-reported visual impairment, emergency department visit, and hospitalization use in the previous 12 months. Results: Among the 387 780 individuals included in the study, 51.8% were female, 77.6% were white, and the mean (SD) age was 46.2 (18.0) years. Latent class analysis identified 5 different classes, with 70.5% of the participants belonging to the healthy group. The other 4 groups represented various degrees and patterns of multimorbidity. The hypertensive group (19.6%) had a high prevalence of hypertension (62.6%), the respiratory conditions group (4.4%) had a high prevalence of emphysema (47.7%) and asthma (45.6%), the heart disease group (3.6%) had high prevalence of coronary heart disease (69.8%), and the severely impaired group (1.8%) had higher prevalence of most conditions compared with the other groups. In the adjusted analysis, compared with the healthy group, participants in all 4 disease groups had elevated risk of visual impairment: heart condition group (odds ratio [OR], 3.19; 95% CI, 2.92-3.48), hypertensive group (OR, 3.28; 95% CI, 3.10-3.48), respiratory condition group (OR, 3.87; 95% CI, 3.56-4.20), and severely impaired group (OR, 10.19; 95% CI, 9.20-11.28). All 4 disease groups had elevated risk of reporting emergency department use and hospitalization. For the severely impaired group, the OR for emergency department use was 9.39 (95% CI, 8.53-10.34), and the OR for hospitalization was 10.80 (95% CI, 9.80-11.92). Conclusions and Relevance: In this study, individuals in all 4 multimorbidity groups had an elevated risk of visual impairment and health care use compared with the healthy group. Characteristics of high-risk groups identified by this study may help in the development and implementation of interventions to avert the more serious consequences of having multiple chronic conditions.


Asunto(s)
Enfermedad Crónica/epidemiología , Aceptación de la Atención de Salud/estadística & datos numéricos , Trastornos de la Visión/epidemiología , Personas con Daño Visual/estadística & datos numéricos , Adulto , Anciano , Estudios Transversales , Femenino , Conductas Relacionadas con la Salud , Estado de Salud , Hospitalización/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Encuestas Nutricionales , Prevalencia , Factores de Riesgo
17.
Psychol Health ; 35(5): 573-592, 2020 05.
Artículo en Inglés | MEDLINE | ID: mdl-31496306

RESUMEN

Objective: The present study had three major aims: 1) To identify sub-groups of adults with differing combinations of childhood maltreatment exposures, 2) to understand the association of childhood maltreatment sub-group membership with subjective sleep quality in midlife, and 3) to assess poor sleep quality in midlife as a mechanism between childhood maltreatment sub-group membership and physical functional limitations in late adulthood. Design: Data come from the Biomarker project of the Midlife Development in the United States study (n = 1251). Outcome measures: The Pittsburgh Sleep Quality Index (Buysse et al., 1989) was used to assess sleep quality in midlife. Functional limitations in late adulthood were measured using a version of the SF-36 (Brazier et al., 1992). Results: Two vulnerable childhood maltreatment sub-groups emerged (Physical and Emotional Maltreatment Sub-group, n = 49, and Sexual Abuse Sub-group, n = 105) and a normative sub-group (n = 1087; low exposure to childhood maltreatment). Poor sleep quality in midlife mediated the association between both maltreatment sub-groups and functional limitations in late adulthood. Conclusion: Results highlight the role of sleep in linking childhood maltreatment with functional impairments in adulthood and offer a potential target for interventions to improve quality of life in older adults.


Asunto(s)
Adultos Sobrevivientes del Maltrato a los Niños/psicología , Adultos Sobrevivientes del Maltrato a los Niños/estadística & datos numéricos , Rendimiento Físico Funcional , Sueño , Anciano , Femenino , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Calidad de Vida , Encuestas y Cuestionarios , Estados Unidos
18.
Front Hum Neurosci ; 13: 356, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31649519

RESUMEN

BACKGROUND: In our Dynamic Pathways, account, we hypothesized that childhood stuttering reflects an impairment in speech sensorimotor control that is conditioned by cognitive, linguistic, and emotional factors. The purpose of this study was to investigate potential differences in levels of sympathetic arousal during performance of speech and non-speech tasks between children who do and do not stutter. METHODS: Seventy-two preschool-aged children participated in the study, 47 children who stutter (CWS; 38 boys) and 25 children who do not stutter (CWNS; 18 boys). We recorded skin conductance and blood pulse volume (BPV) signals, indices of sympathetic arousal, during higher/lower load speech tasks (structured sentence production and picture description) and non-speech tasks (jaw wagging and forceful blowing). We included a measure that reflects children's attitudes about their communication skills and a parent-report assessment of temperament. RESULTS: We found no significant differences between preschool CWS and CWNS in phasic skin conductance response amplitude or frequency, BPV, and pulse rate for any of the experimental tasks. However, compared to CWNS, CWS had, on average, significantly higher skin conductance levels (SCL), indexing slowly changing tonic sympathetic activity, across both speech and non-speech experimental conditions. We found distinctive task-related profiles of sympathetic arousal in both groups of preschool children. Most children produced the highest levels of sympathetic arousal in the physically demanding blowing task rather than in speech, as seen in previous studies of adults. We did not find differences in temperament between the two groups of preschool children nor a relationship among behavioral indices of temperament and communication attitude and physiological measures of sympathetic arousal. CONCLUSION: We did not find that atypically high, speech-related sympathetic arousal is a significant factor in early childhood stuttering. Rather, CWS had higher, on average, task-related tonic SCLs across speech and non-speech tasks. A relationship among behavioral measures of temperament and physiological measures of sympathetic arousal was not confirmed. Key questions for future experiments are how the typical coupling of sympathetic and speech sensorimotor systems develops over childhood and adolescence and whether task related developmental profiles follow a different course in children who continue to stutter.

19.
Mil Behav Health ; 7(3): 245-256, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31595209

RESUMEN

In light of technological advances enabling military couples to communicate throughout deployment, spouses of deployed service members often make decisions about what to share with service members, and how to respond to service members' concerns. In doing so, they manage an emotional boundary between service members and their families. This study focused on two behaviors military spouses may use when managing this boundary, namely their minimization of (1) their own concerns (i.e., self-directed minimization) and (2) service members' concerns (i.e., partner-directed minimization). The purpose of the current study was to identify correlates and consequences of these behaviors. Findings from a longitudinal structural equation model utilizing three waves of data from a sample of 154 married military couples in which the husband was a male National Guard soldier indicated that spouses were more likely to minimize both their own-and service members'-concerns when they themselves reported higher levels of depressive symptomology prior to deployment. Spouses' minimization of service members' concerns during deployment, in turn, predicted higher levels of service members' depressive symptomology at reintegration, even after accounting for their initial depressive symptomology and combat exposure. Implications for intervention efforts aimed at promoting individual and couple adjustment to deployment are discussed.

20.
Ther Adv Chronic Dis ; 10: 2040622318806848, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31452864

RESUMEN

BACKGROUND: Using longitudinal data from the Survey of Mid-Life Development in the United States, this study examined the role of systemic inflammation in mediating the link between multimorbidity and increases in and onset of functional limitations over a 17-19 year follow-up period. METHODS: Participants completed questionnaire assessments of chronic conditions and functional limitations. Interleukin-6, C-reactive protein, and fibrinogen were assayed in serum. Structural equation models were used to predict increases in and onset of functional limitations associated with baseline multimorbidity status; mediation by inflammation was also determined. RESULTS: Multimorbidity (versus 0-1 conditions) predicted more functional limitations and greater odds of onset of limitations over time. Significant indirect effects showed that inflammation partially mediated the link between multimorbidity and changes in, but not onset of, limitations. DISCUSSION: These results show that inflammation, a nonspecific marker of multiple disease conditions, explains in part the degree to which multimorbidity is disabling.

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