Factorial Structure and Validity of Depression (PHQ-9) and Anxiety (GAD-7) Scales after Traumatic Brain Injury.

BACKGROUND: The dimensionality of depression and anxiety instruments have recently been a source of controversy. OBJECTIVES AND DESIGN: In a European-wide sample of patients after Traumatic Brain Injury (TBI), we aim to examine the factorial structure, validity, and association of the Patient Health Questionnaire for depression (PHQ-9) and the Generalized Anxiety Disorder (GAD-7) instruments. This study is based on longitudinal observational data. We conducted analyses of factorial structure and discriminant validity of outcomes six-months after TBI. We also examined the prevalence, co-occurrence, and changes of scores on the PHQ-9 and GAD-7 at 3-, 6-, and 12-month post-TBI assessments. PARTICIPANTS: At six-months post-TBI assessment, 2137 (738 (34.5%) women) participants completed the PHQ-9 and GAD-7 questionnaires. For the longitudinal analysis, we had 1922 participants (672 (35.0%) women). RESULTS: The results of exploratory factor analysis suggested a general latent construct underlying both PHQ-9 and GAD-7 measures. Confirmatory factor analyses showed a slight improvement in the fit indices for the bifactorial model. The Omega hierarchical test clearly differentiated two subfactors of PHQ-9 and GAD-7 items over and above the underlying general factor; however, most of the variance (85.0%) was explained by the general factor and the explained variance of the subfactors was small. The PHQ-9 and GAD-7 performed similarly in detecting post-traumatic stress disorder (PTSD). As defined by conventional cut-offs, depression and anxiety have different prevalence rates in the sample. The scales also differed in their relationships with the short form of health survey (SF-36v2) subscales. The longitudinal analysis showed high stability of depression and anxiety symptoms: 49-67% of the post-TBI patients with comorbid depression and anxiety reported the persistence of the symptoms over time. DISCUSSION: The factorial structure analysis favors a general latent construct underlying both depression and anxiety scales among patients after TBI. We discuss the implications our findings and future research directions.

Association between adolescent rough-and-tumble play and conduct problems, substance use, and risk-taking behaviors: Findings from a school-based sample.

Rough-and-tumble play (RTP), also known as play fighting, is a common form of play frequently reported and studied by researchers. However, one important limitation of past research in the area of RTP has been the neglect of the adolescence period. Consequently, little is known about the function of adolescent RTP as well as about clinical characteristics of youth who engage in this activity after childhood. In a school-based sample of 1,771 middle school students (ages 9-16 years), the current study sought to address this gap by examining, via bivariate and multivariate logistic regression analyses, the potential cross-sectional associations of adolescent RTP with (a) selected demographic variables, (b) conduct problem symptoms, (c) substance use, and (d) risk-taking behaviors, including adjustment for several demographic confounders. Results indicated that adolescents reporting higher rates of conduct problem symptoms were more likely to report a recent participation in RTP. In addition, substance use (experimentation and current consumption of tobacco, alcohol, and marijuana) and risk behaviors assessed all were strongly associated with an increased likelihood of reporting an engagement in RTP. This finding suggests that participation in this activity probably implicates particular phenotypic characteristics including the propensity to engage in health-damaging behaviors. But the most profound issue raised by this research concerns the strong relationship between RTP and great levels of conduct disorder symptoms, suggesting a possible significant change in the functional significance of RTP in the adolescence period.

Measurement invariance of assessments of depression (PHQ-9) and anxiety (GAD-7) across sex, strata and linguistic backgrounds in a European-wide sample of patients after Traumatic Brain Injury.

BACKGROUND: The Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder (GAD-7) are two widely used instruments to screen patients for depression and anxiety. Comparable psychometric properties across different demographic and linguistic groups are necessary for multiple group comparison and international research on depression and anxiety. OBJECTIVES AND METHOD: We examine measurement invariance for the PHQ-9 and GAD-7 by: (a) the sex of the participants, (b) recruitment stratum, and (c) linguistic background. This study is based on non-randomized observational data six months after Traumatic Brain Injury (TBI) that were collected in 18 countries. We used multiple methods to detect Differential Item Functioning (DIF) including Item Response Theory, logistic regression, and the Mantel-Haenszel method. RESULTS: At the 6-month post-injury, 2137 (738 [34.5%] women) participants completed the PHQ-9 and GAD-7 questionnaires: 885 [41.4%] patients were primarily admitted to the Intensive Care Unit (ICU), 805 [37.7%] were admitted to hospital ward, and 447 [20.9%] were evaluated in the Emergency Room and discharged. Results supported the invariance of PHQ-9 and GAD-7 across sex, patient strata and linguistic background. For different strata three PHQ-9 items and one GAD-7 item and for different linguistic groups only two GAD-7 items were flagged as showing differences in two out of four DIF tests. However, the magnitude of the DIF effect was negligible. LIMITATION: Despite high number of participants from ICU, patients have mostly mild TBI. CONCLUSION: The findings demonstrate adequate psychometric properties for PHQ-9 and GAD-7, allowing direct multigroup comparison across sex, strata, and linguistic background.

Microarray analysis of apoptosis gene expression in liver injury induced by chronic exposure to arsenic and high-fat diet in male mice.

Rapid growth in the incidence of liver disease is largely attributable to lifestyle and environmental contaminants, which are often overlooked as the leading causes of this problem. Thus, the possible contribution of arsenic (As) to high-fat diet (HFD)-induced liver damage was examined via microarray analysis. To perform this experiment, a total number of 40 healthy adult male NMRI mice (22-30 g) were used. To this end, these animals were randomly assigned to four groups of 10. Oxidative stress and histopathological parameters were also evaluated in the liver of the mice exposed to a minimally cytotoxic concentration of As (50 ppm) in drinking water while being fed with a HFD for 20 weeks. Subsequently, apoptosis gene expression profiling was utilized via real-time (RT) PCR array analysis. The results showed that As had increased the amount of HFD-induced liver damage and consequently amplified changes in oxidative stress factors, histopathological parameters, as well as apoptosis pathway genes. Investigating the expression profile of apoptosis pathway genes similarly revealed that caspase-8, as a main upstream contributor to the apoptosis pathway, might play an important role in the induction of apoptosis generated by As and HFD. Ultimately, this study highlighted that As in drinking water could increase sensitivity in mice to HFD-induced liver disease through strengthening apoptosis pathway.

Risk Factors Associated With Boys' and Girls' Developmental Trajectories of Physical Aggression From Early Childhood Through Early Adolescence.

Importance: This study used multitrajectory modeling to identify distinct trajectories of physical aggression from ages 1.5 to 13 years for boys and girls. Objectives: To trace the development of boys' and girls' physical aggression problems from infancy to adolescence using mother ratings, teacher ratings, and self-ratings and to identify early family predictors of children on the high physical aggression trajectories. Design, Setting, and Participants: This cohort study used data from the Quebec Longitudinal Study of Child Development (QLSCD), a study of a representative, population-based sample of 2223 infants born in 1997 and 1998 in the Canadian province of Quebec. The dates of analysis were January 2017 to January 2018. Main Outcomes and Measures: Trained research assistants conducted 7 interviews (at child ages 1.5, 2.5, 3.5, 4.5, 5, 6, and 8 years) with the person most knowledgeable about the child (mothers in 99.6% [2214 of 2223] of cases). Teachers assessed the child's behavior at ages 6, 7, 8, 10, 12, and 13 years. Self-reports of behavior problems were obtained from the child at ages 10, 12, and 13 years. Results: The sample included 2223 participants, 51.2% of whom were boys and 91.2% of whom were of white race/ethnicity. The mean response rate for mother ratings of physical aggression during the first 8 years of life was 80.9% (range, 65.1%-91.7%). For teacher ratings of physical aggression from ages 6 to 13 years, the mean response rate was 45.7% (range, 35.4%-56.9%), while the mean response rate of physical aggression assessment from self-ratings between ages 10 and 13 years was 57.9% (range, 55.2%-60.5%). Attrition was higher among families with low socioeconomic status and single-parent families, as well as among young mothers and mothers who were not fluent in French or English. A statistical analysis to examine the consequences of attrition was included. For boys and girls, the frequency of physical aggressions increased from age 1.5 years (2039 [91.7%]) to age 3.5 years (1941 [87.3%]) and then substantially decreased until age 13 years (1228 [55.2%]). Three distinct developmental trajectories of physical aggression were observed for girls and 5 for boys. Most family characteristics measured at 5 months after the child's birth were associated with a high physical aggression trajectory for boys and girls. Conclusions and Relevance: Family characteristics at 5 months after the child's birth could be used to target preschool interventions aimed at preventing the development of boys' and girls' chronic physical aggression problems.

Ambivalent stereotypes link to peace, conflict, and inequality across 38 nations.

A cross-national study, 49 samples in 38 nations (n = 4,344), investigates whether national peace and conflict reflect ambivalent warmth and competence stereotypes: High-conflict societies (Pakistan) may need clearcut, unambivalent group images distinguishing friends from foes. Highly peaceful countries (Denmark) also may need less ambivalence because most groups occupy the shared national identity, with only a few outcasts. Finally, nations with intermediate conflict (United States) may need ambivalence to justify more complex intergroup-system stability. Using the Global Peace Index to measure conflict, a curvilinear (quadratic) relationship between ambivalence and conflict highlights how both extremely peaceful and extremely conflictual countries display lower stereotype ambivalence, whereas countries intermediate on peace-conflict present higher ambivalence. These data also replicated a linear inequality-ambivalence relationship.

Revisiting the Measurement of Anomie.

Sociologists coined the term "anomie" to describe societies that are characterized by disintegration and deregulation. Extending beyond conceptualizations of anomie that conflate the measurements of anomie as 'a state of society' and as a 'state of mind', we disentangle these conceptualizations and develop an analysis and measure of this phenomenon focusing on anomie as a perception of the 'state of society'. We propose that anomie encompasses two dimensions: a perceived breakdown in social fabric (i.e., disintegration as lack of trust and erosion of moral standards) and a perceived breakdown in leadership (i.e., deregulation as lack of legitimacy and effectiveness of leadership). Across six studies we present evidence for the validity of the new measure, the Perception of Anomie Scale (PAS). Studies 1a and 1b provide evidence for the proposed factor structure and internal consistency of PAS. Studies 2a-c provide evidence of convergent and discriminant validity. Finally, assessing PAS in 28 countries, we show that PAS correlates with national indicators of societal functioning and that PAS predicts national identification and well-being (Studies 3a & 3b). The broader implications of the anomie construct for the study of group processes are discussed.

Towards a better understanding of the relationship between executive control and theory of mind: an intra-cultural comparison of three diverse samples.

Previous research has consistently indicated that theory of mind (ToM) is associated with executive control in the preschool years. However, interpretation of this literature is limited by the fact that most studies have focused exclusively on urbanized Western cultural samples. Consequently, it is not clear whether the association between ToM and executive control reflects the specific features of this particular cohort or instead reflects a universal pattern. The present study provides the first empirical assessment of these two constructs in three diverse groups of Iranian children. Participants were 142 preschoolers (4-5 years old) from high-socioeconomic status (SES) urban (n = 33), low-SES urban (n = 37) and rural villages (n = 77). The results show that there is a robust association between ToM and executive control in all three groups, and that executive control contributes significant unique variance to ToM understanding, even after controlling for a range of variables that have been proposed as potential confounders of this relationship. However, although the three groups were equated in ToM, significant differences in executive control were evident. Moreover, cluster analysis identified three distinct clusters that were relatively homogeneous with respect to executive control and SES. One of these clusters was characterized by both low SES and low executive functioning, and showed little evidence of ToM understanding. Taken together, these findings provide possibly the clearest evidence to date that the association between ToM and executive control is not dependent on children's previous experiences on the tasks, or their family and cultural background.

The effect of parent and peer attachment on suicidality: the mediation effect of self-control and anomie.

We explore the influence of psycho-social factors including the attachment to parent and peer, self-control, and anomie on suicidality. Research questionnaires were distributed among 336 students of Shahid Chamran University of Ahvaz in Iran. The results demonstrated that mother and peer attachments had an indirect effect on suicidality via self-control and anomie, and self-control had a direct effect on suicidality and an indirect effect via anomie. Self-control and anomie had the most efficient role in the model with a large effect size. Findings are discussed theoretically and with regards to the socio-cultural sphere of Iranian society.

Development of suicidality within socioeconomic context: mediation effect of parental control and anomie.

Despite some scientific research on suicide as one of the most serious social and mental health problems in Iran, there is still lack of research on the effective structural and socio-familial factors contributing to the issue in Iran. The purpose of this study is to investigate some of the effective variables conditioning suicidality while also establishing a synthetic model. Three hundred-fifty university students (165 males, 185 females) were randomly chosen from Shahid Chamran University, Ahvaz, Iran. The participants were asked to complete a package of self-report questionnaires including subjective socioeconomic status (SES), feeling of anomie, perceived parental control, and suicidality. The results show that all correlations among variables are significant. For testing the theoretical model, results of standardized regression coefficients suggest that SES has direct effect on suicidality and indirect effect via anomie and parental control. In addition, parental control has direct effects on suicidality and indirect effect via anomie as well. The findings confirm the expected paths hypothesized among variables which are consistent with the theories of Durkheim, Merton, Kohn, and Agnew. It implies that the development of suicidality takes place within socioeconomic context through the influence of parental control and feeling of anomie.