Dairy consumption and incident prediabetes: prospective associations and network models in the large population-based Lifelines Study.

BACKGROUND: Evidence on associations between dairy consumption and incident prediabetes is inconsistent. One potential explanation for heterogeneity is that health behavior and food intake covary with the consumption of various high-fat and low-fat dairy types. OBJECTIVE: The objective was to investigate the associations of total dairy and dairy types with incident prediabetes and to assess how dairy intake is linked with metabolic risk factors, lifestyle behaviors, and foods, as potential explanations for these associations. METHODS: Overall, 74,132 participants from the prospective population-based Lifelines study were included (mean age, 45.5 ± 12.3 y; 59.7% female). Baseline dairy intake was measured using a validated food frequency questionnaire. Prediabetes at follow-up was defined based on the World Health Organization/International Expert Committee criteria as fasting plasma glucose of 110-125 mg/dL or glycated hemoglobin concentrations of 6.0%-6.5%. Associations were analyzed using Poisson regression models adjusted for social demographics, lifestyle behaviors, family history of diabetes, and food group intake. Interconnections were assessed with mixed graphical model networks. RESULTS: At a mean follow-up of 4.1 ± 1.1 y, 2746 participants developed prediabetes (3.7%). In regression analyses, neutral associations were found for most dairy types. Intake of plain milk and low-fat milk were associated with a higher risk of prediabetes in the top compared with bottom quartiles (relative risk [RR]: 1.17; 95% confidence interval [CI]: 1.05, 1.30; P-trend = 0.04 and RR: 1.18; 95% CI: 1.06, 1.31; P-trend =0.01). Strong but nonsignificant effect estimates for high-fat yogurt in relation to prediabetes were found (RRservings/day: 0.80; 95% CI: 0.64, 1.01). The network analysis showed that low-fat milk clustered with energy-dense foods, including bread, meat, and high-fat cheese, whereas high-fat yogurt had no clear link with lifestyle risk factors and food intake. CONCLUSIONS: In this large cohort of Dutch adults, low-fat milk intake was associated with higher prediabetes risk. Heterogeneous associations by dairy type and fat content might partly be attributed to confounding caused by behaviors and food intake related to dairy intake.

Context-Dependent Responses to the Spread of COVID-19 Among National and International Students During the First Lockdown: An Online Survey.

BACKGROUND: Restrictions to minimize social contact was necessary to prevent the spread of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus but may have impacted individuals' mental well-being. Emotional responses are modulated by contextual information. Living abroad during the coronavirus disease 2019 (COVID-19) pandemic may have boosted the feeling of isolation as the context is unfamiliar. OBJECTIVES: This study compared the psychological impact of social distancing in national students (living in a familiar context) versus international students (living in an unfamiliar context). METHODS: During March/April 2020 (first lockdown in the Netherlands), 850 university students completed an online survey. Structural equation modeling (SEM) was conducted to compare how students' responses to the virus were predicted by health anxiety, emotional distress, and personal traits. RESULTS: Compared with national students, international students showed higher levels in 4 identified factors (COVID-19-related worry, perceived risk of infection, distance from possibly contaminated objects, distance from social situations). The factors were mainly predicted by health anxiety across international students, while emotional distress and individual traits (eg, intolerance of uncertainty) played a role across national students. CONCLUSIONS: In the familiar context, individual characteristics (traits) predicted the responses to the virus, while the unfamiliar context drove individuals' health-focused responses. Living in a foreign country is associated with psychological burdens and this should be considered by universities for more pronounced social support and clear references to health-related institutions.

Bayesian Uncertainty Estimation for Gaussian Graphical Models and Centrality Indices.

In the network approach to psychopathology, psychological constructs are conceptualized as networks of interacting components (e.g., the symptoms of a disorder). In this network view, interest is on the degree to which symptoms influence each other, both directly and indirectly. These direct and indirect influences are often captured with centrality indices, however, the estimation method often used with these networks, the frequentist graphical LASSO (GLASSO), has difficulty estimating (uncertainty in) these measures. Bayesian estimation might provide a solution, as it is better suited to deal with bias in the sampling distribution of centrality indices. This study therefore compares estimation of symptom networks with Bayesian GLASSO- and Horseshoe priors to estimation using the frequentist GLASSO using extensive simulations. Results showed that the Bayesian GLASSO performed better than the Horseshoe, and that the Bayesian GLASSO outperformed the frequentist GLASSO with respect to bias in edge weights, centrality measures, correlation between estimated and true partial correlations, and specificity. Sensitivity was better for the frequentist GLASSO, but performance of the Bayesian GLASSO is usually close. With respect to uncertainty in the centrality measures, the Bayesian GLASSO shows good coverage for strength and closeness centrality, but uncertainty in betweenness centrality is estimated less well.

Exploring Parenting Profiles to Understand Who Benefits from the Incredible Years Parenting Program.

Behavioral parenting programs are a theory-driven and evidence-based approach for reducing disruptive child behavior. Although these programs are effective on average, they are not equally effective in all families. Decades of moderation research has yielded very few consistent moderators, and we therefore still have little knowledge of who benefits from these programs and little understanding why some families benefit more than others. This study applied a baseline target moderation model to a parenting program, by (1) identifying parenting profiles at baseline, (2) exploring their correlations with other family characteristics and their stability, and (3) assessing whether they moderate intervention effects on child behavior. Individual participant data from four Dutch studies on the Incredible Years (IY) parenting program were used (N = 785 caregiver-child dyads). Children (58.2% boys) were at risk of disruptive behavior problems and aged between 2 and 11 years of age (M = 5.85 years; SD = 1.59). Latent profile analyses indicated three distinct baseline parenting profiles, which we labeled as follows: Low Involvement (81.4%), High Involvement (8.4%), and Harsh Parenting (10.1%). The profiles caregivers were allocated to were associated with their education, minority status, being a single caregiver, and the severity of disruptive child behavior. We found neither evidence that baseline parenting profiles changed due to participation in IY nor evidence that the profiles predicted program effects on child behavior. Our findings do not support the baseline target moderation hypothesis but raise new questions on how parenting programs may work similarly or differently for different families.

No intolerance of errors: The effect of intolerance of uncertainty on performance monitoring revisited.

Errors have been conceptualized as internal forms of threat that can cause harm in unpredictable ways. An index of error processing is the error-related negativity (ERN), an event-related potential reflecting variability in the sensitivity to errors. Prior work has shown the relationship between psychopathology symptoms and the ERN is unclear, and may be moderated by intolerance of uncertainty (IU), a trait that captures how people react to unpredictability. IU includes two subfactors of prospective IU (active seeking of predictability) and inhibitory IU (behavioral paralysis). In the present study, 188 undergraduates performed an Eriksen flanker task designed to elicit the ERN, while brain activity was recorded using electroencephalography (EEG). Participants completed the Intolerance of Uncertainty Scale, Short Form (IUS-12), and other measures of anxiety, depression and worry. Total IU explained 5 % of the variance in correct-response negativity (CRN), but was not associated with the ERN in our sample. In contrast to previous findings, the IU subfactors did not predict the ERN or post-error slowing (PES), nor did total IU and depression interact to predict the ERN. Exploratory analyses also showed that total IU did not moderate the relationship between trait anxiety and the ERN. Small samples may have previously exaggerated the links between self-reported IU and the ERN. As such, further high-powered replications are required to confirm if, and how, they are related.

Early life stress and behavior problems in early childhood: Investigating the contributions of child temperament and executive functions to resilience.

This preregistered study examined whether child temperament and executive functions moderated the longitudinal association between early life stress (ELS) and behavior problems. In a Dutch population-based cohort (n = 2803), parents reported on multiple stressors (age 0-6 years), child temperament (age 5), and executive functions (age 4), and teachers rated child internalizing and externalizing problems (age 7). Results showed that greater ELS was related to higher levels of internalizing and externalizing problems, with betas reflecting small effects. Lower surgency buffered the positive association of ELS with externalizing problems, while better shifting capacities weakened the positive association between ELS and internalizing problems. Other child characteristics did not act as moderators. Findings underscore the importance of examining multiple protective factors simultaneously.

Associations between adolescents' internalizing problems and well-being: is there a buffering role of boys' and girls' relationships with their mothers and fathers?

BACKGROUND: Internalizing mental health problems (i.e., depression and anxiety symptoms) are known to be related negatively to adolescents' well-being. However, whether this negative association manifests equally in boys and girls, and the potential buffering role of high-quality relationships with mothers and fathers, remain unknown. Thus, the present study was conducted to 1) investigate associations among adolescents' internalizing problems and mother- and father-adolescent relationship quality, on the one hand, and adolescents' well-being, on the other hand, 2) explore the buffering role of high-quality mother- and father-adolescent relationships in the association between adolescents' internalizing problems and well-being, and 3) examine gender differences in these main and buffering effects. METHODS: The analysis sample consisted of 1064 adolescents (53.7% girls; aged 11-17 years) from three secondary schools in the Netherlands. Participants filled out an online questionnaire incorporating the Mental Health Continuum-Short Form to measure well-being, the Revised Child Anxiety and Depression Scale-25 to measure internalizing problems, and the Network of Relationships Inventory to measure mother- and father-adolescent relationship quality. The cross-sectional data were analyzed using path models in R, controlling for age, ethnocultural background, and education level. Multigroup analyses were performed to identify gender differences. RESULTS: Adolescents with fewer internalizing problems (ß = - 0.40, p < 0.001) and adolescents with higher-quality relationships with their mothers and fathers reported higher concurrent levels of well-being (ß = 0.10 to 0.18, all p < 0.01). The quality of mother-adolescent relationships had a significantly larger association with adolescents' well-being than that of father-adolescent relationship quality. However, relationships with mothers and fathers did not significantly buffer the association between adolescents' internalizing problems and well-being. Multigroup analyses revealed no difference between boys and girls. CONCLUSIONS: The current study contributes to the understanding of internalizing problems as an important risk factor for adolescents' well-being, regardless of the quality of relationships with mothers and fathers. The quality of adolescents' relationships with their parents is associated positively with their well-being, even in the presence of internalizing problems. These findings underline the importance of mothers' and fathers' roles in adolescent boys' and girls' well-being.

Longitudinal associations among adolescents' internalizing problems, well-being, and the quality of their relationships with their mothers, fathers, and close friends.

RATIONALE: Internalizing problems (i.e., depressive and anxiety symptoms) are known to decrease adolescents' well-being, but knowledge about potential underlying mechanisms is limited. The qualities of adolescents' most proximal relationships with their parents and close friends are expected to play a role in the association between adolescents' internalizing problems and well-being. OBJECTIVE: The present study was conducted to 1) investigate the indirect longitudinal association between internalizing problems and adolescents' well-being via the quality of adolescents' relationships with both their mothers and fathers and their close friends, and 2) test whether our findings were gender invariant. METHODS: Data were collected via online questionnaires in two waves at a 12-month interval from adolescents attending three secondary schools in the Netherlands (N = 1298; M age = 13.7 years, 53.2% girls). The data were analyzed using a two-wave cross-lagged panel model in R. Multigroup analyses were performed to examine the gender invariance of the findings. RESULTS: After controlling for baseline levels, results showed that (1) girls, but not boys, who reported more internalizing problems at T1 had lower well-being at T2; (2) girls and boys who reported more internalizing problems at T1 had lower-quality relationships with their mothers, fathers, and close friends at T2; and (3) boys, but not girls, who reported higher-quality friendships at T1 had higher well-being at T2. However, no significant indirect effects between internalizing problems and well-being via the quality of adolescents' relationships with their parents and close friends were detected. CONCLUSIONS: The current study contributes to understanding internalizing problems as an important risk factor to the quality of adolescents' proximal social relationships (parents, friends) and their well-being. The findings support the importance of building high-quality relationships, particularly friendships, and recommend future research to study adolescents' internalizing problems and well-being including gender-specific examinations.

Combining Web-Based Gamification and Physical Nudges With an App (MoveMore) to Promote Walking Breaks and Reduce Sedentary Behavior of Office Workers: Field Study.

BACKGROUND: Sedentary behavior (SB) and lack of physical activity (PA) have been associated with poorer health outcomes and are increasingly prevalent in individuals working in sedentary occupations such as office jobs. Gamification and nudges have attracted attention as promising strategies to promote changes in health behavior. However, most effectiveness studies thus far lacked active controls, and few studies have tested interventions combining these strategies. OBJECTIVE: This study investigates the effectiveness of combining a gamified digital app with physical nudges to increase PA and reduce SB in Dutch office workers. METHODS: Employees in the municipality of Rotterdam (N=298) from two office locations were randomized at the location level to either a 10-week intervention, combining a 5-week gamification phase encompassing a gamified digital app with social support features and a 5-week physical nudges phase, or to an active control (ie, basic digital app with self-monitoring and goal setting). The primary outcome was the daily step count, objectively measured via accelerometers. Secondary outcomes were self-reported PA and SB measured at baseline and at 5, 10, and 14 weeks. Mixed effects models were used to analyze the effects of the intervention on the outcome measures. RESULTS: A total of 78.5% (234/298) of participants completed the study and provided accelerometer data, whereas 36.9% (110/298) participants completed the self-report measures at 14 weeks. In the gamification phase, step count data were missing for 13.5% (473/3492) of observations in the control and 11.4% (445/3888) in the intervention condition; however, these percentages increased to 39.6% (1154/2910) and 59.6% (1932/3492) at follow-up, respectively. During the gamification phase, intervention participants increased their number of daily steps by 634 (95% CI 154.2-1113.8; P=.01) more than participants in the control group, after controlling for relevant factors. Improvements were not sustained during the physical nudges phase (P=.76) or follow-up (P=.88). CONCLUSIONS: A digital intervention with gamification and social support features significantly increased the step count of office workers compared with an active control. Physical nudges in the workplace were insufficient to promote the maintenance of behavioral changes achieved in the gamification phase. Future research should explore the long-term effectiveness of similar gamified digital interventions. TRIAL REGISTRATION: International Standard Randomized Controlled Trial Number (ISRCTN) 49129401; https://www.isrctn.com/ISRCTN14881571.

Gathering, processing, and interpreting information about COVID-19.

Does cognitive motivation influence how people gather and interpret information about COVID-19 and their adherence to measures? To address these questions, we conducted a longitudinal survey among European and American respondents. Wave 1 (N = 501) was conducted on March 27, 2020 and Wave 2 (N = 326) on July 1, 2020. We assessed COVID-19 knowledge, endorsement of COVID-19 conspiracy theories, media use, Need for Cognition (NC), Need for Cognitive Closure (NCC), and self-reported adherence to governmental measures taken. Results showed that nearly three-quarters of our respondents actively searched for information about COVID-19. Most at least once a day. Information seeking behaviour was not influenced by cognitive motivation (i.e., NC and NCC). However, cognitive motivation was related to (1) knowledge about COVID-19, (2) conspiracy rejection, and (3) change in knowledge over time. Respondents with more knowledge on COVID-19 also indicated to adhere more often to measures taken by their government. Self-reported adherence to measures was not influenced by cognitive motivation. Implications of these findings will be discussed.

Measuring and Modeling Exposure to External Workplace Aggression in Three Types of Emergency Responders.

The measurement properties of indices about workplace aggression initiated by the public, referred to as external workplace aggression, are under-researched. This study addressed how exposure to external workplace aggression is best measured and modeled in three types of emergency responders. The study inspected the factor structure and explored the addition of severity to an existing measure of frequency of exposure to workplace aggression, which addresses forms of physical aggression, threats, and verbal and nonverbal/nonphysical aggression (gestures) by people outside the organization directed toward employees. Self-reported data from 1,499 emergency responders, including emergency medical workers, firefighters, and police officers in the Netherlands, were analyzed using factor analyses in Mplus. In addition, the relationships between workplace aggression indices and a measure of the situational risk for violence were tested. Results show that the frequency index measured exposure to external workplace aggression better than the index combining the frequency and severity, and that factor structures of indices differed, regarding number and content of factors, between the three groups of emergency responders. An important implication is that researchers and policy employees can use a relatively simple measure to examine exposure to aggression in organizations.

Validation of the Multicultural Personality Questionnaire Short Form (MPQ-SF) for use in the context of international education.

The Multicultural Personality Questionnaire (MPQ) is one of the most widely used instruments for measuring individuals' intercultural competences. The original version consists of 91 items, divided into five subscales, and has been shown to predict attitudes, behavior, and outcomes in a variety of intercultural contexts. Recently, a 40-item short form of the MPQ was developed (MPQ-SF), which may be particularly useful in settings in which time or survey space are limited, or where respondent drop-out is likely to occur. For example, the MPQ-SF would be a valuable tool for assessing longitudinal development of multicultural personality traits in training or educational settings. A prerequisite for such research is to establish measurement invariance of the MPQ-SF between different respondent groups, as well as across time points. Using a sample of students in an international university program (n = 519), the present study examines how the scales perform among male and female respondents, between students of Western and Non-Western background, and across two time points, five months apart. Based on our findings, we conclude that all five subscales of the MPQ-SF display sufficient measurement invariance to be reliably used in this and similar contexts, in comparative as well as longitudinal study designs.

Basic Motor Skills of Children With Down Syndrome: Creating a Motor Growth Curve.

PURPOSE: To create a motor growth curve based on the Test of Basic Motor Skills for Children with Down Syndrome (BMS) and estimate the age of achieving BMS milestones. METHODS: A multilevel exponential model was applied to create a motor growth curve based on BMS data from 119 children with Down syndrome (DS) aged 2 months to 5 years. Logistic regression was applied to estimate the 50% probability of achieving BMS milestones. RESULTS: The BMS growth curve had the largest increase during infancy with smaller increases as children approached the predicted maximum score. The age at which children with DS have a 50% probability of achieving the milestone sitting was 22 months, for crawling 25 months, and for walking 38 months. CONCLUSIONS: The creation of a BMS growth curve provides a standardization of the gross motor development of children with DS. Physical therapists then may monitor a child's individual progress and improve clinical decisions.

Coping and resilience in adults: a cross-sectional network analysis.

Background and objectives: Coping and resilience, how we deal with problems and difficulties and recover from misfortune or change, are two well-known interrelated concepts within psychology. The question remains, however, to what extent the two overlap or differ. Design: The present study investigated coping, resilience and their relationship using cross-sectional network analysis. Participants (N = 502), aged between 18 and 64 y old, completed an online survey including the Brief-COPE (Coping Orientation to Problems Experienced) and the SPF-24 (Scale of Protective Factors). Results: Partial correlation networks on coping and resilience separately show strong, mostly positive associations, both within and between different cluster of coping and different higher-order resilience factors. Results for our combined partial correlation network indicate that coping and resilience are distinct, yet clearly related constructs and are likely to influence each other. Overall, the use of social support, active coping, goal efficacy and planning proved important in bridging coping and resilience. Conclusion: The current findings are best replicated using time-series data, person-specific network models and clinical samples. Further implications for future research and clinical practice are discussed.

No effect of repetitive tDCS on daily smoking behaviour in light smokers: A placebo controlled EMA study.

INTRODUCTION: The effectiveness of repetitive transcranial Direct Current Stimulation (tDCS) on reducing smoking behaviour has been studied with mixed results. Smoking behaviour is influenced by affect and context, therefore we choose to use mobile ecological momentary assessments (EMA) to measure changes in smoking behaviour after tDCS. METHODS: In a randomized, placebo-controlled, between subject study, we applied tDCS bilaterally with the anodal electrode targeting the right DLPFC (https://clinicaltrials.gov/ct2/show/NCT03027687). Smokers were allocated to six sessions of either active tDCS (n = 35) or sham tDCS (n = 36) and received two sessions on three different days in one week. They were asked to keep track of their daily cigarette consumption, craving and affect in an application on their mobile phones for three months starting one week before the first tDCS session. RESULTS: Number of smoked cigarettes a day progressively decreased up to one week after the last tDCS session in both conditions. Active treatment had no additional effect on cigarette consumption, craving and affect. CONCLUSIONS: In this exploratory study, repetitive bilateral tDCS over the DLPFC had no effect on daily smoking behaviour. Future research needs to investigate how motivation to quit smoking and the number of tDCS sessions affect the efficacy of repetitive tDCS.

Power of a randomization test in a single case multiple baseline AB design.

A randomization test can be used to statistically test hypotheses in multiple baseline designs to complement the commonly used visual inspection analysis. A crossed factor simulation study was performed to investigate the power of a randomization test in an multiple baseline design. The results show that the degree of autocorrelation of the observations, the number of participants, the effect size, the overlap of possible start moments of the intervention between participants, the ratio of the number of measurements in the baseline- and intervention phase, a gradually emerging effect, and the number of measurements had strong main effects on the power. The two-way interactions between number of participants and effect size, and between the number of measurements and the number of start moments of the intervention also had a large effect. An online tool was developed to calculate the power of a multiple baseline design given several design characteristics.

Impaired subjective self-control in alcohol use: An ecological momentary assessment study.

BACKGROUND: While both theory and empirical findings have supported impaired self-control as a crucial factor in understanding problem drinking, little is known about the relationship of self-control and drinking in naturalistic settings. The present study uses Ecological Momentary Assessment (EMA) to examine the predictive relationships between impaired subjective self-control, craving and alcohol use in everyday life. METHODS: A sample of 172 regular drinkers responded on their smartphone to three random prompts each day for seven days in which amount of perceived self-control and craving were measured with self-report. In the meantime, participants were instructed to initiate an EMA report when they started drinking alcohol. RESULTS: Findings supported the hypotheses that impaired self-control and higher craving levels were prospectively related to the likelihood that people will drink. That is, on random assessments that preceded drinking (i.e., were within two hours of drinking), perceived self-control was lower and craving was higher compared to random assessments that were not followed by drinking. Additionally, during drink consumption, impaired self-control and craving were associated with a higher amount of expected alcohol consumption. Findings further indicated that subjective self-control acted as a moderator of the relationship between craving and alcohol consumption during drinking occasions. CONCLUSIONS: By using a smartphone mobile application, this study showed that impaired subjective self-control and craving are prospectively related to alcohol use in the real-world. Furthermore, findings are consistent with theories of addiction that substance use might be associated with the interplay of control processes and increased motivation.

Latent difference score modeling: A flexible approach for studying informant discrepancies.

The current study proposes a flexible approach to studying informant discrepancies: Latent Difference Scores modeling (LDS). The LDS approach is demonstrated using an empirical example in which associations between mother-adolescent and father-adolescent discrepant parenting perceptions, and concurrent and later adolescent externalizing behaviors, were investigated. Early adolescents (N = 477, aged 12-15 years), mothers (N = 470), and fathers (N = 440) filled out questionnaires about mothers' and fathers' parenting. Results using the LDS approach are compared to results obtained by the 2 existing approaches for informant discrepancies: Observed Difference Scores modeling (ODS) and Polynomial Regression Analyses (PRA). Results from the LDS approach show that adolescents perceive their mothers' and fathers' parenting less favorably than mothers and fathers themselves, and that stronger mother-adolescent discrepancies are consistently related to stronger father-adolescent discrepancies. Parent-adolescent discrepancies were concurrently associated with more aggressive and rule-breaking behaviors, but not longitudinally. Results generalized across the 2 discrepancy approaches, but only very few significant associations were found in the PRA. Advantages and limitations of all 3 approaches to studying informant discrepancies are discussed. (PsycINFO Database Record

A Multilevel AR(1) Model: Allowing for Inter-Individual Differences in Trait-Scores, Inertia, and Innovation Variance.

In this article we consider a multilevel first-order autoregressive [AR(1)] model with random intercepts, random autoregression, and random innovation variance (i.e., the level 1 residual variance). Including random innovation variance is an important extension of the multilevel AR(1) model for two reasons. First, between-person differences in innovation variance are important from a substantive point of view, in that they capture differences in sensitivity and/or exposure to unmeasured internal and external factors that influence the process. Second, using simulation methods we show that modeling the innovation variance as fixed across individuals, when it should be modeled as a random effect, leads to biased parameter estimates. Additionally, we use simulation methods to compare maximum likelihood estimation to Bayesian estimation of the multilevel AR(1) model and investigate the trade-off between the number of individuals and the number of time points. We provide an empirical illustration by applying the extended multilevel AR(1) model to daily positive affect ratings from 89 married women over the course of 42 consecutive days.