Social isolation and poor mental health in young people: testing genetic and environmental influences in a longitudinal cohort study.

We assessed genetic and environmental influences on social isolation across childhood and the overlap between social isolation and mental health symptoms including depression symptoms, conduct problems, and psychotic-like experiences from adolescence to young adulthood. Participants included 2,232 children from the Environmental Risk Longitudinal Twin Study. Social isolation was measured at ages 5, 7, 10, 12, and 18. A Cholesky decomposition was specified to estimate the genetic and environmental influences on social isolation across ages 5, 7, 10, and 12. An independent pathway model was used to assess additive genetic (A), shared environmental (C), and non-shared environmental (E) influences on the overlap between social isolation and mental health problems from age 12 to 18. Genetic and non-shared environmental influences accounted for half of the variance in childhood social isolation. Genetic influences contributed to the continuity of social isolation across childhood, while non-shared environmental influences were age-specific. The longitudinal overlap between social isolation and mental health symptoms was largely explained by genetic influences for depression symptoms (r = 0.15-0.24: 82-84% A, 11-12% C, and 5-6% E) and psychotic-like experiences (r = 0.13-0.15: 81-91% A, 0-8% C, and 9-11% E) but not conduct problems (r = 0.13-0.16; 0-42% A, 42-81% C, 16-24% E). Our findings emphasise that rather than a risk factor or an outcome, social isolation is aetiologically intertwined with the experience of poor mental health. An integrative assessment of social isolation could be a helpful indicator of underlying mental health symptoms in young people.

Longitudinal associations of effort and reward at work with changes in cognitive function: evidence from a national study of U.S. workers.

PURPOSE: This study aimed to examine longitudinal associations of workplace effort and reward with changes in cognitive function among United States workers. METHODS: Data from the national, population-based Midlife in the United States (MIDUS) study with a 9-year follow-up were used. Validated workplace effort and reward scales were measured at baseline, and cognitive outcomes (including composite cognition, episodic memory, and executive functioning) were measured with the Brief Test of Adult Cognition by Telephone (BTACT) at baseline and follow-up. Multivariable linear regression analyses based on generalized estimating equations (GEE) examined the longitudinal associations under study. RESULTS: Among this worker sample of 1,399, after accounting for demographics, socioeconomics, lifestyle behaviors, health conditions, and job control, high reward at baseline was associated with increased composite cognition (regression coefficient: 0.118 [95% CI: 0.049, 0.187]), episodic memory (0.106 [0.024, 0.188]), and executive functioning (0.123 [0.055, 0.191]) during follow-up. The joint exposure of 'high effort and high reward' was also associated with increased composite cognition (0.130 [0.030, 0.231]), episodic memory (0.131 [0.012, 0.250]), and executive functioning (0.117 [0.017, 0.216]), while the combination of 'low effort and high reward' was associated with increased composite cognition (0.106 [0.009, 0.204]) and executive functioning (0.139 [0.042, 0.235]). CONCLUSION: Findings suggest that workplace high reward is related to improved cognitive scores among United States workers. Future research should investigate larger cohorts over longer timespans and expand into disease outcomes such as dementia. If these findings emerge as causal, relevant workplace rewards to promote worker cognitive health should be considered.

Trajectories of childhood bullying behaviors and conduct problems: Associations with cognitive functioning in a nationally representative cohort study.

Bullying behaviors and conduct problems are two forms of antisocial behavior that frequently co-occur in childhood. However, it remains unclear whether their developmental trajectories are distinct and the extent to which different aspects of cognitive functioning account for their development. We aimed to disentangle the developmental trajectories of bullying behaviors and conduct problems, test their interrelations across childhood, and assess associations with children's early cognitive functioning (executive functions, intelligent quotient [IQ], and theory of mind). Participants included 2,232 children from the Environmental Risk (E-Risk) Longitudinal Twin Study. We performed dual group-based trajectory modeling on combined parent and teacher reports of children's bullying behaviors and conduct problems at 5, 7, 10, and 12 years. We assessed associations with age 5 cognitive functioning using regression analyses. We identified five developmental trajectories for bullying behaviors and four for conduct problems. The developmental course of both behaviors was interrelated most strongly among those with high levels. A subgroup of children was likely to transition from conduct problems to bullying behaviors as they got older. Lower IQ was associated with both antisocial behavior trajectories, whereas lower theory of mind was only associated with conduct problems trajectories. The developmental course of bullying behaviors and conduct problems is distinct but linked across childhood. Interventions targeting bullying behaviors or conduct problems could benefit from more integration and should take into account children's cognitive functioning. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Multiple forms of perceived job discrimination and hypertension risk among employed women: Findings from the Sister Study.

BACKGROUND: Hypertension has been linked to socially patterned stressors, including discrimination. Few studies have quantified the risk of hypertension associated with exposure to perceived job discrimination. METHODS: We used prospective cohort data from the Sister Study (enrollment from 2003-2009) to estimate self-reported incident hypertension associated with perceived job discrimination based on race, gender, age, sexual orientation, or health status. Job discrimination in the prior 5 years was assessed in 2008-2012, and incident doctor-diagnosed hypertension was ascertained in previously hypertension-free participants. RESULTS: Among the 16,770 eligible participants aged 37-78 years at the start of follow-up, 10.5% reported job discrimination in the past 5 years, and 19.2% (n = 3226) reported incident hypertension during a median follow-up of 9.7 years (interquartile range 8.2-11.0 years). Self-reported poor health or inclusion in minoritized groups based on race/ethnicity or sexual orientation were more frequent among those reporting job discrimination. In a Cox proportional hazards model adjusting for covariates, report of at least one type of job discrimination (compared to none) was associated with a 14% (hazard ratio = 1.14 [95% confidence: 1.02-1.27]) higher hypertension risk. Results from sensitivity analyses reinforced the findings. CONCLUSIONS: Results suggest that interventions addressing job discrimination could have workplace equity and health benefits.

Associations of adverse childhood experiences with depression and anxiety among children in the United States: Racial and ethnic disparities in mental health.

OBJECTIVE: To assess associations of ACEs with depression and anxiety, with special emphasis on potential racial and ethnic disparities. METHOD: Data were from the National Survey of Children's Health (NSCH), 2021-2022, a large, cross-sectional, nationally representative, population-based study of United States children aged 0-17. The associations of cumulative ACEs with depression and anxiety among 104,205 children and adolescents were assessed via multivariable logistic regression, including adjustment for age, sex, race, household income, and parental educational attainment. RESULTS: ACEs were associated with depression and anxiety in a linear, dose-dependent manner. After adjustment for covariates, compared to no ACE exposures, participants with exposures to one, two, and three ACEs exhibited significantly higher odds of depression (fully-adjusted ORs and 95 % CIs = 2.18 [2.03, 2.35], 4.95 [4.55, 5.39], and 11.39 [10.18, 12.75], respectively). For anxiety, compared to no ACEs exposures, participants with exposure to one, two, and three ACEs had significantly higher odds of anxiety (fully-adjusted ORs and 95 % CIs = 1.90 [1.81, 2.00], 3.66 [3.44, 3.90], and 6.91 [6.30, 7.58], respectively). Notably, stratified analyses indicated potential effect modification by race, wherein the associations of ACEs with depression and anxiety were strongest in Black and White participants. CONCLUSION: ACEs were robustly associated with depression and anxiety in a national sample of U.S. children and adolescents, with differential impacts of ACES on mental health observed across racial and ethnic groups. These findings underscore the need for urgent government and healthcare interventions and policies to ameliorate ACEs' health effects, especially among disproportionately impacted minority groups.

Reduced Cochlear MRI Signal and Hearing Outcomes in Conservatively Managed Vestibular Schwannoma Patients.

OBJECTIVE: This study aimed to determine if hypointense cochlear magnetic resonance imaging (MRI) constructive interference in steady-state (CISS) signal correlates with hearing outcomes in conservatively managed vestibular schwannoma (VS) patients. STUDY DESIGN: Retrospective review of 657 cases from 1992 to 2020. SETTING: Tertiary academic referral center. PATIENTS: A retrospective review was performed to identify conservatively managed VS patients with appropriate baseline MRI, audiology, and at least 12-month audiological follow-up. Patients were excluded if they progressed to surgery or radiotherapy in less than 12 months, bilateral tumors, or surgery on the contralateral ear. INTERVENTION: Conservatively managed patients with CISS imaging studies and audiology testing. MAIN OUTCOME MEASURES: Primary outcome measure change in pure-tone average (PTA) and word recognition score (WRS). Secondary outcome measures tumor size, presence of lateral fluid cap, or cystic changes. RESULTS: A total of 92 individuals (47% male, 58 ± 11.6 yr) met the inclusion criteria, with 36 (39%) of patients demonstrating abnormal cochlear CISS signal. At baseline, abnormal cochlear CISS signal was associated with higher intracanalicular (IC) length (7.9 versus 6.6 mm, p = 0.0177) and lower WRS (55.7 versus 78.8 dBHL, p = 0.0054). During follow-up, individuals with abnormal cochlear CISS signal had significantly higher PTA (62.4 versus 46.4 dBHL, p = 0.0010). After adjusting for baseline covariates, abnormal cochlear CISS signal was consistently associated with a greater increase in PTA of 8.3 dBHL (95% confidence interval, 2.9-13.7; p = 0.0032) from baseline when compared with the normal group. CONCLUSIONS: Abnormal cochlear signal on MRI CISS sequences is associated with poorer hearing outcomes in conservatively managed VS patients.

Prospective associations of occupational and leisure-time physical activity with risk of diabetes: a cohort study from the United States.

OBJECTIVES: Leisure-time physical activity (LTPA) can reduce the risk of incident diabetes, whereas the role of occupational physical activity (OPA) in developing diabetes is still unclear due to conflicting evidence. Moreover, the joint associations of OPA and LTPA with incident diabetes among US workers have not yet been systematically examined. The objective of this study was to assess the independent and joint associations of OPA and LTPA with incident diabetes. METHODS: This prospective cohort study included 1406 workers free from diabetes at baseline (2004-2006) from the national, population-based Mid-life in the United States (MIDUS) study. Associations of OPA and LTPA at baseline with incident diabetes during 9 years of follow-up were examined using Poisson regression models. High OPA was defined based on engagement in physical demands at work, and high LTPA was defined as participation in moderate or vigorous LTPA at least once per week. RESULTS: High OPA was associated with an increased risk of diabetes compared to low OPA (adjusted risk ratios and 95% confidence interval = 1.52 [1.04, 2.22]), while high LTPA was associated with a decreased risk of diabetes compared to low LTPA (0.66 [0.44, 0.97]). Diabetes risk was the highest among workers with high OPA and low LTPA (2.30 [1.30, 4.07]). CONCLUSIONS: In a national, population-based prospective cohort study of US workers, high OPA was associated with an elevated risk of diabetes, while high LTPA was associated with a decreased diabetes risk. The combination of high OPA and low LTPA exhibited the greatest risk of diabetes.

Formulations of Job Strain and Psychological Distress: A Four-year Longitudinal Study in Japan.

Background: Different job strain formulations based on the Job Demand-Control model have been developed. This study evaluated longitudinal associations between job strain and psychological distress and whether associations were influenced by six formulations of job strain, including quadrant (original and simplified), subtraction, quotient, logarithm quotient, and quartile based on quotient, in randomly selected Japanese workers. Methods: Data were from waves I and II of the Survey of Midlife in Japan (MIDJA), with a 4-year follow-up period. The study sample consisted of 412 participants working at baseline and had complete data on variables of interest. Associations between job strain at baseline and psychological distress at follow-up were assessed via multivariable linear regression, and results were expressed as ß coefficients and 95% confidence intervals including R2 and Akaike information criterion (AIC) evaluation. Results: Crude models revealed that job strain formulations explained 6.93-10.30% of variance. The AIC ranged from 1475.87 to 1489.12. After accounting for sociodemographic and behavioral factors and psychological distress at baseline, fully-adjusted models indicated significant associations between all job strain formulations at baseline and psychological distress at follow-up: original quadrant (ß: 1.16, 95% CI: 0.12, 2.21), simplified quadrant (ß: 1.01, 95% CI: 0.18, 1.85), subtraction (ß: 0.39, 95% CI: 0.09, 0.70), quotient (ß: 0.37, 95% CI: 0.08, 0.67), logarithm quotient (ß: 0.42, 95% CI: 0.12, 0.72), and quartile based on quotient (ß: 1.22, 95% CI: 0.36, 2.08). Conclusion: Six job strain formulations showed robust predictive power regarding psychological distress over 4 years among Japanese workers.

The socioeconomic consequences of loneliness: Evidence from a nationally representative longitudinal study of young adults.

The negative health consequences of loneliness have led to increasing concern about the economic cost of loneliness in recent years. Loneliness may also incur an economic burden more directly, by impacting socioeconomic position. Much of the research to date has focused on employment status which may not fully capture socioeconomic position and has relied on cross-sectional data, leaving questions around the robustness of the association and reverse causation. The present study used longitudinal data to test prospective associations between loneliness and multiple indicators of social position in young adulthood, specifically, whether participants who were lonelier at age 12 were more likely to be out of employment, education and training (NEET) and lower on employability and subjective social status as young adults. The data were drawn from the Environmental Risk (E-Risk) Longitudinal Twin Study, a birth cohort of 2,232 individuals born in England and Wales during 1994-1995. Loneliness and subjective social status were measured at ages 12, 18 and 26. Employability and NEET status were assessed at age 18. Findings indicate that greater loneliness at age 12 was prospectively associated with reduced employability and lower social status in young adulthood. The association between loneliness and lower social status in young adulthood was robust when controlling for a range of confounders using a sibling-control design. Results also indicate that loneliness is unidirectionally associated with reduced subjective social status across adolescence and young adulthood. Overall, our findings suggest that loneliness may have direct costs to the economy resulting from reduced employability and social position, underlining the importance of addressing loneliness early in life.

Social isolation, loneliness, and inflammation: A multi-cohort investigation in early and mid-adulthood.

Social isolation and loneliness have been associated with poor health and increased risk for mortality, and inflammation might explain this link. We used data from the Danish TRIAGE Study of acutely admitted medical patients (N = 6,144, mean age 60 years), and from two population-representative birth cohorts: the New Zealand Dunedin Longitudinal Study (N = 881, age 45) and the UK Environmental Risk (E-Risk) Longitudinal Twin Study (N = 1448, age 18), to investigate associations of social isolation with three markers of systemic inflammation: C-reactive protein (CRP), interleukin-6 (IL-6), and a newer inflammation marker, soluble urokinase plasminogen activator receptor (suPAR), which is thought to index systemic chronic inflammation. In the TRIAGE Study, socially isolated patients (those living alone) had significantly higher median levels of suPAR (but not CRP or IL-6) compared with patients not living by themselves. Social isolation prospectively measured in childhood was longitudinally associated with higher CRP, IL-6, and suPAR levels in adulthood (at age 45 in the Dunedin Study and age 18 in the E-Risk Study), but only suPAR remained associated after controlling for covariates. Dunedin Study participants who reported loneliness at age 38 or age 45 had elevated suPAR at age 45. In contrast, E-Risk Study participants reporting loneliness at age 18 did not show any elevated markers of inflammation. In conclusion, social isolation was robustly associated with increased inflammation in adulthood, both in medical patients and in the general population. It was associated in particular with systemic chronic inflammation, evident from the consistently stronger associations with suPAR than other inflammation biomarkers.

Social isolation from childhood to mid-adulthood: is there an association with older brain age?

BACKGROUND: Older brain age - as estimated from structural MRI data - is known to be associated with detrimental mental and physical health outcomes in older adults. Social isolation, which has similar detrimental effects on health, may be associated with accelerated brain aging though little is known about how different trajectories of social isolation across the life course moderate this association. We examined the associations between social isolation trajectories from age 5 to age 38 and brain age assessed at age 45. METHODS: We previously created a typology of social isolation based on onset during the life course and persistence into adulthood, using group-based trajectory analysis of longitudinal data from a New Zealand birth cohort. The typology comprises four groups: 'never-isolated', 'adult-only', 'child-only', and persistent 'child-adult' isolation. A brain age gap estimate (brainAGE) - the difference between predicted age from structural MRI date and chronological age - was derived at age 45. We undertook analyses of brainAGE with trajectory group as the predictor, adjusting for sex, family socio-economic status, and a range of familial and child-behavioral factors. RESULTS: Older brain age in mid-adulthood was associated with trajectories of social isolation after adjustment for family and child confounders, particularly for the 'adult-only' group compared to the 'never-isolated' group. CONCLUSIONS: Although our findings are associational, they indicate that preventing social isolation, particularly in mid-adulthood, may help to avert accelerated brain aging associated with negative health outcomes later in life.

Adverse Childhood Experiences, Social Isolation, Job Strain, and Cardiovascular Disease Mortality in U.S. Older Employees.

Stress is a key driver of cardiovascular disease (CVD), yet the contribution of psychosocial stressors to the development of CVD has not been systematically examined in United States (U.S.) populations. The objective of this study was to assess prospective associations of adverse childhood experiences (ACEs), social isolation, and job strain with CVD mortality. Data were from the large, nationally representative, population-based Health and Retirement Study (HRS). ACEs, social isolation and job strain were assessed using validated survey instruments at baseline between 2006-2008, and death information was followed up through 2018. Cox proportional hazards regression models were used to examine prospective associations of ACEs, social isolation, and job strain with CVD mortality among 4046 older employees free from CVD at baseline. During 42,149 person-years of follow-up time, 59 death cases of CVD were reported. After adjustment for covariates, ACEs and job strain were significantly associated with increased risk of CVD mortality (aHR and 95% CI = 3.67 [1.59, 8.48] and 2.24 [1.21, 4.11], respectively), whereas social isolation demonstrated an inflated but nonsignificant association (aHR and 95% CI = 1.62 [0.72, 3.66]). These findings highlight the role of psychosocial exposures as novel and clinically relevant risk factors for CVD.

Do Children With Attention-Deficit/Hyperactivity Disorder Symptoms Become Socially Isolated? Longitudinal Within-Person Associations in a Nationally Representative Cohort.

Objective: This study examined longitudinal associations between attention-deficit/hyperactivity disorder (ADHD) symptoms and social isolation across childhood. The study tested the direction of this association across time, while accounting for preexisting characteristics, and assessed whether this association varied by ADHD presentation, informant, sex, and socioeconomic status. Method: Participants included 2,232 children from the Environmental Risk (E-Risk) Longitudinal Twin Study. ADHD symptoms and social isolation were measured at ages 5, 7, 10, and 12. Random-intercept cross-lagged panel models were used to assess the directionality of the association across childhood. Results: Children with increased ADHD symptoms were consistently at increased risk of becoming socially isolated later in childhood, over and above stable characteristics (ß = .05-.08). These longitudinal associations were not bidirectional; isolated children were not at risk of worsening ADHD symptoms later on. Children with hyperactive ADHD presentation were more likely to become isolated, compared with inattentive presentation. This was evident in the school setting, as observed by teachers, but not by mothers at home. Conclusion: The study findings highlight the importance of enhancing peer social support and inclusion for children with ADHD, particularly in school settings. This study adds explanatory value beyond traditional longitudinal methods, as the results represent how individual children change over time, relative to their own preexisting characteristics. Diversity & Inclusion Statement: We worked to ensure sex and gender balance in the recruitment of human participants. We worked to ensure that the study questionnaires were prepared in an inclusive way. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/or gender groups in science. We actively worked to promote sex and gender balance in our author group. The author list of this paper includes contributors from the location and/or community where the research was conducted who participated in the data collection, design, analysis, and/or interpretation of the work.

Prediction of in-hospital deterioration in normotensive pulmonary embolism remains elusive: external validation of the calgary acute pulmonary embolism score.

Acute pulmonary embolism (PE) is a frequently diagnosed condition. Prediction of in-hospital deterioration is challenging with current risk models. The Calgary Acute Pulmonary Embolism (CAPE) score was recently derived to predict in-hospital adverse PE outcomes but has not yet been externally validated. Retrospective cohort study of normotensive acute pulmonary embolism cases diagnosed in our emergency department between 2017 and 2019. An external validation of the CAPE score was performed in this population for prediction of in-hospital adverse outcomes and a secondary outcome of 30-day all-cause mortality. Performance of the simplified Pulmonary Embolism Severity Index (sPESI) and Bova score was also evaluated. 712 patients met inclusion and exclusion criteria, with 536 patients having a sPESI score of 1 or more. Among this population, the CAPE score had a weak discriminative power to predict in-hospital adverse outcomes, with a calculated c-statistic of 0.57. In this study population, an external validation study found weak discriminative power of the CAPE score to predict in-hospital adverse outcomes among normotensive PE patients. Further efforts are needed to define risk assessment models that can identify normotensive PE patients at risk for in hospital deterioration. Identification of such patients will better guide intensive care utilization and invasive procedural management of PE.

Problematic technology use and sleep quality in young adulthood: novel insights from a nationally representative twin study.

STUDY OBJECTIVES: Digital technology use is associated with poor sleep quality in adolescence and young adulthood although research findings have been mixed. No studies have addressed the association between the two using a genetically informative twin design which could extend our understanding of the etiology of this relationship. This study aimed to test: (1) the association between adolescents' perceived problematic use of digital technology and poor sleep quality, (2) whether the association between problematic use of technology and poor sleep quality remains after controlling for familial factors, and (3) genetic and environmental influences on the association between problematic use of technology and poor sleep quality. METHODS: Participants were 2232 study members (18-year-old twins) of the Environmental Risk (E-Risk) Longitudinal Twin Study. The sample was 48.9% male, 90% white, and 55.6% monozygotic. We conducted regression and twin difference analyses and fitted twin models. RESULTS: Twin differences for problematic use of technology were associated with differences for poor sleep quality in the whole sample (p < 0.001; B = 0.15) and also when we limited the analyses to identical twins only (p < 0.001; B = 0.21). We observed a substantial genetic correlation between problematic use of technology and sleep quality (rA = 0.31), whereas the environmental correlation was lower (rE = 0.16). CONCLUSIONS: Adolescent reported problematic use of digital technology is associated with poor sleep quality-even after controlling for familial factors including genetic confounds. Our results suggest that the association between adolescents' sleep and problematic digital technology use is not accounted for by shared genetic liability or familial factors but could reflect a causal association. This robust association needs to be examined in future research designed to test causal associations.

Workplace Discrimination and Risk of Hypertension: Findings From a Prospective Cohort Study in the United States.

Background Mounting evidence has demonstrated a role of psychosocial stressors such as discrimination in hypertension and cardiovascular diseases. The objective of this study was to provide the first instance of research evidence examining prospective associations of workplace discrimination with onset of hypertension. Methods and Results Data were from MIDUS (Midlife in the United States), a prospective cohort study of adults in the United States. Baseline data were collected in 2004 to 2006, with an average 8-year follow-up period. Workers with self-reported hypertension at baseline were excluded, yielding a sample size of 1246 participants for the main analysis. Workplace discrimination was assessed using a validated 6-item instrument. During follow-up with 9923.17 person-years, 319 workers reported onset of hypertension, and incidence rates of hypertension were 25.90, 30.84, and 39.33 per 1000 person-years among participants with low, intermediate, and high levels of workplace discrimination, respectively. Cox proportional hazards regression analyses demonstrated that workers who experienced high exposure to workplace discrimination, compared with workers with low exposure, had a higher hazard of hypertension (adjusted hazard ratio, 1.54 [95% CI, 1.11-2.13]). Sensitivity analysis excluding more baseline hypertension cases based on additional information on blood pressure plus antihypertensive medication use (N=975) showed slightly stronger associations. A trend analysis showed an exposure-response association. Conclusions Workplace discrimination was prospectively associated with elevated risk of hypertension among US workers. The adverse impacts of discrimination on cardiovascular disease have major implications for workers' health and indicate a need for government and employer policy interventions addressing discrimination.

Comparison of colour contrast sensitivity in eyes at high risk of neovascular age-related macular degeneration with and without subsequent choroidal neovascular membrane development.

BACKGROUND: Neovascular age-related macular degeneration (nAMD) is a leading cause of blind registrations in the elderly. Unfortunately, it is difficult to detect the early stage of the disease, when treatment is more likely to be successful. Subjects with very early disease are likely to have abnormal macular function, even in the pre-symptomatic stage. In this study, colour vision was evaluated to establish if subjects at high risk of developing nAMD can be identified, thus allowing earlier diagnosis and possible treatment. METHODS: Colour contrast sensitivity (CCS) was evaluated over time in the fellow unaffected eye of subjects with unilateral nAMD. Participants were divided into Group 1 (182 participants) or Group 2 (15 participants) according to whether nAMD did not or did develop in the study period respectively and the two groups were compared. RESULTS: CCS was increased (i.e. worse colour vision) compared with the age-matched reference range in a high proportion of fellow eyes in both Groups 1 and 2. Global mean CCS values did not show statistically significant differences between the two groups. However, there was a statistically significant difference between mean Group 1 CCS values and the last CCS value prior to nAMD diagnosis from Group 2 subjects. CONCLUSION: This study shows that in patients with unilateral nAMD, colour vision is frequently abnormal in the fellow unaffected eye. Abnormal CCS does not predict the development of nAMD within the 12 month period of the study and therefore it is not a viable screening tool for this pathology.

The developmental course of loneliness in adolescence: Implications for mental health, educational attainment, and psychosocial functioning.

The present study examined patterns of stability and change in loneliness across adolescence. Data were drawn from the Environmental Risk (E-Risk) Longitudinal Twin Study, a UK population-representative cohort of 2,232 individuals born in 1994 and 1995. Loneliness was assessed when participants were aged 12 and 18. Loneliness showed modest stability across these ages (r = .25). Behavioral genetic modeling indicated that stability in loneliness was explained largely by genetic influences (66%), while change was explained by nonshared environmental effects (58%). Individuals who reported loneliness at both ages were broadly similar to individuals who only reported it at age 18, with both groups at elevated risk of mental health problems, physical health risk behaviors, and education and employment difficulties. Individuals who were lonely only at age 12 generally fared better; however, they were still more likely to finish school with lower qualifications. Positive family influences in childhood predicted reduced risk of loneliness at age 12, while negative peer experiences increased the risk. Together, the findings show that while early adolescent loneliness does not appear to exert a cumulative burden when it persists, it is nonetheless a risk for a range of concomitant impairments, some of which can endure.

Are trajectories of social isolation from childhood to mid-adulthood associated with adult depression or suicide outcomes.

PURPOSE: Social isolation has been shown to have negative effects on mental health outcomes though little is known about trajectories across the life course. We examined the relationship between trajectory groups and selected mental health outcomes in mid-adulthood. METHODS: We previously created a typology of social isolation based on onset during the life course and persistence into adulthood, using group-based trajectory analysis of longitudinal data from a New Zealand birth cohort. The typology comprises four groups: 'never-isolated', 'adult-only', 'child-only', and 'persistent (child-adult) isolation'. We undertook logistic regression analyses of three mental health outcomes with trajectory group as the predictor, adjusting for sex and a range of familial and child-behavioural factors. RESULTS: Lifetime suicide attempt, and depression and suicide ideation in mid-adulthood were each associated with adult-only but not child-only social isolation. Depression in mid-adulthood was also associated with persistent child-adult social isolation. CONCLUSION: Although our findings are associational and not causal, they indicate that interrupting persistent social isolation may help to prevent adult depression whereas halting adult social isolation may ameliorate both depression and suicide outcomes.

Increased job strain and cardiovascular disease mortality: a prospective cohort study in U.S. workers.

Job strain is considered a potential risk factor of cardiovascular disease (CVD). Our objective was to examine prospective associations of job strain with CVD mortality using data from the national, population-based Mid-life in the United States (MIDUS) cohort study, while considering changes in job strain. Job strain measure was based on Demand-Control model at Wave 1 in 1995-1996 and Wave 2 in 2004-2006, and CVD mortality data through 2018 were retrieved through linkage to the National Death Index (NDI). Cox proportional hazards regression was applied to assess prospective associations between job strain across MIDUS I and MIDUS II and CVD mortality at follow-up in 1,870 workers free from CVD at MIDUS I. After adjustment for relevant covariates, single measurement of job strain at MIDUS I or MIDUS II, and two measurements of job strain between the two waves were not significantly associated with CVD mortality, while the increase in scores between the two waves (increase vs. no increase) demonstrated stronger prospective associations with CVD mortality (HR and 95% CI = 2.37 [0.88, 6.42]). Our findings suggest increased job strain may pose a stronger risk to CVD mortality than single exposure measurement.