Network analysis of anxiety and depressive symptoms during the COVID-19 pandemic in older adults in the United Kingdom.

The health crisis caused by COVID-19 in the United Kingdom and the confinement measures that were subsequently implemented had unprecedented effects on the mental health of older adults, leading to the emergence and exacerbation of different comorbid symptoms including depression and anxiety. This study examined and compared depression and anxiety symptom networks in two specific quarantine periods (June-July and November-December) in the older adult population in the United Kingdom. We used the database of the English Longitudinal Study of Aging COVID-19 Substudy, consisting of 5797 participants in the first stage (54% women) and 6512 participants in the second stage (56% women), all over 50 years of age. The symptoms with the highest centrality in both times were: "Nervousness (A1)" and "Inability to relax (A4)" in expected influence and predictability, and "depressed mood (D1"; bridging expected influence). The latter measure along with "Irritability (A6)" overlapped in both depression and anxiety clusters in both networks. In addition, a the cross-lagged panel network model was examined in which a more significant influence on the direction of the symptom "Nervousness (A1)" by the depressive symptoms of "Anhedonia (D6)", "Hopelessness (D7)", and "Sleep problems (D3)" was observed; the latter measure has the highest predictive capability of the network. The results report which symptoms had a higher degree of centrality and transdiagnostic overlap in the cross-sectional networks (invariants) and the cross-lagged panel network model of anxious and depressive symptomatology.

Intake of foods high in saturated fats, vegetarian dietary pattern, and sociodemographic characteristics associated with body weight in Peruvian university students.

Background: The prevalence of obesity continues to increase among university students and the general population. Consumption of a diet high in saturated fats could be one of the risk factors. Objective: The consumption of foods high in saturated fats, the vegetarian diet pattern, and sociodemographic characteristics associated with excess body weight (overweight/obesity) were evaluated in Peruvian university students. Methods: A cross-sectional study was carried out selecting 5,608 Peruvian university students through no probabilistic convenience sampling. The survey was carried out during the months of February and April 2022. The Chi-square test and binary logistic regression analysis were used to evaluate the association between diet (saturated fats intake and dietary pattern) and sociodemographic factors with excess body weight in a cross-sectional analysis. Results: It was observed that students who reported high consumption of foods high in saturated fats (ORB = 1.14) and those who had a non-vegetarian dietary pattern (ORB = 2.76) were found to be more likely to have excess body weight. On the contrary, students who reported adherence to the vegetarian diet pattern for more than 5 years were less likely to be overweight or obese (ORB = 0.84). Being ≥26 years of age (ORB = 3.28), living in urban areas (ORB = 1.68) and coastal areas of the country (ORB = 1.17), and enrolled in the engineering faculty (ORB = 1.19), were significantly associated with excess body weight. Conclusion: The findings of the current study evidenced several factors associated with excess body weight in university students. Therefore, it is necessary to promote and implement healthy lifestyle programs, considering sociodemographic and dietary aspects such as age and dietary intake to control and prevent obesity in university students.

Body mass index and healthy lifestyle practices among Peruvian university students: a comparative study among academic discipline.

Background: Excess body weight and an unhealthy lifestyle are a risk factor for noncommunicable diseases. University students are susceptible to unhealthy habits and obesity. This study compared body mass index (BMI) and healthy lifestyle practices among university students from four academic disciplines: Health Sciences, Business Sciences, Human Sciences and Education, and Engineering/Architecture. Methods: A cross-sectional study was carried out using a sample of 6,642 university students selected by non-probability convenience sampling. The Diet and Healthy Lifestyle Scale (DEVS), the Peruvian validation of the Vegetarian Lifestyle Index (VLI), was used to assess healthy lifestyle practices. Results: Students in the areas of Business Sciences and Engineering/Architecture had a higher BMI than their peers in Health Sciences (B = 0.35, 95% CI: 0.15-0.56 and 0.32, 95% CI: 0.13-0.52; p = 0.001). Additionally, these students tended to adopt less healthy lifestyle (B = -0.11, 95% CI: -0.20 to -0.01 and -0.09, 95% CI: -0.18 to -0.00; p < 0.05) compared to those in Health Sciences. Conclusion: Although students of Health Sciences and Human Sciences and Education exhibited healthy lifestyle patterns, there is a clear need to improve eating and living habits in general among the university population to mitigate the risk factors associated with non-communicable diseases.

A Network Analysis Approach to Understanding Centrality and Overlap of 21 Dark Triad Items in Adults of 10 Countries.

Background: Previous research has suggested that manipulation and callousness are central to Dark Triad traits, but it has not identified which specific manifestations are expressed across various countries. Objective: This study aimed to identify the core and overlapping manifestations of Dark Triad traits across 10 countries. Methods: We used the Short Dark Triad (SD3) scale and assessed a sample of 8093 participants (59.7% women, M(age) = 32.68 years). For graphical representation, the spinglass algorithm was applied to understand the cluster distribution among Machiavellianism, psychopathy, and subclinical narcissism traits. Centrality indices were used to identify the most influential items, and the clique-percolation algorithm was employed to detect shared attributes among multiple Dark Triad items. Results: Straightforward SD3-21 items demonstrated better interpretability as aversive traits within the broader system. Items with higher centrality values were those related to short-term verbal manipulation from the psychopathy domain, clever manipulation, strategic revenge-seeking from Machiavellianism, and narcissistic motivations for connecting with significant individuals. The most predicted items were linked to planned revenge, using information against others from Machiavellianism, short-term psychopathic verbal manipulation, and narcissistic belief of specialness based on external validation. Items like short-term verbal manipulation had overlaps with both psychopathy and narcissism clusters, while clever manipulation overlapped with Machiavellianism and psychopathy. Conclusion: This cross-cultural study highlights the central role of verbal manipulation within the Dark Triad traits, along with identifying overlapping items among traits measured using straightforward SD3 scale items. In line with our findings, future research that incorporates a wide range of cultural contexts is encouraged to establish the consistency of these findings with the SD3 Scale or alternative measures.

Structure and factorial invariance of a brief version of the Eating Attitudes Test in Peruvian university students.

Background: University students often experience significant changes in their eating habits, which can increase the risk of developing eating disorders (ED). This situation calls for the creation of brief assessment tools to identify college students who may be most at risk. The aim of the study was to determine the psychometric properties of the Eating Attitudes Test-8 (EAT-8) in a Peruvian university population; additionally, the possible differences in the scores of the instrument according to sociodemographic variables, such as gender and age, were examined. Methods: A psychometric study was conducted on 610 participants (M = 24.3, SD = 2.16, and 61.5% female), aged 19 to 31 years, belonging to four universities of different professional careers. Results: The unidimensional eight-item model was found to have fit indices that confirm acceptable factorial validity (X2/df = 3.23, CFI = 0.984, TLI = 0.977, RMSEA = 0.061, SRMR = 0.049) and an internal consistency of 0.833 for the Cronbach's alpha coefficient and 0.838 for the McDonald's omega coefficient. In addition, the EAT-8 was reported to be invariant according to gender and age; likewise, there were no significant differences in the age and gender categories. Conclusion: The EAT-8 has solid psychometric properties, including validity, reliability, and invariance, in the Peruvian university population, which supports its ability to assess the risk of developing ED in this specific group.

Validation of the Working Alliance Inventory- Short Form for Patient (WAI-S-P) in Peruvian Adults.

Background: Although the importance of the therapeutic alliance in the treatment process and health outcomes is recognized, so far, there has been no evaluation in the Peruvian context that considers possible individual differences that could influence this assessment. Purpose: This study assessed the psychometric properties of the WAI-S-P in a sample of individuals from Peru who are receiving psychological therapy. Furthermore, a network analysis was conducted to investigate the direct relationships between the therapeutic alliance and several relevant sociodemographic variables. Methods: The short version of the Working Alliance Inventory was used in a sample of 241 participants (Mage=32.58, SD=12.67) that had attended less than 6 sessions. Three models were considered, including a three-factor and a two-factor correlated model, as well as a bifactor model. In addition, a network of partial associations was created including the overall therapeutic alliance, sex, age, and number of psychotherapeutic sessions. Results: The bifactor model, with an overall therapeutic alliance factor and two specific factors ("contact" and "contract"), better fit the data. Invariance of the structure by sex and age showed equitable measurement. On the other hand, network analysis revealed a positive correlation between total session attendance and therapeutic alliance. Men reported higher therapeutic alliance, while women had higher total session attendance. Conclusion: The results of this study suggest that the therapeutic alliance is better represented by a bifactor model and demonstrates invariance across sex and age in Peruvian adults. Additionally, findings indicate that differences in life experiences and the sex of patients may need to be verified in future studies to better understand nuanced needs in forming therapeutic alliances at least in the early stages of session attendance.

Network Analysis of Dark Triad Traits and Emotional Intelligence in Peruvian Adults.

Background: The study of Dark Triad traits and emotional variables has been conducted in numerous regions; however, there is a lack of research focusing on Latin American samples and considering variables such as sex and age. Incorporating these variables could enhance our understanding of underlying aversive patterns. Purpose: This study aimed to analyze the associations between Dark Triad traits and emotional intelligence in Peruvian adults. Methods: Data were collected in 2021 and 272 adults (M=31.8 years, 68% female) participated through online surveys via non-probability purposive sampling. Dirty Dozen and Trait Meta-Mood Scales were used. Two partial correlation network models were applied between the study variables with and without controlling for gender and age. Bridge-expected influence and predictability analysis were calculated to find interconnected traits and higher connections, respectively. Results: Subclinical psychopathy primarily showed negative associations with emotional clarity (r=-0.17), followed by emotional attention (r=-0.08) and emotional repair in networks with and without age and gender variables. Machiavellianism consistently displayed a negative association with emotional repair (r=-0.13) in both estimated networks. Conversely, subclinical narcissism exhibited a positive association solely with emotional attention (r=0.15). Furthermore, younger age was linked to higher Machiavellianism (r=-0.23), females showed higher emotional attention (r=0.11), and narcissism connected intrapersonal emotional domains with Dark Traits (bridge expected influence >1.25) while Machiavellianism exhibited greater predictability (r2>0.45) due to reinforcement by other Dark Traits. Conclusion: This study revealed negative connections between the Dark Triad and emotional intelligence traits, except for narcissism, which was positively associated with emotional attention and functioned as a "bridge" between all traits. However, relying solely on this single positive emotional aspect of narcissism may not be adequate to characterize it as possessing fully adaptive emotional traits. Findings suggest that detailed aspects of emotional intelligence and sociodemographic factors can provide valuable insights into the complex nature of aversive patterns and their broader impact on society.

Bifactor SEM and MIRT Structure of a 12-Item Human Immunodeficiency Virus Stigma Scale in Peruvian Adults.

BACKGROUND: The stigma associated with human immunodeficiency virus (HIV) can lead to prejudice and discrimination against people who have been infected by this virus, consequently, it is important to have a validated tool to measure this phenomenon. However, there is only 1 national precedent that has validated the scores of this instrument in its 21-item version. Therefore, this study examined the bifactor structural equation method (SEM) and multidimensional item response theory (MIRT) structure of a 12-item human immunodeficiency virus stigma scale in Peruvian adults. METHODS: We evaluated 342 patients (57.6% female and 42.45% male) diagnosed with HIV receiving highly active antiretroviral therapy (HAART) from a hospital located in East Lima, aged 18 to 45 years (M = 31.4, SD = 9.79). A SEM was used to test 2 measurement models, a 4-factor correlated oblique model and a bifactor model due to high interfactor relationships. RESULTS: Acceptable fit indices were identified for the oblique model (χ2/df = 1.26, SRMR = 0.044, RMSEA [90% CI] = 0.028 [0.000-0.047], CFI = 0.996, TLI = 0.994). In the same way, similar results were evident for the bifactor model (χ2/df = 1.14, SRMR = 0.039, RMSEA [90% CI] = 0.020 [0.000-0.044], CFI = 0.998, TLI = 0.997), however, in the latter it showed a greater explanation for the unidimensional model (H = 0.87, PUC = 0.82, LCA = 0.70), which was also evidenced by the bifactor MIRT analysis. CONCLUSION: It is concluded that the 12-item HIV Stigma Scale meets the psychometric properties of internal structure and unifactorial reliability.

Association between frequency of breakfast consumption and cardiometabolic risk in Peruvian university teachers, 2019-2020.

Background: Although the relationship between health status and dietary intake has been extensively studied in the general population, there is a lack of research that has specifically examined the association between frequency of breakfast consumption and cardiometabolic risk in university teachers. Objective: To determine the association between the frequency of breakfast consumption and cardiometabolic risk in university teachers. Methods: A cross-sectional study was conducted in 176 teachers from a private university located in the eastern region of Lima, Peru (Mage: 37.0 years; SD: 0.8, range: 24-59 years). The study was conducted during the period from December 2019 to February 2020. Information was collected on anthropometric and biochemical parameters and frequency of breakfast consumption. Multinomial logistic regression models were used to explore the association between frequency of breakfast with sociodemographic, anthropometric, and biochemical variables. Results: The highest prevalence of excess body weight (44.4%) was observed in those who consumed breakfast 0 to 2 days/week, but without statistical differences. Those who reported Low-density lipoprotein cholesterol (LDL-C) < 160 mg/dL were 77% less likely to fall into the 3-5 day/week breakfast frequency category than those who reported a regular frequency of breakfast (6 to 7 days/week) (Adjusted OR = 0.23, 95% CI 0.08 to 0.73; p < 0.05). In addition, teachers who reported a breakfast frequency of 3 to 5 days/week were 83% more likely to have a glucose concentration < 110 mg/dL compared to those who consumed breakfast of 6 to 7 days/week (Adjusted OR = 0.17, 95% CI 0.04 to 0.75; p < 0.05). Conclusion: Skipping breakfast for an extended period of time can have detrimental effects on cardiometabolic health. Promoting the benefits of breakfast could be a health message of great public health interest.

Psychometric Properties of the Peruvian Version of the MOS Scale for Social Support in Cancer Patients and Convergent Network with Quality of Life.

Introduction: One of the key psychosocial factors that impact mental and emotional health is social support. While much research has been conducted on the role of social support in the lives of cancer patients, there is a lack of studies that consider populations who need specific tools to assess this concept. Purpose: The aim of this study was to evaluate the psychometric properties of the MOS Social Support Scale (1991) in 499 Peruvian cancer patients between the ages of 18 and 87 (M= 46.30, SD = 15.747). Methods: In this study, three models of the MOS were analyzed based on 19-item versions (four factor, second order and bifactor model). Results: The results showed a better psychometric fit in the 19-item bifactor model with optimal fit indices through the structural equation method (SB-χ2/df = 1.94, CFI = 0.966, TLI= 0.955, SRMR = 0.038 and RMSEA = 0.058). Additionally, there was evidence of configural, metric and scalar invariance with this instrument according to the gender of the surveyed cancer patients. Convergent validity using a network analysis approach revealed positive associations between social support dimensions and quality of life. Conclusion: Emotional support and positive interactions dimensions were found to be important interconnections in the overall network, as indicated by their greater centralities. Therefore, this instrument could be suggested as a reliable way to evaluate cancer patients and their perceived support.

Structure and factorial invariance of the Grit-Original scale and convergent validity of the network with job satisfaction and happiness.

Background: The concept of Grit refers to a person's ability to maintain perseverance and passion in the pursuit of long-term objectives. However, research on the applicability of the Grit-Original scale (Grit-O) in the Latin American context is limited. Objective: This instrumental design study aimed to analyze the structure of this scale and its factorial invariance in relation to gender, as well as to examine its convergent validity with job satisfaction and happiness. Methods: A sample of 364 Peruvian workers that were selected through non-probabilistic convenience sampling in 2021. Results: The results of the confirmatory factor analysis showed that the two-dimensional structure of 12 items presented adequate goodness-of-fit indices. Additionally, the instrument is invariant between men and women. Likewise, the convergent relationship between the Grit scale, job satisfaction, and happiness variables was confirmed, which supports the validity of the instrument in the study context. Conclusion: The findings of the study confirm that the GRIT-O is a measure with adequate psychometric properties in the Peruvian context.

Gender network analysis of the Eating Disorder Examination-Questionnaire (EDE-Q7) in Peruvian adults / Análisis de red de género del Eating Disorder Examination-Questionnaire (EDE-Q7) en adultos peruanos

Background: network assessment of eating disorder (ED)-related symptomatology from a gender perspective is an important topic of study; however, there is limited research in the Latin American context. Objective: this study aimed to explore the patterns of association of the components of the Eating Disorder Examination-Questionnaire (EDE-Q7) according to gender, using two simultaneous network models in 890 Peruvian adults (63.51 % were women; mean age: 26.40). Methods: two graphs considering the gender factor were made using the R package qgrap and the merged LASSO graph. Results: higher network centrality measures were obtained for items related to body image dissatisfaction and overvaluation in women; while in the men's network, the items of food restriction and overestimation of weight were the most central symptoms. Conclusion: both network models were invariant and showed no significant differences in both structure and connections.(AU)

Introducción: la evaluación de redes de la sintomatología relacionada con los trastornos alimentarios (TA) desde el punto de vista del géneroes un tema importante de estudio; sin embargo, existen pocas investigaciones en el contexto latinoamericano.Objetivo: el objetivo de este estudio fue explorar los patrones de asociación de los componentes del Eating Disorder Examination-Questionnaire(EDE-Q7) según el sexo mediante dos modelos de red simultánea en 890 adultos peruanos (63,51 % de mujeres; edad promedio: 26,40 años).Métodos: se realizaron dos gráficos considerando el factor género utilizando el paquete R qgrap y el gráfico LASSO fusionado.Resultados: se obtuvieron medidas de centralidad de red más altas para los ítems relacionados con la insatisfacción y la sobrevaloración dela imagen corporal en las mujeres; mientras que, en la red de los hombres, los ítems de restricción alimentaria y sobrevaloración del peso eranlos síntomas más centrales.Conclusión: ambos modelos de red resultaron invariables y no mostraron diferencias significativas a nivel de estructura y conexiones.(AU)

Gender network analysis of the Eating Disorder Examination-Questionnaire (EDE-Q7) in Peruvian adults.

Introduction: Background: network assessment of eating disorder (ED)-related symptomatology from a gender perspective is an important topic of study; however, there is limited research in the Latin American context. Objective: this study aimed to explore the patterns of association of the components of the Eating Disorder Examination-Questionnaire (EDE-Q7) according to gender, using two simultaneous network models in 890 Peruvian adults (63.51 % were women; mean age: 26.40). Methods: two graphs considering the gender factor were made using the R package qgrap and the merged LASSO graph. Results: higher network centrality measures were obtained for items related to body image dissatisfaction and overvaluation in women; while in the men's network, the items of food restriction and overestimation of weight were the most central symptoms. Conclusion: both network models were invariant and showed no significant differences in both structure and connections.

Introducción: Introducción: la evaluación de redes de la sintomatología relacionada con los trastornos alimentarios (TA) desde el punto de vista del género es un tema importante de estudio; sin embargo, existen pocas investigaciones en el contexto latinoamericano. Objetivo: el objetivo de este estudio fue explorar los patrones de asociación de los componentes del Eating Disorder Examination-Questionnaire (EDE-Q7) según el sexo mediante dos modelos de red simultánea en 890 adultos peruanos (63,51 % de mujeres; edad promedio: 26,40 años). Métodos: se realizaron dos gráficos considerando el factor género utilizando el paquete R qgrap y el gráfico LASSO fusionado. Resultados: se obtuvieron medidas de centralidad de red más altas para los ítems relacionados con la insatisfacción y la sobrevaloración de la imagen corporal en las mujeres; mientras que, en la red de los hombres, los ítems de restricción alimentaria y sobrevaloración del peso eran los síntomas más centrales. Conclusión: ambos modelos de red resultaron invariables y no mostraron diferencias significativas a nivel de estructura y conexiones.

Factorial and network structure of the Reynolds Adolescent Depression Scale (RADS-2) in Peruvian adolescents.

Depression in young people is considered a public health problem, given that it affects their personal, social, and academic lives; therefore, early detection of depressive symptoms is of importance for a favorable prognosis. This study aimed to estimate the psychometric properties of the second edition of the Reynolds Adolescent Depression Scale (RADS-2) in Peruvian adolescents. The sample was composed of 917 Peruvian adolescents, aged 13 to 18 years (M = 15,241, SD = 1,020), who were selected from two public educational institutions in Metropolitan Lima. Confirmatory factor analysis supported the 25-item model with the four-dimensional structure and its overall and interdimensional reliability. This structure was found to be gender invariant. Finally, network analysis was performed to assess the relationships and centralities of the depressive symptoms of the validated version of the RADS-2. The results show that the RADS-2 measure is a consistent and reliable test that yields valid results in the Peruvian adolescent context.

Network Structure of Comorbidity Patterns in U.S. Adults with Depression: A National Study Based on Data from the Behavioral Risk Factor Surveillance System.

Background: People with depression are at increased risk for comorbidities; however, the clustering of comorbidity patterns in these patients is still unclear. Objective: The aim of the study was to identify latent comorbidity patterns and explore the comorbidity network structure that included 12 chronic conditions in adults diagnosed with depressive disorder. Methods: A cross-sectional study was conducted based on secondary data from the 2017 behavioral risk factor surveillance system (BRFSS) covering all 50 American states. A sample of 89,209 U.S. participants, 29,079 men and 60,063 women aged 18 years or older, was considered using exploratory graphical analysis (EGA), a statistical graphical model that includes algorithms for grouping and factoring variables in a multivariate system of network relationships. Results: The EGA findings show that the network presents 3 latent comorbidity patterns, i.e., that comorbidities are grouped into 3 factors. The first group was composed of 7 comorbidities (obesity, cancer, high blood pressure, high blood cholesterol, arthritis, kidney disease, and diabetes). The second pattern of latent comorbidity included the diagnosis of asthma and respiratory diseases. The last factor grouped 3 conditions (heart attack, coronary heart disease, and stroke). Hypertension reported higher measures of network centrality. Conclusion: Associations between chronic conditions were reported; furthermore, they were grouped into 3 latent dimensions of comorbidity and reported network factor loadings. The implementation of care and treatment guidelines and protocols for patients with depressive symptomatology and multimorbidity is suggested.

Validation of the Post-Traumatic Growth Inventory in Adolescents Who Lost a Family Member in the Past 4 years: Effects of Time After the Death Event and Gender.

Post-traumatic growth is the psychological capacity to perceive positive changes facing high-stress or potentially traumatic events and may be especially useful in lessening their effects in adolescents' lives. Present study aimed to evaluate the psychometric properties of the Post-Traumatic Growth Inventory (PTGI) in 662 Peruvian adolescents who suffered the death of an immediate family member over the last 4 years. Firstly, an exploratory graphical analysis (EGA) was conducted to determine the best parsimonious structure of the instrument and confirmed with its respective factor models. The results report adequate fit indices in the EGA Bifactor model. Furthermore, another structural model is included, which reports significant latent effects of the time elapsed since the relative's death and gender (male) on PTGI general factor. Likewise, gender measure was significantly related to items 3, 7, and 11, which is linked to personal growth.

Psychometric evaluation and invariance of the Spanish version of the Block Fat Screener (BFS-E) in university students.

Introduction: University students constantly face a number of health challenges related to an unhealthy diet, characterized by a high intake of saturated fats. Objective: This study aimed to analyze the psychometric properties of the Spanish version of the Block Fat Screener (BFS-E) food frequency questionnaire in a university population. Methods: An observational analytical study of instrumental type was carried out in 5608 Peruvian university students. Based on the Block Fat Screener questionnaire, a back-translation and cultural adaptation process was carried out. The validity of the questionnaire was determined through exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), hypothesizing a unidimensional structure. For the determination of reliability, the alpha coefficients were considered; likewise, the ω and H coefficients were used to evaluate the construct. The model explained 63% of the cumulative variance. Results: The CFA confirmed the unidimensionality of the 16-item questionnaire with appropriate goodness-of-fit indicators; therefore, which model of the Peruvian version adequately fits the observed data. The values of the reliability coefficients were higher than 0.90, with ordinal α = 0.94, ω = 0.94, and H = 0.95. Conclusion: The Spanish version of the Block Fat Screener food frequency questionnaire presents adequate psychometric properties and is therefore a valid scale to quickly measure fat intake in university students in a Latin American context.