Childhood Overweight and Obesity and Pubertal Onset Among Mexican-American Boys and Girls in the CHAMACOS Longitudinal Study.

Secular trends in earlier initiation of puberty have been observed in recent decades. One risk factor appears to be increases in adiposity, as measured by body mass index. This trend is particularly notable among Latino populations, who have higher rates of overweight/obesity compared with non-Latino White youth. Previous research has focused primarily on White girls, resulting in data gaps regarding male puberty and among potentially high-risk populations. Using data from the Center for the Health Assessment of Mothers and Children of Salinas (CHAMACOS) study, we examined body mass index at age 5 years (2005-2006) and multiple markers of pubertal onset, assessed repeatedly and longitudinally at 7 in-person visits, starting at age 9 and continuing through age 14 (2009-2015), among 336 Mexican Americans in Salinas, California. We observed no associations among boys, but found significantly earlier thelarche in overweight (HR = 1.7, 95% CI: 1.1, 2.7) and obese girls (HR = 1.5, 95% CI: 1.0, 2.4), menarche in overweight girls (HR = 1.6; CI: 1.0, 2.4), and pubarche in obese girls (HR = 1.9; CI: 1.2, 3.0), compared with normal-weight girls. This study examined an understudied population and included key covariates, such as birth weight and early adverse events, which are typically omitted in studies.

An Examination of Idiographic Networks of Posttraumatic Stress Disorder Symptoms.

Although the application of network theory to posttraumatic stress disorder (PTSD) has yielded promising insights, the lack of equivalence between inter- and intraindividual variation limits the generalizability of these findings to any one individual with PTSD. Instead, a better understanding of how PTSD symptoms occur and vary over time within an individual requires exploring the idiographic network structure of PTSD. To do so, the present study used an intensive repeated-measures design to estimate intraindividual networks of PTSD symptoms on a person-by-person basis. Participants were 20 individuals who met criteria for PTSD and completed daily surveys assessing PTSD symptoms; surveys were completed four times per day for approximately 30 days. Employing a recently validated method provided by Fisher, Reeves, Lawyer, Medaglia, and Rubel (2017), we used these data to estimate a contemporaneous and temporal network of PTSD symptoms for individuals on a person-by-person basis. We then calculated centrality metrics to determine the relative importance of each symptom in each idiographic network. Across all contemporaneous networks, negative trauma-related cognitions and emotions were most commonly the most central symptoms. Further, across all temporal networks, (a) negative trauma-related emotions were the most common driver of variation in other symptoms over time and (b) distressing trauma-related dreams and sleep disturbance were the most common downstream consequences of variation in other PTSD symptoms over time. We also reviewed data from two randomly selected participants to illustrate how this approach could be used to identify maintenance factors of PTSD for each individual and guide individual treatment planning.

Girls' Pubertal Timing and Tempo and Mental Health: A Longitudinal Examination in an Ethnically Diverse Sample.

PURPOSE: Earlier timing and faster tempo of puberty have been linked to adolescents' poor mental health. Previous research rarely adjusted for childhood mental health, did not use physical examination to assess puberty, and excluded Latinas and Asian Americans. This study addressed these limitations. METHODS: We followed 822 girls, recruited at ages 6-8, for 8 years. Breast and pubic hair development and anxiety and depressive symptoms were assessed prospectively and repeatedly. Structural equation models tested whether pubertal timing and tempo were associated with adolescent mental health symptoms and whether associations varied by ethnicity. Models were adjusted for childhood mental health symptoms, body mass index, and family income. RESULTS: Earlier breast development was associated with higher depressive symptoms among whites (ß = -.19; p < .01) and higher anxiety symptoms among Latinas (ß = -.26; p < .05), but lower depressive symptoms among Asians (ß = .24, p < .05). Later pubic hair development (b = .24; p < .05) and faster pubic hair tempo (ß = .26; p < .01) were associated with higher anxiety symptoms among Latinas. Faster pubic hair tempo was associated with lower depressive symptoms among Asians (ß = -.34; p < .05). Tempo of breast development showed no associations. CONCLUSIONS: Findings confirmed that earlier breast development was associated with higher mental health symptoms for Latina and white girls but was protective among Asians. Results for pubic hair and pubertal tempo were inconsistent, requiring future examination. While targeted interventions to prevent mental health problems among early-maturing girls are critical, there is variability among who might benefit most.

Increased epoch-to-epoch parasympathetic cardiac regulation in participants with posttraumatic stress disorder compared to those with panic disorder and control participants.

BACKGROUND: Research on the link between respiratory sinus arrhythmia (RSA) and posttraumatic stress disorder (PTSD) has largely focused on average levels of RSA. However, given that rapid shifts in parasympathetic tone are necessary to maintain adaptive cardiac variability, the exclusive focus on these tonic estimates provides an incomplete quantification of parasympathetic cardiac regulation. METHOD: The present study is a secondary analysis of previously published data. This analysis aimed to address this limitation by examining the dynamic regulatory effect of the parasympathetic nervous system on heart rate. As such, we examined epoch-to-epoch parasympathetic cardiac regulation - operationalized as the lagged relationship between RSA and heart rate (HR) across consecutive 30-s epochs - across a single night in participants with PTSD, panic disorder (PD), comorbid PTSD and PD (PTSD + PD), and healthy controls. Electrocardiogram and respiratory signals were continuously recorded from 23 participants with PTSD, 14 with PD, 16 with PTSD + PD, and 16 control participants over a single night of sleep in a laboratory setting. RESULTS: No group differences in tonic RSA were observed; however, participants with PTSD only and PTSD + PD exhibited significantly greater epoch-to-epoch parasympathetic cardiac regulation over the night than those with PD only and control participants. Moreover, greater severity of hyperarousal symptoms was significantly associated with increased epoch-to-epoch parasympathetic cardiac regulation among participants with PTSD only and PTSD + PD. DISCUSSION: These data provide preliminary evidence for an upregulatory parasympathetic response to self-reported hyperarousal in participants with PTSD only and PTSD + PD reflected by increased epoch-to-epoch parasympathetic cardiac regulation.

Open trial of a personalized modular treatment for mood and anxiety.

Psychosocial treatments for mood and anxiety disorders are generally effective, however, a number of treated individuals fail to demonstrate clinically-significant change. Consistent with the decades-old aim to identify 'what works for whom,' personalized and precision treatments have become a recent area of interest in medicine and psychology. The present study followed the recommendations of Fisher (2015) to employ a personalized modular model of cognitive-behavioral therapy. Employing the algorithms provided by Fernandez, Fisher, and Chi (2017), the present study collected intensive repeated measures data prior to therapy in order to perform person-specific factor analysis and dynamic factor modeling. The results of these analyses were then used to generated personalized modular treatment plans on a person-by-person basis. Thirty-two participants completed therapy. The average number of sessions was 10.38. Hedges g's for the Hamilton Rating Scale for Depression (HRSD) and Hamilton Anxiety Rating Scale (HARS) were 2.33 and 1.62, respectively. The change per unit time was g = .24/session for the HRSD and g = 0.17/session for the HARS. The current open trial provides promising data in support of personalization, modularization, and idiographic research paradigms.

Evidence for the Feasibility of Person-Specific Ecological Momentary Assessment Across Diverse Populations and Study Designs.

Clinical psychological science has seen an exciting shift toward the use of person-specific (idiographic) approaches to studying psychopathology and change in treatment at the level of the individual. One commonly used method in idiographic research is ecological momentary assessment (EMA). EMA offers a way to sample individuals intensively - often multiple times per day - as they go about their lives. While these methods offer benefits such as greater ecological validity and streamlined data collection, many share concerns about their feasibility across diverse clinical populations. To investigate the feasibility of using EMA to study psychological processes idiographically both in- and out of the context of therapy, the present study aggregated participants across seven studies spanning diverse clinical and community populations (N = 496), all of which utilized an idiographic EMA approach to study symptoms of psychopathology (e.g., PTSD, mood and anxiety, substance abuse). In a series of linear regression models, participant and study design characteristics were used to predict compliance with EMA surveys. Across study designs, we found that (1) participants were willing to report on symptoms and mechanisms relating to a wide range of psychopathological domains; (2) on average, participants completed 82.21% (SD = 16.34%) of all EMA surveys; and (3) compliance with EMA surveys was not significantly related to participant demographics, psychological diagnosis, personality characteristics, or most study characteristics (e.g., number of surveys per day). These findings suggest feasibility of idiographic EMA for collecting the data needed to understand psychopathology and change in treatment at the level of the individual.

Exploring the idiographic dynamics of mood and anxiety via network analysis.

Individual variation is increasingly recognized as important to psychopathology research. Concurrently, new methods of analysis based on network models are bringing new perspectives on mental (dys)function. This current work analyzed idiographic multivariate time series data using a novel network methodology that incorporates contemporaneous and lagged associations in mood and anxiety symptomatology. Data were taken from 40 individuals with generalized anxiety disorder (GAD), major depressive disorder (MDD), or comorbid GAD and MDD, who answered questions about 21 descriptors of mood and anxiety symptomatology 4 times a day over a period of approximately 30 days. The model provided an excellent fit to the intraindividual symptom dynamics of all 40 individuals. The most central symptoms in contemporaneous systems were those related to positive and negative mood. The temporal networks highlighted the importance of anger to symptomatology, while also finding that depressed mood and worry-the principal diagnostic criteria for GAD and MDD-were the least influential nodes across the sample. The method's potential for analysis of individual symptom patterns is demonstrated by 3 exemplar participants. Idiographic network-based analysis may fundamentally alter the way psychopathology is assessed, classified, and treated, allowing researchers and clinicians to better understand individual symptom dynamics. (PsycINFO Database Record

Dynamic RSA: Examining parasympathetic regulatory dynamics via vector-autoregressive modeling of time-varying RSA and heart period.

Expanding on recently published methods, the current study presents an approach to estimating the dynamic, regulatory effect of the parasympathetic nervous system on heart period on a moment-to-moment basis. We estimated second-to-second variation in respiratory sinus arrhythmia (RSA) in order to estimate the contemporaneous and time-lagged relationships among RSA, interbeat interval (IBI), and respiration rate via vector autoregression. Moreover, we modeled these relationships at lags of 1 s to 10 s, in order to evaluate the optimal latency for estimating dynamic RSA effects. The IBI (t) on RSA (t-n) regression parameter was extracted from individual models as an operationalization of the regulatory effect of RSA on IBI-referred to as dynamic RSA (dRSA). Dynamic RSA positively correlated with standard averages of heart rate and negatively correlated with standard averages of RSA. We propose that dRSA reflects the active downregulation of heart period by the parasympathetic nervous system and thus represents a novel metric that provides incremental validity in the measurement of autonomic cardiac control-specifically, a method by which parasympathetic regulatory effects can be measured in process.

Sympathetic and hypothalamic-pituitary-adrenal asymmetry in generalized anxiety disorder.

Physiologic investigations of generalized anxiety disorder (GAD) have skewed toward assessment of the autonomic nervous system, largely neglecting hypothalamic-pituitary-adrenal (HPA) axis variables. Although these systems coordinate-suggesting a degree of symmetry-to promote adaptive functioning, most studies opt to monitor either one system or the other. Using a ratio of salivary alpha-amylase (sAA) over salivary cortisol, the present study examined symmetry between the sympathetic nervous system (SNS) and HPA axis in individuals with GAD (n = 71) and healthy controls (n = 37). Compared to healthy controls, individuals with GAD exhibited greater baseline ratios of sAA/cortisol and smaller ratios of sAA/cortisol following a mental arithmetic challenge. We propose that the present study provides evidence for SNS-HPA asymmetry in GAD. Further, these results suggest that increased SNS suppression in GAD may be partially mediated by cortisol activity.

Graduate admissions in clinical neuropsychology: the importance of undergraduate training.

Discussions of and recommendations for the training of clinical neuropsychologists exist at the doctoral, internship, and post-doctoral level. With few exceptions, the literature on undergraduate preparations in clinical neuropsychology is sparse and lacks empirical evidence. In the present study, graduate-level faculty and current trainees completed surveys about graduate school preparations. Faculty expectations of minimum and ideal undergraduate training were highest for research methods, statistics, and assessment. Preferences for "goodness of fit" also emerged as important admissions factors. These results offer evidence for desirable undergraduate preparations for advanced study in clinical neuropsychology. Although undergraduate training in psychology is intentionally broad, results from this study suggest that students who desire advanced study in clinical neuropsychology need to tailor their experiences to be competitive in the application process. The findings have implications for prospective graduate students, faculty who train and mentor undergraduates, and faculty who serve on admissions committees.