Mechanisms linking daily pain and depressive symptoms: the application of diary assessment and bio-psycho-social profiling

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Description
Despite the strong link between pain and depressive symptoms, the mechanisms by which they are connected in the everyday lives of individuals with chronic pain are not well understood. In addition, previous investigations have tended to ignore biopsychosocial individual difference

Despite the strong link between pain and depressive symptoms, the mechanisms by which they are connected in the everyday lives of individuals with chronic pain are not well understood. In addition, previous investigations have tended to ignore biopsychosocial individual difference factors, assuming that all individuals respond to pain-related experiences and affect in the same manner. The present study tried to address these gaps in the existing literature. Two hundred twenty individuals with Fibromyalgia completed daily diaries during the morning, afternoon, and evening for 21 days. Findings were generally consistent with the hypotheses. Multilevel structural equation modeling revealed that morning pain and positive and negative affect are uniquely associated with morning negative pain appraisal, which in turn, is positively related to pain’s activity interference in the afternoon. Pain’s activity interference was the strongest predictor of evening depressive symptoms. Latent profile analysis using biopsychosocial measures identified three theoretically and clinically important subgroups (i.e., Low Functioning, Normative, and High Functioning groups). Although the daily pain-depressive symptoms link was not significantly moderated by these subgroups, individuals in the High Functioning group reported the lowest levels of average morning pain, negative affect, negative pain appraisal, afternoon pain’s activity interference, and evening depressive symptoms, and the highest levels of average morning positive affect across 21 days relative to the other two groups. The Normative group fared better on all measures than did the Low Functioning group. The findings of the present study suggest the importance of promoting morning positive affect and decreasing negative affect in disconnecting the within-day pain-depressive symptoms link, as well as the potential value of tailoring chronic pain interventions to those individuals who are in the greatest need.
Date Created
2017
Agent

Adolescents' emotional well-being during developmental turning points: help and hindrance from interpersonal relationships

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Description
In two complementary studies, I used an innovative ecological momentary assessment (EMA) design to examine associations between adolescents’ daily interactions with parents and peers and their mood states during two developmentally normative, yet demanding contexts: romantic relationships and the transition

In two complementary studies, I used an innovative ecological momentary assessment (EMA) design to examine associations between adolescents’ daily interactions with parents and peers and their mood states during two developmentally normative, yet demanding contexts: romantic relationships and the transition to college. The first study examined how adolescents’ daily romantic relationship experiences (e.g., romantic emotionality, conflict, affiliation) were related to negative affective states. Eighty-eight adolescent romantic couples (Mage = 16.74 , SD = 0.96; 44% Latina/o, 42% White) completed short electronic surveys twice-weekly for 12 weeks, which assessed their affective states and their relationship processes (24 total possible surveys). Results indicated that greater conflict and negative romantic emotionality predicted greater within-person fluctuations in same-day negative affect. Greater daily affiliation with a romantic partner predicted slightly lower levels of same-day negative affect; positive romantic emotionality did not significantly predict negative affect.

Study 2 examined first-year college students’ growth trajectories in positive and negative affect across the transition to college (i.e., spanning the entire first semester), predicted said trajectories and daily affective states. Participants were 146 first-year college students from a large southwestern university entering their first semester of college (Mage = 17.8, SD = 0.5). Electronic diary surveys were administered to students twice weekly between July and December of 2014, so as to span the transition to college and the entire first semester, and assessed daily affective states and interpersonal interactions. Results indicated that students decreased in their positive affect gradually across the first semester, but remained stable in their negative affect. Significant variability emerged around these average trends, and was predicted by indices of conflict and involvement with parents and friends. Generally, greater involvement with friends and parents was associated with greater positive and less negative affect, whereas greater conflict with these important social groups predicted greater negative affect. Together, these studies underscore the importance of positive attachments during developmentally-challenging contexts experienced in adolescence.
Date Created
2017
Agent

Observed parenting practices in early childhood as predictors of child weight status and behavioral problems at age 10

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Description
Pediatric obesity is a public health concern due to its elevated prevalence rates and its relation to concurrent and long-term physical and psychosocial consequences. Pediatric obesity has been found to be associated with problem behaviors, albeit with inconsistent findings.

Pediatric obesity is a public health concern due to its elevated prevalence rates and its relation to concurrent and long-term physical and psychosocial consequences. Pediatric obesity has been found to be associated with problem behaviors, albeit with inconsistent findings. The mechanism of this relation is unclear. It is possible that they have a shared etiology. Self-regulation and parenting practices are two factors that have been implicated in the development of problem behaviors and are garnering evidence for their relation with pediatric obesity. The goal of the present study was to examine whether self-regulation (SREC), positive behavior support (PBSEC), and coercive limit-setting (CLSEC) in early childhood are shared etiological factors of pediatric obesity and problem behaviors. Using multinomial logistic regression the likelihood of belonging to four outcome groups (Comorbid, Problem behavior only, Overweight only, and Typically developing) at age 10 based on these factors was assessed. Analyses controlled for intervention group assignment, child gender, child African-American or Bi-racial, child Hispanic, cumulative risk, child body size impression at age 2, and parent body size impression at baseline. In the models examining SREC alone, for every 1 standard deviation increase in SREC, there was a reliable reduction in the odds of the child belonging to the comorbid and problem behavior only groups at age 10, compared to the typically developing group (OR = 0.386, 95% CI [0.237, 0.628], OR = 0.281, 95% CI [0.157, 0.503], respectively). This relation was maintained when SREC was in the same model as PBSEC and CLSEC. PBSEC and CLSEC alone did not impact the likelihood of belonging to any of the outcome groups. A significant interaction was found between SREC and CLSEC, such that at high levels of both SREC and CLSEC the odds of a child belonging to the overweight only group at age 10 increased, compared to the typically developing group. Results highlight CLSEC as a parenting practice that may place a highly regulated child at risk for becoming overweight. Overall, the findings suggest that problem behaviors and pediatric obesity do not have a shared etiology.
Date Created
2016
Agent

Predicting variation in responsiveness to the family check-up in early childhood: a mixture model approach

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Description
The present study applied latent class analysis to a family-centered prevention

trial in early childhood to identify subgroups of families with differential responsiveness to the Family Check-up (FCU) intervention. The sample included 731 families of 2-year- olds randomized to the FCU

The present study applied latent class analysis to a family-centered prevention

trial in early childhood to identify subgroups of families with differential responsiveness to the Family Check-up (FCU) intervention. The sample included 731 families of 2-year- olds randomized to the FCU or control and followed through age five with yearly follow up assessments (Dishion et al., 2014; Shaw et al., 2015). A two-step mixture model was used to examine whether specific constellations of family characteristics at age 2 (baseline) were related to intervention response at age 3, 4, and 5. The first step empirically identified latent classes of families based on a variety of demographic and adjustment variables selected on the basis of previous research on predictors of response to the FCU and parent training in general, as well as on the clinical observations of FCU implementers. The second step modeled the effect of the FCU on longitudinal change in children's problem behavior in each of the empirically derived latent classes. Results suggested a five-class solution, where a significant intervention effect of moderate-to- large size was observed in one of the five classes. The families within the responsive class were characterized by child neglect, legal problems, and mental health issues. Pairwise comparisons revealed that the intervention effect was significantly greater in this class of families than in two other classes that were generally less at risk for the development of disruptive behavior problems, and post hoc analyses partially supported these results. Thus, results indicated that the FCU was most successful in reducing child problem behavior in the highly distressed group of families. We conclude by discussing the potential practical utility of these results and emphasizing the need for future research to evaluate this approach's predictive accuracy.
Date Created
2016
Agent

Collateral effects of a family-focused behavioral intervention on physical activity

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Description
There are significant and wide-ranging health benefits of physical activity, yet the majority of adolescents in the United States do not engage in the recommended amount. This poses a significant public health challenge. Parents have a substantial influence on adolescents'

There are significant and wide-ranging health benefits of physical activity, yet the majority of adolescents in the United States do not engage in the recommended amount. This poses a significant public health challenge. Parents have a substantial influence on adolescents' levels of activity, indicating that parenting may be an especially salient target of interventions designed to promote physical activity. The current study tested the hypothesis that a family intervention to promote effective parenting would have a positive collateral effect on adolescent physical activity. This study also tested whether the increase in activity was mediated by changes in parental monitoring and family relationship quality. Furthermore, the current study assessed whether adolescent gender moderated the relationship between parental monitoring and physical activity, such that increased parental monitoring predicted increases in physical activity for girls, but not for boys. Participants were 232 adolescents at risk for behavior problems drawn from a larger randomized controlled trial of the Family Check-Up. Adolescents completed questionnaires and participated in a family assessment with their caregivers in the 6th through 9th grades. Youth randomized to the intervention reported significantly more physical activity at follow-up relative to controls. Results failed to confirm the role of family factors as mediators of the effect of the intervention on physical activity. When gender was considered as a moderator, it appeared that parental monitoring was strongly and positively correlated with physical activity for girls, but not for boys. While the mechanism by which the Family Check-Up leads to increased physical activity remains unclear, its robust effects suggest that family intervention can be used to promote physical activity and might therefore have further-reaching health benefits.
Date Created
2015
Agent

A multi-method examination of mother-infant synchrony as a predictor of social and emotional problems

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Description
The parent-child relationship is one of the earliest and most formative experiences for social and emotional development. Synchrony, defined as the rhythmic patterning and quality of mutual affect, engagement, and physiological attunement, has been identified as a critical quality of

The parent-child relationship is one of the earliest and most formative experiences for social and emotional development. Synchrony, defined as the rhythmic patterning and quality of mutual affect, engagement, and physiological attunement, has been identified as a critical quality of a healthy mother-infant relationship. Although the salience of the quality of family interaction has been well-established, clinical and developmental research has varied widely in methods for observing and identifying influential aspects of synchrony. In addition, modern dynamic perspectives presume multiple factors converge in a complex system influenced by both nature and nurture, in which individual traits, behavior, and environment are inextricably intertwined within the system of dyadic relational units.

The present study aimed to directly examine and compare synchrony from three distinct approaches: observed microanalytic behavioral sequences, observed global dyadic qualities, and physiological attunement between mothers and infants. The sample consisted of 323 Mexican American mothers and their infants followed from the third trimester of pregnancy through the first year of life. Mothers were interviewed prenatally, observed at a home visit at 12 weeks postpartum, and were finally interviewed for child social-emotional problems at child age 12 months. Specific aspects of synchrony (microanalytical, global, and physiological) were examined separately as well as together to identify comparable and divergent qualities within the construct.

Findings indicated that multiple perspectives on synchrony are best examined together, but as independent qualities to account for varying characteristics captured by divergent systems. Dyadic relationships characterized by higher reciprocity, more time and flexibility in mutual non-negative engagement, and less tendency to enter negative or unengaged states were associated with fewer child social-emotional problems at child age 12 months. Lower infant cortisol was associated with higher levels of externalizing problems, and smaller differences between mother and child cortisol were associated with higher levels of child dysregulation. Results underscore the complex but important nature of synchrony as a salient mechanism underlying the social-emotional growth of children. A mutually engaged, non-negative, and reciprocal environment lays the foundation for the successful social and self-regulatory competence of infants in the first year of life.
Date Created
2015
Agent

A transdiagnostic approach to understanding psychopathology in late adolescents: parent-adolescent relationship dynamics discriminate latent classes of psychological adjustment

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Description
Comorbidity is a significant problem for current classification systems of psychopathology (i.e., DSM-V). One issue is that the underlying mechanisms shared among comorbid disorders are poorly understood, especially potential psychosocial mechanisms such as family dynamics. The current study used latent

Comorbidity is a significant problem for current classification systems of psychopathology (i.e., DSM-V). One issue is that the underlying mechanisms shared among comorbid disorders are poorly understood, especially potential psychosocial mechanisms such as family dynamics. The current study used latent class analysis to empirically classify patterns of psychopathology within a large community sample of late adolescents (age 18-19) based on their lifetime psychological adjustment measured using the World Health Organization Composite International Diagnostic Interview. Videotaped family interactions of adolescents (age 16-17) and their parents were micro and macro coded and the resulting family dynamics were compared across the three empirically defined groups of psychological adjustment which emerged from the latent class analysis: 1) an early onset, persistent antisocial behavior class; 2) an emotionally distressed and substance using class; and 3) a typically developing class. It was found that some directly observed family dynamics, including parental monitoring, dyadic positive engagement and coercive engagement discriminated among empirically derived classes. It was also found that particular tasks better discriminated among classes with regard to specific family dynamics (e.g., family activity task best discriminated among classes on dyadic positive engagement). Overall, findings suggest that novel methodologies like latent class analysis can be useful in attempting to map underlying transdiagnostic mechanisms onto the current diagnostic framework. The findings also highlight the importance of taking many variables into consideration when attempting to understand how family dynamics are associated with psychological adjustment.
Date Created
2015
Agent