Background: The RU_SATED scale is a multidimensional instrument measuring sleep health, consisting of Regularity, Satisfaction, Alertness, Timing, Efficiency, Duration dimensions. We adapted and validated the Chinese RU_SATED (RU_SATED-C) scale. Methods: The RU_SATED-C scale was developed through a formal linguistic validation process and was validated in an observational longitudinal survey design. Healthcare students completed the RU_SATED scale, Sleep Quality Questionnaire, and Patient Health Questionnaire-4 among two sites of Hangzhou and Ningbo, China. Psychometric assessments included structural validity, longitudinal measurement invariance, convergent and divergent validity, internal consistency, and test–retest reliability. Results: A total of 911 healthcare students completed the RU_SATED-C scale at baseline (Time 1, T1) and follow-up (Time 2, T2) with an average time interval of 7 days + 5.37 h. Confirmatory factor analysis (CFA) confirmed a single-factor model and resulted in an acceptable model fit. The two-factor model previously found in the Japanese version fit better than the one-factor model, whereas the one-factor model fit had a better fit than the two-factor model found in the English version. Longitudinal CFA resulted in negligible changes in fit indices for four forms of increasingly restrictive models and supported that a single-factor model was equivalent over time. The data also endorsed longitudinal measurement invariance among the two-factor models found in the English and Japanese samples. The RU_SATED-C scale total score displayed a moderately strong negative correlation with sleep quality; however, negligible associations were observed with anxiety and depression. Ordinal Cronbach’s alpha and Ordinal McDonald's omega at T1 and T2 ranged from suboptimal to acceptable. The RU_SATED-C scale and all items were significantly correlated across time intervals. Conclusion: The RU_SATED-C scale is an easy-to-use instrument with potentially valid data for the measurement of multidimensional sleep health. Use of the RU_SATED-C scale can help raise awareness of sleep health and could pave the way for important efforts to promote healthy sleep.
Prior studies of oil spills have reported adverse impacts on mental health, but have not examined some potentially important moderators. In this cross-sectional analysis of n = 38,361 responses to the 2010–2011 Gulf States Population Survey, we assessed the association of direct oil contact with depression severity following the Deepwater Horizon oil spill, and modification by self-mastery, emotional support, and cleanup participation using Tobit regression models accounting for the complex survey design. Oil contact was associated with increased depression severity. Among respondents with oil contact, depression was more severe for those reporting lower self-mastery. However, respondents with oil contact had lower depression severity if they participated in cleanup efforts, compared to exposed individuals who did not participate. This potential protective effect was larger for respondents with lower self-mastery. Our results are consistent with the notion that participation in recovery efforts may reduce depressive symptoms following oil spills among impacted individuals.
BACKGROUND: Depression and depressive symptoms are risk factors for hypertension (HTN) and cardiovascular disease (CVD). Hispanic women have higher rates of depressive symptoms compared to other racial/ethnic groups yet few studies have investigated its association with incident prehypertension and hypertension among postmenopausal Hispanic women. This study aims to assess if an association exists between baseline depression and incident hypertension at 3 years follow-up among postmenopausal Hispanic women.
METHODS: Prospective cohort study, Women's Health Initiative (WHI), included 4,680 Hispanic women who participated in the observational and clinical trial studies at baseline and at third-year follow-up. Baseline current depressive symptoms and past depression history were measured as well as important correlates of depression-social support, optimism, life events and caregiving. Multinomial logistic regression was used to estimate prevalent and incident prehypertension and hypertension in relation to depressive symptoms.
RESULTS: Prevalence of current baseline depression ranged from 26% to 28% by hypertension category and education moderated these rates. In age-adjusted models, women with depression were more likely to be hypertensive (OR = 1.25; 95% CI 1.04-1.51), although results were attenuated when adjusting for covariates. Depression at baseline in normotensive Hispanic women was associated with incident hypertension at year 3 follow-up (OR = 1.74; 95% CI 1.10-2.74) after adjustment for insurance and behavioral factors. However, further adjustment for clinical covariates attenuated the association. Analyses of psychosocial variables correlated with depression but did not alter findings. Low rates of antidepressant medication usage were also reported.
CONCLUSIONS: In the largest longitudinal study to date of older Hispanic women which included physiologic, behavioral and psychosocial moderators of depression, there was no association between baseline depressive symptoms and prevalent nor incident pre-hypertension and hypertension. We found low rates of antidepressant medication usage among Hispanic women suggesting a possible point for clinical intervention.
The aim of this paper is to examine coping behaviors in the context of discrimination and possible gender-specific differences among a national sample of African American adults in the 2001–2003 National Survey of American Life (NSAL). Results show that in multivariable logistic regression models, African American women (vs. African American men) were less likely to accept discrimination as a fact of life but were more likely to get mad about experiences of discrimination, pray about it, and talk to someone. After adjusting for differences in the frequency of discrimination, African American women were also significantly more likely to try to do something about it. African American men were more likely to accept discrimination as a fact of life with higher frequency of day-to-day discrimination while women tended to talk to someone with a higher frequency of day-to-day discrimination and lifetime discrimination. These findings suggest gender differences in behavior concerning discrimination.
Objective: This study examined cancer knowledge in adolescent and young adult (AYA) survivors and pilot tested a Web-based resource to provide individually tailored information regarding cancer treatment history, late effects risk, and resources.
Methods: Fifty-two survivors (15–28 years old) who completed cancer treatment were recruited from the University of Minnesota oncology clinics. Participants were randomly assigned to receive access to personalized health history, late effects information, and resources via a password-protected Web portal or to standard of care (physician counseling) only. Participants completed surveys measuring cancer knowledge, health locus of control, and psychosocial well-being prior to randomization and approximately 1 year later.
Results: Overall, few participants accurately reported their chemotherapy history with detail (19% at baseline and 33% at follow-up), and many did not recognize that previous cancer treatments could impact future health (60% at baseline and 54% at follow-up). Among those randomized to the receive access to the website, utilization was very low, making it difficult to draw conclusions about efficacy. Nonetheless, these data suggest that offering tailored information through the Web was not more effective than standard of care at improving cancer knowledge. Anxiety and health beliefs were associated with cancer knowledge, including knowledge of steps survivors could take to mitigate late effects risks (p < 01).
Conclusions: Knowledge gaps exist among AYA survivors regarding important aspects of their treatment histories and ongoing health risks. Offering purely educational information (either in person by providers or via the Web) does not appear to be enough to close this gap.
Several models of anxiety in autistic adults have focused on the role of intolerance of uncertainty which has biological and evolutionary bases, as a cognitive explanation for the high prevalence of anxiety in autism. This framework suggests that all people are born with a healthy level of intolerance of uncertainty, and as we develop, this intolerance is lessened as we learn when situations are safe and begin to understand and manage the uncertainty. This process of learning about managing uncertainty does not happen in the same way in those who are high in autistic traits, which could be the reason for the high levels of anxiety symptoms commonly seen in this population. We examined archival data of 199 non-autistic and 55 autistic adults from prior studies in which we collected self-report measures of autistic traits, intolerance of uncertainty, sensory processing, and anxiety. We conducted two path analyses to examine the role of intolerance of uncertainty in anxiety in autistic adults. The first model tested the idea that intolerance of uncertainty, an evolutionary phenomenon common for all people, could explain some of the cognitive aspects of anxiety in autism. The second model suggests that primary neurodevelopmental differences associated with autistic traits underlie the sensory sensitivity and sensory seeking behaviors, which in turn increase intolerance of uncertainty and subsequent anxiety. We found that the “neurodevelopmental” model had better model fit than the “evolutionary stress” model, suggesting that the neurodevelopmental impact of higher levels of autistic traits could moderate a non-autistic trajectory of learning to manage uncertainty as children develop and understand that uncertainty is common and acceptable.
by
Andrew Paladino;
Janeane N. Anderson;
Carolyn Graff;
Rebecca Krukowski;
Ryan Blue;
Tameka Jones;
Joanne Buzaglo;
Mehmet Kocak;
Gregory Vidal;
Ilana Graetz
Objective: Social support is a critical component of breast cancer care and is associated with clinical and quality of life outcomes. Significant health disparities exist between Black and White women with breast cancer. Our study used qualitative methods to explore the social support needs of Black and White women with hormone receptor-positive breast cancer on adjuvant endocrine therapy (AET).
Methods: We conducted four focus group (FG) interviews (N = 28), stratified by race (ie, Black and White) and time on AET. FGs were audiotaped, transcribed, and analyzed according to conventions of thematic analysis.
Results: Participants noted the importance of having their informational and emotional social support needs met by friends and family members. White participants reported support provided by others with breast cancer was crucial; Black women did not discuss other survivors as part of their networks. Notably, both White and Black participants used the FG environment to provide experiential social support to each other.
Conclusions: White participants noted that having other breast cancer survivors in their support network was essential for meeting their social support needs. However, Black participants did not reference other breast cancer survivors as part of their networks. Cancer centers should consider reviewing patients' access to experiential support and facilitate opportunities to connect women in the adjuvant phase.
Objectiv:e DNA methylation has been associated with both early life stress and depression. This study examined the combined association of DNA methylation at multiple CpG probes in five stress-related genes with depressive symptoms and tested whether these genes methylation mediated the association between childhood trauma and depression in two monozygotic (MZ) twin studies.
Methods: The current analysis comprised 119 MZ twin pairs (84 male pairs [mean = 55 years] and 35 female pairs [mean = 36 years]). Peripheral blood DNA methylation of five stress-related genes (BDNF, NR3C1, SLC6A4, MAOA, and MAOB) was quantified by bisulfite pyrosequencing or 450K BeadChip. We applied generalized Poisson linear-mixed models to examine the association between each single CpG methylation and depressive symptoms. The joint associations of multiple CpGs in a single gene or all five stress-related genes as a pathway were tested by weighted truncated product method. Mediation analysis was conducted to test the potential mediating effect of stress gene methylation on the relationship between childhood trauma and depressive symptoms.
Results: Multiple CpG probes showed nominal individual associations, but very few survived multiple testing. Gene-based or gene-set approach, however, revealed significant joint associations of DNA methylation in all five stress-related genes with depressive symptoms in both studies. Moreover, two CpG probes in the BDNF and NR3C1 mediated approximately 20% of the association between childhood trauma and depressive symptoms.
Conclusions: DNA methylation at multiple CpG sites are jointly associated with depressive symptoms and partly mediates the association between childhood trauma and depression. Our results highlight the importance of testing the combined effects of multiple CpG loci on complex traits and may unravel a molecular mechanism through which adverse early life experiences are biologically embedded.
Ample research links mothers’ postpartum depression (PPD) to adverse interactions with their infants. However, most studies relied on general population samples, whereas a substantial number of women are at elevated depression risk. The purpose of this study was to describe mothers’ interactions with their 6- and 12-month-old infants among women at elevated risk, although with a range of symptom severity. We also identified higher-order factors that best characterized the interactions and tested longitudinal consistency of these factors from 6 to 12 months of infant age. We leveraged data from eight projects across the United States (n = 647), using standardized depression measures and an adaptation of the NICHD Mother-Infant Interaction Scales. Overall, these depression-vulnerable mothers showed high levels of sensitivity and positive regard and low levels of intrusiveness, detachment, and negative regard with their infants. Factor analyses of maternal behaviors identified two overarching factors—“positive engagement” and “negative intrusiveness” that were comparable at 6 and 12 months of infant age. Mothers’ ability to regulate depressed mood was a key behavior that defined “positive engagement” in factor loadings. An exceptionally strong loading of intrusiveness on the second factor suggested its central importance for women at elevated depression risk. Mothers with severe depressive symptoms had significantly more “negative intrusiveness” and less “positive engagement” with their 6-month-old infants than women with moderate or fewer depressive symptoms, suggesting a potential tipping point at which symptoms may interfere with the quality of care. Results provide the foundation for further research into predictors and moderators of women’s interactions with their infant among women at elevated risk for PPD. They also indicate a need for evidence-based interventions that can support more severely depressed women in providing optimal care.
Although research has shown that mothers significantly influence daughters' willingness to be vaccinated against the human papillomavirus (HPV), cultural factors influencing immigrant Haitian mothers' willingness to have adolescent daughters to be vaccinated are unknown. This is of concern as this population experiences disproportionately higher rates of HPV infection and related cervical cancers. This study identifies cultural beliefs influencing 31 immigrant Haitian mothers' willingness to vaccinate their daughters against HPV using semistructured interviews. Mothers had low levels of HPV and HPV vaccine knowledge, and desired more information. Concerns centered on cultural values regarding adolescent sexuality and HIV/AIDS stigmas specific to Haitian communities. If vaccination were recommended by a physician, mothers are more likely to have their daughters vaccinated. HPV vaccination uptake efforts targeting Haitian months should emphasize physician involvement and incorporate culturally relevant health concerns.