Community-based Sample Research Articles

Prevalence and comorbidity rates of disruptive mood dysregulation disorder in epidemiological and clinical samples: systematic review and meta-analysis.

This systematic review and meta-analysis evaluates the prevalence of disruptive mood dysregulation disorders (DMDD) in community-based and clinical populations. PubMed and PsychINFO databases were searched, using terms specific to DMDD, for studies of prevalence and comorbidity rates conducted in youths below 18. Fourteen studies reporting data from 2013 to 2023 were included. The prevalence of DMDD in the community-based samples was 3.3% (95% confidence interval [CI], 1.4-6.0) and 21.9% (95% CI, 15.5-29.0) in the clinical population. The differences in the identification strategy of DMDD were associated with significant heterogeneity between studies in the community-based samples, with a prevalence of 0.82% (95% CI, 0.11-2.13) when all diagnosis criteria were considered. Anxiety, depressive disorders, and ADHD were the most frequent comorbidity present with DMDD. The association with other neurodevelopmental disorders remained poorly investigated. Caution is required when interpreting these findings, considering the quality of the reviewed data and the level of unexplained heterogeneity among studies. This review stresses the importance of considering a strict adhesion to DMDD criteria when exploring its clinical correlates.

Trauma exposure, contextual stressors, and PTSD symptoms: patterns in racially and ethnically diverse, low-income postpartum women.

Racial, ethnic, and socioeconomic disparities persist in posttraumatic stress disorder (PTSD), which are partly attributed to minoritized women being trauma-exposed, while also contending with harmful contextual stressors. However, few have used analytic strategies that capture the interplay of these experiences and their relation to PTSD. The current study used a person-centered statistical approach to examine heterogeneity in trauma and contextual stress exposure, and their associations with PTSD and underlying symptom dimensions, in a diverse sample of low-income postpartum women. Using a community-based sample of Black, Hispanic/Latina, and White postpartum women recruited from five U.S. regions (n = 1577), a latent class analysis generated profiles of past-year exposure to traumatic events and contextual stress at one month postpartum. Regression analyses then examined associations between class membership and PTSD symptom severity at six months postpartum as a function of race/ethnicity. A four-class solution best fit the data, yielding High Contextual Stress, Injury/Illness, Violence Exposure, and Low Trauma/Contextual Stress classes. Compared to the Low Trauma/Contextual Stress class, membership in any of the other classes was associated with greater symptom severity across nearly all PTSD symptom dimensions (all ps < 0.05). Additionally, constellations of exposures were differentially linked to total PTSD symptom severity, reexperiencing, and numbing PTSD symptoms across racial/ethnic groups (ps < 0.05). A person-centered approach to trauma and contextual stress exposure can capture heterogeneity of experiences in diverse, low-income women. Moreover, racially/ethnically patterned links between traumatic or stressful exposures and PTSD symptom dimensions have implications for screening and intervention in the perinatal period.

Changes in life satisfaction over six years in the general population: A longitudinal study with the Satisfaction With Life Scale (SWLS).

Satisfaction with life is a key concept for most individuals. The Satisfaction With Life Scale (SWLS) for measuring general life satisfaction has been widely analyzed in terms of cross-sectional associations. However, the knowledge about long-term changes in life satisfaction and the associations between such changes and changes in other variables of physical and mental health is limited. A community-based representative sample of the general population has been examined twice with a time interval of six years (n = 4,999), using the SWLS and several other scales. Over the six years, the mean SWLS score of the total sample remained nearly unchanged (M = 27.0, SD = 5.2, both at t1 and at t2). The test-retest correlation was rtt = 0.66 for the total sample, and there were only marginal differences in temporal stability between male and female respondents. Changes in the SWLS over the six years were correlated with changes in optimism (r = 0.23), mental health (r = 0.26), social functioning (r = 0.22), perceived social support (r = 0.21), anxiety (r = -0.30), and physical complaints (r = -0.18). These change score correlations were lower than the corresponding coefficients under the cross-sectional perspective. Measurement invariance across sex, age, and time was established. The SWLS proved to be an appropriate tool for assessing changes in life satisfaction, and correlations between change scores of life satisfaction and health-related variables complement the knowledge about these associations from a cross-sectional perspective.

Factors Associated with the Use of Psychotropic Medication in a Norwegian Community-Based Sample of Adults with Intellectual Disability

Factors Associated with the Use of Psychotropic Medication in a Norwegian Community-Based Sample of Adults with Intellectual Disability

Risk factor, consequence, or common cause? Linking lower self-regulation and internalizing symptoms during middle childhood in a random intercept cross-lagged panel model.

This study investigates whether lower self-regulation (SR) facets are risk factors for internalizing symptoms (vulnerability models), consequences of these symptoms (scar models), or develop along the same continuum and thus share common causes (spectrum models) during middle childhood. To analyze these models simultaneously, a random intercept cross-lagged panel model was estimated using Mplus. Data were assessed at three measurement time points in a community-based sample of N = 1657 (52.2% female) children in Germany, aged 6-13. Internalizing symptoms were measured via parent report by the emotional problems scale of the Strengths and Difficulties Questionnaire. Seven SR facets were assessed behaviorally, via parent report and teacher report. At the within-person level, internalizing symptoms were concurrently associated with emotional reactivity at all measurement time points, while no cross-lagged paths reached significance. At the between-person level, internalizing symptoms were associated with working memory updating (r = -.29, p < .001), inhibitory control (r = -.29, p < .001), planning behavior (r = -.49, p < .001), and emotional reactivity (r = .59, p < .001). As internalizing symptoms and SR facets were primarily associated at the between-person level, the results lend support to spectrum models suggesting common causes of internalizing symptoms and impaired SR.

How does attention deficit/hyperactivity disorder affect driving behavior components? Baseline findings from Persian traffic cohort.

Attention-deficit/hyperactivity disorder (ADHD) increases the risk of road traffic injuries through various mechanisms including higher risky driving behaviors. Therefore, drivers with ADHD are shown to be more prone to road traffic injuries. This study was conducted in a community-based sample of drivers to determine how ADHD affects driving behavior components. At the cross-sectional phase of a national population-based cohort, a representative sample of 1769 drivers were enrolled. Manchester driving behavior questionnaire and Conners' adult ADHD rating scales were used to assess driving behavior and ADHD symptom scores, respectively. Data were analyzed using Stata version 17. Multiple linear regression was used to investigate the association of driving behavior with ADHD while adjusting for the potential confounding role of age, sex, marital status, educational level, driving history, etc. RESULTS: According to the results, the normalized driving behavior score of drivers with ADHD was 4.64 points higher than drivers without ADHD. Having an academic compared to school education, increased the driving behavior score by 1.73 points. The normalized driving behavior score of drivers under 18 years of age was 6.27 points higher than drivers aged 31- 45 years. The score of the aggressive violation subscale of drivers with ADHD was 7.33 points higher than drivers without ADHD compared to an increment of a range of 4.50-4.82 points for other driving subscales. The score of the ordinary violation subscale of female drivers was 2.23 points lower than that of male drivers. No significant relationship was found between sex and other subscales of driving. Drivers with ADHD who are in adolescence or early adulthood exhibit more dangerous and aggressive driving behaviors than those who are older. Implementing training interventions to increase awareness of drivers with ADHD, their families, and psychologists regarding the effects of ADHD on driving is an essential step in preventing motor vehicle crashes among drivers with ADHD.

Experience of Intimate Partner Violence-Related Head Trauma and Its Association With Posttraumatic Stress Disorder and Depression Symptoms Among Community Dwelling Women and Men.

Individuals who experience intimate partner violence (IPV) often report posttraumatic stress disorder (PTSD) and depressive symptoms and IPV-related head trauma (IPV-HT), which can also affect mental health. We aimed to estimate rates of IPV-HT and examine the unique associations of IPV, HT, and IPV-HT with PTSD and depression symptom severity in a community-based sample of cohabitating couples. A total of 413 participants (216 women, 1 non-binary) self-reported lifetime history of HT and physical IPV. Chi-square analyses and Fisher's exact tests were used to compare the proportion of women and men who reported IPV-HT. Kruskal-Wallis tests with Dunn's post-hoc testing and Bonferroni correction were used to compare symptom severity across five groups: (a) IPV-HT, (b) non-IPV-related HT (Other HT) with exposure to physical IPV (IPV-Other HT), (c) Other HT without exposure to physical IPV (No IPV-Other HT), (d) no exposure to HT with exposure to physical IPV (IPV-No HT), and (e) no exposure to HT without exposure to physical IPV (No IPV-No HT). A greater proportion of women than men reported IPV-HT from a fight or being strangled (fight: 50.0% vs. 3.6%, p < .001; Strangulation: 74.1% vs. 3.8%, p < .001). The IPV-HT and IPV-Other HT groups endorsed greater PTSD and depression symptom severity compared to all individuals with no history of physical IPV, regardless of HT exposure (IPV-No HT and IPV-Other HT groups). No differences in symptom severity between the IPV-HT and the other IPV groups (No HT and Other HT) were found. These results suggest that PTSD and depression symptom severity may be driven by experiencing physical IPV, with some exacerbation due to experiencing HT of any etiology. Future work seeking to examine the effects of IPV-HT on PTSD and depression symptom severity should consider any history of physical IPV and any additional HT exposures.

Association between neighborhood walkability and physical activity in a community-based twin sample.

We investigated associations between neighborhood walkability and physical activity using twins (5477 monozygotic and same-sex dizygotic pairs) as "quasi-experimental" controls of genetic and shared environment (familial) factors that would otherwise confound exposure-outcome associations. Walkability comprised intersection density, population density, and destination accessibility. Outcomes included self-reported weekly minutes of neighborhood walking and moderate-to-vigorous physical activity (MVPA) and days per week using transit services (eg, bus, commuter rail). There was a positive association between walkability and walking, which remained significant after controlling for familial and demographic factors: a 1% increase in walkability was associated with a 0.42% increase in neighborhood walking. There was a positive association between walkability and MVPA, which was not significant after considering familial and demographic factors. In twins with at least 1 day of transit use, a 1-unit increase in log (walkability) was associated with a 6.7% increase in transit use days; this was not significant after considering familial and demographic factors. However, higher walkability reduced the probability of no transit use by 32%, considering familial and demographic factors. Using a twin design to improve causal inference, walkability was associated with walking, whereas walkability and both MVPA and absolute transit use were confounded by familial and demographic factors. This article is part of a Special Collection on Environmental Epidemiology.

The Role of "The Talk" and Its Themes in Black Youths' Anticipatory Stress of Police Brutality.

Research on conversations between caregivers and their children about how to prepare or conduct themselves when stopped by police (ie, "the talk") has grown in recent years. However, little is known about how having "the talk" may influence youths' stress about future experiences of police brutality (ie, anticipatory stress of police brutality). The objective of the present study is to examine how youths' anticipatory stress regarding police brutality varies by whether they have had "the talk" with their caregivers. Data come from the Survey of Police-Adolescent Contact Experiences (SPACE), a cross-sectional survey of a community-based sample of Black youth aged 12 to 21years in Baltimore, Maryland (n = 339), collected from August 2022 to July 2023. Multivariable ordinary least squares regressions were conducted to (1) examine associations between "the talk" and anticipatory stress of police brutality among a sample of Black youth in Baltimore and (2) examine the associations between messages in "the talk" and anticipatory stress of police brutality among youth who received "the talk." Findings indicate that having "the talk" was associated with lower anticipatory stress of police brutality. Moreover, among youth who received "the talk," certain messages from parents during "the talk" were associated with significant increases in anticipatory stress of police brutality compared with other messages. Findings underscore the need for a nuanced understanding of "the talk's" broader implications on youth well-being and may be used to expand opportunities for youth to encounter affirmative racial socialization messages.

The gut microbiota genus Blautia is associated with skeletal muscle mass reduction in community-dwelling older Japanese adults: the Wakayama Study.

This cross-sectional study examined the gut microbiota species associated with skeletal muscle mass reduction in a community-based sample of older Japanese adults. The study included 744 participants (320 men and 424 women) aged 65-89years (mean age: 73years) with no history of treatment for colorectal, chronic kidney, or liver diseases. Bioelectrical impedance analysis was performed to estimate the appendicular skeletal muscle mass (ASM) of each participant. The gut microbiota composition was assessed using next-generation sequencing targeting the V3-V4 regions of the prokaryotic 16S rRNA genes. A self-administered questionnaire was used to evaluate daily living habits, including food intake associated with maintaining the gut microbiota. Among the participants, those with reduced muscle mass (defined as an ASM index of less than 4.4kg/m2 for men and 3.7kg/m2 for women) had significantly higher levels of the genus Blautia when compared with those with normal muscle mass (P = 0.009). Logistic regression analysis revealed that the association between the genus Blautia and skeletal muscle mass remained significant even after adjusting for multiple confounding factors (P = 0.012). Additionally, an increase in the genus Blautia was positively associated with excessive alcohol consumption (≥ 20g/day, β = 0.125, P = 0.002) and negatively associated with regular yogurt intake (≥ 1 time/week, β = -0.101, P = 0.010), independent of other lifestyle and dietary factors. Elevated levels of the genus Blautia were associated with reduced skeletal muscle mass in older Japanese adults, suggesting that improving the gut microbiota may be a potential approach to preserving muscle mass among this population.

How do children understand and respond to the EQ-5D-Y-3L? A mixed methods study in a community-based sample of 6–12-year-olds

BackgroundThe EQ-5D-Y-3L is widely used for measuring and valuing HRQoL in paediatric populations. This mixed methods study used the EQ-5D-Y-3L measure and applied a retrospective think-aloud approach to examine the self-report validity in children of varying chronological age.MethodsA mixed methods study was conducted in a community-based sample of 39 children aged 6–12 years. In a semi-structured interview, children self-completed the EQ-5D-Y-3L and then engaged in retrospective think-aloud. Conversations were audio-recorded and transcribed for analysis in NVivo using the Tourangeau four-stage response model framework to assess comprehension, judgment, recall, and response mapping issues. Fisher’s exact test was used to assess the differences between child-self reported HRQoL across subgroups. The inter-rater agreement between child-parent dyads was assessed with CCC for overall HRQoL and Gwet’s AC1 for dimension level HRQoL.ResultsOverall, response issues were detected in n = 18 (46%) children. Comprehension issues were apparent in the “having pain or discomfort” dimension where children found it challenging to understand ‘discomfort’. Recall-related issues were observed where children’s responses were influenced by their typical tendencies (e.g., being usually worried) or past incidences (e.g., feeling pain sometimes). Judgement-related issues were the most common, particularly in the “doing usual activities” dimension, where children tended to respond based on their self-perceived ability to engage in activities rather than health-related limitations. None of the participants were found to have problems with response mapping. A healthy lifestyle that included diet and exercise was a notable consideration in EQ VAS ratings.The younger age groups had a higher proportion of response issues (6–7 years: 64%, 8–10 years: 62%), compared to older children (11–12 years: 20%). Moreover, children with response issues demonstrated significantly lower EQ-5D-Y-3L scores (mean = 0.78, se = 0.04) as compared to those without (mean = 0.95, se = 0.02) (p-value < 0.001). The overall inter-rater agreement was higher for those without any response issues (CCC = 0.33) than those with (CCC = 0.14). Additionally, higher agreement was noted across all the five dimensions in the subgroup with no response issues relative to those with.ConclusionsChildren in the general community may have different perceptions of HRQoL when responding to the EQ-5D-Y-3L possibly due to their limited experience with health-related challenges. The retrospective think-aloud approach adopted highlighted the relatively higher prevalence of response issues in the younger children (ages < 11 years), indicating the need for careful interpretation of self-reported HRQoL using the current version of the EQ-5D-Y-3L in this population.

High-sensitivity cardiac troponin T and N-terminal b-type natriuretic propeptide are associated with cardiac and all-cause mortality in older adults - A population-based ten-year follow-up study.

Cardiac troponin T (cTnT) and N-terminal B-type natriuretic propeptide (proBNP) are mainly used as biomarkers to diagnose specific conditions of the heart, but they also have predictive ability. Our aim was to study their associations with cardiovascular and all-cause mortality in an older population in non-acute conditions. A population-based study with a ten-year follow-up. The data comes from a community-based representative sample of an older population with 1260 participants (participation rate 82 %). Associations were analyzed using Cox proportional hazard models. Altogether, 467 (37%) subjects died during the 10-year follow-up period, and 149 of those of a cardiovascular disease. Both elevated cTnT and proBNP concentrations were statistically significantly associated with cardiovascular and all-cause mortality in older adults. Our study shows that older population with higher cTnT and proBNP concentrations have an increased risk of cardiovascular and all-cause mortality. Acknowledging the elevated risk may aid in targeting follow-up, prevention, and treatment adequately and more individually.

Officer gunpoint during police stops: Repercussions for youth mental health and perceived safety.

Youth-police contact is increasingly acknowledged as a stressor and a racialized adverse childhood experience that can undermine youths' mental health. The present study investigates a particularly distressing feature of youths' direct and witnessed in-person police stops-officer gunpoint (i.e., officers drawing of firearms and pointing them at youth, their peers, or other community members). We examine patterns of youths' officer gunpoint exposure and associations with youth mental health and safety perceptions. Data come from the Survey of Police-Adolescent Contact Experiences (SPACE), a cross-sectional survey of a community-based sample of Black youth ages 12-21 in Baltimore City, Maryland (n = 335), administered from August 2022 to July 2023. Findings indicate that ~33% of youth reporting in-person police stops had been exposed to officer gunpoint during stops. Officer gunpoint was significantly and positively associated with being male, unemployed, having an incarcerated parent, living in a neighborhood with greater disorder, and having been directly stopped by police, in addition to youth delinquency and impulsivity. Net of covariates, experiencing officer gunpoint was associated with a significantly higher rate of youth emotional distress during stops. Significant associations between officer gunpoint and youths' current police violence stress, police avoidance, and diminished safety perceptions also emerged and were largely explained by youths' heightened emotional distress at the time of police stops. Trauma-informed approaches are needed to mitigate the mental health harms of youth experiencing officer gunpoint.

Livin' La Vida Sola: Network Diversity and Well-Being in Middle-Aged Adults Living Alone.

For individuals living alone, having a diverse personal network is considered crucial for mitigating the risk of social isolation and enhancing well-being. Although a reciprocal dynamic between network diversity and well-being is likely, longitudinal evidence supporting reciprocal effects is limited. This study investigates dynamic transactions between network diversity and well-being (life satisfaction, loneliness, and depressiveness) in a community-based sample of middle-aged adults from Germany. It also explores moderations by the duration of living alone. Data were drawn from the three-wave RIKSCHA (Risks and Chances of Living Alone) project, which includes N = 389 middle-aged adults living alone. Cross-lagged panel models revealed high rank-order stabilities and correlated changes in network diversity and well-being. Random-intercept cross-lagged panel models and dynamic panel models indicated that unobserved traits accounted for these high stabilities. Correlated changes disappeared when accounting for the trait-like stability of variables. Across all models, no evidence of reciprocal associations between network diversity and well-being was found. All results remained consistent regardless of the duration of living alone. The study discusses trait factors accounting for the high stabilities observed in network diversity and well-being among middle-aged adults living alone. Future research should further explore the traits impacting successful adaptation to living alone within the context of personal networks.

Wolastoqiyik adaptation of the Aaniish Naa Gegii: the Children's Health and Well-Being Measure.

Indigenous children in Canada represent one of the fastest-growing pediatric populations and experience severe health inequities. There is an ongoing need for new research on relevant methods to measure the health and wellbeing of Indigenous children that considers the cultural differences between communities. The Aaniish Naa Gegii: the Children's Health and Well-Being Measure (ACHWM) is a self-reported questionnaire that was developed to meet this need and to include the voices of Indigenous children. The purpose of this study was to assess the cultural relevance of the ACHWM for Wolastoqiyik children and to determine what revisions may be needed to ensure that the questions are well understood and culturally appropriate. We recruited a community-based sample of nine Wolastoqiyik children (ages 8 to 16 years), two caregivers, and a community Elder within the Madawaska Maliseet First Nation community in New Brunswick. Through a process of cognitive debriefing, we probed children's comprehension of the 62 questions of the First Nation French version of the ACHWM. We analyzed the information reported to determine the participants' understandings relative to the other participants and to the original intent of the ACHWM content. Each of the nine children identified at least one item they recommended for revision during the interview. We observed similarities in the suggestions offered by several respondents. A total of 23 questions were considered, and 14 questions (22.6%) were modified, taking into consideration all participants' suggestions. While measures like the ACHWM offer useful information, relying solely on a 'one size fits all' Indigenous questionnaire is insufficient. Our findings underline the importance of having methods that are easily accessible, adaptable, and culturally appropriate for assessing and addressing Indigenous children's unique health and wellbeing. Such information allows clinicians to develop interventions that are culturally relevant, addressing children's individual needs within the context of their distinct cultural identity.

Physical Activity Environments and Adherence to Health Guidelines in Postsecondary Students

Sedentary lifestyle is one of the greatest contributors to global mortality. From a public health perspective, identifying modifiable factors that reduce sedentary is important. The objective is to examine associations between postsecondary students&amp;rsquo; physical activity environments, including joint physical activity with parents during childhood, engagement in physical activity during adolescence, current parental physical activity, and adherence to screen time and physical activity recommendations during young adulthood. We used a community-based sample of 1,514 Canadian students, aged 17-22 years (60.8% female) enrolled during Fall 2021 and Winter 2022. Participants reported joint physical activity with parents during childhood, engagement in physical activity during adolescence, and current parental physical activity. Participants also self-reported screen time (hours/day), physical activity (minutes of moderate to vigorous intensity/week), and sociodemographic characteristics (age, sex, disability, employment status). Multivariate logistic regressions modeled associations between physical activity environments and adherence to screen time and physical activity recommendations while controlling for sociodemographic characteristics. Engagement in physical activity during adolescence showed a stronger relation with adherence to screen time and physical activity recommendations (odds ratio = 1.42, 95% CI, 1.09-1.83; odds ratio = 2.76, 95% CI, 2.11-3.60). Parental involvement in childhood physical activity was associated with adherence to screen time (odds ratio = 1.30, 95% CI, 1.03&amp;ndash;1.64) and physical activity recommendations (odds ratio = 1.32, 95% CI, 1.03&amp;ndash;1.68). There were no associations with current parental physical activity. Findings highlight the importance of family support for physical activity during childhood and continued activity during adolescence in promoting health.

Coping strategies and perceptions of mental health services among women in South India

Objectives Lack of engagement with mental health services is a challenge for Global Mental Health research and intervention in lower- and middle-income settings. In India particularly, there is a significant treatment gap for people experiencing common mental disorders. This exploratory mixed-method study investigated women’s attitudes toward mental healthcare in Mysuru, India, and investigated what distress copings strategies they used in their everyday lives. Methods We conducted qualitative interviews and administered a depression symptom screener with a community-based sample of 54 adult women. Interviews asked women to comment on their own distress experiences and stress management techniques, as well as their dispositions toward seeking mental healthcare for themselves or others. Results Nearly 65 percent of the study sample screened for any level of depression risk, but only 5 had ever received mental healthcare. Around 20 percent of women stated that they would hypothetically be open to receiving such care. Yet, there was strong agreement across the study sample that mental healthcare was not an appropriate resource for addressing their own distress. Most women who rejected mental healthcare mentioned concerns about stigma and lack of perceived need or treatment inadequacy as their main reasons. Women described a broad range of coping strategies they used for dealing with distress, and which they reported as being effective. Many of these approaches resemble behavioral and talk therapies used in psychology and psychiatry. Conclusions Women in this study generally did not view clinical mental healthcare as an appropriate treatment for their distress. Many already had effective strategies for managing their distress and analogous to existing psychological behavioral and talk therapies. A better understanding of why people reject mental healthcare is necessary for increasing the success of mental health interventions, and for developing new intervention approaches that support coping outside of clinical encounters.

The role of youth extracurricular activities and political intentions in later political participation and civic engagement.

Current literature recognizes that various socialization agents often shape political behavior. This study employs frameworks of political socialization and political agency to explore how extracurricular activities and political intentions established at age 16 influence aspects of political participation and civic engagement at age 20. A 4-year longitudinal study was conducted using a community-based sample of 933 adolescents from a medium-sized Swedish city with a population of approximately 135,000. Data were collected in 2010 and 2014, allowing for an analysis of the impact of extracurricular activities and political intentions developed during adolescence on later political and civic behaviors. The analytical sample comprised 933 individuals (50.8% females; mean age = 16.62, SD = 0.71). The analysis revealed that participation in extracurricular activities at age 16 is a significant predictor of offline political participation at age 20. However, no significant associations were found between these activities and other forms of participation, such as illegal behaviors or broader civic engagement. Political intentions at age 16 also significantly predicted offline political participation at age 20. The findings highlight the pivotal roles of both socialization agents and individual factors related to youth political agency in shaping political trajectories during adolescence. Understanding the effects of extracurricular activities and political intentions on political participation and civic engagement can aid policymakers and educators in developing strategies to foster active citizenship among young people.

Associations between preschooler screen time trajectories and executive function

ObjectivesTo examine associations between preschooler screen time trajectories and executive functions and effortful control at age 5. MethodsProspective, community-based convenience sample of 315 parents of preschoolers (54% male), studied at the ages of 3.5 (2020), 4.5 (2021), and 5.5 (2022). Parent-reported screen use at the ages of 3.5, 4.5, and 5.5 was used to estimate preschooler screen use trajectories. Using latent growth modeling, we identified low (mean=.9 hrs/day, 23%), medium (mean=3.0 hrs/day, 56%), and high (mean=6.38 hrs/day, 21%) screen time groups.Children completed assessments of inhibitory control and cognitive flexibility at age 5.5. Both tasks are from the NIH Toolbox. Parents reported child effortful control at the age of 3.5 and 5.5 using the Children’s Behavior Questionnaire, educational attainment, and parenting stress. ResultsChildren in the average (b =-5.24) and high (b=.9.30) screen time trajectories scored significantly lower on inhibitory control than those in the low screen time group. Children in the average and high screen time groups also scored higher than children in the low screen time group on cognitive flexibility (b =-4.50) and (b=-10.12), respectively. Finally, children in the average and high screen time groups scored lower than children in the low screen time groups on effortful control (b =-.41) and (b=-.61), respectively. ConclusionsThe present study shows that stability in high levels of screen use is common among preschoolers and may forecast higher risk of cognitive difficulty and lower levels of cognitive control by the time of school entry. SummaryHigh levels of preschooler screen use were associated with lower scores on assessments of inhibitory control, cognitive flexibility, and effortful control.

Resting Heart Rate and Incident Atrial Fibrillation in Black Adults in the Jackson Heart Study

Resting heart rate (RHR) is a widely available measure of cardiovascular fitness that has been associated with several cardiovascular outcomes. RHR has previously been associated with the risk of atrial fibrillation (AF) among individuals of European ancestry, but little is known about this association in Black adults. To evaluate the association between RHR and incident AF in a large community-based sample of Black adults, independently of established risk factors. This cohort study uses data from the Jackson Heart Study, a prospective community-based cohort in Jackson, Mississippi. Participants without prevalent AF were included and were monitored for new-onset AF during follow-up, from 2000 through 2016. Data analysis was performed from August 1 to December 11, 2023. RHR was assessed from resting 12-lead electrocardiograms performed at examination 1 (2000-2004) and examination 3 (2009-2013). AF was identified from study electrocardiograms, hospitalization discharge diagnosis codes, and Medicare claims diagnosis codes. Cox regression was used to evaluate the association between baseline (examination 1) RHR and incident AF, adjusting for established AF risk factors. Among 4965 Black adults eligible for analysis, the mean (SD) age was 55 (13) years, 1830 (37%) were male, and the mean (SD) RHR at baseline was 65 (11) beats per minute (bpm). During a median (IQR) 14 (12-15) years of follow-up, there were 458 incident AF events, resulting in an incident rate of 7.5 per 1000 person-years (95% CI, 6.8-8.2 incidents per 1000 person-years). Each 10-bpm higher RHR was associated with a 9% higher risk of incident AF after adjustment for AF risk factors (hazard ratio, 1.09; 95% CI, 1.00-1.19). In a sensitivity analysis that excluded individuals with prior heart failure, prior myocardial infarction, and antiarrhythmic medication use at baseline, the hazard ratio was 1.14 (95% CI, 1.02-1.28). There was little evidence of effect modification of these associations by age, sex, body mass index, hypertension, or physical activity level. In this large prospective cohort study of Black adults, elevated baseline RHR was associated with increased risk of incident AF, consistent with findings from previous studies of European ancestry populations. Future research should focus on determining whether RHR can be used to screen patients at high risk of AF.