Latent Class Growth Modeling Research Articles

Developmental trajectories of interpersonal stress in school and psychological pain contributing to self-harm in adolescents.

This study investigated the trajectories of interpersonal stress and psychological pain and their effects on self-harm behaviors in adolescents and explored the reciprocal associations between interpersonal stress and NSSI/SA. The participants included 1149 adolescents (50.3% women; Mage = 12.86, SD = 0.69) who participated in three waves of data collection. Latent class growth models and cross-lagged panel models were used to identify subgroups of individuals and interactions between interpersonal stress and NSSI/SA. Controlling for sex and age, compared to the low interpersonal stress class, the moderate to high and increasing classes have higher risks of NSSI and SA. Compared to adolescents in the low increasing feelings with high increasing avoidance class, those in the low increasing feelings with low decreasing avoidance class reported lower probabilities of NSSI and SA. Pain avoidance and painful feelings mediated the pathway from interpersonal stress to NSSI/SA, whereas pain arousal mediated the pathway from NSSI/SA to interpersonal stress. Shared impact of interpersonal stress and distinct effects of psychological pain over time on maintaining and distinguishing self-harm behaviors were found. Adolescent crisis interventions should simultaneously focus on building social networks within the school context and regulating maladaptive minds.

Longitudinal trajectories of frailty and cognitive decline among older Korean cancer survivors

This study aimed to identify frailty trajectories among older adults diagnosed with cancer, as well as the impacts of frailty trajectories on cognitive decline at an eight-year follow-up. We used longitudinal data from the Korean Longitudinal Study of Aging. A total of 173 older Korean cancer survivors were included in our analysis. Frailty and cognitive function were assessed using the multi-domain frailty index and the Korean version of the mini mental state examination, respectively. Latent class growth modeling and multivariate logistic regression were employed. Two distinct frailty trajectories were identified: “low and stable” (75.1%) and “moderate and increasing” (24.9%). Older cancer survivors in the “moderate and increasing” frailty group were 4.89 times more likely to experience cognitive decline at the eight-year follow-up than their counterparts in the “low and stable” frailty group. Periodic evaluation and timely management of frailty could contribute to preventing cognitive decline among older cancer survivors.

Trajectories of lipid profile during adolescence and risk of subclinical atherosclerosis in early adulthood: a two-decade population-based study

Abstract Background/Introduction Recent studies have shown the highest burdens of premature cardiovascular diseases (CVDs) in the Middle-eastern, and North Africa (MENA) region. The role of dyslipidemia, as a major metabolic disturbance, in the progression of subclinical atherosclerosis and subsequently premature CVDs, indicated by carotid intima-media thickness (cIMT), must not be overlooked, specifically in young adults. Purpose To examine the impact of early-life lipid profile trajectories in adolescence on subclinical atherosclerosis, evidenced by cIMT in adulthood. Methods In this trajectory analysis, with 1006 participants (472 male, mean age=14.72±3.23 years), latent class growth modeling, particularly Group-based multi-trajectory modeling (GBMTM) was used to analyze the heterogeneity in the longitudinal lipid alterations (total cholesterol [TC], triglycerides [TG], high-density lipoprotein cholesterol [HDL-C], low-density lipoprotein cholesterol [LDL-C], and non-HDL-C). The trajectories were named based on direction (rising/decreasing) and slopes of the associated trends in lipid alterations (stable/ slow/ rapid). The association between lipid trajectories, and cIMT values, both as continuous and categorical variables, were evaluated using multivariate regression analysis adjusted for age, sex, body mass index, and systolic blood pressure at the baseline, as well as antihypertensive and lipid-lowering drug use, smoking, physical activity, and desired lipid parameter at the nearest survey to cIMT measurement. Results During a median follow-up of 17.6 years, the "Rising" trajectories of TC, TG, LDL-C, and non-HDL-C were linked to elevated cIMT values (in the fully-adjusted model beta-coefficients [βs]=0.08 [-0.01,0.14], 0.11 [0.05,0.17], 0.13 [0.05,0.21], and 0.12 [0.06,0.18], respectively). The "Rapid-Rising" trajectories of TG, LDL-C, and non-HDL-C notably amplified the risk (in the fully-adjusted model odds ratios (OR)=2.05 [1.46-2.75], 1.99 [1.35-2.92], and 2.02 [1.45-2.77], respectively). Conversely, the "Decreasing" trajectories of TC, LDL-C, and TG were associated with lower cIMT measures (βs =-0.09 [-0.16,-0.03], -0.11 [-0.17,-0.01], and -0.08 [-0.14,-0.02], respectively); also "Decreasing" trajectories of TC and LDL-C lowered the risk by at least 30% in the fully-adjusted model (ORs=0.59 [0.39-0.81] and 0.68 [0.41-1.02], respectively). While HDL-C "Rapid-Decreasing" trajectory doubled the risk of elevated cIMT (OR=1.98 [1.47-2.68]). Conclusion The findings showed the unfavorable trajectory alterations in all lipid parameters were significantly associated with higher cIMT values, underscoring the need for sustained efforts to monitor lipid levels from early adolescence.

Trajectories of depressive symptoms in early to mid-adolescence: associations with school pedagogical and social climate.

Adolescence is a critical period for mental health development, yet research exploring how contextual factors influence the development of depressive symptoms remains limited. This study explored trajectories of depressive symptoms during early to mid-adolescence and their association with various aspects of school climate. The study sample comprised 3671, 7th-grade students (aged 12-13 years) from 101 schools across Sweden, followed longitudinally across three time points spanning grades 7, 8 and 9. Depressive symptom trajectories were identified using latent class growth modelling. The Pedagogical and Social Climate questionnaire assessed school climate, and multinomial logistic regression was employed to predict trajectory membership based on sociodemographic and school climate factors. Four distinct developmental patterns of depressive symptoms emerged: 'Sustained low symptoms' (76.7%), 'Low-increasing' (10.9%), 'Sustained high symptoms' (7.9%), and 'High-decreasing' (4.5%). Gender, parental education and six specific school climate factors, out of the total 19 examined, significantly distinguished these trajectory classes. Positive teacher expectations and strong principal involvement were associated with more favourable trajectories, whereas teaching activities, teacher support and communication between school and home were associated with less favourable trajectories, suggesting a nuanced understanding of their relationship with depressive symptom trajectories. Few school factors were found to be relevant to depressive symptoms, highlighting the importance of considering external factors beyond the school environment in supporting adolescents during this developmental stage. Although the findings are multifaceted, it is primarily positive interpersonal relationships, especially through teacher expectations, that stand out as significant factors in promoting youth mental health.

Sex-specific co-developmental trajectories of childhood victimization among elementary school students: Relations to social behavior

This study aimed to identify sex-specific co-developmental trajectories of multiple forms of childhood victimization: family maltreatment (FM), psychological maltreatment by teachers (PMT), and peer victimization (PV), and their relations to prosocial and delinquent behaviors among elementary school students. A total of 4378 Chinese elementary school students (Mage = 9.93; SD = 0.92; 55.14% boys) participated in assessments on five occasions, using six-month intervals. Parallel process latent class growth model analyses revealed three trajectories for boys: Congruent-low (75.64%), High-PV, Moderate-FM and PMT (14.62%), and Moderate-PV, High-FM and PMT (9.74%). Similarly, girls exhibited three trajectories: Congruent-low (81.11%), Moderate-PMT, High-FM and PV (10.54%), and High-PMT, Moderate-FM and PV (8.35%). The results indicated that boys were more susceptible than girls to three forms of childhood victimization. Furthermore, boys were especially vulnerable to co-occurring FM and PMT. In contrast, girls were more vulnerable to co-occurring FM and PV. Additionally, after experiencing childhood victimization, girls showed a greater hindrance in prosocial behavior development, whereas boys exhibited a more significant increase in delinquent behavior. These findings underscore the importance of considering sex differences in understanding multiple forms of childhood victimization and provide important insights for prevention and intervention efforts.

Cognitive Trajectories and Associated Social and Behavioral Determinants Among Racial/Ethnic Minority Older Adults in the United States.

Despite higher risks of developing Alzheimer's disease and Alzheimer's disease-related dementias (AD/ADRD) among racial/ethnic minority populations, some maintain good cognition until old age. This study aimed to investigate heterogeneous cognitive trajectories among non-Hispanic Black and Hispanic older adults, examine cognitive impairment prevalence across trajectory classes, and identify associated social and behavioral determinants. Using 11 waves of data from the Health and Retirement Study (1996-2016), 1,322 non-Hispanic Black and 747 Hispanic adults aged 50 + with normal cognition in 1996 were included. Latent class growth modeling and multinomial logistic regressions were performed to examine cognitive trajectories and associated determinants. For both racial/ethnic groups, three trajectory classes were identified: high, medium, and low cognition. In the low cognition class, 87% and 100% of non-Hispanic Black and Hispanic participants developed cognitive impairment. For both racial/ethnic groups, older age and living in rural areas during school time increased the likelihood of being in the low cognition class, while more education was associated with a lower likelihood. Unique risk and protective determinants for non-Hispanic Black and Hispanic participants were also identified. This study reveals the heterogeneity of cognitive trajectories among racial/ethnic minority older adults and various associated social and behavioral determinants. More prevention interventions and accessible, affordable diagnosis and treatment should be provided to older racial/ethnic minorities with these characteristics to reduce disparities. More research is needed to further explore associations between unique determinants and cognition in racial/ethnic minority populations to better inform interventions.

Disability trajectories individuals with spinal cord injury in mainland China: do psychosocial resources and diseases factors predict trajectories?

Observational cohort study. To identify classes of disability trajectories from 1 month post-injury (acute hospital) to 6 months post-injury (individuals with SCI individuals who stay in rehabilitation setting or back in the community), and to investigate whether psychosocial resources and disease factors can predict disability trajectory. Spinal surgery in three Class III hospitals. Hospitals in China are divided into three classes (Class I, II and III). All the participants were submitted to WHO Disability Assessment Schedule (WHO-DAS 2.0) at three times; and personal data anamnesis, level of hope, level of PTSD, level of social support were recorded at first time. All the data collected by the master's students who participated in this study. Two disability trajectories were identified using the latent class growth model: the continuous high disability group (N = 196, 93.3%) and the low starting point stabilization group (N = 14, 6.7%). Complete injury(ASIA-A) with SCI and more depression in the stable condition after SCI surgery were more likely to be classified as having higher disability than those with a lower disability trajectory. Occupation, annual family income, hope, social support, and Post-traumatic Stress Disorder (PTSD) cannot predict individuals belonging to trajectory classes. These findings emphasize the importance of ASIA and depression in the early recovery stage after SCI and support the opinion that strengthening psychological nursing and rehabilitation management at an early stage after SCI will benefit individuals with a lower disability trajectory.

Serum uric acid trajectories and the risk of cardiovascular disease: a longitudinal association and pathway analysis.

Age-specifically longitudinal associations and potential pathways between serum uric acid (SUA) and cardiovascular disease (CVD) remained unclear. This study aimed to explore SUA trajectories in different age populations and to determine their associations and potential pathways with incident CVD. This prospective cohort included 41,367 participants from the Kailuan study, including 30,938 participants aged <55 years and 10,419 participants aged ≥55. The SUA trajectories during year 2006-2012 were identified by latent class growth models. Three SUA trajectories were identified in the overall, aged <55 and aged ≥55 years participants, as "low-stable" (51.9%, 54.4%, and 43.3%), "moderate-stable" (39.0%, 36.9%, and 45.6%), and "high-stable" (9.1%, 9.7%, and 11.1%), respectively. During a median follow-up of 6.75 years, incident CVD occurred in 2302 participants (5.56%). Overall, a high-stable trajectory was independently associated with a higher risk of CVD (hazard ratio [HR], 1.23; 95% [confidence interval], 1.06-1.42). Notably, the associations differed by age, a significant association was only observed in participants aged ≥55 years (HR, 1.29; 95% CI, 1.05-1.58), rather than those aged <55 years (HR, 1.08; 95% CI, 0.89-1.33). The addition of SUA trajectories to a baseline risk model for CVD improved the integrated discrimination improvement value (P < 0.05) and category-free net reclassification improvement value (P < 0.05). Bayesian network showed the conditional probability of high CVD risk associated with aging, elevated SUA trajectories, blood pressure, glucose, and inflammation was 15.5%. High-stable SUA trajectories were independently associated with an elevated risk of CVD, which is mainly induced by hypertension, diabetes, and inflammation, especially in participants aged ≥55 years.

Moderating effects of clock genes DNA methylation on the relationship between physical activity trajectories and depressive symptoms among Chinese college students.

To explore the 2-year physical activity trajectory of Chinese college students and further examine the longitudinal relationship between physical activity trajectory and depressive symptoms. Furthermore, our study aimed to clarify the potential role of clock genes deoxyribonucleic acid (DNA) methylation in the association between physical activity and depressive symptoms. From April 2019 to May 2021, College Student Behavior and Health Cohort Study was conducted among 1,179 students from two universities in Anhui and Jiangxi provinces. Latent Class Growth Model was applied to simulate and group physical activity in a total of five surveys. The PROCESS macro for SPSS was used to analyze the moderating effects of clock genes DNA methylation on the association between physical activity and depressive symptoms. Two physical activity trajectories were identified: "continued high level" and "gradual low level." Multinomial logistic regression analysis showed that the "gradual low level" of physical activity trajectory was independently associated with moderate-to-severe depressive symptoms. Furthermore, DNA methylation of the PER2 and CRY1 genes had negatively moderating effects between physical activity and depressive symptoms, and there was sex-specific effect for CRY1 gene. Our findings suggests that long-term low physical activity was connected to more severe depressive symptoms among college students, and clock genes DNA methylation may play a negative moderating role, attenuating the positive effect of high intensity physical activity levels on depressive symptoms. In this regard, intervention programs regarding depressive symptoms among Chinese college students should consider multiple approaches such as increasing the duration and intensity of physical activity. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The developmental and dynamic relationship between psychopathology and psychotic-like experiences trajectories in children and adolescents

BackgroundThe previous cross-sectional and prospective studies have reported that psychopathology was associated with the occurrence of psychotic-like experiences (PLEs). However, few of these studies have examined this longitudinal association considering the different developmental trajectories of PLEs, as well as the growth or changes of psychopathology over time. MethodsFour waves PLEs and psychopathology assessments from Adolescent Brain Cognitive Development (ABCD) study were used. The latent class growth modeling (LCGM) and latent growth curve modeling (LGCM) was used to assess latent PLEs class (group) and time-varying psychopathology, respectively. Lastly, the multinomial logistic regression model was used to examined the dynamic and developmental relationship between intercept/slope in psychopathology and different PLEs trajectories. ResultsThree PLEs trajectory classes were confirmed: low decreasing PLEs (84.7 %), persistent PLEs (7.01 %) and high decreasing PLEs trajectories (8.29 %). We also found that the intercept of anxious/depressed problems and total problems scales and the slope of social problems were associated with the persistent PLEs trajectory compared with the low decreasing PLEs trajectories, indicating both the early onset and the growth of psychopathology over time are needed to be clinical attention. LimitationsThe CBCL as the sole outcome measure for psychopathology and a widely acknowledged definition for PLEs is lacking. We lacked the mechanisms underlying the current results. ConclusionThese longitudinal and dynamic results suggest that future intervention studies aimed at preventing the transition from persistent PLEs to psychotic disorders can focus on both the early onset and the growth of psychopathology over time.

Negative life events predict depressive trends: the moderating effect of overgeneral autobiographical memory and early parenting behaviour

ABSTRACT The Emerging Adulthood is a complex and chaotic period and depression is one of the main psychological health problems during this period. Overgeneral autobiographical memory (OGM) is prevalent among patients with clinical depression. However, the prediction of OGM in groups with non-clinical depression and its influencing mechanisms remain inconclusive. Studies have shown that OGM and early parenting behaviour are vulnerable factors of depression in emerging adulthood, which may be triggered by negative life events. Our longitudinal study included 241 participants (M age = 21.88 years). At baseline, participants completed measures of current negative life events, depression, early parenting behaviour and an autobiographical memory test. Thereafter, they were tracked for depression every 35 days. We used the latent class growth model to differentiate levels and trends of depression among non-clinical participants. The analysis showed that the effect of negative life events on depression was moderated by OGM and early parenting behaviour. However, this moderating effect was found only in the low-risk depression group. Our findings indicate that early parenting behaviour might account for the different mechanisms of OGM production in non-clinical groups. Moreover, it underlines the importance of OGM and early parenting behaviour as potential predictors of future depression in non-clinical groups.

Suicide Risk among Chinese Left-Behind Adolescents: Developmental Trajectories and Multi-Contextual Predictors.

Suicide is prevalent among left-behind youth, a group that has yet to be thoroughly explored in terms of the developmental dynamics of their suicide risk and associated factors. This study adopted a person-centered approach to investigate the developmental trajectories of suicide risk among Chinese left-behind adolescents, along with multi-dimensional predictors. A total of 774 left-behind adolescents (Mage = 13.60, 50.1% female) completed three surveys over a year, with six-month intervals. Result of Latent Class Growth Modeling identified three subgroups with distinct developmental trajectories: High Risk-Escalating (7.6% of participants started at the highest levels with a worsening trend), Risk-Holding (21.6% maintained a stable but risk level starting above the critical threshold), and Low Risk-Diminishing (70.8% started low and continued to decrease). Gender (being a female), increased levels of childhood maltreatment, psychological pain, and depression were risk factors for High Risk-Escalating and/or Risk-Holding trajectories, while increased sense of control and regulatory emotional self-efficacy played protective roles. The findings underscore the malignant developmental patterns of suicide risk among left-behind adolescents. The predictive factors play a crucial role in distinguishing and improving these developmental trajectories.

Trajectories and influencing factors of psychological resilience among Chinese patients with maintenance hemodialysis

ObjectiveTo identify distinct trajectories of psychological resilience among Chinese patients with maintenance hemodialysis, explore influencing factors and inform the formulation of corresponding interventions. MethodsThis was a multi-center longitudinal study with a 6-month follow-up. With convenience sampling, a total of 231 patients with maintenance hemodialysis were recruited between September 2020 and July 2021. Patients’ characteristics, including sociodemographic information, social support and family resilience was collected through structured questionnaires as potential baseline influencing factors of psychological resilience trajectories. Psychological resilience was evaluated using the 25-item Chinese version of the Conner and Davidson resilience scale. Latent class growth modeling was conducted to identify homogeneous subgroups with distinct trajectories of psychological resilience. Univariable and multinomial logistic regression analysis were used to examine whether baseline influencing factors were associated with trajectories in patients with maintenance hemodialysis. ResultsFive distinct psychological resilience trajectory groups were identified: declining group (n = 20, 8.7 %), rising group (n = 17, 7.4 %), moderate-stable group (n = 128, 55.4 %), high-stable group (n = 7, 3.0 %) and low-stable group (n = 59, 25.5 %). High-stable group and moderate-stable group were combined into the well-psychological resilience group for multinomial logistic regression analysis. The multinomial logistic regression analysis showed that influencing factors associated with trajectories of psychological resilience were age, religion, monthly household income per capita, and baseline family resilience. ConclusionsThe results highlight the heterogeneity in the development of psychological resilience among Chinese patients with maintenance hemodialysis. There is a need for healthcare professionals to screen for trajectories of psychological resilience in Chinese maintenance hemodialysis patients and prepare individual mental healthcare interventions.

Trajectories of suicidality during a 2-year early-intervention program for first-episode psychosis: A longitudinal study

Little is known about the individual course of suicidal ideations and attempts (i.e., suicidality) after treatment initiation. We examined the trajectories of suicidality and associated risk factors over a 2-year early intervention program for first-episode psychosis in 450 patients (age range 18–35 years at admission) consecutively admitted from 2003 to 2017. Suicidality was assessed via systematic file review, while sociodemographic and clinical variables were assessed at admission. Latent class growth modelling identified three trajectories: low (69.6 %), initially high (22.9 %), and persistently high (7.6 %) suicidality. Patients who were younger, lived alone and were diagnosed with affective psychosis were significantly more likely to follow the initially high trajectory. Patients who attempted suicide up to 3 months before admission, lived alone and presented lower levels of the PANSS excited factor were significantly more likely to follow the persistently high trajectory. Attempting suicide up to 3 months before admission distinguished persistently high and initially high suicidality trajectories. Suicide risk during early intervention program for first-episode psychosis is heterogenous, with acute and enduring suicidal risk, suggesting the need to adapt suicide prevention strategies to these different risk profiles.

Longitudinal Trajectories of Self-Reported Cognitive Function and Associated Factors Among Older Cancer Survivors.

Cancer-associated cognitive decline may result in difficulties in maintaining daily life activities for older patients with cancer. It is, therefore, critical to identify changes in cognitive function throughout illness trajectories. To determine the longitudinal patterns and factors associated with cognitive function among older cancer survivors. A secondary analysis was conducted using data from the 2012 to 2020 Korean Longitudinal Study of Aging database. A total of 207 cancer survivors aged 60 years and above were included in the analysis. Latent class growth modeling was employed to identify the trajectories of self-reported cognitive function, and logistic regression analysis was used to identify factors associated with these trajectories. The cognitive function of older adults with cancer was divided into 2 distinct trajectories, characterized by differences in intercept (8) and slope (0.7): the "low and declining class" and the "high and sustainable class." The proportion of individuals belonging to the "high and sustainable class" (n = 153, 73.9%) was significantly and considerably higher than those in the "low and declining class" (n = 54, 26.1%). Individuals with low and declining cognitive function were more likely to be older, have a lower education level, live in rural areas, have poor handgrip strength, experience depression, and have lower social participation compared to those with high and sustainable cognitive function. Our findings can help health care professionals develop tailored interventions for older cancer survivors with low cognitive function based on their physical and mental health status, as well as their environmental backgrounds.

Using machine learning to explore the predictors of life satisfaction trajectories in older adults.

Life satisfaction is vital for older adults' well-being, impacting various life aspects. It is dynamic, necessitating nuanced approaches to capture its trajectories accurately. This study aimed to explore the diverse trajectories and predictors of life satisfaction among older adults in China using longitudinal data from the China Health and Retirement Longitudinal Study. Latent class growth modeling and growth mixture modeling were employed to identify distinct trajectories of life satisfaction. Machine learning (ML) models were developed to predict different trajectories and identify important predictors of different trajectories. Four distinct trajectories of life satisfaction were identified, showcasing nuanced patterns of life satisfaction that changed over time. ML models, especially random forest, effectively predicted these trajectories. Emotional experiences (particularly the frequency of happiness and loneliness), body mass index, and self-report health emerged as significant predictors of different life satisfaction trajectories. Our finding revealed the importance of focusing on individuals or groups with consistently low life satisfaction and paying more attention to mental and physical health predictors. Our models might guide future targeted preventative treatments.

Associations of longitudinal BMI percentile classification patterns in early childhood with neighborhood-level social determinants of health.

Understanding social determinants of health (SDOH) that may be risk factors for childhood obesity is important to developing targeted interventions to prevent obesity. Prior studies have examined these risk factors, mostly examining obesity as a static outcome variable. We extracted EHR data from 2012-2019 for a children's health system that includes 2 hospitals and wide network of outpatient clinics spanning 5 East Coast states in the US. Using data-driven and algorithmic clustering, we have identified distinct BMI-percentile classification groups in children from 0 to 7 years of age. We used two separate algorithmic clustering methods to confirm the robustness of the identified clusters. We used multinomial logistic regression to examine the associations between clusters and 27 neighborhood SDOHs and compared positive and negative SDOH characteristics separately. From the cohort of 36,910 children, five BMI-percentile classification groups emerged: always having obesity (n=429; 1.16%), overweight most of the time (n=15,006; 40.65%), increasing BMI-percentile (n=9,060; 24.54%), decreasing BMI-percentile (n=5,058; 13.70%), and always normal weight (n=7,357; 19.89%). Compared to children in the decreasing BMI-percentile and always normal weight groups, children in the other three groups were more likely to live in neighborhoods with higher poverty, unemployment, crowded households, single-parent households, and lower preschool enrollment. Neighborhood-level SDOH factors have significant associations with children's BMI-percentile classification and changes in classification. This highlights the need to develop tailored obesity interventions for different groups to address the barriers faced by communities that can impact the weight and health of children living within them. This study demonstrates the association between longitudinal BMI-percentile patterns and SDOH in early childhood. Five distinct clusters with different BMI-percentile trajectories are found and a strong association between these clusters and SDOH is observed. Our findings highlight the importance of targeted prevention and treatment interventions based on children's SDOH.

Trajectory patterns and predictors of cancer-related fatigue in postoperative lung cancer patients receiving chemotherapy.

Cancer-related fatigue (CRF) is a chronic symptom that can affect the overall functioning of lung cancer patients throughout the course of the disease. However, there is limited research on the trajectory and predictors of CRF specifically in lung cancer patients. Furthermore, few studies have investigated the predictive role of positive psychological and social factors in relation to CRF. This study aimed to explore the trajectory of CRF and its predictors in postoperative chemotherapy patients with lung cancer. A total of 202 lung cancer patients who underwent surgery and received adjuvant chemotherapy were recruited for this study. Baseline questionnaires were completed, covering sociodemographic information, disease details, CRF levels, personality traits, psychological resilience, and social support. CRF was assessed at three time points: first chemotherapy (T1), 3months after chemotherapy (T2), and 6months after chemotherapy (T3). Latent class growth modeling (LCGM) was used to identify distinct developmental trajectories of CRF. Logistic regression analysis was employed to examine predictors of CRF within different patient groups. The LCGM analysis revealed three distinct CRF trajectories: persistent high fatigue group (30.7%), rising fatigue group (30.7%), and no fatigue group (38.6%). Cancer stage (OR = 7.563, 95% CI = 2.468-23.182, P < 0.001), melancholic personality (OR = 6.901, 95% CI = 1.261-37.764, P = 0.026), and high psychological resilience (OR = 0.171, 95% CI = 0.041-0.706, P = 0.015) were associated with the CRF trajectory. On the other hand, sanguine personality (OR = 0.254, 95% CI = 0.071-0.916, P = 0.036) and high social support (OR = 0.168, 95% CI = 0.045-0.627, P = 0.008) were associated with the increasing fatigue trajectory. This study demonstrated that 60% of lung cancer patients experienced persistent fatigue throughout the assessment period. Moreover, it confirmed the heterogeneity of CRF trajectories among lung cancer patients. The severity of CRF was found to be higher in patients with advanced clinical stages, depressive personality traits, and lower psychological resilience.

Long-term Trajectories of Low Back Pain in Older Men: A Prospective Cohort Study With 10-Year Analysis of the Osteoporotic Fractures in Men Study.

Although low back pain (LBP) may persist or recur over time, few studies have evaluated the individual course of LBP over a long-term period, particularly among older adults. Based on data from the longitudinal Osteoporotic Fractures in Men (MrOS) Study, we aimed to identify and describe different LBP trajectories in older men and characterize members in each trajectory group. A total of 5 976 community-dwelling men (mean age = 74.2) enrolled at 6 U.S. sites were analyzed. Participants self-reported LBP (yes/no) every 4 months for a maximum of 10 years. Latent class growth modeling was performed to identify unique LBP trajectory groups that explained variation in the LBP data. The association of baseline characteristics with trajectory group membership was assessed using univariable and multivariable multinominal logistic regression. A 5-class solution was chosen; no/rare LBP (n = 2 442/40.9%), low frequency-stable LBP (n = 1 040/17.4%), low frequency-increasing LBP (n = 719/12%), moderate frequency-decreasing LBP (n = 745/12.5%), and high frequency-stable LBP (n = 1 030/17.2%). History of falls (OR = 1.52), history of LBP (OR = 6.37), higher physical impairment (OR = 1.51-2.85), and worse psychological function (OR = 1.41-1.62) at baseline were all associated with worse LBP trajectory groups in this sample of older men. These findings present an opportunity for targeted interventions and/or management to older men with worse or increasing LBP trajectories and associated modifiable risk factors to reduce the impact of LBP and improve quality of life.

Exploring for the Change in Change of Employment Status Over Time

The study seeks to explore for presence of dissimilar developmental paths in employment status of American individuals. The empirical longitudinal exercise is conducted with hybrid latent class growth model and latent class growth mixtures. For testing the hypothesis of heterogeneous subgroups within employment status data three mainstream modelling variants of growth modelling are tested and elaborated in terms of model performance. Progressive employment status based typology is found robust to alternative model specifications voting for presence of clustered growth patterns in experiencing employment status over time. The resulted employment status based typology describes three clusters of active, inactive and mediocre active participants in terms of moving between various stages of employment status for the age span of 18years to 35 years i.e., from adult to post adult prime working life years. The presented approach to understand and explore employment status is novel perspective compared to classic survey based employment status data.