Latent Growth Modeling Analysis Research Articles

Exercise, grit, and life satisfaction among Korean adolescents: a latent growth modeling analysis

BackgroundLife satisfaction among Korean students is declining substantially, and multifaceted improvement efforts are required.MethodsWe analyzed longitudinal change trajectories for exercise, grit, and life satisfaction levels among Korean adolescents using latent growth modeling with longitudinal data from the Korean Children and Youth Panel Surveys of 2,142 students (male: 1,070, female: 1,072) from sixth grade (2020) through eighth grade (2022).ResultsThe model, which tracked linear changes in the students’ exercise, grit, and life satisfaction, showed consistent declines over three school years for all variables. We also identified a longitudinal causal relationship among exercise, grit, and life satisfaction. A higher grit intercept was associated with higher intercept for—and a partial mediating effect between—exercise and life satisfaction. The grit slope was positively related to the life satisfaction slope, and both the intercept and exercise slope had positive effects on life satisfaction. Moreover, grit had a longitudinal mediating effect between exercise and life satisfaction.ConclusionsWe discuss the longitudinal change trajectories of exercise, grit, and life satisfaction, the causal and mediating effects among them, and the implications of the findings. These findings bolster our understanding of Korean adolescents’ life satisfaction and have practical significance for designing programs to improve their quality of life.

Longitudinal study on the trajectory and influencing factors of cognitive dysfunction in lung transplantation patients

IntroductionLung transplantation is an effective method for treating end-stage lung disease. It prolongs the survival time of patients, improves the quality of life, and prevents the degree of mental disability. In particular, postoperative cognitive dysfunction (POCD) is one of the complications after lung transplantation. Despite this, longitudinal studies on the identification and heterogeneity of cognitive dysfunction subgroup trajectories in transplant patients are lacking. Therefore, our study aimed to evaluate the factors that influence POCD in lung transplant patients. MethodsThis prospective longitudinal study included patients who underwent lung transplantation at the transplant center of Wuxi People's Hospital from September 2022 to September 2023. Patients with lung transplants were evaluated at 8 days (T1), 1 month (T2), 3 months (T3), and 6 months (T4) after the operation. The general information questionnaire evaluated cognitive functions using the Montreal Cognitive Assessment (MoCA) numerical rating scale (NRS) and the digital pain assessment to obtain the POCD values. Latent category growth model (LCGM) analysis was used to identify heterogeneous POCD subgroups in the four observation periods. Univariate and logistic regression analyses were used to identify factors affecting POCD classification and independent risk factors. ResultsBased on clinical outcomes, 79 patients completed all four surveys, of whom 16 were lost during the follow-up period (loss rate, 16.8%). The cognitive function by MoCA NRS score was 14.18 ± 5.32 points on day 8 (T1), 22.51 ± 5.13 points at 1 month (T2), 25.44 ± 3.61 at 3 months (T3), and 27.04 ± 3.03 points at 6 months (T4) after lung transplantation, showing an increasing trend. The LCGM, used to fit the trajectory of MoCA scores, observed a heterogeneous trajectory of changes in lung transplant patients. Based on this analysis, patients could be divided into two categories: those with high risk (25,32%) and those with low risk (54,68%). The single-factor analysis identified that POCD values were affected by early postoperative rehabilitation exercise, degree of pain, intensive care unit (ICU) stay time, and donor lung cold ischemia time (all P < 0.05). Using the low-risk group as the reference class, logistic regression analysis showed that the model could correctly classify the subjects. ConclusionOur 6-month observation of lung transplant patients showed that the degree of cognitive dysfunction had an overall downward trend and that patients could be divided into two trajectories of high and low risk for POCD. Early postoperative rehabilitation exercise, degree of pain, ICU stay time, and donor lung cold ischemia time were all influencing factors for POCD in lung transplant patients.

중고령 남성 은퇴자의 은퇴만족도 변화궤적 유형과 영향 요인

The purpose of this study was to identify patterns of retirement satisfaction trajectory and their associated factors among middle-aged and older male retirees using data from the 5th (2014) to 8th (2020) waves of the Korean Longitudinal Study of Ageing (KLoSA). To this end, a three-step approach to the Latent Class Growth Model (LCGM) and multinomial logistic regression analysis were conducted on the sample of 543 male retirees over the age of 50 who responded that they had fully retired during the 5th to 8th waves. As a result of the analysis of the Latent Class Growth Model analysis, the retirement satisfaction of middle-aged and older male retirees was derived as 'high-level of retirement satisfaction maintaining type', 'increased retirement satisfaction type', and 'low-level of retirement satisfaction maintaining type'. The results of the multinomial logistic regression analysis showed that subjective economic status, frequency of social activities, subjective health status, and age significantly predicted the trajectories of retirement satisfaction, and in particular, it was found that those with high subjective economic status were more likely to belong to the high-level of retirement satisfaction maintaining type than the low-level of retirement satisfaction maintaining type or the increased retirement satisfaction type. This study examined the patterns of retirement satisfaction trajectory among middle-aged and older male retirees by subdividing them, and in particular discussed what level of preparation would be needed to prepare for their retirement.

Effects of sleep disturbance, cancer-related fatigue, and psychological distress on breast cancer patients’ quality of life: a prospective longitudinal observational study

More attention has gone to researching the cancer-related fatigue (CRF)–sleep disturbance (SD)–psychological distress (PD) symptom cluster in breast cancer patients during the chemotherapy period, but the change trend and heterogeneous development track in the whole treatment stage remain unclear, and it is also unclear whether the appearance of and changes in one symptom cause changes in other symptoms and quality of life (QoL). This study, using breast cancer patients’ data collected through a validated questionnaire, examined the relationships between SD, CRF, PD, and QoL using latent growth modeling analyses. CRF developmental trajectories showed an upward trend over five surveys (slope = 0.649, P < 0.001); PD showed a significant weakening trend (slope = − 0.583, P < 0.001); SD showed an increasing trend (slope = 0.345, P < 0.001), and QoL showed a statistically significant weakening trend (slope = − 0.373, P < 0.001). The initial CRF (coefficient = − 0.233, P < 0.01), PD (coefficient = − 0.296, P < 0.01), and SD (coefficient = − 0.388, P < 0.001) levels had a statistically significant negative effect on initial QoL level. The linear development rate of PD was statistically significant and negatively affected that of QoL (coefficient = − 0.305, P < 0.05), whereas the quadratic development rate of SD negatively affected that of QoL (coefficient = − 0.391, P < 0.05). Medical staff should identify the change characteristics of different variables based on SD, CRF, PD, and QoL change trajectories, and advance the intervention time, as changes in variables affect other variables’ subsequent changes.

Individual differences in environmental sensitivity: associations between cognitive emotion regulation and mental health.

Environmental sensitivity is defined as the ability to perceive and process internal and external information. Previous studies have suggested that mental health-related factors differ by sensitivity level. This study aimed to investigate whether environmental sensitivity moderates the associations between cognitive emotion regulation strategies (e.g., rumination and blaming others) and mental health. In this three-wave longitudinal study, participants (N = 1,233, 585, and 349 at Times 1, 2, and 3, respectively) completed the Cognitive Emotion Regulation Questionnaire-short and Kessler 10 scale at all the measurement points as well as the 10-item version of the Highly Sensitive Person scale and some covariates only at Time 1. Latent growth model analyses indicated that the blaming others strategy had contrastive effects on changes in mental health by sensitivity level; the increase in refocusing on planning was associated with improved mental health over time only for highly sensitive individuals; and the rumination and catastrophizing strategies were the most important risk factors for mental health problems, although their effects differed slightly by sensitivity level. The associations between some of the cognitive strategies and mental health differ by environmental sensitivity level. Future investigations based on individual differences in sensitivity could provide innovative insights into practices.

대학 입학전형을 고려한 학업 성적의 변화 추이 및 영향요인 분석: 코로나-19 전후 비교

This study aims to examine the educational outcomes of college students by admission types, with a focus on the impact of COVID-19. For this purpose, we conducted a comparative analysis of academic progress and influencing factors among students admitted before and after the onset of the pandemic. Data from 1,074 students enrolled in 2018 and 1,136 students enrolled in 2020 were used. The results of a multi-group latent growth model analysis are as follows. First, irrespective of the admission year, students from both the 2018 and 2020 panels exhibited improvements in grades over the span of three semesters. Nonetheless, the 2020 group displayed a higher initial value and slope of academic progress compared to the 2018 panel. Second, among students admitted in 2018, those under regular-admission exhibited higher initial GPA compared to their early-admission counterparts. However, no such distinction by admission type was observed among students admitted in 2020. Furthermore, solely the 2020 panel demonstrated a positive impact of competency and extracurricular mileage on their initial GPAs. Finally, we provide a summary and discuss the implications of the study results.

Developmental trajectories of hyperactive behavior in children from low-income families: A latent variable growth model analysis

Developmental trajectories of hyperactive behavior in children from low-income families: A latent variable growth model analysis

Change in resilience among spousal caregivers of patients with newly-diagnosed advanced cancer over the first six months posttreatment in China

ObjectiveA longitudinal observational study was conducted and aimed to examine the change in resilience among spousal caregivers of newly-diagnosed advanced cancer patients over the first six months after initial treatment. MethodsIn total, 312 Chinese spousal caregivers who were taking care of their patients with newly-diagnosed advanced cancer were recruited. The level of resilience was measured using the Connor–Davidson Resilience Scale at the first month post-initial treatment (T1), three-month post-initial treatment (T2), and six-month post-initial treatment (T3). Latent growth modeling analyses were performed to examine changes in resilience using Mplus 8.3. ResultsThe mean scores of resilience in spousal caregivers were 54.01 ± 7.68 at T1, 56.20 ± 6.38 at T2, and 57.97 ± 6.70 at T3, respectively. Results of latent growth modeling indicated that spousal caregivers showed a significant increase in their resilience scores over the first six months post-treatment (Mean slope = 1.98, p < 0.001). Furthermore, a significant individual variation in the rate of changes in resilience scores allowed spouses to be categorized into two groups: 42.9% participants with fast growth and 57.1% participants with slight growth. ConclusionOur findings highlight the importance that new knowledge about change patterns of resilience in the nursing field is beneficial to reveal different psychosomatic health. Acknowledging that resilience is a dynamic process that changes over time, it is crucial for healthcare providers to monitor the psychological adjustment and focus of vulnerable caregivers, particularly spouses.

Trajectories of Cognitive Function and Their Associated Factors in Community-Dwelling Older Adults by Living Arrangement Using the Korean Longitudinal Study of Aging

The purpose of this study was to describe the distinct cognitive trajectories for 8 years according to living arrangement among community-dwelling older adults using the Korean longitudinal study of ageing.We analyzed data from a final sample of 3,049 community-dwelling older adults aged 65 years or older who participated in at least three cognitive function measures in an 8-year period (2012-2020). Cognitive function was assessed by Korean mini mental state examination. Latent class growth model analysis was applied to determine the number and shape of trajectories of older adults according to living arrangement. Multinomial logistic regression analysis was used to determine risk factors for cognitive function trajectories.We identified five trajectory patterns in cognitive function among older adults living alone; ‘high-stable (35.6%)’, ‘high-declining (32.5%)’, ‘moderate-steep declining (6.2%)’, ‘low-stable (18.9%)’, and ‘low declining (6.8%)’. In older adults living with family, there were four trajectory patterns; ‘high-stable (46.4%)’, ‘high-declining (32.0%)’, ‘low-stable (15.9%)’, and ‘low-declining (5.7%)’. Age, instrumental activities of daily living, and depression were common factors of cognitive changes in both older adults living alone and those living with family members. However, monthly incomes was only associated with the risk of cognitive function in older adults living alone.We found that cognitive function trajectories among older adults may differ depending on the type of living arrangement. Therefore, further studies and health policies are required for avoiding cognitive impairment by living arrangement among older adults based on the results of this study.

Trajectories of cognitive reactivity and its predictive value on postpartum depression in Chinese women: a latent class growth modeling analysis

Many women are experiencing postpartum depression (PPD) after giving birth. How to recognize and intervene in high-risk PPD women early and effectively remains unknown. Our objective is to describe the latent trajectory groups of cognitive reactivity (CR) in perinatal women, and their relationship to demographic and disease-related factors, as well as investigate the associations with PPD. Data from 321 perinatal women who were evaluated in urban tertiary hospitals in China at three-time points: 32-35 weeks of pregnancy, 1 week postpartum, and 6 weeks postpartum. Latent class growth modeling was used to identify the trajectory patterns of CR and logistic regression was used to explore the association between demographic and disease-related factors, CR trajectories, and depression. Three trajectory groups were identified: the continuing deterioration group (17.2%), the postpartum deterioration group (22.1%), and the consistent resilient group (60.7%). Participants with a bachelor’s degree or higher and with gestational diabetes diagnosis were more likely to be in the continuing deterioration group. Those who were from only-child families were more likely to be in the postpartum deterioration group. Women in the continuing deterioration group and postpartum deterioration group were more likely to experience PPD. Targeted interventions should be developed based on trajectory group of CR.

Recovery trajectories of IQ after pediatric TBI: A latent class growth modeling analysis.

To identify latent trajectories of IQ over time after pediatric traumatic brain injury (TBI) and examine the predictive value of risk factors within and across recovery trajectories. 206 children ages 3-7 years at injury were included: 87 TBI (23 severe, 21 moderate, 43 complicated mild) and 119 orthopedic injury (OI). We administered intelligence tests shortly after injury (1½ months), 12 months, and 6.8 years postinjury. Latent class growth modeling was used to identify latent subgroups. Separate models examined verbal and nonverbal IQ recovery trajectories following TBI versus OI. Variables included: age at injury, sex, race, socioeconomic status, injury severity, quality of the home environment, family functioning, and parenting style. Both the TBI and OI analyses yielded different growth models for nonverbal (k = 3) and verbal IQ (k = 3). Although all models resulted in 3 latent classes (below average, average, and aboveaverage performance); trajectory shapes, contributors to class membership, and performance within each class varied by injury group and IQ domain. TBI severity was associated with class membership for nonverbal IQ, with less severe injuries associated with higher IQ scores; however, TBI severity did not influence verbal IQ class membership. Parenting style had a more prominent effect on verbal and nonverbal IQ within the TBI than OI trajectories. Findings suggest TBI severity is related to recovery trajectories for nonverbal but not verbal IQ and parenting style has stronger effects on recovery in TBI than OI. Results highlight the importance of parental factors on long-term recovery after TBI.

Developmental trajectories of eating behaviors and cross-lagged associations with weight across infancy

Examining typical developmental trajectories of infant eating behaviors, correlates of those trajectories, and cross-lagged associations between eating behaviors and anthropometry, is important to understand the etiology of these behaviors and their relevance to growth early in the lifespan. Mothers (N = 276) completed the Baby Eating Behavior Questionnaire (BEBQ) and infant anthropometrics were measured at ages 1, 2, 4, 6, and 10 months. Infant and maternal characteristics were collected by maternal report. Trajectories of eating behaviors were identified using latent class growth modeling and bivariate analyses examined associations of infant eating behavior trajectory membership with infant and maternal characteristics. Cross-lagged analyses examined associations between BEBQ subscales and infant weight-for-length z-score. Infant eating behavior trajectories included: Consistently High (62%) and Consistently Moderate (38%) Enjoyment of Food; Consistently High (9%), Moderate & Decreasing (43%), and Low & Decreasing (48%) Food Responsiveness; and Consistently High (62%) and Moderate & Decreasing (38%) General Appetite. Trajectory group membership was not associated with infant sex, gestational age, birthweight, or having been exclusively fed breastmilk at 2 months. Consistently High trajectories for Enjoyment of Food, Food Responsiveness, and General Appetite were associated with maternal demographic markers of psychosocial risk (e.g., lower maternal age and educational attainment). Food Responsiveness and General Appetite tracked strongly across infancy within individuals. Cross-lagged associations of Enjoyment of Food, Food Responsiveness, and General Appetite with weight-for-length z-score across infancy were generally null. Much additional work is needed to understand eating behaviors in infancy, their development, and their etiology. Further understanding of infant eating behaviors will provide the basis for future interventions to improve life course nutrition, growth, and health.

Intergenerational Effects of Parenting on Children's Internalizing and Externalizing Trajectories: A Latent Growth Model Analysis.

Externalizing and internalizing problems in childhood are associated with risk for later psychopathology. It is important to identify antecedents as they may be targets for intervention. In a sample of 501 children (M = 6.07; 54.7% male; 12.4% Hispanic; 12.2% non-White), we leveraged data from a longitudinal study to examine the transmission of parenting behaviors across two generations and its effects on children's internalizing and externalizing outcomes in the subsequent generation. The results suggested transmission of parenting behaviors, confirmed the role of parenting on children's psychopathology, and provided novel evidence of a direct and indirect role of grandparent's caregiving on children's psychopathology via parenting continuity. These findings may inform interventions addressing continuity of parenting behaviors and their subsequent effects.

Socioeconomic status and school adjustment trajectories among academically at-risk students: The mediating role of parental school-based involvement

This study examined whether and how parental school-based involvement mediated the effect of early family socioeconomic status (SES) on the development of four dimensions of school adjustment, namely academic achievement, classroom engagement, teacher-student relationship, and peer relationship. Latent growth modeling and longitudinal mediation analyses were conducted with a sample of 784 academically at-risk students from Grades 1 to 5. Results revealed that higher SES predicted higher levels of each of the four dimensions of school adjustment in Grade 1, effects that were mediated by Grade 1 parental school-based involvement. SES did not predict growth in parental involvement and school adjustment outcomes. These findings highlight the negative cascading processes by which low SES predicts low parental school-based involvement in early elementary school, which heightens the developmental risks in school adjustment in both the academic and social domains in academically at-risk students.

Patient-Concerned Other Dyads' 12-Step Involvement and Patients' Substance Use: A Latent Class Growth Model Analysis.

This study aimed to inform clinical practice by identifying subgroups of patient-concerned other (CO) dyads. Patients with alcohol use disorders (AUDs) were characterized on Alcoholics Anonymous (AA) involvement and substance use together with COs' Al-Anon involvement. Predictors and recovery maintenance outcomes of subgroup membership were examined. Participants were 279 patient-CO dyads. Patients were in residential treatment for AUD. Parallel latent class growth model analysis characterized 12-step involvement and substance use at treatment entry and 3-, 6-, and 12-month follow-ups. Three classes were as follows: 38% Low AA/Low Al-Anon (patients' low AA and COs' low Al-Anon involvement, and patients' high-to-moderate substance use), 10% High AA/High Al-Anon (patients' high AA and COs' high Al-Anon involvement, and patients' moderate-to-low substance use), and 52% High AA/Low Al-Anon (patients' high AA and COs' low Al-Anon involvement, and patients' moderate-to-low substance use). At follow-up, the Low AA/Low Al-Anon classes' patients were less likely to have spirituality as recovery support, confidence about staying abstinent, and satisfaction with recovery progress. The High AA classes' COs had less concern about patients' drinking and scored higher on positive aspects of relationships with patients. Clinicians should encourage patients' and COs' 12-step group involvement (12-step practices' engagement). Among patients treated for AUD, AA involvement was related to better outcomes, and to COs' lessened concern about the patients' drinking. COs' Al-Anon involvement was associated with having a more positive view of their relationship with the patient. That more than one third of dyads had low 12-step group involvement suggests that treatment programs may need to facilitate involvement in non-12-step mutual-help groups.

How final year high school students' depression develop during COVID-19 in China? A latent class growth modeling analysis.

Depression increased sharply during the initial months of COVID-19, but how it developed over time is rarely explored, especially for adolescents. The current study measured depression of 605 final year high school students in China over 11months in 4 waves. The latent growth curve modeling (LGCM) was used to examine overall trends in depression and latent class growth modeling (LCGM) was used to identify potential subgroups of adolescents' depressive trajectories. At the same time, gender, life events, and rumination were included as time-invariant covariates. Overall, the development of depression in the final year of high school students showed a slight downward trend. Meanwhile, the depression trajectories showed heterogeneity, and three categories of depression trajectories were identified, which were low-stable (24.3%), depression-risk (67.9%), and high-stable (7.8%). Neuroticism, rumination, and life events such as punishment and loss were found to significantly predict these trajectories of depression. This study helps to characterize differential depression trajectories among adolescents throughout the COVID-19 pandemic and establish several related predictors of the trajectory of depression.

Examining the outcomes and acceptability of a peer-led spiritual intervention for moral injury in a veteran service organization.

The purpose of this proof-of-concept study was to examine the outcomes and acceptability of a spiritual intervention for moral injury led by veteran peers in a Veteran Service Organization (VSO), called "Heroes to Heroes." From baseline to 1-year follow-up, 101 veterans who participated in the intervention completed the evaluation surveys at four time points assessing psychological outcomes (moral injury, posttraumatic stress disorder [PTSD] symptoms, and life satisfaction), spiritual outcomes (spiritual struggles and spiritual transcendence), and their perceived helpfulness of the program. In addition, we conducted four focus groups with six to eight alumni to more fully understand veterans' views and experiences of the program. Focusing on the longitudinal surveys, latent growth modeling analyses revealed veterans generally improved across the psychological and spiritual outcomes in the study. Specifically, veterans reported steady decreases in moral injury outcomes, PTSD symptoms, and spiritual struggles along with increased life satisfaction and spiritual transcendence over the 1-year period. An inductive content analysis of veterans' responses to open-ended items in the surveys and focus group interviews revealed four possible mechanisms or facilitators of these outcomes: (a) social connectivity and belonging (e.g., shared vulnerability and camaraderie); (b) behavioral engagement in core aspects of their spirituality (e.g., sacred practices and visiting sacred places); (c) spiritual transformation and growth (e.g., closeness with God and divine forgiveness); and (d) appreciation for diversity (e.g., religious and military). Overall, these findings affirm the potential effectiveness and acceptability of the VSO's peer-led spiritual intervention for promoting the holistic healing among veterans who are contending with emotional and spiritual wounds of war. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

A Study on the Longitudinal Changes and Influencing Factors of Satisfaction with Marital Relationship of Middle-aged Couples: Focusing on Sex Differences

본 연구는 중년기 부부관계만족도와 우울감, 자녀와의 관계만족도의 종단적 변화 궤적을 파악하고, 부부관계만족도 변화에 영향을 미치는 요인들의 남녀 차이를 살펴보는 데에 목적이 있다. 한국복지패널 자료를 활용하여 잠재성장모형과 다중집단분석을 통해 분석한 결과, 중년기 부부관계만족도와 우울감, 자녀와의 관계만족도는 시간의 흐름에 따라 감소하는 것으로 나타났다. 또한 우울감의 상승은 부부관계만족도 감소에 영향을 미치며, 자녀와의 관계만족도의 증가는 부부관계만족도 증가에 미치는 영향력이 유의하였다. 남녀 차이에 있어서 중년기 우울감의 변화가 부부관계만족도의 변화에 미치는 영향은 여성의 경우만 유의한 것으로 나타났으며, 자녀와의 관계만족도 변화가 부부관계만족도 변화에 미치는 영향력은 남성과 여성 모두 유의하게 나타났으나 남성이 여성보다 더 큰 영향력을 받는 것으로 나타났다. 본 연구 결과는 중년기 부부관계 강화를 위하여 다양한 접근이 필요함을 시사한다.Objectives: This study aimed to identify the longitudinal trajectory in middle-aged marital relationship satisfaction and depression, and relationship satisfaction with children; and to research the differences between men and women in factors affecting changes in marital relationship satisfaction. Methods: Analysis was performed applying multivariate latent growth modeling and multiple group analysis from the Korean Welfare Panel was performed. Results: This study found that middle-aged marital satisfaction, depression, and relationship satisfaction with children decreased over time. Moreover, changes in depression had a negative effect on changes in marital satisfaction, and relationship satisfaction with children had a significant influence on changes in marital satisfaction. For the gender gap, the effect of changes in the depression on changes in marital satisfaction was only found for women, while the influence of the rate of change in relationship satisfaction with children on the rate of change in marital satisfaction was related to both men and women, although the effect size of the rate of change was greater for men than for women. Conclusions: The results of this study confirm that various approaches are required to strengthen middle-aged marital relationships.

잠재성장모형을 활용한 대학생의 스트레스가 진로미결정에 미치는 종단적 영향관계 분석

This study examined the longitudinal effects of college students' stress on their career indecision using data from the 12th (2018), 13th (2019), and 14th (2020) rounds of the ｢Youth Panel Survey｣ conducted by the Korea Employment Information Service. A latent growth model analysis was conducted for the relationship. As a result of the study, first, the 12th, 13th, and 14th data of college students' stress and career indecision showed a tendency to gradually increase over time. Second, the initial value of stress had a significant positive effect on the initial value of career indecision. Third, the initial value of stress was not statistically significant in the change rate of career indecision. Fourth, the change rate of stress had a significant positive effect on the change rate of career indecision. Through this study, the longitudinal changes in college student stress and career indecision and the longitudinal effect of stress on career indecision were confirmed.

Predictors and trajectories of fear of cancer recurrence in Chinese breast cancer patients

ObjectiveFear of cancer recurrence (FCR) is one of the most common and aversive psychological phenomena among cancer patients. This study explored the trajectories of FCR over the 18 months following discharge, and evaluated the associations between baseline demographic and clinical variables and FCR trajectories among Chinese women treated for breast cancer. MethodsThis is a longitudinal prospective study. All participants were asked to completed a battery of questionnaires (FCR-7, PHQ-9, GAD-7 and MPQ-VAS) at baseline, 6, 12, and 18 months after discharge. Generalized linear mixed model and group-based trajectory analyses were conducted. ResultsThree hundred women with breast cancer were recruited. Latent class growth modeling analysis showed that three-group trajectory solution was the best fitting (i.e., ‘intermediate level-stable group’ (63.3%), ‘low level-increasing group’ (18.3%), and ‘high level-decreasing group’ (18.3%). Patients reported significant higher FCR at baseline assessment compared to other time points. Significant positive associations were found between anxiety, depression and FCR. Patients who had no baseline depression (estimate = −2.14, 95% CI: −2.78-(−1.51), P < 0.001) or anxiety (estimate = −2.77, 95% CI: −3.44-(−2.10), P < 0.001) tended to report significant lower FCRs over time. Women with none/mild life stress exhibited significant lower FCRs than those with moderate/high life stress, and participants with a family history of cancer or pessimism reported higher FCRs. Conclusion>60% of the breast cancer women showed intermediate level-stable FCRs over the 18 months after discharge. Baseline anxiety, depression, life stress, family cancer history and pessimism predicts higher FCR levels. Clinical teams responsible for continuing patient care following treatment should develop clearer strategies for management of FCR.