Latent Growth Research Articles

Social Isolation Patterns and Health Outcomes in Midlife and Later Life

Conceptualizing social isolation as a multidimensional construct encompassing social networks, social contacts, perceived support and loneliness, this research aims to: (1) identify patterns of social isolation trajectory among middle-aged and older adults in the U.S.; (2) investigate how different patterns of social isolation trajectory are related to adults’ physical, mental, cognitive, and overall health. Latent class growth modeling was used to examine social isolation trajectory patterns over nine years in a national sample of 6,457 adults aged 51+. Four patterns of social isolation trajectory were identified: severely isolated, moderately isolated, subjectively integrated, and objectively integrated. The objectively integrated group reported the best physical, mental, cognitive, and overall health, whereas the severely isolated group reported the worst. The moderately isolated and subjectively integrated groups fell in between, with the latter displaying relatively better health outcomes. Findings support a close relationship between poor health and long-term social isolation.

Metabolic Syndrome and Objective Physical Performance Measures in Mid-to-Early Late Life Women: SWAN

Recent evidence shows that more complex clusters of chronic conditions are associated with poorer health outcomes. Less clear is the extent to which these clusters are associated with different types of disability (basic and instrumental activities of daily living (ADL, IADL) and functional mobility (FM)) over time. This was a longitudinal analysis using the National Health and Aging Trends Study (NHATS) (n = 6,179). Using latent class analysis, we determined the optimal clusters of chronic conditions, then assigned each person to a best-fit class. Next, we used mixed-effects models with repeated measures to examine the effects of group (best-fit class), time (years from baseline), and the group by time interaction on each of the outcomes in separate models over 4 years. We identified 5 chronic condition clusters: “multisystem morbidity” (13.9% of the sample), “diabetes” (39.5%), “osteoporosis” (24.9%), “cardio/stroke/cancer” (4.5%), and “minimal disease” (17.3%). Group by time interaction was not significant for any outcome. For ADL outcome, only time was significant (F3,16249 = 224.72, p < .001). For IADL, both group (F4,5403 = 6.62, p < .001) and time (F3,22622 = 3.87, p = .009) were significant. For FM, both group (F4,5920 = 2.96, p = .02) and time were significant (F3,16381 = 213.41, p < .001). We did not find evidence that any cluster experienced greater increases in disability over time, but all clusters containing multiple chronic conditions had risk of IADL and FM disability. Increased screening for IADL and FM disability could identify early disability and prevent decline.

Transitions in Adherence Trajectories From Intervention to Maintenance of a Falls Prevention Exercise Program

The successful implementation of a falls prevention exercise program for older adults hinges on self-maintenance after active intervention. However, little is known about the pattern of adherence from the intervention to the maintenance phase of such programs, and the factors influencing adherence. We investigate transitions in exercise adherence trajectories from the active intervention to the maintenance phase of a falls prevention exercise program in Singapore, and whether exercise self-efficacy is associated with adherence in the maintenance phase. We analyze data of 143 older adults who participated in a 12-week, group-based falls prevention exercise program, followed by a 6-month maintenance phase, in 2018-2019. Sequential process latent class growth modeling identifies the distinct exercise adherence trajectories in the active intervention and the maintenance phase separately and their transition patterns. Multivariable regression examines whether baseline and change in self-efficacy during the active intervention predict adherence during the maintenance phase. The analysis reveals three exercise adherence trajectories— adherent (40% of participants), intermittent (38%), and disengaged (22%)—in the active intervention phase, and two trajectories—adherent (33%) and disengaged (67%)—in the maintenance phase. Those adherent in the maintenance phase comprise participants who were adherent (42%) or intermittent (58%) in the active intervention phase. Baseline and increase in exercise self-efficacy during the active intervention are positively associated with adherence in the maintenance phase. The findings capture the heterogeneity in exercise adherence patterns within and across the active intervention and maintenance phases of falls prevention exercise program, and the importance of exercise self-efficacy in continued adherence to exercise.

The influence of multidimensional deprivation on problem drinking developmental trajectory among young adults: a longitudinal study using latent class growth analysis

BackgroundMany young people in Korea today experience deprivation in various areas of life. The social determinants of health approach maintains that social factors play an important role in an individual’s physical and mental health. This study aimed to investigate the problem drinking trajectory of young Korean people and identify the effects of multidimensional deprivation on problem drinking.MethodsThe study used data from 2012 to 2018 found in the Korea Welfare Panel Study. Latent class growth analysis was performed to determine the number of trajectories of problem drinking. After identifying latent classes, a multinomial logistic regression analysis was utilized to examine multidimensional deprivation as a predictor of class membership.ResultsLatent class analysis yielded three groups: (1) a low-level maintenance group (low level of alcohol use maintained at the low level), (2) a moderate-level increasing group (moderate level of problem drinking with a moderate increase in problem drinking), and (3) a risky drinking increasing group (high level of problem drinking with a rapid increase in problem drinking). Results from multinomial logistic regression showed that deprivation in housing and social deprivation increased the probability of belonging to the risky drinking increasing group compared to other reference groups.ConclusionThe study speaks to the need to establish appropriate intervention strategies according to the level and changes in the pattern of alcohol use. The implications of housing and social deprivation concerning problem drinking among young Korean people are also discussed.

P.0776 Premorbid childhood and adolescent functioning trajectories in patients with first-episode of schizophrenia using Latent Class Growth Analysis: 2-year follow-up study

P.0776 Premorbid childhood and adolescent functioning trajectories in patients with first-episode of schizophrenia using Latent Class Growth Analysis: 2-year follow-up study

Abstract 10307: Predictors of Growth Trajectory in Infants with Congenital Heart Disease

Introduction: Infants born with critical congenital heart disease (cCHD) are known to experience growth failure in infancy, particularly those with single ventricle physiology. Differences in early weight-for-age Z-score growth trajectory (WAZ-GT) within this population have not been defined. We aimed to describe the WAZ-GT of infants with cCHD after cardiac surgery in the first 4 months of life and assess potential risk factors. Methods: This is a secondary analysis of a previously reported RCT, REACH telehealth program (2012-2017, Trial NCT01941667). Sample included both intervention and control infants (n=178). Weights over the first 4 months of life were converted to WAZ using the World Health Organization standards. WAZ-GT classes were identified using latent class growth modeling. Multinomial logistic regression models were used to examine the associations between socio-demographic and clinical characteristics and WAZ-GT classes. Results: Four distinct classes of WAZ-GT were identified (maintaining WAZ &gt;0, 14%; stable around WAZ=0, 35%; partially recovered, 28%; never recovered, 23%; see Figure). No differences existed in WAZ-GT when stratified by single and two ventricle physiology or by telehealth intervention and control groups. The stable around WAZ=0 class was assigned as the reference group. Compared with these infants, those in the never recovered class were 3-6 times more likely to have length of stay (LOS) ≥ 14 days, tube feeding at discharge, and low appetite. Partially recovered infants were 3 times more likely to have LOS ≥ 14 days and be an only child. Infants maintaining WAZ &gt;0 were 3 times more likely to have two ventricle physiology and parents with at least a college education and who did not report infant borderline appetite. Conclusions: This study is the first to describe distinct classes of WAZ-GT for infants with cCHD early in infancy. We identified associated predictors that can be used to target interventions in this vulnerable population.

Irritability, Defiant and Obsessive-Compulsive Problems Development from Childhood to Adolescence

Little is known about the coexistence of oppositionality and obsessive-compulsive problems (OCP) in community children and how it affects their development until adolescence to prevent possible dysfunctions. The co-development of oppositional defiant dimensions and OCP is studied in 563 children (49.7% female) from ages 6 to 13 years, assessed yearly with measures answered by parents and teachers. A 4-class model based on Latent Class Growth Analysis for three parallel processes (irritability, defiant, and OCP) was selected, which showed adequate fitting indexes. Class 1 (n = 349, 62.0%) children scored low on all the measures. Class 2 (n = 53, 9.4%) contained children with high OCP and low irritability and defiant. Class 3 (n = 108, 19.2%) clustered children with high irritability and defiant and low OCP. Class 4 (n = 53, 9.4%) clustered comorbid irritability, defiant, and OCP characteristics. The classes showed different clinical characteristics through development. The developmental co-occurrence of irritability and defiant plus obsessive-compulsive behaviors is frequent and adds severity through development regarding comorbidity, peer problems, executive functioning difficulties, and daily functioning. The identification of different classes when combining oppositional problems and OCP may be informative to prevent developmental dysfunctions and to promote good adjustment through development.

The maturing moral perception of crime: The development of moral correspondence and its association with emerging adults’ delinquent involvement

Abstract Purpose: This study scrutinizes Situational Action Theory’s (SAT) implications of how internal and external criminogenic factors concerning the rule of moral correspondence develop conjointly over the life-course and how this affects offending during emerging adulthood.Objectives: The main objective is to empirically explore whether the development of moral correspondence displays heterogeneity that can be theoretically linked to heterogeneous offending developments. Additionally, the paper also discusses unexpected co-occurrences arising specifically for the new opportunity structures to commit crimes in emerging adulthood via the broader developmental perspective proposed by the Developmental Ecological Action model of SAT (DEA).Methods: Results from two separate classification models (latent class growth analysis and repeated-measurement latent class analysis) following a German non-offender sample’s (N = 1810) transition between adolescence and emerging adulthood (ages 14 to 28) are cross-tabulated.Results: Five moral correspondence pathways differentiated by the timing, speed and completeness of achieving pro-social states can be extracted. The longer individuals resist this maturitation process during adolescence, the higher their chances are to follow a trajectory during emerging adulthood characterized by proclivities for youth crimes. However, these also follow a diminishing trend. Contrary, rising trajectories fueled by proclivities to commit adult crimes are less often associated by a remiss to maturity. Social selection into specific activity fields seems to play an important role in the availability and accessibility to either type of crime, thus, offering an explanation for these diverging results.Conclusion: SAT and its developmental framework DEA serve as useful blueprints to map the development of changes in crime and its related causes even with non-situational data through its analytical rigor to integrate micro-, meso-, and macro-levels of explanation.

Latent class growth modeling of depression and anxiety in older adults: an 8-year follow-up of a population-based study

BackgroundDepression and anxiety are common mental health conditions in the older adult population. Understanding the trajectories of these will help implement treatments and interventions.AimsThis study aims to identify depression and anxiety trajectories in older adults, evaluate the interrelationship of these conditions, and recognize trajectory-predicting characteristics.MethodsGroup-based dual trajectory modeling (GBDTM) was applied to the data of 3983 individuals, aged 65 years or older who participated in the Korean Health Panel Study between 2008 and 2015. Logistic regression was used to identify the association between characteristics and trajectory groups.ResultsFour trajectory groups from GBDTM were identified within both depression and anxiety outcomes. Depression outcome fell into “low-flat (87.0%)”, “low-to-middle (8.8%)”, “low-to-high (1.3%)” and “high-stable (2.8%)” trajectory groups. Anxiety outcome fell into “low-flat (92.5%)”, “low-to-middle (4.7%)”, “high-to-low (2.2%)” and “high-curve (0.6%)” trajectory groups. Interrelationships between depression and anxiety were identified. Members of the high-stable depression group were more likely to have “high-to-low” or “high-curved” anxiety trajectories. Female sex, the presence of more than three chronic diseases, and being engaged in income-generating activity were significant predictors for depression and anxiety.ConclusionsDual trajectory analysis of depression and anxiety in older adults shows that when one condition is present, the probability of the other is increased. Sex, having more than three chronic diseases, and not being involved in income-generating activity might increase risks for both depression and anxiety. Health policy decision-makers may use our findings to develop strategies for preventing both depression and anxiety in older adults.

\u201cWild Years\u201d: Rock Music, Problem Behaviors and Mental Well-being in Adolescence and Young Adulthood

Adolescent preferences for non-mainstream types of rock music can be markers of adolescent problem behaviors, but no study has ever investigated whether this relationship continues into adulthood. In a six-wave study, 900 Dutch adolescents were followed from ages 12 to 21 (Mage T1 12.4, 51.1% girls), while reporting on depressive symptoms, mental well-being, aggression and drug use. A latent class growth analysis on their preferences for specific types of rock music revealed four fan groups. When these fan groups were compared to one another, in adolescence, the all-out rock fans displayed the highest peak in depressive symptoms and the lowest dip in well-being and the rock/metal fans reported the most aggression. And for both these groups, drug use increased at the onset of adulthood. Pop fans displayed a profile characterized by low depressive symptoms and aggression, and high in mental well-being. Finally, the popular rock fans held an in-between position between pop fans, on one side, and the all-out rock fans and rock/metal fans, on the other side. Thus, music preferences can be markers of problems, not only in adolescence but also in young adulthood. Still, music can enhance mood, helps to cope with problems, and peers in fan groups can provide support. This research focuses on the relationship between music and problem behaviors, specifically among members of the all-out rock fans and rock/metal fans, but many of these young people might have had more personal problems if they had not had their music and their fan-group peers.

Pain trajectories and possible predictors of a favourable course of low back pain in patients consulting musculoskeletal physicians in The Netherlands

BackgroundIn The Netherlands, low back pain patients can consult physicians specialized in musculoskeletal (MSK) medicine. Previous studies have reported on the characteristics of patients consulting MSK physicians, and the treatment options used. There are no studies yet reporting on the course of Low Back Pain (LBP) after treatment by musculoskeletal (MSK) physicians in The Netherlands.MethodsIn an observational cohort study MSK physicians recorded data about all low back pain patients presenting for a first consultation. At baseline they recorded age, gender, type and duration of the main complaint, and concomitant complaints. At the end of treatment they recorded the type of treatment and the number of treatment sessions. Patients were recruited to answer questionnaires at baseline, and at 6-weekly intervals during a follow-up period of six months. Patient questionnaires included information about previous medical consumption, together with PROMs measuring the level of pain and functional status. Latent Class Growth Analysis (LCGA) was used to classify patients into different groups according to their pain trajectories. Baseline variables were evaluated as predictors of a favourable trajectory using logistic regression analyses, and treatment variables were evaluated as possible confounders.ResultsA total of 1377 patients were recruited, of whom 1117 patients (81%) answered at least one follow-up measurement. LCGA identified three groups of patients with distinct pain trajectories. A first group (N = 226) with high pain levels showed no improvement, a second group (N = 578) with high pain levels showed strong improvement, and a third group (N = 313) with mild pain levels showed moderate improvement. The two groups of patients presenting with high baseline pain scores were compared, and a multivariable model was constructed with possible predictors of a favourable course. Male gender, previous specialist visit, previous pain clinic visit, having work, a shorter duration of the current episode, and a longer time since the complaints first started were predictors of a favourable course. The multivariable model showed a moderate area under the curve (0.68) and a low explained variance (0.09).ConclusionsIn low back pain patients treated by musculoskeletal physicians in The Netherlands three different pain trajectories were identified. Baseline variables were of limited value in predicting a favourable course.

Abstract 853: Body mass index trajectories across the adult life course and pancreatic cancer risk

Abstract Background: Adiposity is associated with pancreatic ductal adenocarcinoma (PDAC), but the effects of weight excess over an adult life course have not been studied extensively. We examined the association between trajectories of body mass index (BMI) from ages 18 up to 71 years and risk of subsequent PDAC. Methods: Our analysis included 270,722 (163,873 men, 106,849 women) NIH-AARP Diet and Health Study participants, 50-71y, who successfully completed questionnaires with self-reported height and weight at ages 18, 35, 50 and at baseline (50-71y, 1995-1996) and from which BMI (kg/m2) was calculated. We used latent class growth mixture modeling to identify BMI trajectories using adult BMI reported at each of the four timepoints. We identified BMI trajectories for all sample combined and separately for men and women. We then examined the association between BMI trajectories and incident PDAC using Cox proportional hazards models to calculate age, smoking, and sex adjusted hazard ratios (HR) and 95% confidence intervals (CI) overall and by sex. Participants that maintained normal weight status over their adulthood were set as the referent group. Results: Over an average follow-up time of 13.1 years (max: 15.17 years), 3105 incident PDAC cases (2033 men, 1072 women) were identified in the overall cohort. We identified four overall and sex specific BMI trajectory groups, each with one maintainer and three increasers. Participants either maintained normal weight (N-N, 37.1% of the cohort), or increased from normal-overweight (N-OW, 36.4%), normal-obese (N-O, 20.7%), or normal-severely obese (N-SO, 5.8%). The male cohort was divided into N-N (35.5%), N-OW (23.3%), normal-higher overweight (N-HOW, 34.8%), and N-SO (6.6%) while the female cohort was divided into N-N (51.6%), N-OW (34.5%), N-SO (11.3%), and OW-SO (2.7%). Compared to N-N, the N-OW (HR=1.12, 95% CI 1.03-1.21), N-O (1.22, 1.11-1.35) and N-SO (1.22, 1.04-1.45) groups were at significantly increased risk for PDAC. Compared to the sex-specific maintainer groups, men in the N-OW (1.14, 1.02-1.28), N-HOW (1.16, 1.04-1.29), and N-SO (1.39, 1.15-1.67) groups were significantly associated with PDAC, while only women in the N-OW (1.12, 1.00-1.29) group showed a borderline significant association. Adding diabetes to the models slightly attenuated the associations by less than 10% with the greatest attenuation observed in the SO groups. The overall associations were not significantly modified by sex (P-interaction = 0.10) or smoking status (never, former, current, P-interaction = 0.17). Conclusions: In this large prospective cohort study, increasing BMI throughout adulthood was associated with a greater risk for PDAC. Citation Format: Simran Arjani, Pedro F. Saint-Maurice, Sachelly Julian-Serrano, Rachael Stolzenberg-Solomon. Body mass index trajectories across the adult life course and pancreatic cancer risk [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 853.

Wastewater treatment and Mycoremediation by P. ostreatus mycelium

Wastewater from industries contains a considerable amount of chemicals and is characterized by high biological oxygen demand (BOD), heavy metals, intense color and are thus toxic to the environment. White-rot fungi such as Oyster mushrooms are comprised of high biomass and various degradative enzymes that add to another dimension of use, such as mycoremediation. The mushroom was maintained in vitro in mycelial form. Remazol Brilliant Blue R (RBBR), Methyl Red (M.R.), and Malachite Green (M.G.) dyes, which are recalcitrant dyes that are often used for the preparation of many polymeric dyes, and textile dyeing, were used to test the decolorization potential of natural isolates of oyster mushroom. Mycelium was grown in the presence of RBBR, MR, and M.G. at a concentration of 100μM. It was found to decolorize more than 70%, 95%, and 80% of RBBR, MR, and M.G. dye, respectively, within 6 days. Mushroom mycelium was also tested for its lead tolerance and heavy metal biosorption potential. Lead tolerance was studied up to 500mg/L, which shows species′ latent growth with fungal morphology changes. Biosorption ability was observed by the use of Inductively Coupled Plasma spectrometry, which shows lowered concentrations of heavy metals (Pb, Cr, Ni) after 5 days of mycelial growth in the presence of these metals. The isolated strain was also found to have significant decolorizing and degrading potential for synthetic dyes and phenolic compounds in industrial effluents. This study focuses on edible oyster mushrooms′ ability to develop environmentally less aggressive processes in the treatment of industrial effluents.

Patterns of joint damage in severe haemophilia A treated with prophylaxis

The primary objective of this study was to assess whether there are different patterns (classes) of joint health in young boys with severe haemophilia A (SHA) prescribed primary tailored prophylaxis. We also assessed whether age at first index joint bleed, blood group, FVIII gene abnormality variant, factor VIII trough level, first-year bleeding rate and adherence to the prescribed prophylaxis regimen significantly predicted joint damage trajectory, and thus class membership. Using data collected prospectively as part of the Canadian Hemophilia Primary Prophylaxis Study (CHPS), we implemented a latent class growth mixture model technique to determine how many joint damage classes existed within the cohort. We used a multinomial logistic regression to predict the odds of class membership based on the above predictors. We fitted a survival model to assess whether there were differences in the rate of dose escalation across the groups. We identified three distinct classes of trajectory: persistently low, moderately increasing and rapidly increasing joint scores. By multinomial regression, we found that only age at first index joint bleed predicted rapidly increasing joint scores. The rapidly increasing joint score class group moved through dose escalation significantly faster than the other two groups. Using tailored prophylaxis, boys with SHA follow one of three joint health trajectories. By using knowledge of disease trajectories, clinicians may be able to adjust treatment according to a subject's predicted long-term joint health and institute cost-effective programmes of prophylaxis targeted at the individual subject level.

Virologic Response to Very Early HIV Treatment in Neonates.

Factors that influence viral response when antiretroviral therapy (ART) is initiated in neonates are not well characterized. We assessed if there is consistency in predictive factors when operationalizing viral response using different methods. Data were collected from a clinical study in South Africa that started ART in neonates within 14 days of birth (2013–2018). Among 61 infants followed for ≥48 weeks after ART initiation, viral response through 72 weeks was defined by three methods: (1) clinical endpoints (virologic success, rebound, and failure); (2) time to viral suppression, i.e., any viral load (VL: copies/mL) <400, <50, or target not detected (TND) using time-to-event methods; and (3) latent class growth analysis (LCGA) to empirically estimate discrete groups with shared patterns of VL trajectories over time. We investigated the following factors: age at ART initiation, sex, birthweight, preterm birth, mode of delivery, breastfeeding, pre-treatment VL and CD4, maternal ART during pregnancy, and maternal VL and CD4 count. ART was initiated 0–48 h of birth among 57.4% of the infants, 48 h–7 days in 29.5% and 8–14 days in 13.1%. By Method 1, infants were categorized into ‘success’ (54.1%), ‘rebound’ (21.3%), and ‘failure’ (24.6%) for viral response. For Method 2, median time to achieving a VL <400, <50, or TND was 58, 123, and 331 days, respectively. For Method 3, infants were categorized into three trajectories: ‘rapid decline’ (29.5%), ‘slow decline’ (47.5%), and ‘persistently high’ (23.0%). All methods found that higher pre-treatment VL, particularly >100,000, was associated with less favorable viral outcomes. No exposure to maternal ART was associated with a better viral response, while a higher maternal VL was associated with less favorable viral response and higher maternal CD4 was associated with better viral response across all three methods. The LCGA method found that infants who initiated ART 8–14 days had less favorable viral response than those who initiated ART earlier. The other two methods trended in a similar direction. Across three methods to operationalize viral response in the context of early infant treatment, findings of factors associated with viral response were largely consistent, including infant pre-treatment VL, maternal VL, and maternal CD4 count.

Identifying Return to Work Self-Efficacy Trajectories in Employees with Mental Health Problems

Purpose Return to work self-efficacy (RTW-SE) is a strong predictor of return to work (RTW) in employees with mental health problems (MHPs). However, little is known about the development of RTW-SE during the RTW process. In this study, we aimed to identify RTW-SE trajectories in the year following sick leave in employees with MHPs and provided a description of the trajectories in terms of personal and work characteristics, and RTW status. Methods This multi-wave study included 111 employees with MHPs. RTW-SE was measured at baseline, and at 3, 6, and 12 months follow-up with the RTW-SE scale for employees with MHPs. Results Latent class growth analysis revealed six trajectories. In three trajectories employees had increasing RTW-SE scores, namely (class 1) low start, moderate increase, (class 3) moderate start, small increase and (class 5) moderate start, steep increase. The other trajectories were defined by (class 2) persistently high, (class 6) persistently low, and (class 4) decreasing RTW-SE scores over time. Employees across the various trajectories differed significantly with respect to RTW status, and personal and work characteristics measured at baseline, including age, gender, and type of MHP. Less favorable trajectories (class 4 and 6) were characterized by higher age, a higher prevalence of anxiety disorder and lower RTW rates. The most favorable trajectory (class 2) was characterized by a higher proportion of stress-related disorders and less major depression diagnoses. Conclusions Large heterogeneity exists in terms of RTW-SE trajectories in employees with MHPs and significant differences were found across the trajectories regarding personal and work characteristics, and RTW status. Insights into RTW-SE trajectories and their attributes are important to advance more effective and personalized RTW treatment for employees with MHPs.

Developmental Trajectories of Delinquent Peer Association Among Korean Adolescents: A Latent Class Growth Analysis Approach to Assessing Peer Selection and Socialization Effects on Online and Offline Crimes

The relationship between peers and delinquency has been taken as evidence for selection and socialization effects in the etiology of adolescents. Accumulating evidence suggests that both effects are involved. This study examines whether adolescents’ aggressive propensities and behaviors predict their peers (selection) and whether peers’ propensities and behaviors predict adolescents’ behaviors (socialization). The latent class growth analysis approach revealed three distinct subgroups: an early-onset group (0.9%); a late-peak group (3.37%); and a normative group (95.73%). Both selection and socialization effects were supported using a longitudinal Korean adolescent self-report. The results showed that adolescents with less self-control who are online more frequently and exhibit higher levels of traditional bullying and delinquency were more likely to be members of both the early-onset and late-peak groups compared with the normative group. Also, the aggressive behaviors fully mediated the link between aggressive propensities and delinquent peer associations. Furthermore, adolescents in the late-peak group (but not those in the early-onset group) were associated with a greater likelihood of online and offline delinquency, but cyberbullying and traditional bullying in late adolescence levels were high in both groups’ members.

Symptom Trajectory among Formerly Abused Women: An Exploratory Study

Women who have experienced intimate partner violence suffer from symptoms that persist long after the abuse has ended. However, the patterns and trajectory of these symptoms are poorly understood. The objective of this longitudinal research was to explore symptom trajectory typologies. A latent class growth analysis with multi-outcomes modeling was used to explore typologies based on women’s (N = 30) trajectories over 4 months. Two distinct symptom typologies were identified: (1) consistently lessening symptom group (n = 16); (2) moderately worsening symptom group (n = 14). Women who experienced severe psychological vulnerability exhibited better symptom trajectories; a potential reflection of resilience in this population.

Longitudinal trajectories of diet quality and subsequent mortality among Chinese adults: results from the China health and nutrition survey 1997\u20132015

BackgroundChina has witnessed a significant nutritional transition. However, there is a gap in the literature investigating the association between change of diet and mortality among Chinese. Thus, we aimed to explore the longitudinal trajectories of diet quality over 10 years (from 1997 to 2006) and the subsequent risk of death till 2015 among Chinese adults.MethodsData from the China Health and Nutrition Survey were analyzed in 6398 adults. Dietary intake was assessed using three consecutive 24-h recalls. Diet quality was assessed by the Chinese Healthy Eating Index (CHEI), which includes 17 components and is based on the Dietary Guidelines for Chinese. Latent Class Growth Analysis was conducted to derive trajectories of diet quality over 10 years. Cox proportional hazard regression was used to calculate hazard ratios for total mortality.ResultsFour distinct CHEI trajectories were identified: 1) worsening; 2) low-moderate-low; 3) improving; 4) high-moderate-high. Group 3 had the lowest mortality rate (5.6%) in the subsequent 9 years, while the groups with worsening or low diet quality had a higher mortality rate (Group 1: 7.5%; Group 2: 10.8%). In the fully adjusted model, compared to group 2, mortality rates were lower for group 3 (RR = 0.73; 95% CI: 0.55, 0.97) and group 4 (RR = 0.76; 95% CI: 0.59, 0.98). No associations with mortality were found for the group 1, when compared to group 2.ConclusionsLong-term improved diet quality and adherence to the Dietary Guidelines for Chinese may decrease the risk of death in Chinese adults.

Latent class growth modelling for the evaluation of intervention outcomes: example from a physical activity intervention

Intervention studies often assume that changes in an outcome are homogenous across the population, however this assumption might not always hold. This article describes how latent class growth modelling (LCGM) can be performed in intervention studies, using an empirical example, and discusses the challenges and potential implications of this method. The analysis included 110 young adults with mobility disability that had participated in a parallel randomized controlled trial and received either a mobile app program (n = 55) or a supervised health program (n = 55) for 12 weeks. The primary outcome was accelerometer measured moderate to vigorous physical activity (MVPA) levels in min/day assessed at baseline, 6 weeks, 12 weeks, and 1-year post intervention. The mean change of MVPA from baseline to 1-year was estimated using paired t-test. LCGM was performed to determine the trajectories of MVPA. Logistic regression models were used to identify potential predictors of trajectories. There was no significant difference between baseline and 1-year MVPA levels (4.8 min/day, 95% CI: −1.4, 10.9). Four MVPA trajectories, ‘Normal/Decrease’, ‘Normal/Increase’, ‘Normal/Rapid increase’, and ‘High/Increase’, were identified through LCGM. Individuals with younger age and higher baseline MVPA were more likely to have increasing trajectories of MVPA. LCGM uncovered hidden trajectories of physical activity that were not represented by the average pattern. This approach could provide significant insights when included in intervention studies. For higher accuracy it is recommended to include larger sample sizes.