Life Satisfaction Trajectories 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.

10-year variability in high and low life satisfaction trajectories post-traumatic brain injury: a TBI model systems study

ABSTRACT Purpose To determine how life satisfaction changes across the first 10 years following traumatic brain injury (TBI). Methods Participants included 1,941 individuals from the TBI Model Systems database with life satisfaction data at 1-, 5-, and 10-years post-TBI. Based on Satisfaction With Life Scale scores, individuals were characterized as having one of the five 10-year life satisfaction trajectories: ‘Stable High,’ ‘Stable Low,’ ‘Increased to High,’ ‘Decreased to Low,’ and ‘Unstable.’ These were analyzed for group differences in demographics and psychosocial and functional outcomes. Results Sixty percent participants had ‘Stable High’ or ‘Increasing to High’ trajectories. Approximately 25% had “Stable Low’ or ‘Decreasing to Low’ trajectories, and approximately 15% had unstable trajectories. Higher life satisfaction trajectories were associated with the best psychosocial and functional outcomes whereas lower trajectories were associated with the worst psychosocial and functional outcomes. Trajectories were indistinguishable based on demographics. Conclusion Life satisfaction over the first 10 years following TBI is dynamic, with most individuals reporting high life satisfaction by 10 years post-TBI. Examination of psychosocial and functional factors related to life satisfaction trajectories may inform community-based intervention recommendations, resources, and supports to maximize long-term satisfaction with life.

Disparities between Native Americans and Whites in trajectories of functional independence and life satisfaction over the 5 years after traumatic brain injury.

Traumatic brain injury (TBI) can lead to impairments in motor and cognitive function and reduced life satisfaction. TBI is one of the leading causes of death and disability worldwide and disproportionately affects Native Americans, who have the highest rates of TBI among all races in the United States and elevated likelihood for fatality and severe complications. This study investigated whether disparities in functional and life satisfaction outcomes exist longitudinally over the 5 years after complicated mild, moderate, or severe TBI between Native Americans and White individuals; it further explored which demographic and injury-related covariates account for them. The current study used a subsample of the national TBI Model Systems Database of 80 demographically and injury-severity matched Native American and White pairs (total n = 160). A series of longitudinal hierarchical linear models found that Native Americans experienced significantly lower Functional Independence Measure Cognitive and Motor trajectories than Whites; however, life satisfaction was comparable. Native Americans had declining cognitive function over time relative to a slight increase in White individuals. This differential movement dissipated with the addition of employment status at the time of injury and type of health insurance. These results demonstrate a profound need to further investigate the cultural and contextual variables unique to Native Americans that underlie these differences and highlight the importance of culturally responsive treatment and rehabilitation in bridging the gap in recovery. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

GENDER INEQUALITIES IN THE DISRUPTION OF LONG-TERM LIFE SATISFACTION TRAJECTORIES DURING COVID-19

Abstract Evidence suggests that women’s mental health has been disproportionately impacted by the COVID-19 pandemic. Time-use differences have been hypothesised as an explanatory factor, as women generally spent more time than men on psychologically taxing activities. We used data on life satisfaction spanning 25 years (1996-2021, age 26-51) from a birth cohort representing adults born in Britain in 1970 (n=6,766). We used piecewise latent growth curve models to study gender differences in the long-term trajectories of life satisfaction and in the impact of the pandemic onset on these trajectories, and whether time-use differences partly explained that differential impact. Women had consistently higher life satisfaction levels prior to the pandemic (Δintercept,unadjusted=0.204 [95% CI: 0.073, 0.336], p=.002), and then experienced a more accelerated decline with its onset (Δquad2,unadjusted=-0.019 [-0.026, -0.011], p<.001). This gap remained stable after accounting for time use differences (Δquad2,adjusted=-0.019 [-0.028, -0.011], p<.001). Nevertheless, time spent working was positively related to life satisfaction in women but negatively in men (Δworking1-8h=0.499 [-0.168, 0.829], p= .003; Δworking>8h=0.543 [0.185, 0.902], p=.003), whereas time spent doing housework was negatively related to life satisfaction in women but positively in men (Δhousework1h=-0.723 [-0.749, -0.045], p=.027). Results were robust to adjustment for the concurrent financial situation. Our study shows gender inequalities in the impact of the pandemic on the long-term life satisfaction trajectories of adults in their 50s and suggests that time-use differences do not explain these inequalities. Further research on the mechanisms underlying the differential impact of the pandemic across genders in positive mental health is needed.

HOW SPOUSAL BEREAVEMENT SHAPES LIFE SATISFACTION: STABILITY AND CHANGE ACROSS HISTORICAL TIME

Abstract Lifespan psychological and life course sociological research have long shown that spousal bereavement constitutes one of the most stressful life events in older adulthood that is often associated with marked declines in well-being. It is an open question though whether and how the well-being implications of spousal loss have changed over the past decades. To do so, we used multi-year within-person longitudinal change data from 2,042 participants (Mage at event =65.73 years, 71% women) of the German Socio-Economic Panel obtained annually since 1984. We combine latent basis growth models with methods that analyze the Area under the Curve so as to consider the time window from five years prior to five years after spousal loss. Results revealed that having lost one’s spouse in the 2000s and 2010s is associated with overall less well-being declines than having lost one’s spouse in the 1980s and 1990s. Building on earlier approaches that have distinguished anticipation, reaction, and adaptation phases of bereavement revealed that such improvements are primarily driven by fewer declines in the anticipation phase and faster recovery in the adaptation phases (both by about 0.1 SD per 10 years of historical time), whereas we found partial evidence for steeper declines in the immediate reaction phase. We discuss and in part examine possible explanatory factors at the individual, spousal, social, and societal level for the observed historical improvements in life satisfaction trajectories surrounding spousal loss in Germany over the last three decades.

The Impact of Early Marriage on the Life Satisfaction, Education and Subjective Health of Young Women in India: A Longitudinal Analysis

Despite progress in reducing rates of early marriage, it is still a widespread practice in India accounting for 30 per cent of the world’s early marriages. Understanding its impacts is thus of high importance to global gender equality goals. This article examines the impact of early marriage on multi-dimensional aspects of well-being: life satisfaction, subjectively assessed health and educational attainment. Difference-in-differences analysis with propensity score matching examines causal effects using Young Lives Study data. The analysis shows women who married early experience a trajectory of lower life satisfaction which is in evidence before marriage, even at age 12, persisting until the latest survey at age 22. There is no evidence of a causal negative effect of early marriage on life satisfaction; the relationship is more complicated, linked to trajectories of deprivation which commence from a very young age. In contrast, early marriage negatively affects women’s self-reported health and educational attainment by age 22.

Differences in the impact of the COVID-19 pandemic in the long-term trajectories of life satisfaction by sex in the UK: a prospective cohort study

BackgroundThe COVID-19 pandemic has disproportionately affected women's mental health, with most evidence focused on mental ill-health outcomes. Previous research suggests that differences in time-use might explain this disparity, as women generally spent more time doing psychologically taxing activities than men. We investigated (1) sex differences in the impact of the pandemic in the long-term trajectories of life satisfaction and (2) whether time-use differences partly explained that differential impact. MethodsIn this prospective cohort study, we used the 1970 British Cohort Study, a birth cohort representing people born in Great Britain in 1970. Since 1970, information has been collected for all cohort members every 4–10 years (ten sweeps). Additional data were collected at three timepoints during the pandemic (May 2020, September–October 2020, February–March 2021) as part of the COVID-19 Survey. Response rates within the target population ranged between 23·6% (May, 2020) and 32·5% (March, 2021) in the COVID-19 Survey. We used non-response weights to restore sample representativeness to the target population (cohort members alive and residing in the UK during the pandemic). Life satisfaction was prospectively assessed at ages 26 (1996), 30, 34, 42, 46, 50, 50·5, and 51 years (2021) using a single question with responses ranging from 0 (lowest life satisfaction) to 10 (highest life satisfaction). We used multiple-group piecewise latent growth curve models grouped by sex assigned at birth. Additional models were adjusted for self-reported number of hours spent working, volunteering, home-schooling children, taking care of children and other people, and doing housework during the pandemic. Participants provided verbal informed consent. Ethics approval was not sought as non-sensitive, open-access data with minimal risk of identification was used. FindingsWe analysed data from 6766 adults (3799 [56·2%] women and 2967 [43·8%] men). Compared with men, women had consistently higher levels of life satisfaction before the pandemic (Δintercept,unadjusted = 0·213, 95% CI 0·087 to 0·340, p=0·0009), and experienced a more accelerated decline with its onset (Δquad2,unadjusted = –0·018, –0·026 to –0·011; p<0·0001), even after accounting for time use (Δquad2,adjusted = –0·016, –0·031 to –0·001; p=0·0348). Results were robust to adjustment for concurrent financial and occupational situation (Δquad2,adjustedfull = –0·019, –0·035 to –0·004; p=0·0158). InterpretationOur study shows sex inequalities in the impact of the pandemic on the long-term life satisfaction trajectories of adults in their 50s. Self-reported time-use differences did not account for these inequalities. One of the limitations is that we relied on self-reported time-use and were not able to include factors like the so-called mental load (being responsible for organising or monitoring activities, regardless of being involved in their execution), which might partly explain these results. FundingEconomic and Social Research Council (ESRC) Centre for Society and Mental Health at King's College London.

Age-friendly neighbourhood environment, functional abilities and life satisfaction: A longitudinal analysis of older adults in urban China

The construction of age-friendly neighbourhoods is a priority for practice and policy to promote active ageing and increase life satisfaction for older adults. However, there has been a paucity of longitudinal evidence on the interaction effects of age-friendly neighbourhood environment and functional abilities on life satisfaction among older adults in urban China. This study makes the first attempt to examine the effect of person-environment fit on life satisfaction by the accumulative effects of age-friendliness of the baseline neighbourhood environment (measured within the WHO Age-Friendly City framework) on functional abilities and life satisfaction trajectories and the long-term effects of functioning changes on life satisfaction, drawing from four waves of longitudinal data from the China Health and Retirement Longitudinal Study (CHARLS) and latent growth curve modelling. Results indicated that the age-friendliness of transportation was positively associated with functional abilities, and housing was the primary factor that shaped life satisfaction at the baseline. Better maintenance of functional abilities could promote life satisfaction over time. For older adults living in recently built neighbourhoods, social environment factors such as associations and facilities for social participation were more important in functional abilities, and communication and information were more important in life satisfaction. For those living in neighbourhoods built before 2000, physical environment factors such as transportation were essential in functional abilities, and housing was more essential in life satisfaction; health-related facilities and services at baseline exerted a cumulative effect on maintaining functional abilities in the long run. Our findings inform policymakers about how to effectively allocate public resources to enhance older adults’ life satisfaction in the Chinese urban context.

Cohort differences in trajectories of life satisfaction among Japanese older adults.

Individual development and aging are shaped by historical changes in sociocultural contexts. Studies indicate that later-born cohorts experience improvements in well-being in the young-old. However, whether this historical trend holds in the old-old remains unknown. Using longitudinal data of Japanese older adults, we examined birth cohort differences in trajectories of well-being as measured by life satisfaction. Data were derived from a nationally representative study conducted from 1987 to 2012. We compared earlier- and later-born cohorts over 10 years in two age groups: the young-old (n = 1,195 per cohort; age 63-74; years of birth: 1913-1924 and 1925-1936) and the old-old (n = 436 per cohort; age 75-86; years of birth: 1901-1912 and 1913-1924). To control for covariates, we used case-matched cohorts based on age and sex. Growth curve models were employed to estimate age-related changes in life satisfaction by age group. At age 75 years, life satisfaction was higher in the later-born cohort than in the earlier-born cohort across age groups. Cohort differences in the rate of change in life satisfaction were absent among the young-old. Among the old-old, the later-born cohort showed steeper declines than the earlier-born cohort. Socioeconomic, social, and health resources did not fully explain the cohort differences in both age groups. Our results suggest that historical improvements in well-being in the young-old do not persist into the old-old. Societal advancements may enable later-born cohorts to survive with limited resources. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Life satisfaction trajectories among junior high school students in China: The role of parent–child communication

AbstractA 3‐year follow‐up test (from grades 7 to 9) was administered to 807 junior high school students from two regions in Hunan Province, China, using multilevel analysis to examine trends in junior high school students' life satisfaction, differences by gender and location of life and the effects of father–child/mother–child communication on the development of life satisfaction. The results showed that (1) Chinese junior high school students' life satisfaction showed a decreasing trend from the seventh grade to the ninth grade, and there was a significant decreasing process in the eighth grade; (2) father–child communication and mother–child communication had a significant positive predictive effect on Chinese junior high school students' life satisfaction and (3) father–child communication and mother–child communication had a significant negative predictive effect on the decreasing trend of life satisfaction, in which the effect of mother–child communication was particularly significant.

Trajectories of life satisfaction in Hispanic individuals over the 10 years after traumatic brain injury: A model systems study

ABSTRACT Purpose To identify life satisfaction trajectories at 1–10 years post-traumatic brain injury (TBI) and examine which demographic and injury characteristics at the time of injury are associated with those trajectories. Methods Participants included 1,051 Hispanic individuals from the multi-site, longitudinal TBI Model Systems (TBIMS) database. Individuals were enrolled after sustaining a TBI and while undergoing inpatient rehabilitation at a TBIMS site; they were included if they completed the Satisfaction with Life Scale during one or more follow-up data collections at 1, 2, 5, or 10 years after TBI. Results A linear (straight-line) movement of life satisfaction trajectories was the best fit to the data. Across the overall sample, life satisfaction increased over time, with higher trajectories for Hispanic individuals who had been partnered at baseline, born outside the US and experienced a nonviolent injury cause. There were no significant interactions between time and any of these main effect predictors, suggesting no differential change over time in life satisfaction trajectories as a function of these characteristics. Conclusions Results revealed increases in life satisfaction over time among Hispanic individuals with TBI and shed light on critical risks and protective factors that may inform targeted rehabilitation services with this underserved group.

Historical and cross-country differences in life satisfaction across retirement in Germany and Switzerland from 2000-2019.

Recent trends, such as changes in pension systems or cohort differences in individual resources, have altered the face of retirement transitions. Little is known about how these trends have affected older people's life satisfaction around retirement age in the past decades. In this study, we investigated how levels and changes in life satisfaction before and after retirement changed over historical time in Germany and Switzerland. We used longitudinal data from the German Socioeconomic Panel Study (SOEP) and the Swiss Household Panel (SHP) from 2000 to 2019. Level, pre-retirement change and short- and long-term change in life satisfaction (0-10) after retirement were predicted by year of retirement (2001-2019) in a multigroup piecewise growth curve model. We found improvements in levels of life satisfaction and pre-retirement changes in life satisfaction with historical time in both countries. Furthermore, we found that in unlike in Switzerland, short-time changes in life satisfaction across retirement improved over historical time in Germany. Our findings imply that life satisfaction trajectories around retirement age have improved over the last 20 years. These findings may be explained by general improvements in the health and psychosocial functioning of older people. More research is needed to show for whom these improvements are stronger or weaker and if they will be maintained in a changing retirement landscape.

Preretirement resources and postretirement life satisfaction change trajectory: Examining the mediating role of retiree experience during retirement transition phase.

Successfully adjusting to retirement represents a major challenge for many older workers. Following the temporal unfolding of retirement process (i.e., preretirement, transition, and postretirement phases), the present study draws on the resource-based dynamic model of retirement adjustment to investigate how a diverse set of preretirement personal resources (i.e., physical health, mental health, financial well-being, family support, proactive personality, and general cognitive ability) impact postretirement change trajectory of life satisfaction through the pathway of retirement transition experience (i.e., retirees' subjective experience in terms of how well they are adjusting during the transition phase of retirement immediately after the workforce exit). Using multiwave longitudinal data from 667 Chinese older workers transitioning into retirement collected with a prospective design over 2 years, we found positive effects of the levels of preretirement mental health, financial well-being, family support, proactive personality, and cognitive ability on retirement transition experience. We also found positive effects of the changes in physical health, financial well-being, and family support on retirement transition experience. Retirement transition experience, in turn, was associated with older workers' postretirement change trajectory of life satisfaction. Our findings highlight the importance of the transition phase of retirement, as well as the role of retirement transition experience during this critical phase in explaining the relationships between preretirement resources, in terms of both their levels and changes, and postretirement changes in well-being. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Life satisfaction in UK emerging adults during the COVID-19 pandemic

Current research indicates that young adults are at a higher risk of deteriorating wellbeing during the COVID-19 pandemic compared to older adults. Drawing upon the Understanding Society COVID-19 survey, this study examined the trajectory of life satisfaction in UK emerging adults from May 2020 to September 2021 with social, health, financial, and demographic factors as covariates. The analytic sample included 880 participants (612 females, 268 males) between the ages of 18–29. Growth curve modelling was used to estimate the trajectory of life satisfaction and examine whether the covariates account for variation in the mean level and/or slopes. The trajectory of life satisfaction declined slightly between May 2020 and January 2021 and then increased to September 2021, aligning with the tightening and easing of UK COVID-19 policies. Greater perceived current financial difficulties, pre-existing mental health and physical health conditions, and higher self-reported loneliness were associated with lower life satisfaction. Being female and living with a romantic partner, more face-to-face social interactions, and higher household income were associated with more life satisfaction. Gender interacted with pre-existing mental health conditions. Women with no pre-existing mental health conditions reported the highest level of life satisfaction, while women with pre-existing mental health conditions reported the lowest level, compared to men who reported a similar level of life satisfaction regardless of their mental health. The findings from the present study contribute toward the current understanding of changes in life satisfaction throughout the pandemic among emerging adults. Implications for intervention are discussed.

Exploring racial/ethnic disparities in rehabilitation outcomes after TBI: A Veterans Affairs Model Systems study.

Almost one-third of the U.S. military population is comprised of service members and veterans (SMVs) of color. Research suggests poorer functional and psychosocial outcomes among Black and Hispanic/Latine vs. White civilians following traumatic brain injury (TBI). This study examined racial/ethnic differences in 5-year functional independence and life satisfaction trajectories among SMVs who had undergone acute rehabilitation at one of five Veterans Affairs (VA) TBI Model Systems (TBIMS) Polytrauma Rehabilitation Centers (PRCs). Differences in demographic and injury-related factors were assessed during acute rehabilitation among White (n = 663), Black (n = 89), and Hispanic/Latine (n = 124) groups. Functional Independence Measure (FIM) Motor, FIM Cognitive, and Satisfaction with Life Scale (SWLS) scores were collected at 1, 2, and 5 years after injury. Racial/ethnic comparisons in these outcome trajectories were made using hierarchical linear modeling. Black SMVs were less likely than White and Hispanic/Latine SMVs to have been deployed to a combat zone; there were no other racial/ethnic differences in any demographic or injury-related variable assessed. In terms of outcomes, no racial/ethnic differences emerged in FIM Motor, FIM cognitive, or SWLS trajectories. The absence of observable racial/ethnic differences in 5-year outcome trajectories after TBI among SMVs from VA TBIMS PRCs contrasts sharply with previous research identifying disparities in these same outcomes and throughout the larger VA health care system. Individuals enrolled in VA PRCs are likely homogenized on key social determinants of health that would otherwise contribute to racial/ethnic disparities in outcome trajectories.

베이비붐 세대 통합적 노후준비에 따른 삶의 만족도 변화 연구

The purpose of this study was to longitudinally analyze how the baby boomer generation's integrated preparation for old age affects the change trajectory of life satisfaction. Data were collected from the 4th to 7th years of the National Old Age Security Panel Data and analyzed with the potential growth model analysis method. The research results were as follows. First, the life satisfaction of the baby boom generation, examined through the unconditional model, showed a non-linear trajectory of change, maintaining a slightly increasing pattern over time and then slightly decreasing. Second, the effects of economic preparation for old age, emotional and social preparation for old age, and physical preparation for old age, which were examined through the conditional model, on the change trajectory of life satisfaction showed different results. The baby boomer generation's economic preparation for old age did not affect changes in life satisfaction. On the other hand, the baby boom generation who prepares for old age emotionally and socially had high life satisfaction in their early years, and the high life satisfaction showed a trajectory of change that was maintained over time. The baby boom generation, who is physically preparing for old age, showed a trajectory of change in which life satisfaction increased rapidly as time passed, although life satisfaction at the beginning was insignificant. Based on the results, a proposal was made to promote volunteer activities and lifelong education, expand social networks, and policies and services related to health promotion and disease prevention.

Gender-specific trajectories of academic achievement in Chinese elementary school students: Relations with life satisfaction trajectories and suicidal ideation trajectories

This study explored heterogeneous developmental trajectories of academic achievement and their relations to trajectories of life satisfaction and trajectories of suicidal ideation among Chinese elementary school students. A sample of 547 students (55.0% boys; Mage = 9.00 years, SD = 0.76 at Time 1) completed a packet of measures on five occasions across two years, using 6-month intervals. Three distinct trajectories of academic achievement were identified: “high-stable” (86.28%), “low-increasing” (8.94%), and “low-decreasing” (4.78%). Girls demonstrated higher academic achievement than boys. Students displaying adverse developmental trends in academic achievement were more likely to show adverse trends in life satisfaction. Finally, trajectories of academic achievement and trajectories of suicidal ideation were related for girls, but not boys. Programs promoting academic achievement may require adaptations for the differing genders and start as early as elementary school.

Trajectories of life satisfaction during one-year period among university students: Relations with measures of achievement strategies and perception of criteria for adulthood

Aim: The aim of this study was to examine how university students’ achievement strategies in an academic context and perceptions of criteria for adulthood relate to life satisfaction trajectories across one year.&#x0D; Methods: A convenience sample of 143 young adults 18-28 years (mean age: 20.9±2.7 years; 109 females and 34 males) attending the University of Turin in northwest Italy completed questionnaires at three points with a six-month interval between each measurement. Latent Growth Curve Modelling and Latent Class Growth Analysis were used to assess longitudinal changes in life satisfaction and the related heterogeneity within the current sample.&#x0D; Results: Three trajectories of life satisfaction emerged: high stable (37%), moderate decreasing (57%), and low stable (6%). At every time point high success expectations were related to a high stable life satisfaction trajectory. In turn, those adopting achievement avoidance strategies were more likely to have low-stable or moderately decreasing life satisfaction trajectories. The perception of the criteria deemed important to be defined as adults did not change across time points or across life satisfaction trajectories’ groups.&#x0D; Conclusion: These findings suggest that self-reported measures of achievement strategies among university students relate longitudinally to life satisfaction levels. Positive and optimistic dimensions of personal striving may be protective factors against the risk of decrease of life satisfaction among university students.&#x0D;

U.S. vs. Foreign Nativity and 10-Year Trajectories of Mental Health after Traumatic Brain Injury: A Model Systems Study.

Previous research has found racial and ethnic disparities in life satisfaction, depression, and anxiety after traumatic brain injury (TBI). However, limited studies have examined differences in these variables between U.S.- and foreign-born individuals with TBI. The purpose of this study was to examine whether differences exist in mental health outcomes between U.S.- and foreign-born individuals with TBI at 1, 2, 5, and 10 years after injury, as well as examine whether demographic and injury-related characteristics account for these differences. Participants were 8289 individuals with TBI who identified as U.S.-born and 944 who identified as born outside the U.S. in the TBI Model Systems study. Participants completed measures of mental health outcomes at 1, 2, 5, and 10 years after injury. Foreign-born individuals with TBI had comparable levels of depression and anxiety trajectories to U.S.-born individuals, yet higher life satisfaction trajectories, even after controlling for demographic and injury-related variables. Rehabilitation professionals should consider in their clinical work the mechanisms that likely influence mental health outcomes among foreign-born individuals, including family-based values that increase resilience, as well as the possible under-reporting of mental health symptoms along the lines of cultural norms.

Psychosocial Functioning in Transgender Youth after 2 Years of Hormones

BackgroundLimited prospective outcome data exist regarding transgender and nonbinary youth receiving gender-affirming hormones (GAH; testosterone or estradiol).MethodsWe characterized the longitudinal course of psychosocial functioning during the 2 years after GAH initiation in a prospective cohort of transgender and nonbinary youth in the United States. Participants were enrolled in a four-site prospective, observational study of physical and psychosocial outcomes. Participants completed the Transgender Congruence Scale, the Beck Depression Inventory–II, the Revised Children’s Manifest Anxiety Scale (Second Edition), and the Positive Affect and Life Satisfaction measures from the NIH (National Institutes of Health) Toolbox Emotion Battery at baseline and at 6, 12, 18, and 24 months after GAH initiation. We used latent growth curve modeling to examine individual trajectories of appearance congruence, depression, anxiety, positive affect, and life satisfaction over a period of 2 years. We also examined how initial levels of and rates of change in appearance congruence correlated with those of each psychosocial outcome.ResultsA total of 315 transgender and nonbinary participants 12 to 20 years of age (mean [±SD], 16±1.9) were enrolled in the study. A total of 190 participants (60.3%) were transmasculine (i.e., persons designated female at birth who identify along the masculine spectrum), 185 (58.7%) were non-Latinx or non-Latine White, and 25 (7.9%) had received previous pubertal suppression treatment. During the study period, appearance congruence, positive affect, and life satisfaction increased, and depression and anxiety symptoms decreased. Increases in appearance congruence were associated with concurrent increases in positive affect and life satisfaction and decreases in depression and anxiety symptoms. The most common adverse event was suicidal ideation (in 11 participants [3.5%]); death by suicide occurred in 2 participants.ConclusionsIn this 2-year study involving transgender and nonbinary youth, GAH improved appearance congruence and psychosocial functioning. (Funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development.)