Repeated Measures Multilevel Modeling Research Articles

Postpartum Insomnia and Poor Sleep Quality Are Longitudinally Predictive of Postpartum Mood Symptoms.

Insomnia and poor sleep quality are frequently reported by perinatal women. Both are noted to increase the risk of postpartum depression, with less known about their association with postpartum anxiety. This study sought to assess whether perinatal sleep disturbances predicted depression and anxiety symptoms across each month of the first 6 months postpartum in women with a history of depression. Pregnant women without active depression at enrollment ( N = 159), 18 to 45 years of age, were recruited. In late pregnancy and for up to 6 months postpartum, women completed monthly online questionnaires including the Insomnia Symptom Questionnaire, Pittsburgh Sleep Quality Index, Edinburgh Postnatal Depression Scale, and Generalized Anxiety Disorder-7. Repeated-measures multilevel models were used to predict depression and anxiety across the postpartum. The prevalence of insomnia was 20.4%, and the prevalence of poor sleep quality was 67.8% across the first 6 months postpartum. Postpartum insomnia and poor sleep quality at the between-subject and within-subject levels tended to uniquely predict greater depressive and anxiety symptoms, even after controlling for demographic characteristics, prenatal insomnia, and prenatal poor sleep quality. Most of the women in our sample had sleep disturbances across the perinatal period. Consistent with the extant literature, postpartum insomnia and poor sleep quality, but not prenatal measures of sleep, longitudinally predicted greater postpartum depression and anxiety symptoms. The chronic sleep deprivation of insomnia and the subjective experience of poor sleep quality are uniquely relevant risks of postpartum mood disorders. Evaluation and mitigation of perinatal sleep disturbance are ideal opportunities to reduce postpartum mood disorders and subsequent health outcomes.

0627 Postpartum Insomnia and Poor Sleep Quality are Uniquely Predictive of Postpartum Mood Disorders

Abstract Introduction Many postpartum women experience symptoms of depression (PPD) and anxiety (PPA). Insomnia and poor sleep quality are frequently reported by postpartum women and are risk factors for postpartum mood disorders. This longitudinal study sought to assess whether perinatal insomnia or sleep quality predicted depression and anxiety across each month of the first 6 months postpartum in women with a history of depression. Methods Pregnant women (N = 178) aged 18-45 years with a self-reported prior history of depression were recruited from social media in late pregnancy. None of the women were depressed at enrollment. In late pregnancy and for up to six months postpartum, women completed monthly online questionnaires including the ISQ, PSQI, EPDS, and GAD-7. Repeated-measures multilevel models were performed using the generalized linear mixed model command in the software IBM SPSS 28 to determine predictive associations across the postpartum. Demographics (age, education, race, and sex of baby) were statistically controlled for in these models. Results The rate of depression averaged (15.7%) and anxiety averaged (17.0%) across the postpartum. The prevalence of insomnia was 20.4%, and the prevalence of poor sleep quality was 67.8% across the first 6 months postpartum. Insomnia in the postpartum predicted greater depressive and anxiety symptoms, even after controlling for prenatal insomnia. Likewise, poor sleep quality in the postpartum predicted greater depressive and anxiety symptoms after controlling for prenatal poor sleep quality scores. When considering clinical cutoffs of the EPDS ≥ 12 and GAD ≥ 10, postpartum insomnia and sleep quality uniquely predicted postpartum depression (OR = 5.69, 95% CI 3.33-9.74 and OR = 3.13, 95% CI 1.70 -5.77). Insomnia predicted postpartum anxiety (OR = 11.15, 95% CI 5.99-20.78), with sleep quality trending (OR = 1.76, 95% CI 0.99 -3.12). None of the demographic variables significantly contributed (P’s > 05). Conclusion Both postpartum insomnia and poor sleep quality contributed to clinical postpartum mood. The chronic sleep deprivation of insomnia and the subjective experience of poor sleep quality are uniquely relevant to risk for postpartum mood. The consideration and treatment of both is important as they are uniquely associated with adverse outcomes for mother and child. Support (if any) Happiest Baby, Inc

Attitudes towards no-European Immigrants in EU: The Role of Legacy Media and New Media

Many studies in different scientific fields offer controversial results on the media’s role to influence attitudes towards immigration. In the present paper, the attitude that European public opinion has towards no-European immigration is analysed through data from Eurobarometer in the 3 waves starting in 2017 until the latest updated in 2019 with the aim to estimate the relationship with new and legacy media use. Specifying repeated measures multilevel models, we find that the use of legacy media (TV, press, and radio) and new media (website and online social networks) affects the relationship between citizens’ opinion in EU and attitudes towards no-European immigrants, when the European migration crisis reaches high levels and the migration issue becomes heated for public opinion. High exposure to news communication produces different relationships looking at legacy and new media. If radio, TV, newspapers are used frequently to obtain political information, the attitudes towards external migration are hostile but also in the case of new media. Legacy media manage to soften the negative attitude towards no-European immigrants, at least for low levels of immigration. On the contrary, new media are able to bring European citizens into line with even negative or hostile attitudes.

Neural response to social but not monetary reward predicts increases in depressive symptoms during the COVID-19 pandemic.

The prevalence of depressive symptoms has increased during the COVID-19 pandemic, especially among those with greater pandemic-related stress exposure; however, not all individuals exposed to pandemic stress will develop depression. Determining which individuals are vulnerable to depressive symptoms as a result of this stress could lead to an improved understanding of the etiology of depression. This study sought to determine whether neural sensitivity to monetary and/or social reward prospectively predicts depressive symptoms during periods of high stress. 121 participants attended pre-pandemic laboratory visits where they completed monetary and social reward tasks while electroencephalogram was recorded. Subsequently, from March to August 2020, we sent eight questionnaires probing depressive symptoms and exposure to pandemic-related stressors. Using repeated-measures multilevel models, we evaluated whether neural response to social or monetary reward predicted increases in depressive symptoms across the early course of the pandemic. Furthermore, we examined whether neural response to social or monetary reward moderated the association between pandemic-related episodic stressors and depressive symptoms. Pandemic-related stress exposure was strongly associated with depressive symptoms. Additionally, we found that blunted neural response to social but not monetary reward predicted increased depressive symptoms during the pandemic. However, neither neural response to social nor monetary reward moderated the association between episodic stress exposure and depressive symptoms. Our findings indicate that neural response to social reward may be a useful predictor of depressive symptomatology under times of chronic stress, particularly stress with a social dimension.

Upper Body Muscle Activation And Measures Of Sprint Performance

PURPOSE: Effective arm swing and core muscle activation are involved in acceleration and maximal sprinting, yet muscle activity in these areas have not been measured via electromyography (EMG) during over ground sprinting trials. The purpose of this study was to explore the relationship between muscle activation of the upper body and measures of performance during sprint acceleration and maximal sprinting. METHODS: Sixteen participants (20.93 ± 0.96 yrs.; 1.71 ± 0.07 m; 67.69 ± 11.81 kg) completed six 40-m sprint trials on an outdoor track, with three from a block start and three from a split start. Muscle activation was measured via EMG in the triceps brachii, biceps brachii, upper trapezius, anterior deltoid, latissimus dorsi, erector spinae, rectus abdominis, and oblique muscles, recorded as a percentage of maximal voluntary isometric contraction. Split times recorded during each sprint were used to calculate acceleration, net horizontal force (Fh), and the ratio of Fh and resultant ground reaction force (%RF) using previously validated methods. Repeated measures multilevel modeling was used to evaluate the relationship between mean upper body muscle activation and average acceleration, Fh, and %RF during each 10-m window of the sprint. RESULTS: During the 0-10 m window, mean activation of the upper trapezius showed a significant positive relationship with acceleration (t = 2.66, p = 0.01), Fh (t = 2.20, p = 0.03), and %RF (t = 2.57, p = 0.01), erector spinae activation was positively associated with %RF (t = 2.42, p = 0.02), and biceps activation was negatively associated with Fh (t = -2.23, p = 0.03). In the 30-40 m window, there was a significant negative relationship between mean latissimus dorsi activation and %RF (t = -2.16, p = 0.04). There were no significant relationships between upper body muscle activation and indicators of sprint performance detected during the 10-20 m or 20-30 m windows. CONCLUSIONS: These results indicate that upper trapezius muscle activity is important during initial sprint acceleration, which agrees with past research on scapular restriction limiting maximal acceleration while sprinting. After the initial period of sprint acceleration, there was no evidence that greater activation of certain upper body muscles was related to improving maximal sprinting performance.

Child and Youth Coaching in families experiencing complex and multiple problems: A longitudinal evaluation study

Studies investigating services for families experiencing complex and multiple problems have emphasized the need for more child-centred support. The aim of this longitudinal study was to investigate whether providing child-centred services (Child and Youth Coaching) combined with family-focused services (Ten for the Future) is effective for children growing up in families experiencing complex and multiple problems. Children's psychosocial skills, emotional and behavioural problems, and the quality of their pedagogical environment were measured at baseline, 6 months and 12 months. Parent and coach reports of children indicated for Child and Youth Coaching (n = 57) and nonindicated children (n = 18) were analysed using repeated measures multilevel models. Both parents and coaches reported improved psychosocial skills of children, but changes were only significant for coach reports. In both reports, no significant decrease in emotional and behavioural problems was observed for both indicated and nonindicated children. Many children still experienced considerable problems at case closure. Furthermore, no significant improvement in quality of the pedagogical environment was observed in both groups. Given the limitations in this study, more research is needed to identify whether these findings can be replicated and attributed to the Child and Youth Coaching and Ten for the Future programmes.

Longitudinal Association between Weight Status, Aerobic Capacity, Muscular Strength, and Endurance among New York City Youth, 2010-2017.

Background: Child weight status is inversely associated with fitness, but less is known about this relationship across fitness domains. This study examined the longitudinal association between weight status and fitness domains in a large, diverse sample of children. Methods: Data were drawn from the New York City Fitnessgram (2010-2011 to 2017-2018). Height and weight were collected annually and converted to weight status using Centers for Disease Control and Prevention growth charts. Aerobic capacity, muscular strength, and endurance were measured as age and sex standardized z-scores based on the fitness performance tests. Repeated-measures multilevel models were run testing the association between weight status and 1-year lagged fitness domains. Results: The sample included 917,554 children (51.8% male, 39.3% Hispanic, 29.9% non-Hispanic Black, 13.9%, 4.7%, and 1.7% class I, II, and III obesity, respectively). For each fitness domain, fitness scores decreased with increasing weight status across all demographic categories, with the lowest fitness scores observed in children with the most severe obesity, and highest magnitude of effects for aerobic capacity, and particularly among boys, non-Hispanic Whites, and older youth. For example, compared with youth with healthy weight, youth with overweight had 0.28 standard deviation lower aerobic capacity performance [confidence interval (95% CI): -0.29 to -0.28], followed by class 1 obesity (β = -0.57, 95% CI: -0.58 to -0.57), class 2 obesity (β = -0.88, 95% CI: -0.88 to -0.88), and class 3 obesity (β = -1.19, 95% CI: -1.20 to -1.18). Conclusions: Compared with youth with healthy weight, youth at every other weight status had lower subsequent fitness, with the magnitude of the relationship increasing as weight status increased. Future research should examine interventions targeting aerobic capacity to reduce fitness disparities.

Reading enhancements for students with autism spectrum disorder: A matched randomized pilot experimental study

BackgroundFor students with autism spectrum disorder (ASD), improving reading comprehension is critical for increasing both their opportunities for successful postsecondary experiences including attending college and obtaining meaningful employment. The purpose of this pilot study was to investigate the effects of a multicomponent reading intervention on the vocabulary and reading outcomes of middle grade students with ASD. MethodWe conducted a matched randomized pilot experimental study for students with ASD in grades 3–8 (N = 28) identified by their district personnel as having reading difficulties (i.e., not passing state reading test). An independent researcher matched participants according to symptom severity and reading fluency and then randomly assigned a member of each pair to treatment or comparison condition. Participants in treatment condition were provided 1:1 instruction for 23–30 sessions (M = 27) of 30 min each four to five days per week. Instructional components included (a) vocabulary instruction; (b) fluency with text, and (c) reading comprehension. In this pilot study, data were analyzed using repeated measures multilevel models in HLM 7. Due to the associated low statistical power to detect effects, the small sample size, and the exploratory nature of the study, we selected an alpha level of 0.10. Data were modeled as student-level variables classifying students based on their ASD symptomology from mild (level 1) to severe (level 3). ResultsThe multicomponent intervention was associated with significant gains in WJ-PC scores of 22.62 (se = 8.19, df = 3, p = .070) for students at GARS severity level 1. Significant gains favoring the intervention were also detected on vocabulary score of 10.19 (se = 2.78, df = 3, p = .035) and for students rated at GARS severity level 1 and for students rated at GARS severity level 2 [vocabulary score 5.46 (se = 1.60, df = 3, p = .042)]. Significant effects were not detected for scores on a standardized measure of reading and fluency (TOSREC), and a researcher-developed measure of reading comprehension. ConclusionsThis pilot study shows enough promise to warrant future studies employing larger sample sizes and fully powered randomized control trial (RCT) studies. Although growth is modest and appears to be limited to participants who are in the mid to higher range of the autism spectrum, considering the large percentage of students with ASD in the mid to higher range, this study contributes to the development of evidence-based practices. We interpret the findings as having implications for future research with larger sample sizes and in providing initial guidance on instruction for consideration by practitioners.

Annual rhythms in adults\u2019 lifestyle and health (ARIA): protocol for a 12-month longitudinal study examining temporal patterns in weight, activity, diet, and wellbeing in Australian adults

BackgroundAlmost one in three Australian adults are now obese, and the rate continues to rise. The causes of obesity are multifaceted and include environmental, cultural and lifestyle factors. Emerging evidence suggests there may be temporal patterns in weight gain related, for example, to season and major festivals such as Christmas, potentially due to changes in diet, daily activity patterns or both. The aim of this study is to track the annual rhythm in body weight, 24 h activity patterns, dietary patterns, and wellbeing in a cohort of Australian adults. In addition, through data linkage with a concurrent children’s cohort study, we aim to examine whether changes in children’s body mass index, activity and diet are related to those of their parents.MethodsA community-based sample of 375 parents aged 18 to 65 years old, residing in or near Adelaide, Australia, and who have access to a Bluetooth-enabled mobile device or a computer and home internet, will be recruited. Across a full year, daily activities (minutes of moderate to vigorous physical activity, light physical activity, sedentary behaviour and sleep) will be measured using wrist-worn accelerometry (Fitbit Charge 3). Body weight will be measured daily using Fitbit wifi scales. Self-reported dietary intake (Dietary Questionnaire for Epidemiological Studies V3.2), and psychological wellbeing (WHOQOL-BREF and DASS-21) will be assessed eight times throughout the 12-month period. Annual patterns in weight will be examined using Lowess curves. Associations between changes in weight and changes in activity and diet compositions will be examined using repeated measures multi-level models. The associations between parent’s and children’s weight, activity and diet will be investigated using multi-level models.DiscussionTemporal factors, such as day type (weekday or weekend day), cultural celebrations and season, may play a key role in weight gain. The aim is to identify critical opportunities for intervention to assist the prevention of weight gain. Family-based interventions may be an important intervention strategy.Trial registrationAustralia New Zealand Clinical Trials Registry, identifier ACTRN12619001430123. Prospectively registered on 16 October 2019.

Commuter e-bike use is associated with increased total physical activity over time

Abstract Background Active commuting such as cycling has been recommended as a practical way to increase population physical activity levels and improve health. Beside positive health effects observed in experimental studies, less is known about how e-bikes can improve public health outcomes in real-life settings. Objectives To describe the patterns over time in physical activity, sedentary behavior, cardiorespiratory fitness and psychophysiological well-being in a population of new commuter e-bike users. Methods This was a population-based prospective longitudinal study in France. 33 new users of e-bike were recruited and measured at 4-time points (T0, T1, T2, T3), from before the effective beginning of the e-bike use (T0) until a mean of 4.6 months of use (T3) (min: 3.2, max: 7). Repeated measures multilevel modeling was used on 4 waves of measurements to assess variations over time of e-bike use, total moderate and vigorous physical activity (MVPA) and total sedentary time (SED-time). Pre-post comparisons between T0 and T3 were performed to detect change in cardiorespiratory fitness, markers of adiposity, self-esteem, quality of life (SF12-v2), and physical activity motivations (EMAPS). Results Adherence to e-bike commuting was high and stable, with a mean of 82% (3%) of weekly use. Multilevel modeling indicated that MVPA followed a significant increasing curvilinear trajectory over time, plateauing after 90 days (+ 21 MET-h/week compared to mean T0 at 33 MET-h/week). No significant change was found in SED-time, averaging a mean of 8.6 hours/day. Greater adherence to using an e-bike was associated with greater increases in MVPA. Several markers of physical and mental health improved. Conclusions New commuter e-bike users undergo a significant increase in MVPA while being already at a high level before e-bike use onset. This increase in MVPA could be meaningful to attenuate detrimental effects of a persistent high sedentary behavior. Key messages MVPA significantly increases among new commuter e-bike users, along with improvements in physical and mental health. High SED-time is persistent, making increase in MVPA in a population with a moderately high initial level still crucial.

Childhood Cognition and Age-Related Change in Standing Balance Performance From Mid to Later Life: Findings From a British Birth Cohort.

BackgroundCognitive processing plays a crucial role in the integration of sensory input and motor output that facilitates balance. However, whether balance ability in adulthood is influenced by cognitive pathways established in childhood is unclear, especially as no study has examined if these relationships change with age. We aimed to investigate associations between childhood cognition and age-related change in standing balance between mid and later life.MethodsData on 2,380 participants from the MRC National Survey of Health and Development were included in analyses. Repeated measures multilevel models estimated the association between childhood cognition, assessed at age 15, and log-transformed balance time, assessed at ages 53, 60–64, and 69 using the one-legged stand with eyes closed. Adjustments were made for sex, death, attrition, anthropometric measures, health conditions, health behaviors, education, other indicators of socioeconomic position (SEP), and adult verbal memory.ResultsIn a sex-adjusted model, 1 standard deviation increase in childhood cognition was associated with a 13% (95% confidence interval: 10, 16; p < .001) increase in balance time at age 53, and this association got smaller with age (cognition × age interaction: p < .001). Adjustments for education, adult verbal memory, and SEP largely explained these associations.ConclusionsHigher childhood cognition was associated with better balance performance in midlife, with diminishing associations with increasing age. The impact of adjustment for education, cognition and other indicators of SEP suggested a common pathway through which cognition is associated with balance across life. Further research is needed to understand underlying mechanisms, which may have important implications for falls risk and maintenance of physical capability.

Psychosocial environment in childhood and body mass index growth over 32years.

The psychosocial environment and especially various psychosocial risks in childhood have been shown to predict later negative health behavior and health problems. In this study, we examined whether various psychosocial factor domains in childhood and adolescence: socioeconomic status, the emotional family environment (parental nurturance, life-satisfaction), parental lifestyle, life-events, the child's self-regulatory behavior and the child's social adaptation were associated with body mass index (BMI) trajectories individually by domain and as a cumulative score across domains. The participants were a nationally representative sample of 2016 men and women from the Young Finns study aged 3-18years at study entry in 1980. Their BMI was measured at six study phases from 1980 to 2012. Their parents reported all the factors related to their psychosocial environment in 1980. The participants responded to questions on adulthood socioeconomic status in 2007. The accumulation of psychosocial factors in childhood was the main exposure variable. The findings from repeated measures multilevel modeling showed that parental lifestyle and life-events and the more positive cumulative psychosocial factors score were associated with a slower increase in BMI during follow-up (regression coefficient range from -0.06 to -0.50). In conclusion, the psychosocial environment in childhood and adolescence, particularly parental lifestyle and lack of stressful life-events, are associated with a lower increase of BMI.

Altered time course of amygdala activation during speech anticipation in social anxiety disorder

BackgroundExaggerated anticipatory anxiety is common in social anxiety disorder (SAD). Neuroimaging studies have revealed altered neural activity in response to social stimuli in SAD, but fewer studies have examined neural activity during anticipation of feared social stimuli in SAD. The current study examined the time course and magnitude of activity in threat processing brain regions during speech anticipation in socially anxious individuals and healthy controls (HC). MethodParticipants (SAD n=58; HC n=16) underwent functional magnetic resonance imaging (fMRI) during which they completed a 90s control anticipation task and 90s speech anticipation task. Repeated measures multi-level modeling analyses were used to examine group differences in time course activity during speech vs. control anticipation for regions of interest, including bilateral amygdala, insula, ventral striatum, and dorsal anterior cingulate cortex. ResultsThe time course of amygdala activity was more prolonged and less variable throughout speech anticipation in SAD participants compared to HCs, whereas the overall magnitude of amygdala response did not differ between groups. Magnitude and time course of activity was largely similar between groups across other regions of interest. LimitationsAnalyses were restricted to regions of interest and task order was the same across participants due to the nature of deception instructions. ConclusionsSustained amygdala time course during anticipation may uniquely reflect heightened detection of threat or deficits in emotion regulation in socially anxious individuals. Findings highlight the importance of examining temporal dynamics of amygdala responding.

Examining the Relationship Between Worry and Sleep: A Daily Process Approach

There is growing evidence suggesting that worry and sleep are intimately linked. However, the relationship between these two phenomena over the course of a day remains largely unstudied. It is possible that (a) worry predicts sleep disturbance that night, (b) sleep disturbance predicts worry the following day, or (c) there is a bidirectional relationship between worry and sleep disturbance. The present study examined the daily relationship between worry (both during the day and immediately prior to sleep onset) and sleep in 50 high trait worriers who were randomly assigned to one of two interventions aimed at reducing worry as part of a larger study. A daily process approach was utilized wherein participants completed daily reports of sleep and worry during a 7-day baseline period followed by a 14-day intervention period. Results of repeated measures multilevel modeling analyses indicated that worry experienced on a particular day predicted increased sleep disturbance that night during both the baseline and intervention weeks. However, there was no evidence of a bidirectional relationship as sleep characteristics did not predict worry the following day. Additionally, the type of intervention that participants engaged in did not affect the daily relationship between worry and sleep. Results of the present study are consistent with the cognitive model of insomnia (Harvey, 2002) and highlight the importance of addressing and treating worry among individuals with high trait worry and sleep disturbance.

Mood States Associated with Transitory Physical Symptoms Among Breast and Ovarian Cancer Survivors

This study used electronic diaries to examine patterns of mood and physical symptoms within and across days in two independent samples of cancer patients. Twenty-three breast cancer survivors (post-treatment) and 33 ovarian cancer survivors (on chemotherapy) recorded mood and physical symptoms 4 times daily for 7 consecutive days. A series of repeated-measures multilevel models using SAS Proc Mixed were calculated to estimate the degree to which physical symptoms (e.g., pain, fatigue, and nausea) were associated with participants' moods. Across days, mood vectors with a pleasantness component (i.e., happy-sad and calm-anxious) and mood vectors with an arousal component (i.e., active-passive and peppy-tired) were significantly associated with physical symptom severity. Specifically, breast cancer survivors with greater fatigue and pain reported more negative moods (eta2 < or = 0.33). Ovarian cancer survivors with greater fatigue (eta2 < or = 0.35), pain (eta2 < or = 0.04), and nausea (eta2 < or = 0.04) also reported more negative moods. Diurnal analyses showed that happy-sad (eta2 < or = 0.16), active-passive (eta2 < or = 0.27), and peppy-tired moods (eta2 < or = 0.33) were significantly negatively associated with fatigue at each of the four daily assessment times in both samples. Although correlational, our findings are consistent with previous studies suggesting that variations in both pleasant and aroused mood covary with changes in real-time physical symptom reports.