Time 1 Research Articles

Gratitude uniquely predicts lower depression in chronic illness populations: A longitudinal study of inflammatory bowel disease and arthritis.

Although gratitude has been identified as a key clinically relevant trait for improving well-being, it is understudied within medical populations. The current study addressed this gap and extended previous and limited cross-sectional research by examining the longitudinal associations of gratitude to depression in 2 chronic illness samples, arthritis and inflammatory bowel disease (IBD). Two chronic illness samples, arthritis (N = 423) and IBD (N = 427), completed online surveys at Time 1 (T1). One hundred sixty-three people with arthritis and 144 people with IBD completed the 6-month follow-up survey (T2). Depression, gratitude, illness cognitions, perceived stress, social support, and disease-related variables were assessed at T1 and T2. At T2, 57.2% of the arthritis sample and 53.4% of the IBD sample met the cut off scores for significant depression. T1 gratitude was negatively associated with depressive symptoms at T1 and T2 in both samples (rs from -.43 to -.50). Regression analyses revealed that T1 gratitude remained a significant and unique predictor of lower T2 depression after controlling for T1 depression, relevant demographic variables, illness cognitions, changes in illness-relevant variables, and another positive psychological construct, thriving, in both samples. As the first investigation of the longitudinal associations of gratitude to psychological well-being in the context of chronic illness, the current study provides important evidence for the relevance of gratitude for health-related clinical populations. Further intervention-based research is warranted to more fully understand the potential benefits of gratitude for adjustment to chronic illness. (PsycINFO Database Record

Young children who screen positive for autism: Stability, change and “comorbidity” over two years

BackgroundAutism spectrum disorder (ASD) is a developmental disorder with a wide variety of clinical phenotypes and co-occurrences with other neurodevelopmental conditions. Symptoms may change over time. AimsThe aim of the present study was to prospectively follow 96 children, initially assessed for suspected ASD at an average age of 2.9 years. Methods and proceduresAll children had been identified with autistic symptoms in a general population child health screening program, and had been referred to the Child Neuropsychiatry Clinic in Gothenburg, Sweden for further assessment by a multi-professional team at Time 1 (T1). This assessment included a broad neurodevelopmental examination, structured interviews, a cognitive test and evaluations of the child́s adaptive and global functioning. Two years later, at Time 2 (T2), the children and their parents were invited for a follow-up assessment by the same team using the same methods. Outcomes and resultsOf the 96 children, 76 had met and 20 had not met full criteria for ASD at T1. Of the same 96 children, 79 met full ASD criteria at T2. The vast majority of children with ASD also had other neurodevelopmental symptoms or diagnoses. Hyperactivity was observed in 42% of children with ASD at T2, and Intellectual Developmental Disorder in 30%. Borderline Intellectual Functioning was found in 25%, and severe speech and language disorder in 20%. The children who did not meet criteria for ASD at T2 had symptoms of or met criteria for other neurodevelopmental/neuropsychiatric disorders in combination with marked autistic traits. Changes in developmental profiles between T1 and T2 were common in this group of young children with ASD. The main effect of Cognitive level at T1 explained more than twice as much of the variance in Vineland scores as did the ASD subtype; children with IDD had significantly lower scores than children in the BIF and AIF group. Co-existence with other conditions was the rule. Conclusions and implicationsReassessments covering the whole range of these conditions are necessary for an optimized intervention—adapted to the individual child’s needs.

Impact of providing case-specific knowledge in simulation: a theory based study of learning

BackgroundSimulation-based education (SBE) has been lauded for its ability to help students recognise and react appropriately to common and rare circumstances. While healthcare professions have started to implement SBE into...

Parent-child negative emotion reciprocity and children's school success: An emotion-attention process model.

Research has demonstrated that emotions expressed in parent-child relationships are associated with children's school success. Yet the types of emotional expressions, and the mechanisms by which emotional expressions are linked with children's success in school, are unclear. In the present article, we focused on negative emotion reciprocity in parent-child interactions. Using structural equation modeling of data from 138 parent to child dyads [children's mean age at Time 1 (T1) was 13.44 years, SD = 1.16], we tested children's negative emotionality (CNE) at T1 and low attention focusing (LAF) at Time 2 (T2) as sequential mediators in the relation between parent and child negative emotion reciprocity at T1 and children's grade point average (GPA) and inhibitory control at T2. Our findings supported an emotion-attention process model: parent-child negative emotion reciprocity at T1 predicted CNE at T1, which predicted children's LAF at T2, which was, in turn, related to low inhibitory control at T2. Findings regarding children's GPA were less conclusive but did suggest an overall association of negative reciprocity and the two mediators with children's GPA. Our findings are discussed in terms of emotion regulation processes in children from negatively reciprocating dyads, and the effects of these processes on children's ability to obtain and use skills needed for success in school.

A Longitudinal Study of the Predictors of Perceived Procedural Justice in Australian University Staff.

Purpose: This study examined the factors that predict employees' perceptions of procedural justice in university settings. The paper also reviews the ethical aspects of justice and psychological contracts within employment relationships.Design/Methodology/Approach: The study examined the predictors of perceived procedural justice in a two-wave longitudinal sample of 945 employees from 13 universities by applying the Job Demands-Resources theoretical model of stress. The proposed predictors were classified into two categories: Job demands of work pressure and work-home conflict; and job resources of job security, autonomy, trust in senior management, and trust in supervisor. The predictor model also examined job satisfaction and affective organizational commitment, demographic (age, gender, tenure, role) and individual characteristics (negative affectivity, job involvement) as well as Time 1 (T1) perceptions of procedural justice to ensure that tests were rigorous.Findings: A series of hierarchical multiple regression analyses found that job satisfaction at T1 was the strongest predictor of perceived procedural justice at Time 2. Employees' trust in senior management, and their length of tenure also positively predicted justice perceptions. There were also differences between academic and non-academic staff groups, as non-academic employees' level of job satisfaction, trust in senior management, and their length of organizational tenure predicted procedural justice perceptions, whereas for academics, only job satisfaction predicted perceived justice. For the “all staff” category, job satisfaction was a dominant and enduring predictor of justice, and employees' trust in senior management also predicted justice.Research limitations/implications: Results highlight the importance of workplace factors in enhancing fair procedures to encourage reciprocity from employees. As perceived procedural justice is also conceptually linked to the psychological contract between employees-employers, it is possible that employees' levels of job satisfaction and perceptions of trust in senior management, relative to other work attitudinal outcomes, may be more effective for improving the broader working environment, and promoting staff morale.Originality/value: This study adds to research on applied business ethics as it focuses on the ethical aspects of perceived procedural justice and highlights the importance of workplace factors in enhancing fair procedures in organizational policy to encourage reciprocity and promote healthy organizational environments.

Bidirectional Associations Between Parental Responsiveness and Executive Function During Early Childhood.

In this study, we examined bidirectional associations between parental responsiveness and executive function (EF) processes in socioeconomically disadvantaged preschoolers. Participants were 534 3- to 5-year-old children (71% Hispanic/Latino; 28% African American; 1% European American) attending Head Start programs. At Time 1 (T1) and 6.5 months later at Time 2 (T2), parents and children participated in a videotaped free play session and children completed delay inhibition (gift delay-wrap, gift delay-bow) and conflict EF (bear/dragon, dimensional change card sort) tasks. Parental warm acceptance, contingent responsiveness, and verbal scaffolding were coded from the free play videos and aggregated to create a parental responsiveness latent variable. A cross-lagged panel structural equation model indicated that higher T1 parental responsiveness significantly predicted more positive gain in delay inhibition and conflict EF from T1 to T2. Higher T1 delay inhibition, but not T1 conflict EF, significantly predicted more positive change in parental responsiveness from T1 to T2. These associations were not explained by several possible confounding variables, including children's age, gender, race/ethnicity, and verbal ability. Findings suggest that parental responsiveness may support EF development in disadvantaged children, with reciprocal effects of delay inhibition on parental responsiveness.

Exploring the Contributions of School Belonging to Complete Mental Health Screening

Considering the many positive outcomes associated with adolescents’ sense of school belonging, including psychological functioning, it is possible that including an assessment of school belonging within a complete mental health screening process could contribute to the prediction of students’ future mental health status. This exploratory study used complete mental health screening data obtained from a central California high school (N = 1,159). At Time 1 (T1) schoolwide screening was used to identify complete mental health groups by applying a dual-factor strategy and concurrently measuring students’ school belonging. One year later at Time 2 (T2), social-emotional wellbeing and internal distress were assessed. Cross-sectional T1 results indicated that there were significant differences in school belonging between students who reported low global life satisfaction and those who reported average or high global life satisfaction, regardless of reported level of psychological distress. A comparison of T1 to T2 data revealed that global life satisfaction and psychological distress were predictive of wellbeing and internal distress. However, contrary to study expectations, school belonging at T1 added little to the prediction of T2 psychological distress beyond the information already provided by the T1 dual-factor screening framework. Implications for practice and future directions are discussed.

Androgyny in Liking and in Being Liked Are Antecedent to Well-Being in Pre-Adolescent Boys and Girls

The present study is a two-wave longitudinal study of the concurrent and prospective associations between patterns of same- and other-gender liking and well-being in a sample of 403 fifth and sixth-grade girls and boys from Montreal Quebec, Canada that was used to examine Sandra Bem’s perspective that androgyny is related to well-being. In our study androgyny was operationally defined as (a) the combination of liking for same- and other-gender peers and (b) the combination of being liked by same- and other-gender peers. Well-being was indexed with a measure of the self-concept. Findings drawn from analyses conducted with structural equation modeling showed that androgynous liking was an antecedent and a consequence of well-being. Specifically (a) Time 1 (T1) well-being was a predictor of how much girls and boys liked same-gender and other-gender peers at Time 2 (T2) whereas T2 well-being was predicted by how much girls and boys liked same- and other-gender peers at T1 and (b) T2 well-being was predicted by how much girls and boys were liked by same-gender and other-gender peers. These findings are discussed according to the dynamics of experiences with peers from one’s own gender and the other-gender.

Parents' Romantic Attachment Predicts Family Ritual Meaning and Family Cohesion Among Parents and Their Children With Cancer.

Family functioning is associated with adaptation in pediatric illness. This study examines the role of parents’ relationships (specifically romantic attachment) as a predictor of family ritual meaning and family cohesion for parents and their children with cancer. The dyads, 58 partnered Portuguese parents and their children in treatment, reported on family ritual meaning and family cohesion at Time 1 (T1) and after 6 months (T2). Parents also completed the questionnaire assessing romantic attachment at T1. Parents’ avoidant attachment, but not anxious attachment, predicted lower family ritual meaning and family cohesion after 6 months. T2 family ritual meaning mediated the relationship between T1 avoidant attachment and T2 family cohesion. Parents’ avoidant attachment may have a negative effect on family functioning in parents and children. Clinical intervention to address avoidant attachment or/and to promote family ritual meaning may help strengthen family ties.

Maladaptive mood repair, atypical respiratory sinus arrhythmia, and risk of a recurrent major depressive episode among adolescents with prior major depression.

Because depressive illness is recurrent, recurrence prevention should be a mainstay for reducing its burden on society. One way to reach this goal is to identify malleable risk factors. The ability to attenuate sadness/dysphoria (mood repair) and parasympathetic nervous system functioning, indexed as respiratory sinus arrhythmia (RSA), are impaired during depression and after it has remitted. The present study therefore tested the hypothesis that these two constructs also may mirror risk factors for a recurrent major depressive episode (MDE). At time 1 (T1), 178 adolescents, whose last MDE had remitted, and their parents, reported on depression and mood repair; youths' RSA at rest and in response to sad mood induction also were assessed. MDE recurrence was monitored until time 2 (T2) up to 2 years later. Mood repair at T1 (modeled as a latent construct), and resting RSA and RSA response to sadness induction (RSA profile), served to predict onset of first recurrent MDE by T2. Consistent with expectations, maladaptive mood repair predicted recurrent MDE, above and beyond T1 depression symptoms. Further, atypical RSA profiles at T1 were associated with high levels of maladaptive mood repair, which, in turn, predicted increased risk of recurrent MDE. Thus, maladaptive mood repair mediated the effects of atypical RSA on risk of MDE recurrence. This study documented that a combination of behavioral and physiological risk factors predicted MDE recurrence in a previously clinically referred sample of adolescents with depression histories. Because mood repair and RSA are malleable, both could be targeted for modification to reduce the risk of recurrent depression in youths.

Spiritual well-being and spiritual distress predict adjustment in adolescent and young adult cancer survivors.

Spirituality is related to many aspects of cancer survivors' physical and psychological adjustment. Given their unique developmental issues, spiritual issues may be especially important to adolescent and young adult (AYA) survivors, yet little research has been conducted on spirituality with AYA survivors. The present study examines how two aspects of spirituality, spiritual well-being (comprising faith and meaning/peace), and spiritual struggle relate to later post-cancer adjustment. At Time 1 (T1), 120 AYA survivors completed questionnaires on spirituality and adjustment (fear of recurrence, post-traumatic stress symptoms, perceived post-traumatic growth, psychological distress, and health-related quality of life). Eighty-three of these participants also completed these questionnaires at Time 2 (T2), one year later. Our sample reported fairly low spiritual well-being (meaning/peace, faith) and spiritual struggle. As expected, T1 spiritual well-being was positively correlated with some aspects of psychological adjustment at T2, whereas T1 spiritual struggle was inversely correlated with T2 psychological adjustment. Both dimensions of T1 spiritual well-being, but not struggle, were positively associated with perceived T2 posttraumatic growth. In general, T1 spiritual well-being and struggle correlated with T2 psychological adjustment even when demographics and cancer-related variables were controlled. These results suggest that while spirituality is not important to all AYA survivors, both spiritual well-being and struggle have important associations with adjustment and may warrant clinical attention. Future research is needed to more fully understand the role of spirituality in AYA survivors' adjustment in more depth. Copyright © 2016 John Wiley & Sons, Ltd.

Impulsive Personality and Alcohol Use: Bidirectional Relations Over One Year.

Impulsive personality traits have been found to be robust predictors of substance use and problems in both cross-sectional and longitudinal research. Studies examining the relations of substance use and impulsive personality over time indicate a bidirectional relation, where substance use is also predictive of increases in later impulsive personality. The present study sought to build on these findings by examining the bidirectional relations among the different impulsive personality traits assessed by the UPPS-P Impulsive Behavior Scale, with an interest in urgency (the tendency to act rashly when experiencing strong affect). Participants were 525 first-year college students (48.0% male, 81.1% White), who completed self-report measures assessing personality traits and a structured interview assessing past and current substance use. Data collection took place at two different time points: the first occurred during the participants' first year of college, and the second occurred approximately 1 year later. Bidirectional relations were examined using structural equation modeling. Time 1 (T1) positive urgency predicted higher levels of alcohol use at Time 2 (T2), whereas T1 lack of perseverance predicted lower levels of alcohol use at T2. T1 alcohol use predicted higher levels of positive urgency, negative urgency, sensation seeking, and lack of premeditation at T2. Findings provide greater resolution in characterizing the bidirectional relation between impulsive personality traits and substance use.

The impact of quitting smoking on depressive symptoms: findings from the International Tobacco Control Four-Country Survey.

To determine whether abstinence or relapse on a quit attempt in the previous year is associated with current depressive symptoms. Prospective cohort with approximately annual waves. Mixed-effect logistic regressions tested whether time 2 (T2) quitting status was associated with reporting symptoms at T2, and whether time 1 (T1) symptoms moderated this relationship. Waves 5-8 of the Four-Country International Tobacco Control Study: a quasi-experimental cohort study of smokers from Canada, the United States, the United Kingdom and Australia. A total of 6978 smokers who participated in telephone surveys. T1 and T2 depressive symptoms in the last 4weeks were assessed with two screening items from the PRIME-MD questionnaire. Quitting status at T2: (1) no attempt since T1; (2) attempted and relapsed; and (3) attempted and abstinent at T2. Compared with no attempt, relapse was associated with reporting T2 symptoms [odds ratio (OR)=1.46, 95% confidence interval (CI)=1.33, 1.59]). Associations between T2 quitting status and T2 symptoms were moderated by T1 symptoms. Relapse was associated positively with T2 symptoms for those without T1 symptoms (OR=1.71, 95% CI=1.45, 2.03) and those with T1 symptoms (OR=1.45, 95% CI=1.23, 1.70). Abstinence was associated positively for those without T1 symptoms (OR=1.37, 95% CI=1.10, 1.71) and negatively for those with T1 symptoms (OR=0.74, 95% CI=0.59, 0.94). Age moderated these associations significantly. Relapse did not predict T2 symptoms for those aged 18-39 irrespective of T1 symptoms. The negative effect of abstinence on T2 symptoms for those with T1 symptoms was significant only for those aged 18-39 (OR =0.61, 95% CI=0.40, 0.94) and 40-55 (OR =0.58, 95% CI=0.40, 0.84). The positive effect of abstinence on T2 symptoms for those without T1 symptoms was significant only for those aged more than 55 (OR =1.97, 95% CI=1.35, 2.87). Most people who stop smoking appear to be at no greater risk of developing symptoms of depression than if they had continued smoking. However, people aged more than 55 who stop smoking may be at greater risk of developing symptoms of depression than if they had continued smoking.

A New Strategy for Trichomonas Testing Female Adolescents in the Emergency Department

Study ObjectiveSensitive trichomonas diagnostic testing has become available, including nucleic acid amplification tests (NAATs) and a rapid antigen test. The study purpose was to determine if adding sensitive trichomonas testing to routine female sexually transmitted infection (STI) evaluations would increase trichomonas identification and treatment. DesignTwo study time periods. Study time 1 (T1) was used for a retrospective review. Study time 2 (T2) was used for a prospective study. SettingEmergency Department. ParticipantsSymptomatic female patients aged 13-20 years (N = 447). InterventionsImplementation of routing trichomonas testing in the Emergency Department during T2. Main Outcome MeasuresTrichomonas diagnosis and treatment rates were compared during T1 and T2. ResultsDuring T1 31 of 234 of eligible patients (13%) were trichomonas-tested. Laboratory-confirmed trichomonas was identified in 3 of 234 (1.3%). During T2, 212 of 213 of eligible patients (99.5%) were trichomonas-tested; 39 of 212 tested trichomonas-positive (18.4%); 29 of 212 tested rapid trichomonas antigen test-positive (13.6%; P < .001), and 33 of 188 tested trichomonas NAAT-positive (15.5%; P < .001). Trichomonas treatment was given to 3 of 3 laboratory-confirmed trichomonas cases during T1 (100%) compared with 37 of 39 during T2 (95%; P = .688). During T1, 14 of 17 women who received trichomonas treatment (82.4%) did not have a laboratory-confirmed trichomonas diagnosis and during T2 13 of 52 women without a laboratory-confirmed trichomonas diagnosis (25%) were treated for trichomonas (P < .001). Rapid trichomonas antigen tests and trichomonas NAATs were concordant in 178 of 188 patients (94.6%). ConclusionIncorporating trichomonas rapid antigen tests and NAATs into routine female adolescent STI testing significantly increased the number of laboratory-confirmed adolescent trichomonas diagnosis and treatment and are useful Emergency Department STI screening tools.

A Longitudinal Study of Sexual Entitlement and Self-Efficacy among Young Women and Men: Gender Differences and Associations with Age and Sexual Experience.

Many scholars have called for an increased focus on positive aspects of sexual health and sexuality. Using a longitudinal design with two assessments, we investigated patterns of entitlement to sexual partner pleasure and self-efficacy to achieve sexual pleasure among 295 young men and women aged 17–25 years attending one Australian university. We also tested whether entitlement and efficacy differed by gender, and hypothesized that entitlement and efficacy would be higher in older participants and those with more sexual experience. A sense of entitlement to sexual partner pleasure increased significantly over the year of the study, whereas, on average, there was no change in self-efficacy over time. At Time 1 (T1), young women reported more entitlement than young men. Age was positively associated with T1 entitlement, and experience with a wider range of partnered sexual behaviors was concurrently associated with more entitlement and efficacy and was also associated with increased entitlement to partner pleasure and increased self-efficacy in achieving sexual pleasure at T2 relative to T1. A group with the least amount of sexual experience was particularly low in entitlement and efficacy when compared to groups with a history of coital experience. There was no evidence that any association differed between young men and young women. Limitations of the study include a sample of predominantly middle class, Caucasian students at one university and the possibility that students more interested in sex and relationships, and with more sexual experience, chose to participate.

Protocol for a feasibility cluster randomised controlled trial of a peer-led school-based intervention to increase the physical activity of adolescent girls (PLAN-A)

BackgroundPhysical activity levels are low amongst adolescent girls, and this population faces specific barriers to being active. Peer influences on health behaviours are important in adolescence and peer-led interventions might hold promise to change behaviour. This paper describes the protocol for a feasibility cluster randomised controlled trial of Peer-Led physical Activity iNtervention for Adolescent girls (PLAN-A), a peer-led intervention aimed at increasing adolescent girls’ physical activity levels.Methods/designA two-arm cluster randomised feasibility trial will be conducted in six secondary schools (intervention n = 4; control n = 2) with year 8 (12–13 years old) girls. The intervention will operate at a year group level and consist of year 8 girls nominating influential peers within their year group to become peer-supporters. Approximately 15 % of the cohort will receive 3 days of training about physical activity and interpersonal communication skills. Peer-supporters will then informally diffuse messages about physical activity amongst their friends for 10 weeks. Data will be collected at baseline (time 0 (T0)), immediately after the intervention (time 1 (T1)) and 12 months after baseline measures (time 2 (T2)). In this feasibility trial, the primary interest is in the recruitment of schools and participants (both year 8 girls and peer-supporters), delivery and receipt of the intervention, data provision rates and identifying the cost categories for future economic analysis. Physical activity will be assessed using 7-day accelerometry, with the likely primary outcome in a fully-powered trial being daily minutes of moderate-to-vigorous physical activity. Participants will also complete psychosocial questionnaires at each time point: assessing motivation, self-esteem and peer physical activity norms. Data analysis will be largely descriptive and focus on recruitment, attendance and data provision rates. The findings will inform the sample size required for a definitive trial. A detailed process evaluation using qualitative and quantitative methods will be conducted with a variety of stakeholders (i.e. pupils, parents, teachers and peer-supporter trainers) to identify areas of success and necessary improvements prior to proceeding to a definitive trial.DiscussionThis paper describes the protocol for the PLAN-A feasibility cluster randomised controlled trial which will provide the information necessary to design a fully-powered trial should PLAN-A demonstrate evidence of promise.Trial Registration ISRCTN12543546

Conversations about mental states and theory of mind development during middle childhood: A training study

Despite 30years of productive research on theory of mind (ToM), we still know relatively little about variables that influence ToM development during middle childhood. Recent experimental studies have shown that conversations about the mind affect ToM abilities, but they have not explored the mechanisms underlying this developmental effect. In the current study, we examined two potential mechanisms through which conversations about mental states are likely to influence ToM: an increased frequency of references to mental states when explaining behavior and an increased accuracy of mental-state attributions. To this aim, we conducted a training study in which 101 children were assigned to either an intervention condition or a control condition. The conversation-based intervention was made up of four sessions scheduled over 2weeks. Children completed a battery of assessments before and after the intervention as well as 2months later. The groups were equivalent at Time 1 (T1) for age, family affluence, vocabulary, and executive functions. The ToM group showed an improvement in ToM skills (as evaluated on both the practiced tasks and a transfer task). Mediation analyses demonstrated that the accuracy of mental-state attributions, but not the mere frequency of mental-state references, mediated the positive effect of conversations about the mind on ToM development. Our results indicate that conversational experience can enhance mental-state reasoning not by simply drawing children’s attention to mental states but rather by scaffolding a mature understanding of social situations.

Greater family identification—but not greater contact with family members—leads to better health: Evidence from a Spanish longitudinal study

AbstractWe investigated the effect of family identification (one's subjective sense of belonging to and commonality with the family) on self‐reported ill‐health in 206 Valencian undergraduates, with eight months between Time 1 (T1) and Time 2 (T2). While greater family identification T1 predicted lower ill‐health T2, ill‐health T1 did not predict family identification T2. Family contact T1 (one's intensity of interaction with family) was unrelated to ill‐health T2. This shows that family identification impacts positively on health over time (rather than health impacting positively on family identification over time), and this is not reducible to effects exerted by family contact. These findings indicate that encouraging patients to engage in group activities might produce negligible health gains unless the patient identifies with the group in question.

Internet use expectancy for tension reduction and disinhibition mediates the relationship between borderline personality disorder features and Internet addiction among college students – One-year follow-up

Borderline personality disorder (BPD) features with affective instability and impulsivity have been shown to correlate with Internet addiction (IA) in cross-sectional studies. Moreover, Internet use expectancies were found to be positively associated with IA. Thus, this follow-up study was aimed to examine whether BPD features would increase the risk for IA severity, mediated through the Internet use expectation as a coping method for tension reduction and disinhibition.1826 Taiwan college students were sampled through a stratified and random clustering in time 1 (T1), and 623 students were followed up one year later (T2). A comprehensive survey was administered.Structure equation modeling results showed that IA severity (T2) was significantly predicted by BPD features (T1), fully mediated through Internet use expectancy for tension reduction and disinhibition (T2). The model yielded an adequate fit, and was able to explain 43.0% of the variance.The mediating role of the Internet use expectation for tension reduction and disinhibition in the relationship between BPD features and IA severity were discussed.

Impaired bone mineral accrual in prepubertal HIV-infected children: a cohort study

ObjectiveTo evaluate bone mass accrual and determine the influence of clinical, anthropometric, dietary and biochemical parameters on bone mass. MethodsA cohort study including 35 prepubertal HIV-infected children, between 7 and 12 years, attended at a referral center. At time 1 (T1) and time 2 (T2), patients were assessed according to clinical, anthropometric, dietary, biochemical parameters and bone mineral density (BMD). At T2, patients were divided into prepubertal and pubertal. ResultsDespite the increase in bone mass absolute values, there was no improvement in lumbar spine BMD (LSBMD) Z-score (p=0.512) and worsening in total body BMD (TBMD) Z-score (p=0.040). Pubertal patients (n=19) showed higher bone mineral content (BMC) (p=0.001), TBMD (p=0.006) and LSBMD (p=0.002) compared to prepubertal patients. After multivariate linear regression analysis, the predictors of bone mass in T1 were age, BMI and HA Z-scores for BMC; BMI Z-score, adequate serum magnesium concentration and dietary calcium intake for TBMD; adequate serum concentration of magnesium, BMI and HA Z-scores for LSBMD. In T2, age, total body fat and lean body mass (kg) for BMC; BMI Z-score and puberty for TBMD; dietary fat intake, BMI Z-score for BMD and puberty for LSBMD. ConclusionHIV-infected children have compromised bone mass and the presence of puberty seems to provide suitability of these parameters. Adequate intake of calcium and fat appears to be protective for proper bone mass accumulation factor, as well as monitoring nutritional status and serum magnesium concentration.