Within-individual Associations Research Articles

Detecting Longitudinal Trends between Passively Collected Phone Use and Anxiety among College Students

Introduction: Existing theories and empirical works link phone use with anxiety; however, most leverage subjective self-reports of phone use (e.g., validated questionnaires) that may not correspond well with true behavior. Moreover, most works linking phone use with anxiety do not interrogate associations within a temporal framework. Accordingly, the present study sought to investigate the utility of passively sensed phone use as a longitudinal predictor of anxiety symptomatology within a population particularly vulnerable to experiencing anxiety. Methods: Using data from the GLOBEM study, which continuously collected longitudinal behavioral data from a college cohort of N = 330 students, weekly PHQ-4 anxiety subscale scores across 3 years (2019–2021) were paired with median daily phone use records from the 2 weeks prior to anxiety self-report completion. Phone use was operationalized through unlock duration which was passively curated via Apple’s “Screen Time” feature. GPS-tracked location data was further utilized to specify whether an individual’s phone use was at home or away from home. Within-individual and temporal associations between phone use and anxiety were modeled within an ordinal mixed-effects logistic regression framework. Results: While there was no significant association between anxiety levels and either median total phone use or median phone use at home, participants in the top quartile of median phone use away from home were predicted to exhibit clinically significant anxiety levels 20% more frequently than participants in the bottom quartile during the first study year; however, this association weakened across successive years. Importantly, these associations remained after controlling for age, physical activity, sleep, and baseline anxiety levels and were not recapitulated when operationalizing phone use with unlock frequency. Conclusions: These findings suggest that phone use may be leveraged as a means of mitigating or coping with anxiety in social situations outside the home, while pandemic-related developments may also have attenuated this behavior later in the study. Nevertheless, the present results suggest promise in interrogating a larger suite of objectively measured phone use behaviors within the context of social anxiety.

Monitoring Within-Individual Dose-Response Relationships in Professional Soccer Players: The Importance of Fitness Level.

To (1)examine within-individual player dose-response associations between selected training-load measures and changes in aerobic fitness level via submaximal exercise heart rate (HRex%) and (2)measure the relationships between these dose-response associations with basal HRex% (to study the influence of fitness level on dose-response relationship). During an in-season phase, selected training-load measures including total minutes, total distance, mechanical work (the sum number of accelerations and decelerations > 3m2), high metabolic load distance, and Edwards' training impulse were collected via Global Positioning System and heart-rate sensors for analyzing accumulated load. A submaximal warm-up test was used repeatedly before and after 9 phases to elicit HRex% and track fitness changes at an individual level. Negative to positive extensive ranges of within-individual associations were found among players for different metrics (r = -.84 to .89). The relationship between pooled HRex% (basal fitness) and dose-response correlations showed inverse very large (r = -.71) and large (r = -.65) values for accumulated weekly minutes and distance. However, moderate values were found for all other measures (r = -.35 to -.42). Individual players show extensive different ranges of dose-response associations with training measures. The dose-response association is influenced by players' fitness level, and players with lower fitness levels show stronger inverse relationships with accumulated minutes and total distance.

Longitudinal study of changes in greenness exposure, physical activity and sedentary behavior in the ORISCAV-LUX cohort study

BackgroundGreenness exposure has been associated with many health benefits, for example through the pathway of providing opportunities for physical activity (PA). Beside the limited body of longitudinal research, most studies overlook to what extent different types of greenness exposures may be associated with varying levels of PA and sedentary behavior (SB). In this study, we investigated associations of greenness characterized by density, diversity and vegetation type with self-reported PA and SB over a 9-year period, using data from the ORISCAV-LUX study (2007–2017, n = 628).MethodsThe International Physical Activity Questionnaire (IPAQ) short form was used to collect PA and SB outcomes. PA was expressed as MET-minutes/week and log-transformed, and SB was expressed as sitting time in minutes/day.Geographic Information Systems (ArcGIS Pro, ArcMap) were used to collect the following exposure variables: Tree Cover Density (TCD), Soil-adjusted Vegetation Index (SAVI), and Green Land Use Mix (GLUM). The exposure variables were derived from publicly available sources using remote sensing and cartographic resources. Greenness exposure was calculated within 1000m street network buffers around participants’ exact residential address.ResultsUsing Random Effects Within-Between (REWB) models, we found evidence of negative within-individual associations of TCD with PA (β = − 2.60, 95% CI − 4.75; − 0.44), and negative between-individual associations of GLUM and PA (β = − 2.02, 95% CI − 3.73; − 0.32). There was no evidence for significant associations between greenness exposure and SB. Significant interaction effects by sex were present for the associations between TCD and both PA and SB. Neighborhood socioeconomic status (NSES) did not modify the effect of greenness exposure on PA and SB in the 1000 m buffer.DiscussionOur results showed that the relationship between greenness exposure and PA depended on the type of greenness measure used, which stresses the need for the use of more diverse and complementary greenness measures in future research. Tree vegetation and greenness diversity, and changes therein, appeared to relate to PA, with distinct effects among men and women. Replication studies are needed to confirm the relevance of using different greenness measures to understand its’ different associations with PA and SB.

Effectiveness of substance use disorder treatment as an alternative to imprisonment

IntroductionDrug courts are criminal justice programs to divert people with substance use disorders from incarceration into treatment. Drug courts have become increasingly popular in the US and other countries. However, their effectiveness in reducing important public health outcomes such as recidivism and substance-related health harms remains ambiguous and contested. We used nationwide register data from Sweden to evaluate the effectiveness of contract treatment sanction, the Swedish version of drug court, in reducing substance misuse, adverse somatic and mental health outcomes, and recidivism.MethodsIn this prospective cohort study, two quasi-experimental designs were used: difference-in-differences and the within-individual design. In the latter, we compared the risk of outcomes during time on contract treatment to, 1) parole after imprisonment and, 2) probation.ResultsThe cohort included 11,893 individuals (13% women) who underwent contract treatment. Contract treatment was associated with a reduction of 7 percentage points (95% CI: -.088, -.055) in substance misuse, 5 percentage points (-.064, -.034) in adverse mental health events, 9 percentage points (-.113, -.076) in adverse somatic health events, and 3 fewer charges (-3.16, -2.85) for crime in difference-in-differences analyses. Within-individual associations suggested that the same individual had longer times-to-event for all outcomes during contract treatment than on parole or on probation.ConclusionsContract treatment is an effective intervention from both public health and criminal justice perspective. Our findings suggest that it is a superior alternative to incarceration in its target group. Further, we find that an implementation approach that is less punitive and more inclusive than what is typical in the US can be successful.

No effect of testosterone or sexual ornamentation on telomere dynamics: A case study and meta-analyses.

Life-history theory predicts that reproductive investments are traded-off against self-maintenance. Telomeres, the protective caps on the ends of chromosomes, offer a promising avenue for assessing life-history trade-offs, as they shorten in response to stressors and are predictive of the remaining lifespan. In males, testosterone frequently mediates life-history trade-offs, in part, through its effects on sexual ornamentation, which is an important aspect of reproductive investment. However, studies of within-individual associations between telomere dynamics and sexual ornamentation are limited in number and have produced mixed results. Furthermore, most such studies have been observational, making it difficult to discern the nature of any causal relationship. To address this, we used short-acting testosterone implants in free-living male superb fairy-wrens (Malurus cyaneus) to stimulate the production of a sexual ornament: early moult into a costly blue breeding plumage. We found no evidence that elevated testosterone, and the consequent earlier moult into breeding plumage, accelerated telomere shortening. We therefore followed up with a systematic review and two meta-analyses (28 studies, 54 effect sizes) exploring the associations between telomeres and (1) testosterone and (2) sexual ornamentation. In line with our experimental findings, neither meta-analysis showed an overall correlation of testosterone or sexual ornamentation with telomere length or telomere dynamics. However, meta-regression showed that experimental, compared to observational, studies reported greater evidence of trade-offs. Our meta-analyses highlight the need for further experimental studies to better understand potential responses of telomere length or telomere dynamics to testosterone or sexual ornamentation.

Bidirectional associations between alcohol drinking and depressive symptom scores among US older adults

BackgroundThis study examines the bidirectional associations between alcohol drinking and depression in which low to moderate alcohol drinking may reduce the risk of depression, while the occurrence of depression may increase the amount of alcohol drinking as a coping strategy. MethodData for the community-dwelling older adults from the Medicare Current Beneficiary Survey (MCBS) 2016 to 2019 were analyzed using random intercept cross-lagged panel models to explore the within-individual causal associations for males and females separately. Socioeconomic status (SES), smoking and comorbidities were adjusted in the models. ResultsAmong 3388 older adults with three measures for the number of alcohol drinks and Patient Health Questionnaire (PHQ) depression scores, a prior increase in the number of drinks was related to a moderate non-significant decrease in PHQ scores in the follow-up, but a previous increase in the PHQ scores was significantly associated with a decrease in the number of drinks at the follow-up visit in the adjusted models (regression coefficient = −0.144, p = 0.017 for males; and coefficient = −0.11, p < 0.001 for females). ConclusionPrior depression may lead to reduced drinking in the follow up visits, but no bidirectional association was found among US older adults.

O.2.2-4 Longitudinal associations between residential greenness exposure, physical activity and sedentary behavior levels: a country-wide study in Luxembourg

Abstract Greenness exposure has been associated with many health benefits, by providing opportunities for physical activity. Longitudinal studies are lacking, and most studies overlook the varying effects of different greenness types on physical activity (PA) and sedentary behavior (SB). We investigated 9-year associations of greenness characterized by overall greenness, vegetation type, and mix, with PA and SB using data from the ORISCAV-LUX study and the MET’HOOD project. The PA and SB outcomes were measured using the International Physical Activity Questionnaire (IPAQ) short form. PA is expressed as MET-minutes/week and log-transformed, and SB is expressed as sitting time in minutes/day. The exposure variables were Tree Cover Density (TCD), Soil-adjusted Vegetation Index (SAVI), and Green Land Use Mix (GLUM). The study population consisted of 628 adults, who completed the questionnaires between January 2007-2009 and January 2016-July 2017. Missing data were imputed. Greenness exposure was collected within 800-meter street network buffers based on participants’ exact residential address. Associations between TCD, SAVI and GLUM and PA and SB were estimated using a Random Effects Within-Between (REWB) model. Interaction by gender and SES were explored. Sensitivity analyses were performed on smaller (500 meter buffer) and larger (1000, 2000 meter buffers) definitions of the residential neighborhood. We found evidence of between-individual associations of GLUM and PA (β = 0.17, 95% CI: 0.03; 0.91), and within-individual associations of TCD with PA (β = 0.03, 95% CI: 0.002; 0.438) (in 800 meter buffers). There was no evidence for associations between greenness exposure and SB. Sensitivity analysis using varying buffer sizes showed similar associations. Our study found evidence of associations of GLUM and TCD with PA, and no associations between greenness exposure and SB. Promoting different types of greenness may result in different PA levels and behaviors. Replication studies are needed to inform urban planning interventions. This study is funded by the EU Horizon2020 Program under grant agreement number 956780 (SURREAL). The ORISCAV-LUX study is funded by the Luxembourg Ministry of Health and Ministry of Higher Education and Research. The MET'HOOD project is funded by the Luxembourg National Research Fund as part of the CORE 2020 programme (C20/BM/14787166).

Enhancing the Initial Acceleration Performance of Elite Rugby Backs. Part I: Determining Individual Technical Needs.

This study sought to quantify the within-individual relationships between spatiotemporal variables and initial acceleration sprint performance in elite rugby backs and to establish a normative data set of relevant strength-based measures. First, the spatiotemporal variables, ratios of step length to step rate and of contact time to flight time, and initial acceleration performance were obtained from 35 elite male rugby backs (mean [SD] age 25 [3]y) over the first 4 steps of 3 sprints. Angular and linear kinematic aspects of technique and strength-based qualities were collected from 25 of these participants. Second, the same spatiotemporal variables were collected from 19 of the participants on 3 further occasions (12 trials in total) to determine the within-individual associations of these variables and initial acceleration performance. Moderate to very large meaningful within-individual relationships (|r| = .43-.88) were found between spatiotemporal variables and initial acceleration performance in 17 of the 19 participants. From these relationships, a theoretically "desirable" change in whole-body kinematic strategy was individually determined for each participant, and normative strength-based measures to contextualize these were established. Meaningful within-individual relationships are evident between sprint spatiotemporal variables and initial acceleration performance in elite rugby backs. Individualized approaches are therefore necessary to understand how aspects of technique relate to initial acceleration performance. This study provides an objective, evidence-based approach for applied practitioners to identify the initial acceleration technical needs of individual rugby backs.

Physical activity and mental health: Comparing between-person and within-person associations in longitudinal analysis

BackgroundExtensive research has consistently highlighted the strong association between physical activity and mental health. But few have examined how this association may differ at the between-person and the within-person level. This longitudinal study compares how within-person and between-person changes in physical activity are associated mental health during the COVID-19 pandemic among the American population. MethodsWe analyzed data from the Understanding Coronavirus in America (UCA) survey, a probability-based online panel of American adults. An average of more than 6000 panel members repeatedly participated across 33 waves from the start of the pandemic in March 2020 to January 2023. Measures of physical activity include 1) number of days exercised in the past week (0–7), and 2) whether gone outside to walk, hike, and exercise in the past week (0 = no, 1 = yes), capturing both the frequency and the context (e.g., outdoor) of physical activity. Mental health is indicated using the four-item Patient Health Questionnaire (PHQ-4). We used multilevel Within-Between Random Effects models (REWB) that provide coefficients for both between-individual as well as within-individual associations. ResultsWe reported three main findings. First, both within-person and between-person increases in physical activity are significantly associated with lower levels of anxiety and depression regardless of the measure. Second, between-person changes in physical activity are more strongly associated with mental health than within-person changes. Third, a large share of the between-person association (about 32%) can be attributed to structural inequalities captured by status markers such as gender, race, and SES. ConclusionsOur findings indicate the value of physical activity as a mental health intervention and highlight that both between-individual inequality in physical activity, as well as within-individual changes in physical activity, should be considered. The finding of a stronger between-person association that is largely related to status markers such as gender, race, and SES can be used to develop targeted intervention and prevention strategies to improve mental health through physical activity among the most vulnerable populations.

Is There a Causal Relationship between Physical Activity and Bone Microarchitecture? A Study of Adult Female Twin Pairs.

The reasons for the association between physical activity (PA) and bone microarchitecture traits are unclear. We examined whether these associations were consistent with causation and/or with shared familial factors using a cross-sectional study of 47 dizygotic and 93 monozygotic female twin pairs aged 31-77 years. Images of the nondominant distal tibia were obtained using high-resolutionperipheral quantitative computed tomography. The bone microarchitecture was assessed using StrAx1.0 software. Based on a self-completed questionnaire, a PA index was calculated as a weighted sum of weekly hours of light (walking, light gardening), moderate (social tennis, golf, hiking), and vigorous activity (competitive active sports) = light + 2 * moderate + 3 * vigorous. We applied Inference about Causation through Examination of FAmiliaL CONfounding (ICE FALCON) to test whether cross-pair cross-trait associations changed after adjustment for within-individual associations. Within-individual distal tibia cortical cross-sectional area (CSA) and cortical thickness were positively associated with PA (regression coefficients [β] = 0.20 and 0.22), while the porosity of the inner transitional zone was negatively associated with PA (β = -0.17), all p < 0.05. Trabecular volumetric bone mineral density (vBMD) and trabecular thickness were positively associated with PA (β = 0.13 and 0.14), and medullary CSA was negatively associated with PA (β = -0.22), all p ≤ 0.01. Cross-pair cross-trait associations of cortical thickness, cortical CSA, and medullary CSA with PA attenuated after adjustment for the within-individual association (p = 0.048, p = 0.062, and p = 0.028 for changes). In conclusion, increasing PA was associated with thicker cortices, larger cortical area, lower porosity of the inner transitional zone, thicker trabeculae, and smaller medullary cavities. The attenuation of cross-pair cross-trait associations after accounting for the within-individual associations was consistent with PA having a causal effect on the improved cortical and trabecular microarchitecture of adult females, in addition to shared familial factors. © 2023 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).

Examining daily stimulant medication use and sleep in adolescents with ADHD.

Research has been inconclusive as to whether stimulant treatment causes or exacerbates sleep problems in adolescents with ADHD. This study examined sleep differences in adolescents with ADHD as a function of stimulant use. Participants were adolescents with ADHD (N = 159, ages 12-14). Parents reported on receipt of stimulant treatment (n = 92, 57.86%; n = 47 amphetamines, n = 45 methylphenidate). Adolescents wore actigraphs and completed daily diaries assessing sleep and daily use of stimulants for 2 weeks. Sleep parameters included daily-reported bedtime, sleep onset latency (SOL), sleep duration, daytime sleepiness, and difficulty waking the following morning; and actigraphy-measured sleep onset time, total time in bed, and sleep efficiency. We estimated between- and within-individual associations between stimulant medication use and sleep indices with all stimulants, after removing adolescents using sleep aids and weekend days, and as a function of stimulant type. Adolescent sleep did not differ between those receiving and not receiving stimulant treatment. Within individuals using stimulants, we largely observed no significant differences between medicated and unmedicated days, though findings were most often significant for school days only. Small effects were found indicating longer SOL, later sleep onset time, and more daytime sleepiness related to medication use. In contrast, there were slight improvements to sleep duration and sleep efficiency related to methylphenidate use, though methylphenidate was also associated with later sleep onset time and more daytime sleepiness. Given the inconsistent and small effects, findings suggest that stimulant medication may impact sleep, but does not appear to be a primary contributor to sleep problems in adolescents with ADHD.

Within-Person Bidirectional Associations Over Time Between Parenting and Youths’ Callousness

ABSTRACT Objective Callousness has been identified as a key driver of aggressive and violent behavior from childhood into early adulthood. Although previous research has underscored the importance of the parenting environment in contributing to the development of youth callousness, findings have generally been confined to the between-individual level and have not examined bidirectionality. In the current study, we test whether aspects of parenting are associated with callousness from childhood to adolescence both between and within individuals, examine the temporal ordering of associations, and test whether these relations are moderated by gender or developmental stage. Method Data came from a longitudinal study in which parents of 1,421 youth (52% girls; 62% White and 22% Black) from the second, fourth, and ninth grades were interviewed three times, with one year between consecutive interviews. Results A random-intercept cross-lagged panel model indicated that elevated youth callousness predicts subsequent increases in parental rejection and decreases in consistency of discipline. Findings were largely similar for boys and girls, but within-individual associations were generally stronger for 4th graders compared to the 2nd and 9th graders. Conclusions Callousness and parenting practices and attitudes were related both at the between-individual and within-individual level. These results have implications for the etiology and treatment of children and adolescents who exhibit callousness.

The Within-Individual Effects of U.S. Immigration on Individual-Level Offending During Adolescence and Early Adulthood

Objectives: Prior contextual-level studies suggest that individuals who reside in areas with higher concentrations of foreign-born residents engage in less crime and delinquency. Yet, this work has relied on either cross-sectional models or longitudinal data with only baseline measurements of immigration, which tells us little about whether temporal changes in immigrant concentration affect changes in individual-level offending. We addressed this shortcoming by conducting a contextual-level study that uses a within-individual research design. Methods: Using public and restricted data from the National Longitudinal Survey of Youth 1997 and U.S. Census data, we employed Bayesian random-effects models to examine the within-individual associations between the percentage of the population that is foreign-born in respondents’ county of residence and two indicators of criminal offending during adolescence and early adulthood. Results: Findings indicated that percent foreign-born was associated with subsequent reductions in criminal arrest but not self-reported offending. Moreover, we found that these effects were similar regardless of whether respondents moved or remained in place over time. Finally, for self-reported offending, the effects of percent foreign-born were stronger for first-generation immigrants, but for arrest, they were similar across generation. Conclusions: Immigrant concentration is a time-varying phenomenon that has the potential to reduce individual-level offending.

Longitudinal associations between cognitive functioning and depressive symptoms among couples in the Mexican Health and Aging Study.

To examine the bidirectional associations between older adult spouses' cognitive functioning and depressive symptoms over time and replicate previous findings from the United States (US) in Mexico. Longitudinal, dyadic path analysis with the actor-partner interdependence model. Data were from the three most recent interview waves (2012, 2015, and 2018) of the Mexican Health and Aging Study (MHAS), a longitudinal national study of adults aged 50+ years in Mexico. Husbands and wives from 905 community-dwelling married couples (N = 1,810). The MHAS cognitive battery measured cognitive function. Depressive symptoms were assessed using a modified nine-item Center for Epidemiologic Studies Depression Scale. Baseline covariates included age, education, number of children, limitation with any activity of daily living, limitation with any instrumental activity of daily living, and pain. As hypothesized, there were significant within-individual associations in which one person's own cognitive functioning and own depressive symptoms predicted their own follow-up cognitive functioning and depressive symptoms, respectively. In addition, a person's own cognitive functioning predicted their own depressive symptoms, and a person's own depressive symptoms predicted their own cognitive functioning over time. As hypothesized, there was a significant partner association such that one person's depressive symptoms predicted more depressive symptoms in the partner. Findings from this study of older Mexican couples replicates findings from studies of older couples in the US, showing that depressive symptoms in one partner predict depressive symptoms in the other partner over time; however, there was no evidence for cognition-depression partner associations over time.

Associations between depressive symptoms and sedentary behaviors in dyads: Longitudinal crossover effects

ObjectiveEvidence-based models linking depressive symptoms and sedentary behaviors suggest that they may both exacerbate each other, leading to a vicious cycle. While existing theory and research focus on within-individual associations between sedentary behaviors and depressive symptoms, this study investigated crossover effects (i.e., from one person to another) of sedentary behaviors of one person in the dyad on depressive symptoms in their partners. Second, we tested the crossover effects of depressive symptoms of one person in the dyad on sedentary behaviors in their partners. MethodsData from 320 dyads were analyzed using cross-lagged path models. Dyads included a person attempting to become more physically active (the focus person) and their partners, supporting behavior change of focus persons. Participants were 18–90 years old. Depressive symptoms were assessed with the Patient Health Questionnaire-9 and sedentary time was measured with GT3X-BT accelerometers at Time 1 (T1; baseline), Time 2 (T2; 8-month follow-up), and Time 3 (T3; 14-month follow-up). ResultsSignificant time-lagged crossover effects were found: focus persons' depressive symptoms (T1) predicted partners' sedentary time (T2); partners' sedentary time (T1) predicted focus persons' depressive symptoms (T2); and focus persons' depressive symptoms (T2) predicted partners’ sedentary time (T3). A significant indirect effect indicated that longer sedentary time among partners (T1) predicted more depressive symptoms among focus persons (T2), which in turn were associated with longer sedentary time among partners (T3). ConclusionsThe study provides preliminary support for a dyadic vicious cycle of sedentary behaviors and depressive symptoms.

0651 Daily Associations Between Insomnia and Depression: Emotion Regulation as a Mediator

Abstract Introduction Insomnia has been shown to prospectively predict depression in longitudinal studies. The mechanisms underlying this relationship have not been fully elucidated. Emotion regulation (ER) has been proposed as a potential mediating mechanism; however, empirical tests of it are limited. This study aimed to examine the within-individual relationship between insomnia and depressive symptoms in a 14-day daily study. It was hypothesized that insomnia symptoms on a given night would positively predict depressive symptoms in the subsequent day via ER. Methods This study was conducted in 60 adults (65% female, age = 18-65 years) with elevated insomnia symptoms (Insomnia Severity Index ≥10). They were asked to fill out morning and evening diaries and wear an actigraph for 14 days. The morning diary measured their sleep parameters in the previous night with the Consensus Sleep Diary. The evening diary measured emotional reactivity with the International Positive and Negative Affect Schedule, ER strategy use with the Emotion Regulation Questionnaire and Cognitive Emotion Regulation Questionnaire, and depression with the Center for Epidemiologic Studies Depression Scale. Multilevel modeling was used to analyze the within-individual associations, controlling for between-individual factors such as age and gender. Results Shorter total sleep time on one night predicted greater next-day depressive symptoms (β = -0.063, SE = 0.009, p = .028). Sleep quality was negatively associated with next-day depression at the between-individual level (β = -0.387, SE = 0.882, p = .003). Negative reactivity partially mediated the relationships between sleep quality and depression (β = -0.463, SE = 0.030, p = .008), total sleep time and depression (β = -0.611, SE = 4.938 , p = .011), and sleep efficiency and depression (β = -0.702, SE = 0.007, p = .002), all at the between-individual level. Conclusion The findings suggest that total sleep time is associated with depressive symptoms on a daily level. They also suggest that one of the facets of emotion regulations, namely negative reactivity, plays a mediating role in the insomnia-depression relationship. Nonetheless, we did not find evidence for the mediating role of ER at the within-individual level. Emotional reactivity and ER strategy use may not vary substantially across days. Support (If Any)

Influence of work hours and commute time on food practices: a longitudinal analysis of the Household, Income and Labour Dynamics in Australia Survey

ObjectivesWork hours and commute time are key contributors to time scarcity, with potential detrimental implications for healthy eating. This study examined (1) associations between work and commute hours with food...

The Good Behaviour Game intervention to improve behavioural and other outcomes for children aged 7–8 years: a cluster RCT

BackgroundUniversal, school-based behaviour management interventions can produce meaningful improvements in children’s behaviour and other outcomes. However, the UK evidence base for these remains limited.ObjectiveThe objective of this trial was to investigate the impact, value for money and longer-term outcomes of the Good Behaviour Game. Study hypotheses centred on immediate impact (hypothesis 1); subgroup effects (at-risk boys, hypothesis 2); implementation effects (dosage, hypothesis 3); maintenance/sleeper effects (12- and 24-month post-intervention follow-ups, hypothesis 4); the temporal association between mental health and academic attainment (hypothesis 5); and the health economic impact of the Good Behaviour Game (hypothesis 6).DesignThis was a two-group, parallel, cluster-randomised controlled trial. Primary schools (n = 77) were randomly assigned to implement the Good Behaviour Game for 2 years or continue their usual practice, after which there was a 2-year follow-up period.SettingThe trial was set in primary schools across 23 local authorities in England.ParticipantsParticipants were children (n = 3084) aged 7–8 years attending participating schools.InterventionThe Good Behaviour Game is a universal behaviour management intervention. Its core components are classroom rules, team membership, monitoring behaviour and positive reinforcement. It is played alongside a normal classroom activity for a set time, during which children work in teams to win the game to access the agreed rewards. The Good Behaviour Game is a manualised intervention delivered by teachers who receive initial training and ongoing coaching.Main outcome measuresThe measures were conduct problems (primary outcome; teacher-rated Strengths and Difficulties Questionnaire scores); emotional symptoms (teacher-rated Strengths and Difficulties Questionnaire scores); psychological well-being, peer and social support, bullying (i.e. social acceptance) and school environment (self-report Kidscreen survey results); and school absence and exclusion from school (measured using National Pupil Database records). Measures of academic attainment (reading, standardised tests), disruptive behaviour, concentration problems and prosocial behaviour (Teacher Observation of Child Adaptation Checklist scores) were also collected during the 2-year follow-up period.ResultsThere was no evidence that the Good Behaviour Game improved any outcomes (hypothesis 1). The only significant subgroup moderator effect identified was contrary to expectations: at-risk boys in Good Behaviour Game schools reported higher rates of bullying (hypothesis 2). The moderating effect of the amount of time spent playing the Good Behaviour Game was unclear; in the context of both moderate (≥ 1030 minutes over 2 years) and high (≥ 1348 minutes over 2 years) intervention compliance, there were significant reductions in children’s psychological well-being, but also significant reductions in their school absence (hypothesis 3). The only medium-term intervention effect was for peer and social support at 24 months, but this was in a negative direction (hypothesis 4). After disaggregating within- and between-individual effects, we found no temporal within-individual associations between children’s mental health and their academic attainment (hypothesis 5). Last, our cost–consequences analysis indicated that the Good Behaviour Game does not provide value for money (hypothesis 6).LimitationsLimitations included the post-test-only design for several secondary outcomes; suboptimal implementation dosage (mitigated by complier-average causal effect estimation); and moderate child-level attrition (18.5% for the primary outcome analysis), particularly in the post-trial follow-up period (mitigated by the use of full information maximum likelihood procedures).Future workQuestions remain regarding programme differentiation (e.g. how distinct is the Good Behaviour Game from existing behaviour management practices, and does this makes a difference in terms of its impact?) and if the Good Behaviour Game is impactful when combined with a complementary preventative intervention (as has been the case in several earlier trials).ConclusionThe Good Behaviour Game cannot be recommended based on the findings reported here.Trial registrationThis trial is registered as ISRCTN64152096.FundingThis project was funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme and will be published in full inPublic Health Research; Vol. 10, No. 7. See the NIHR Journals Library website for further project information.

Daily Associations of Sleep Quality and Sleep Duration with Anxiety in Young Adults: The Moderating Effect of Alexithymia

ABSTRACT Objectives The present study examined the daily, within-individual associations of anxiety with sleep quality and sleep duration and the moderating effects of alexithymia on these associations in community-dwelling young adults. It was hypothesized that daily anxiety and sleep parameters would be bidirectionally related and alexithymia would moderate these relationships. Method Participants completed morning and evening diaries assessing daily anxiety and sleep parameters for 30 consecutive days. They also completed questionnaires assessing baseline sleep parameters, anxiety, and alexithymia. Multilevel modeling was used to evaluate the within-individual associations between daily anxiety and sleep parameters and whether between-individual differences in alexithymia moderated these associations. Results Higher anxiety relative to personal averages across the study period was associated with shorter sleep duration at night. Poorer sleep quality and shorter sleep duration relative to personal averages were associated with higher next-day anxiety. A significantly stronger association between poorer sleep quality and higher next-day anxiety was observed in individuals with higher levels of alexithymia. Conclusion Daily anxiety and sleep quantity are bidirectionally associated within individuals in community-dwelling young adults. Poorer sleep quality was associated with higher next-day anxiety but not vice versa. Individuals with higher levels of alexithymia might be more vulnerable to the effects of poor sleep on next-day anxiety.

Hair cortisol concentration across the peripartum period: Documenting changes and associations with depressive symptoms and recent adversity

Women experience dramatic physiological changes during pregnancy, including changes in the production of the “stress hormone,” cortisol. Evidence has been mixed regarding whether hair cortisol concentration (HCC) can be used to accurately capture the trajectory of cortisol during this period and whether factors related to psychosocial stress are related to HCC in pregnant and postpartum women. In the current study, we collected hair samples from 85 individuals during the peripartum period (with collection occasions in pregnancy [12–37 weeks], at 3–8 weeks postpartum, and at 5–8 months postpartum) from which we derived 783 monthly observations of HCC. In addition, at each assessment individuals reported their current depressive symptoms and experiences of recent psychosocial adversity. Using piecewise mixed effects modeling, we identified significant increases in HCC across pregnancy (approximately a 2-fold rise) followed by significant decreases in HCC postpartum. Beyond these effects, however, there was substantial within-individual variability in HCC. Disaggregating between- from within-individual associations of depressive symptoms and adversity with HCC, we found that within-individual fluctuations in adversity were positively coupled with levels of HCC. Overall, the current findings suggest that measurement of cortisol in human hair captures its trajectory from conception through six months postpartum, including prenatal increases and gradual recovery of typical levels following childbirth. In addition to the overall severity of psychosocial adversity, change in women's experiences of adversity during the peripartum period merit attention.