Relationship satisfaction, feelings of closeness and annoyance, and linkage in electrodermal activity.

Physiological linkage refers to moment-to-moment, time-linked coordination in physiological responses among people in close relationships. Although people in romantic relationships have been shown to evidence linkage in their physiological responses over time, it is still unclear how patterns of covariation relate to in-the-moment, as well as general levels of, relationship functioning. In the present study with data collected between 2014 and 2017, we capture linkage in electrodermal activity (EDA) in a diverse sample of young-adult couples, generally representative and generalizable to the Los Angeles community from which we sampled. We test how naturally occurring, shifting feelings of closeness with and annoyance toward one's partner relate to concurrent changes in levels of physiological linkage over the course of 1 day. Additionally, we examine how linkage relates to overall relationship satisfaction. Results showed that couples evidenced significant covariation in their levels of physiological arousal in daily life. Further, physiological linkage increased during hours that participants felt close to their romantic partners but not during hours that participants felt annoyed with their partners. Finally, those participants with overall higher levels of relationship satisfaction showed lower levels of linkage over the day of data collection. These findings highlight how individuals respond in sync with their romantic partners and how this process ebbs and flows in conjunction with the shifting emotional tone of their relationships. The discussion focuses on how linkage might enhance closeness or, alternatively, contribute to conflict escalation and the potential of linkage processes to promote positive interpersonal relationships. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Conduct Problems As a Pathway From Childhood Adversity to Community Violence Exposure: The Protective Roles of Caregiver Knowledge and Involvement.

Exposure to community violence (ECV) poses a prevalent threat to the health and development of adolescents. Research indicates those who have more Adverse Childhood Experiences (ACEs) are at higher risk for ECV, which further exacerbates risk of negative mental and physical health impacts. Additionally, those with more ACEs are more likely to exhibit conduct problems, which has also been linked to risk for ECV. Despite the prevalence and impact of ECV, there is limited longitudinal research on the risk factors that precede this exposure as well as family-level factors that may prevent it. The current study examined conduct problems as a potential mediator between ACEs and future indirect (i.e. witnessing) ECV in adolescents. Additionally, this study included caregiver factors, such as caregiver knowledge about their adolescent, caregiver involvement, and caregiver-adolescent relationship quality as potential protective moderators. Participants included (N = 1137) caregiver-adolescent dyads identified as at-risk for child maltreatment prior to child's age four for inclusion in the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN). Conduct problems at age 14 mediated the relationship between ACEs from ages 0-12 and indirect ECV at age 16 (standardized indirect effect = .03, p = .005). Caregiver knowledge moderated the indirect relationship (b = -.40, p = .030), and caregiver involvement moderated the direct relationship between ACEs and indirect ECV (b = -.03, p = .033). Findings expand our knowledge about the longitudinal pathways that increase risk of violence exposure over the course of adolescent development, as well as the protective benefits caregivers can offer to disrupt these pathways and reduce risk of future traumatization. Implications are discussed for interventions that aim to address and prevent trauma and adverse outcomes among youth exposed to child maltreatment, household dysfunction, and community violence.

A Call to Action on Assessing and Mitigating Bias in Artificial Intelligence Applications for Mental Health.

Advances in computer science and data-analytic methods are driving a new era in mental health research and application. Artificial intelligence (AI) technologies hold the potential to enhance the assessment, diagnosis, and treatment of people experiencing mental health problems and to increase the reach and impact of mental health care. However, AI applications will not mitigate mental health disparities if they are built from historical data that reflect underlying social biases and inequities. AI models biased against sensitive classes could reinforce and even perpetuate existing inequities if these models create legacies that differentially impact who is diagnosed and treated, and how effectively. The current article reviews the health-equity implications of applying AI to mental health problems, outlines state-of-the-art methods for assessing and mitigating algorithmic bias, and presents a call to action to guide the development of fair-aware AI in psychological science.

Bidirectional associations between family conflict and child behavior problems in families at risk for maltreatment.

BACKGROUND: Children's exposure to family conflict is associated with the development of behavior problems. However, it remains unclear whether this association (1) functions bidirectionally and (2) exists independent of more severe forms of violent victimization. OBJECTIVE: The present study aimed to examine bidirectional and transactional associations between family conflict and children's behavioral problems, controlling for time-varying violent victimization experiences. Invariance testing examined whether these models differed by gender and by maltreatment status prior to initial recruitment. PARTICIPANTS AND SETTING: Participants were caregiver-child dyads identified prospectively as being at risk for maltreatment and family violence exposure prior to age four (N = 1281; 51.4 % female; 74.6 % persons of color). METHODS: Caregivers were interviewed prospectively about family conflict, children's aggressive and delinquent behavior, and children's victimization experiences at child ages 6, 8, and 10. RESULTS: After controlling for prior victimization, significant cross-lagged bidirectional associations were identified between family conflict and child behavior problems. Indirect effects from age 6 to age 10 externalizing problems through age 8 family conflict were not supported. Several bidirectional paths were stronger among boys than girls. Results revealed little evidence for moderation by prerecruitment maltreatment status. CONCLUSIONS: Findings support a conceptualization of the family-child relationship that is reciprocal in nature and highlight the importance of non-violent, everyday negative family processes. Interventions aiming to improve child behavior problems by targeting severely dysfunctional family processes should also address non-violent, lower-level patterns of negative family interactions, such as everyday instances of blame, criticism, nonacceptance, and favoritism.

Trajectories of adolescent psychopathology among youth who were maltreated and placed in out-of-home care.

BACKGROUND: Although researchers have found an increased risk for psychopathology among maltreated adolescents placed in out-of-home care, different trajectories of psychopathology by out-of-home placements have not been previously studied. OBJECTIVE: The current study is built on previous investigation of youth in different long-term out-of-home placements and examined the trajectories of adolescent psychopathology by out-of-home placement classes. PARTICIPANTS AND SETTING: We leveraged data from the Southwestern site of the Longitudinal Studies of Child Abuse and Neglect. Participants included caregiver-youth dyads (N = 273), who had substantiated reports of child maltreatment (CM) prior to children's age four and were placed in out-of-home care. METHODS: Five out-of-home placement classes from ages 4 to 12 (i.e., stable adopted, stable reunified, stable kinship care, stable non-kin foster care, and unstable placement) were identified from previous study and participants were interviewed at youth ages 12, 14, and 16 to assess adolescent psychopathology. Latent Growth Curve Analysis was used to examine trajectories of psychopathology by placement classes. RESULTS: Adolescents in unstable placement and stable adopted classes had higher intercepts and more positive or less negative slopes for psychopathology compared to those in stable kinship care and stable reunified classes. CONCLUSIONS: Adolescents in unstable placement and stable adopted classes were at similarly elevated risk for psychopathology, whereas adolescents in stable kinship care and stable reunified classes were at lower risk for psychopathology. We discuss the clinical implication to preventing and intervening risks for psychopathology among maltreated youth in unstable and adopted placements.

Differences in late adolescent psychopathology among youth with histories of co-occurring abuse and neglect experiences.

BACKGROUND: Knowledge about the impacts of child abuse and neglect (CAN) experiences on late adolescent psychopathology has been limited by a failure to consider the frequent co-occurrence of CAN types and potential unique impacts of specific combinations. OBJECTIVE: Using person-centered analyses, we aimed to identify unobserved groups of youth with similar patterns of lifetime CAN experiences before age 16 and differences in psychopathology symptom counts between groups two years later. PARTICIPANTS AND SETTING: Participants were 919 adolescent-caregiver dyads (56% female; 56% Black, 7% Latina/o, 13% mixed/other). METHODS: Prospective, multi-informant data, including child protective services records and caregiver and youth reports were collected, and youth completed a diagnostic interview at age 18. RESULTS: Latent Class Analyses classified adolescents into four distinct groups based on patterns of physical neglect, supervisory neglect, and physical, sexual, and psychological abuse: "Low-Risk" (37%), "Neglect" (19%), "Abuse" (11%), and "Multi-type CAN" (33%). The Multi-type CAN class had significantly more major depressive, generalized anxiety, and nicotine use symptoms than the Low-Risk class, and more post-traumatic stress, antisocial personality, and illicit substance use symptoms, than Low-Risk and Neglect classes. The Abuse class had significantly more generalized anxiety and attention deficit/hyperactivity symptoms than the Low-Risk class, and more major depressive, antisocial personality, and illicit substance use symptoms, than Low-Risk and Neglect classes. The Neglect class did not have elevated psychopathology symptoms. CONCLUSION: Findings highlight important differences in the associations between lifetime CAN experience patterns and psychopathology. Researchers should explore mechanisms underlying psychopathology that are impacted by different CAN experience patterns.

Reward-related neural correlates of early life stress in school-aged children.

OBJECTIVES: Early life stress likely contributes to dysfunction in neural reward processing systems. However, studies to date have focused almost exclusively on adolescents and adults, measured early life stress retrospectively, and have often failed to control for concurrent levels of stress. The current study examined the contribution of prospectively measured cumulative life stress in preschool-age children on reward-related neural activation and connectivity in school-age children. METHODS: Children (N = 46) and caregivers reported children's exposure to early life stress between birth and preschool age (mean = 4.8 years, SD = 0.80). At follow-up (mean age = 7.52 years, SD = .78), participants performed a child-friendly monetary incentive delay task during functional magnetic resonance imaging. RESULTS: Children with higher levels of cumulative early life stress, controlling for concurrent stressful life events, exhibited aberrant patterns of neural activation and connectivity in reward- and emotion-related regions (e.g., prefrontal cortex, temporal pole, culmen), depending on the presence of a potential reward and whether or not the target was hit or missed. CONCLUSIONS: Findings suggest that stress exposure during early childhood may impact neural reward processing systems earlier in development than has previously been demonstrated. Understanding how early life stress relates to alterations in reward processing could guide earlier, more mechanistic interventions.

Systematic Review and Meta-Analysis: Preoperative Vedolizumab and Postoperative Complications in Patients with IBD.

OBJECTIVES: The effect of vedolizumab on postoperative outcomes in patients with inflammatory bowel disease (IBD) remains unclear. We aimed to determine the relation between preoperative vedolizumab and early postoperative complications in patients with IBD undergoing abdominal surgery. METHODS: A search of databases and abstracts from gastroenterology conferences was performed. Primary outcomes included overall and infectious postoperative complication rates as well as surgical site infections. Studies that compared Crohn disease, ulcerative colitis, or patients with IBD-undefined with preoperative vedolizumab treatment undergoing abdominal surgery with controls with preoperative antitumor necrosis factor-α (anti-TNF-α) treatment or no preoperative biologic treatment were included. A meta-analysis was completed using the Mantel-Haenszel and DerSimonian and Laird models. RESULTS: Six studies totaling 1201 patients were included; 281 patients were treated preoperatively with vedolizumab, 327 patients were treated preoperatively with anti-TNF-α agents, and 593 patients were not treated preoperatively with any biologics. There was no significant difference in overall complications (odds ratio [OR] 1.04, 95% confidence interval [CI] 0.48-2.24, P = 0.92, I2 =77%) between the vedolizumab and no-biologic groups. There also was no significant difference in infectious complications (OR 1.00, 95% CI 0.37-2.69, P = 1.00, I2 = 78%), which persisted after sensitivity analysis (OR 0.71, 95% CI 0.31-1.60, P = 0.41, I2 = 46%). Furthermore, there was no significant difference in overall complications (OR 0.77, 95% CI 0.24-2.46, P = 0.66, I2 = 85%) and infectious complications (OR 0.89, 95% CI 0.20-3.94, P = 0.87, I2 = 86%) between the vedolizumab and anti-TNF-α groups. After sensitivity analysis, differences in overall and infectious complications remained insignificant (OR 0.54 and 0.50, 95% CI 0.24-1.17 and 0.22-1.15, P = 0.12 and 0.10, I2 = 39% and 18%, respectively). Vedolizumab was also not associated with a significant increase in surgical site infections compared with the no-biologic (OR 1.45, 95% CI 0.33-6.32, P = 0.62, I2 = 75%) and anti-TNF (OR 1.30, 95% CI 0.22-7.60, P = 0.77, I2 = 81%) groups. CONCLUSIONS: Preoperative treatment with vedolizumab in patients with IBD undergoing abdominal surgery is not associated with increases in overall or infectious postoperative complications compared with preoperative anti-TNF-α treatment and no preoperative biologic treatment. Large, prospective studies are needed to further assess the impact of preoperative vedolizumab treatment on postoperative complications, particularly with respect to IBD subtype.

Examining the Factor Structure and Measurement Invariance of the Trauma Symptom Checklist for Children in a Diverse Sample of Trauma-Exposed Adolescents.

The Trauma Symptom Checklist for Children (TSCC) is a widely used youth assessment of broad, transdiagnostic symptomatology following trauma. However, its factor structure has not been thoroughly tested in diverse samples. Youth (N = 738) exposed to interpersonal violence, including physical and sexual abuse, completed the TSCC. Confirmatory factor analysis was used to test one-, six-, and eight-factor models of the TSCC clinical scales, based on previous literature and the TSCC manual. We examined measurement invariance across boys and girls and Black and non-Black participants, as well as convergent and discriminant validity. An eight-factor structure, consisting of posttraumatic stress, anxiety, depression, anger, overt dissociation, fantasy dissociation, sexual preoccupation, and sexual distress, demonstrated the best fit, with two items removed. Invariance tests supported configural and metric (but not scalar) invariance. This research highlights the need for further testing before differences between gender and racial groups can be accurately compared.

Interpersonal Psychotherapy-Adolescent Skills Training With Youth From Asian American and Immigrant Families: Cultural Considerations and Intervention Process.

Although research has identified effective evidence-based depression prevention interventions for diverse youth, little is known about how the intervention process unfolds with immigrant family youth. This study utilized a qualitative approach to explore cultural and clinical differences in the implementation of Interpersonal Psychotherapy-Adolescent Skills Training (IPT-AST) in two schools, one serving youth from primarily immigrant, Asian American families and the second, youth from mostly nonimmigrant, non-Hispanic White families. A total of 131 IPT-AST sessions were audio recorded, transcribed, and coded for presence and patterns of cultural and clinical constructs. Results revealed that sessions with immigrant family youth were more likely to contain discussions of interpersonal problems characterized by estrangement, goals of spending time together with important others, mentions of emotion suppression and academic achievement expectations, conversations about acculturation, differences in value orientation, and discomfort with implementing new intervention skills. Dialogue from interventionist and youth exchanges is presented to illustrate how these themes emerged and were addressed by interventionists in a culturally responsive manner. The study highlights how IPT-AST with immigrant family and Asian American youth may unfold differently compared to youth from nonimmigrant families. Implications of findings for providers are discussed.

Racial/ethnic group differences in parenting attitudes among at-risk emerging adults: The roles of adversity, relationship quality, and caregiver involvement and attitudes.

BACKGROUND: Healthy parenting attitudes are foundational for positive parenting and child well-being. However, few studies explore their formation and mediators explaining racial/ethnic group differences. OBJECTIVE: The present study prospectively examines potential mediators for racial/ethnic group differences in parenting attitudes in a diverse sample of emerging adults (EA). PARTICIPANTS & SETTING: Participants are EA and their caregivers (N = 891) who participated in the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN). METHODS: Adverse childhood experiences (ACEs), parenting attitudes, and caregiver-child relationship quality and involvement were assessed. Mediators of racial/ethnic group differences were tested using Structural Equation Modeling with bias-corrected confidence intervals based on 1000 bootstrapped samples. RESULTS: Black EA had less appropriate developmental expectations and perceptions of family roles, empathy toward children, and rejection of physical punishment, compared to White EA. Latinx EA also had less empathy toward children compared to White EA. Caregivers' parenting attitudes mediated group differences, beyond ACEs and relationship quality and involvement. Significant mediation effects include: appropriate developmental expectations, R2 = 0.08, p < .05; rejection of physical punishment, R2 = 0.06, p < .05; appropriate family roles, R2 = 0.16, p < .05; and empathy toward children, R2 = 0.15, p < .05, for Black relative to White EA, as well as, empathy toward children, R2 = 0.12, p < .05, for Latinx relative to White EA. CONCLUSION: Findings highlight the mediating role of intergenerational transmission of parenting attitudes for explaining racial-ethnic differences and supporting positive parenting practices in diverse communities.

Systematic review and meta-analysis: risks of postoperative complications with preoperative use of anti-tumor necrosis factor-alpha biologics in inflammatory bowel disease patients.

OBJECTIVE: The preoperative use of anti-tumor necrosis factor-alpha (anti-TNF) in inflammatory bowel disease (IBD) patients undergoing surgery has been controversial due to concern for increased risks of postoperative complications. We aimed to determine the effect of preoperative anti-TNF therapy on postoperative complications in IBD patients undergoing abdominal surgery. METHODS: A literature search of Google Scholar, PubMed, The Cochrane Library, EMBASE, and CINAHL was performed through October 2019. Studies reporting postoperative complication rates of Crohn's disease (CD), ulcerative colitis (UC), and IBD-unspecified patients with preoperative anti-TNF treatment undergoing abdominal surgery compared to controls without preoperative anti-TNF treatment were included. The main outcomes measured were overall, infectious, and noninfectious postoperative complications. RESULTS: Forty-one studies totaling 20 274 patients were included. There was a significant increase in overall complications in all patients treated with anti-TNF vs. controls [odds ratio (OR) = 1.13, 95% confidence interval (CI), 1.01-1.25, P = 0.03, I2 = 6%] with an absolute risk increase (ARI) of 5.5% and a number needed to harm (NNH) of 18. There was also a significant increase in infectious complications in CD patients (OR = 1.44; 95% CI 1.02-2.03, P = 0.04, I2 = 49%, ARI = 5.5%, NNH = 20) only. Contrastingly, there was a significant increase in noninfectious complications in all patients (OR = 1.44, 95% CI 1.13-1.85, P = 0.003, I2 = 8%, ARI = 6.4%, NNH = 16) and UC patients (OR = 1.57, 95% CI 1.15-2.14, P = 0.005, I2 = 25%, ARI = 8.5%, NNH = 12) only. CONCLUSION: Preoperative use of anti-TNF agents in IBD patients undergoing abdominal surgery is associated with increases in overall postoperative complications in all patients, infectious postoperative complications in CD patients, and noninfectious postoperative complications in UC patients.

Intergenerational Transmission of Abusive Parenting: Role of Prospective Maternal Distress and Family Violence.

Parents who were abused as children are at increased risk for perpetuating maladaptive parenting practices, yet the mechanisms underlying this relationship remain unclear. This study prospectively examined maternal distress (a latent variable consisting of depressive symptoms and daily stress) and family violence as potential mediators in the intergenerational transmission of abusive (i.e., psychologically aggressive and physically assaultive) parenting. Participants included (N = 768) mother-child dyads identified as being at-risk for family violence and maltreatment prior to children's age four. More maternal childhood abuse was associated with more distress and increased risk for family violence exposure in adulthood. However, only maternal distress mediated the association between mothers' history of abuse and their use of abusive parenting strategies. This study provides critical information about ecological mechanisms underlying the intergenerational transmission of abusive parenting and suggests the importance of targeting depression and stress management among mothers with abuse histories to curtail the cycle of violence.

Decreased risk of hepatocellular carcinoma recurrence with direct-acting antivirals compared with no treatment for hepatitis C: a meta-analysis.

BACKGROUND: Studies investigating the association between direct-acting antivirals (DAAs) and the recurrence of hepatocellular carcinoma (HCC) related to hepatitis C (HCV) have yielded conflicting results. The objective of this meta-analysis was to define the short- and long-term recurrence rates of HCC after DAA treatment. METHODS: A search of multiple databases was performed, including Scopus, Cochrane, MEDLINE/PubMed and abstracts from gastroenterology meetings. Only studies reporting the recurrence of HCC in patients receiving DAA treatment, compared to HCV controls without DAA treatment, were evaluated. A meta-analysis was completed using the Mantel-Haenszel model. RESULTS: A comprehensive literature search resulted in 32 abstracts and papers. Six papers met our inclusion criteria and were included in the analysis. Follow up ranged from 1.25-4 years. Analysis of these 6 studies found a >60% lower risk of HCC recurrence in patients exposed to DAA compared to controls (odds ratio [OR] 0.36, 95% confidence interval [CI] 0.27-0.47; P<0.001; I 2=88%). A sensitivity analysis, which excluded studies showing the lowest recurrence rate to reduce heterogeneity, showed that patients receiving DAA still had a 60% lower risk of developing HCC (OR 0.4, 95%CI 0.26-0.61; P<0.0001; I 2=39%) and a 66% lower risk of developing HCC beyond 1 year (OR 0.34, 95%CI 0.22-0.54; P<0.00001; I 2=0%) compared to controls. CONCLUSIONS: The use of DAA is associated with a significantly lower risk of HCC development compared to DAA-untreated patients, both overall and beyond 1 year of treatment. Further studies are needed to assess the impact of DAAs on early recurrence.