Impulsivity profiles across five harmonized longitudinal childhood preventive interventions and associations with adult outcomes.

This study aimed to parse between-person heterogeneity in growth of impulsivity across childhood and adolescence among participants enrolled in five childhood preventive intervention trials targeting conduct problems. In addition, we aimed to test profile membership in relation to adult psychopathologies. Measurement items representing impulsive behavior across grades 2, 4, 5, 7, 8, and 10, and aggression, substance use, suicidal ideation/attempts, and anxiety/depression in adulthood were integrated from the five trials (N = 4,975). We applied latent class growth analysis to this sample, as well as samples separated into nonintervention (n = 2,492) and intervention (n = 2,483) participants. Across all samples, profiles were characterized by high, moderate, low, and low-increasing impulsive levels. Regarding adult outcomes, in all samples, the high, moderate, and low profiles endorsed greater levels of aggression compared to the low-increasing profile. There were nuanced differences across samples and profiles on suicidal ideation/attempts and anxiety/depression. Across samples, there were no significant differences between profiles on substance use. Overall, our study helps to inform understanding of the developmental course and prognosis of impulsivity, as well as adding to collaborative efforts linking data across multiple studies to better inform understanding of developmental processes.

Individual Mobility across Clusters: The Impact of Ignoring Cross-Classified Data Structures in Discrete-Time Survival Analysis.

A multilevel-discrete time survival model may be appropriate for purely hierarchical data, but when data are non-purely hierarchical due to individual mobility across clusters, a cross-classified discrete time survival model may be necessary. The purpose of this research was to investigate the performance of a cross-classified discrete-time survival model and assess the impact of ignoring a cross-classified data structure on the model parameters of a conventional discrete-time survival model and a multilevel discrete-time survival model. A Monte Carlo simulation was used to examine the performance of three discrete-time survival models when individuals are mobile across clusters. Simulation factors included the value of the between-clusters variance, number of clusters, within-cluster sample size, Weibull scale parameter, and mobility rate. The results suggest that substantial relative parameter bias, unacceptable coverage of the 95% confidence intervals, and severely biased standard errors are possible for all model parameters when a discrete-time survival model is used that ignores the cross-classified data structure. The findings presented in this study are useful for methodologists and practitioners in educational research, public health, and other social sciences where discrete-time survival analysis is a common methodological technique for analyzing event-history data.

HIV co-infection increases the risk of post-tuberculosis mortality among persons who initiated treatment for drug-resistant tuberculosis.

Little is known regarding the relationship between common comorbidities in persons with tuberculosis (TB) (including human immunodeficiency virus [HIV], diabetes, and hepatitis C virus [HCV]) with post-TB mortality. We conducted a retrospective cohort study among persons who initiated treatment for rifampicin-resistant and multi/extensively drug-resistant (RR and M/XDR) TB reported to the country of Georgia's TB surveillance during 2009-2017. Exposures included HIV serologic status, diabetes, and HCV status. Our outcome was all-cause post-TB mortality determined by cross-validating vital status with Georgia's death registry through November 2019. We estimated adjusted hazard rate ratios (aHR) and 95% confidence intervals (CI) of post-TB mortality among participants with and without comorbidities using cause-specific hazard regressions. Among 1032 eligible participants, 34 (3.3%) died during treatment and 87 (8.7%) died post-TB treatment. Among those who died post-TB treatment, the median time to death was 21 months (interquartile range 7-39) post-TB treatment. After adjusting for confounders, the hazard rates of post-TB mortality were higher among participants with HIV co-infection (aHR=3.74, 95%CI 1.77-7.91) compared to those without HIV co-infection. In our cohort, post-TB mortality occurred most commonly in the first three years post-TB treatment. Linkage to care for common TB comorbidities post-treatment may reduce post-TB mortality rates.

Psychosis Symptom Trajectories Across Childhood and Adolescence in Three Longitudinal Studies: An Integrative Data Analysis with Mixture Modeling.

Psychotic-like experiences (PLEs) are common throughout childhood, and the presence of these experiences is a significant risk factor for poor mental health later in development. Given the association of PLEs with a broad number of mental health diagnoses, these experiences serve as an important malleable target for early preventive interventions. However, little is known about these experiences across childhood. While these experiences may be common, longitudinal measurement in non-clinical settings is not. Therefore, in order to explore longitudinal trajectories of PLEs in childhood, we harmonized three school-based randomized control trials with longitudinal follow-up to identify heterogeneity in trajectories of these experiences. In an integrative data analysis (IDA) using growth mixture modeling, we identified three latent trajectory classes. One trajectory class was characterized by persistent PLEs, one was characterized by high initial probabilities but improving across the analytic period, and one was characterized by no reports of PLEs. Compared to the class without PLEs, those in the improving class were more likely to be male and have higher levels of aggressive and disruptive behavior at baseline. In addition to the substantive impact this work has on PLE research, we also discuss the methodological innovation as it relates to IDA. This IDA demonstrates the complexity of pooling data across multiple studies to estimate longitudinal mixture models.

Associations among discrimination, psychological functioning, and substance use among US Black adults aged 18-28: Moderation by racial attribution and sex.

INTRODUCTION: Discrimination is associated with poor mental health and substance use among Black Americans, but research is needed on mediators and moderators of these relationships. This study tested whether: 1) discrimination is associated with current alcohol, tobacco (cigarette or e-cigarette), and cannabis use among US Black emerging adults; 2) psychological distress (PD) and positive well-being (PW) are mediators of discrimination-substance use relationships; and 3) these relationships are moderated by sex and attributions to discrimination (racial vs. nonracial). METHODS: Using data from a 2017 US nationally representative survey, we conducted bivariate and multiple-group moderated mediation analyses among 1118 Black American adults aged 18-28. The study assessed discrimination and attribution to discrimination using the Everyday Discrimination scale, past 30-day PD with the Kessler-6 scale, and past 30-day PW with the Mental Health Continuum Short Form. We utilized probit regression for all structural equation models and adjusted final models for age. RESULTS: Discrimination was positively associated with past 30-day cannabis and tobacco use directly and indirectly through PD in the overall model. Among males who reported race as the sole/main attribution to discrimination, discrimination was positively associated with alcohol, cannabis, and tobacco use through PD. Among females who reported race as the sole/main attribution to discrimination, discrimination was positively associated with cannabis use through PD. Discrimination was positively associated with tobacco use among those who reported nonracial attributions to discrimination and with alcohol use among those whose attribution was not assessed. Discrimination was positively associated with PD among those who reported race as a secondary attribution to discrimination. CONCLUSIONS: Discrimination specifically attributed to race may contribute to greater PD and in turn alcohol, cannabis, and tobacco use among Black emerging adults, especially males. Future substance use prevention and treatment efforts targeted to Black American emerging adults may benefit from addressing racial discrimination and PD.

Recency measures matter: Variability in reported last use of tobacco and marijuana products among a nationally representative study of U.S. young adults.

INTRODUCTION: Current use of tobacco and marijuana products is largely defined as use within the past 30-days or more recently. These products are not used in the same manner, frequency, or context especially among young adults who are increasingly at risk for poly-product use. The purpose of this study was to examine patterns of most recent product use across select tobacco and marijuana products. MATERIALS AND METHODS: Data used in this study come from a cross-sectional survey conducted among a nationally representative sample of young adults ages 18-34 (n = 1,189) in the U.S. from October-November 2020. Respondents were asked about past product and most recent use of select tobacco/nicotine products (cigarettes, little filtered cigars and cigarillos, large cigars, e-cigarettes, hookah/water pipes) and marijuana products (blunts, e-cigarettes with marijuana, and other products with marijuana). RESULTS: A high proportion of young adults reported having used at least one tobacco (79.6%) or marijuana (68.6%) products. There is variability in the distribution of most recent use across different tobacco and marijuana users even within the past 3 to past 6 months where nearly one in five users of any product report last use. The average number of tobacco/nicotine products used as well as concurrent marijuana use were lowest when looking at those whose most recent use was within the past 30-days. As the measures of most recent use became more broad, the number of tobacco/nicotine products used increased as did the prevalence of concurrent marijuana use which extended through the past 6-months. CONCLUSION: Measures of current use may need to be expanded beyond the past 30-days to include through the past 6-months to better encapsulate usage patterns when considering poly-tobacco and marijuana co-use.

Utilizing Moderated Non-linear Factor Analysis Models for Integrative Data Analysis: A Tutorial.

Integrative data analysis (IDA) is an analytic tool that allows researchers to combine raw data across multiple, independent studies, providing improved measurement of latent constructs as compared to single study analysis or meta-analyses. This is often achieved through implementation of moderated nonlinear factor analysis (MNLFA), an advanced modeling approach that allows for covariate moderation of item and factor parameters. The current paper provides an overview of this modeling technique, highlighting distinct advantages most apt for IDA. We further illustrate the complex modeling building process involved in MNLFA by providing a tutorial using empirical data from five separate prevention trials. The code and data used for analyses are also provided.

Dyadic effects of minority stress and problematic alcohol use on sexual intimate partner violence in same sex couples.

Little is known about the factors that facilitate the perpetration of sexual violence within the context of same-sex romantic relationships (sexual intimate partner violence perpetration [S-IPV]). The present study sought to identify the effects of external and internal minority stress and problematic drinking on perpetration of S-IPV within a dyadic framework. A community-based sample of 137 sexual and gender minority (SGM) couples (N = 274; 59 male assigned at birth and 78 female assigned at birth couples) completed self-report surveys about minority stressors, alcohol use, and S-IPV perpetration. Multilevel logistic regression analyses were conducted within an actor-partner interdependence framework. This approach accounted for both actor effects (e.g., how much one's S-IPV perpetration is predicted by their own risk factors) and partner effects (e.g., how much one's S-IPV perpetration is influenced by their partner's risk factors). Both Actor external minority stress and internal minority stress were positively associated with Actor S-IPV perpetration. Actor problematic drinking was not associated with Actor S-IPV perpetration; however, Partner problematic drinking was positively associated with Actor S-IPV perpetration. Observed effects were robust above the addition of other risk factors. This research innovatively extricates S-IPV perpetration from other forms of IPV and indicates that Actor minority stress and Partner problematic drinking increase S-IPV likelihood. Results serve as a starting point for development of etiological models to inform the design of culturally-informed interventions to reduce S-IPV among SGM couples.

Tobacco Whack-A-Mole: A Consumption Taxonomy of Cigar & Other Combustible Tobacco Products among a Nationally Representative Sample of Young Adults.

INTRODUCTION: Little filtered cigars and cigarillos (LCCs) are consumed infrequently, co-administered with marijuana, and concurrently used with other tobacco products. Reliance on the past 30-day use estimate, a marker of tobacco user status, may underestimate the dynamic nature of intermittent LCC and other tobacco product use. We developed a framework to capture the intermittent nature of exclusive LCC use and dual/poly use with cigarettes and large cigars using broader timing of last product use categories and product use modality (e.g., with marijuana). METHODS: Data come from the baseline C'RILLOS study, a U.S. nationally representative sample of young adults aged 18-34 (n = 1063) collected in October 2019. We developed a consumption taxonomy framework that accounted for respondents' modality of LCC use (i.e., use with tobacco, LCC-T, or use with marijuana as blunts, LCC-B), the exclusive use of LCCs and other tobacco products (i.e., cigarettes, and large cigars) or their co-use and the timing of last product use (i.e., ever and past 30 days, past 3 months, past 6 months, greater than 6 months). RESULTS: Seventy-five percent of our sample reported ever use of any combustible tobacco product, including LCCs. The most common ever use pattern was poly use of LCC-T + LCC-B + cigarettes (16%). Our consumption taxonomy framework demonstrated the fluid nature of combustible tobacco product use among LCC users. For instance, among past 30-day cigarette users, 48% reported using LCC-T, 39% reported using LCC-B, and 32% reported using large cigars in the past 3 months or more. DISCUSSION: The tobacco use field currently classifies 'tobacco users' based on the product they smoked in the past 30 days. Any tobacco product use beyond the past 30-day period is considered 'discontinued use' and not the focus of intervention or tobacco regulatory science decisions. We documented the substantial proportion of young adult LCC, cigarette, and large cigar users who either exclusively or dual/poly used these combustible products in recent (e.g., past 3 months) periods. To prevent underestimation of use, surveillance measures should assess the use modality, timing of last product use, and exclusive/multiple product use to more accurately identify the smoking status of young adult LCC users.

Latent classes of aggression and peer victimization: Measurement invariance and differential item functioning across sex, race-ethnicity, cohort, and study site.

Peer victimization is common and linked to maladjustment. Prior research has typically identified four peer victimization subgroups: aggressors, victims, aggressive-victims, and uninvolved. However, findings related to sex and racial-ethnic differences in subgroup membership have been mixed. Using data collected in September of 2002 and 2003, this study conducted confirmatory latent class analysis of a racially-ethnically diverse sample of 5415 sixth graders (49% boys; 50.6% Black; 20.9% Hispanic) representing two cohorts from 37 schools in four U.S. communities to replicate the four subgroups and evaluate measurement invariance of latent class indicators across cohort, sex, race-ethnicity, and study site. Results replicated the four-class solution and illustrated that sociodemographic differences in subgroup membership were less evident after accounting for differential item functioning.

Discrimination, psychological functioning, and substance use among U.S. young adults aged 18-28, 2017.

This study aimed to test whether (a) discrimination is associated with past 30-day/current alcohol, cigarette, e-cigarette, alcohol, marijuana, and other illicit drug use among Black and White U.S. adults aged 18-28, (b) psychological distress (PD) and positive well-being (PW) are mediators of the discrimination-substance use relationships, and (c) the associations are moderated by race and sex. Using data from a 2017 U.S. nationally representative survey we conducted multiple-group moderated mediation analyses among 2,192 young adults aged 18-28 (508 Black males, 594 Black females, 533 White males, 557 White females). Black males had higher discrimination, Whites had higher PW, and females had higher PD scores. Discrimination was positively associated with PD and negatively associated with PW. Among all groups, discrimination was positively associated with other illicit drug (direct and indirect), and marijuana use through PD. Indirect effects were stronger among White males for other illicit drugs and Black males for marijuana. The indirect effect of discrimination and alcohol use through PW was positive for Black females and negative for all other groups examined. Among Black males only, discrimination was positively associated with cigarette and alcohol use through PD (positive) and cigarette smoking through PW (negative). This study highlights the negative influence of perceived discrimination on current licit and illicit substance use among Black and White young adults. Our results suggest that this relationship may be partially mediated by PD and PW, especially among Black male young adults. Future discrimination and substance use studies should consider potential mediation effects of poor mental health and differences by race and sex. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Parenting stress predicts longitudinal change in parental involvement among mothers living with HIV.

Mothers living with HIV (MLH) face unique challenges that may compound parenting stress and impede effective parenting practices. Among the general population, research has demonstrated bidirectional longitudinal relations between parenting stress and parenting practices; yet, despite the additional stressors faced by MLH, these processes have not been examined longitudinally in this population. Utilizing the process model of parenting, the present study examined the longitudinal relations between parenting stress and parental involvement among a sample of MLH with children aged 6-14 years (N = 174). MLH completed self-report measures on their parenting stress and parental involvement at four timepoints spanning 15 months. Latent change score modeling was employed to examine how changes in parenting stress and changes in parental involvement were related across time. Results revealed that increases in parenting stress-specifically distress within the parental role-predicted subsequent decreases in parental involvement. The effects were unidirectional; parental involvement did not predict subsequent changes in parenting stress. Other aspects of parenting stress (perceptions of dysfunctional parent-child interactions and perceptions of the child's temperament as difficult) did not have significant longitudinal associations with changes in parental involvement. Results highlight the central role of parenting stress for MLH as a potential driving factor of parenting quality. Beyond supporting the use of effective parenting skills, clinical prevention and intervention efforts with families affected by HIV should also incorporate stress reduction techniques to increase MLH's capacity for active parental involvement and thereby support positive outcomes for their children. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Longitudinal Bidirectional Relations among Parenting Quality, Parenting Stress, and Child Functioning in HIV-affected Families.

Mothers living with HIV (MLH) face unique stressors impacting parenting, parenting stress, and child psychosocial functioning, but longitudinal, bidirectional relations among family processes have not been examined in this population. This study examined relations among parenting quality, parenting stress, and child functioning in 174 MLH-child dyads (aged 6-14, Mage = 9.65, SD = 2.49; 51% female; 57% Black/African American; 35% Latinx). Families completed self-report questionnaires over four waves spanning 15 months. Cross-lagged panel analysis revealed unidirectional and bidirectional relations between parenting stress and child functioning; parenting quality and child functioning; and parenting quality and parenting stress. The findings suggest that prevention and intervention efforts with HIV-affected families should target both parent factors (e.g., communication skills) and child factors (e.g., emotion regulation), emphasizing parenting stress reduction in order to bolster family outcomes.

The Intersection of Alcohol Use, Gender Based Violence and HIV: Empirical Findings among Disadvantaged Service-Seeking Youth in Kampala, Uganda.

The SAVA syndemic is frequently used to describe the co-occurrence of HIV, gender-based violence (GBV), and substance use. In this study we determine the extent to which the typologies of the SAVA syndemic can be described and utilized for intervention strategies among youth living in the slums of Kampala, Uganda. We analyzed the "Kampala Youth Survey 2014," a cross-sectional survey conducted in the spring of 2014, consisting of a convenience sample (N = 1134) of urban youth (12-18 years of age). Descriptive statistics were computed for hypothesized risk factors and demographic variables among the 8 typologies of GBV, HIV, and alcohol use. Multinomial logistic regression was conducted to determine statistically significant correlates with each typology. The overall prevalence of GBV was 31.7%, whereas the overall prevalence of alcohol use in the past 12 months was 31.2%. HIV-Positive youth comprised 10.5% of the total sample. Females comprised the majority of the typology with no SAVA components compared to males (55% vs. 45%, respectively), as well as the SAVA syndemic typology (GBV + HIV + ALC +) (58% vs. 42%, respectively). Engaging in commercial sex work (36%), witnessing parental abuse (61%), and depression/suicidality (81%) were all highly prevalent among youth in the SAVA syndemic typology (GBV, HIV, and alcohol use). Sex work and observing parental abuse were associated with the SAVA syndemic typology in the multivariable model. In our study, alcohol rarely coexisted without GBV among the typologies. Therefore, prevention efforts including structural interventions may be particularly warranted in vulnerable populations to address alcohol use, which may directly or indirectly impact GBV and HIV.

Individual Differences in the Stability and Change of Childhood Depression: A Growth Mixture Model With Structured Residuals.

Studies of developmental trajectories of depression are important for understanding depression etiology. Existing studies have been limited by short time frames and no studies have explored a key factor: differential patterns of responding to life events. This article introduces a novel analytic technique, growth mixture modeling with structured residuals, to examine the course of youth depression in a large, prospective cohort (N = 11,641, ages 4-16.5, 96% White). Age-specific critical points were identified at ages 8 and 13 where depression symptoms spiked for a minority of children. Most depression risk was due to dynamic responses to environmental events, drawn not from a small pool of persistently depressed children, but a larger pool of children who varied across higher and lower symptom levels.

The interrelationships of child maltreatment, alcohol use, and suicidal ideation among youth living in the slums of Kampala, Uganda.

BACKGROUND: Youth living in the slums of Kampala face many adversities, such as dire environmental conditions, poverty, and lack of government infrastructure. OBJECTIVE: The purpose of this study is to examine the interplay of alcohol use and child maltreatment on suicidal ideation among youth living in the slums of Kampala, Uganda. PARTICIPANTS AND SETTING: The study sample includes service-seeking youth who were attending Uganda Youth Development Link (UYDEL) drop-in centers in spring 2014 (n = 1134). METHODS: Indicators of child maltreatment included parental physical abuse, parental neglect, and sexual abuse. Problematic alcohol use was specified using a hybrid structural equation mixture model that distinguished current drinking status with the frequency and intensity of use among current drinkers. This novel approach is more flexible than restricting our analysis to only drinkers or analyzing only current drinking status. The primary outcome of interest was suicidal ideation. All associations controlled for gender and age, and all associations were estimated simultaneously. All analyses were conducted in SAS 9.4 and Mplus 7.4. RESULTS: The overall prevalence of suicidal ideation was 23.5 % (n = 266). Overall, current drinking status (OR: 1.80; 95 % CI: 1.31, 2.46), the child maltreatment sum score (OR: 1.88; 95 % CI: 1.48, 2.39), and sexual abuse (OR: 2.88; 95 % CI: 1.52, 5.47) were statistically significantly associated with reporting suicidal ideation. CONCLUSIONS: This study highlights a population that would potentially benefit from prevention efforts not only aimed at suicide prevention but also harm reduction in terms of alcohol use and experiences of child maltreatment.

A Mixed-Methods Longitudinal Investigation of Mothers' Disclosure of HIV to Their Children.

Mothers living with HIV (MLH) must navigate disclosing their serostatus to their children, but the longitudinal impact on families remains unknown. This study examined HIV disclosure, parenting, parenting stress, and child adjustment among 174 MLH-child dyads (aged 6-14; 35% Latinx; 57% Black/African American). Quantitative data were collected over four waves spanning 15 months. Qualitative data were collected with 14 families in which disclosure had occurred. Latent change score modeling revealed that disclosure led to improvements in parenting stress, communication, and relationship quality. Disclosure did not predict child adjustment. Qualitative themes contextualized these findings, revealing stability and improvements in family functioning. MLH should be supported in disclosing their serostatus to their children to minimize parenting stress and bolster parenting skills.

How do collective student behavior and other classroom contextual factors relate to teachers' implementation of an evidence-based intervention? A multilevel structural equation model.

Building on prior work regarding the potential for peer contagion or deviance training in group delivered interventions (Dishion & Dodge, 2005, 2006; Dodge, Dishion, & Lansford, 2006), we leveraged data from a randomized trial, testing the integration of two preventive interventions (Promoting Alternative THinking Strategies and PAX Good Behavior Game), to explore the extent to which classroom contextual factors served as either a barrier to or a motivator for teachers to implement the evidence-based PAX Good Behavior Game with high frequency or dosage. We included students' baseline levels of behavior, measured with regard to both positive (i.e., engagement and social emotional skills) and negative (i.e., hyperactive and aggressive-disruptive) behaviors. Data were collected from 204 teachers in 18 urban elementary schools. A series of multilevel structural equation models were fit to the data. The analyses indicated that classrooms with higher classroom levels of aggressive behavior, on average, at baseline had teachers with lower implementation dosage (i.e., played fewer games) across the school year. In addition, teachers who reported higher baseline levels of emotional exhaustion, regardless of student behavior, also reported lower implementation dosage. Taken together, the results indicated that negative, but not positive, contextual factors at baseline were related to lower implementation dosage; this, in turn, suggests that negative contextual factors may serve as a barrier, rather than a motivator, of teachers' implementation dosage of classroom-based preventive interventions.

Evaluating a Method to Estimate Mediation Effects With Discrete-Time Survival Outcomes.

The utility of evaluating mediation effects spans across research domains. The model facilitates investigation of underlying mechanisms of event timing and, as such, has the potential to help strengthen etiological research and inform intervention work that incorporates the evaluation of mediating variables. In order for the analyses to be maximally useful however, it is critical to employ methodology appropriate for the data under investigation. The purpose of this paper is to evaluate a regression-based approach to estimating mediation effects with discrete-time survival outcomes. We empirically evaluate the performance of the discrete-time survival mediation model in a statistical simulation study, and demonstrate that results are functionally equivalent to estimates garnered from a potential-outcomes framework. Simulation results indicate that parameter estimates of mediation in the model were statistically accurate and precise across the range of examined conditions. Type 1 error rates were also tolerable in the conditions studied. Adequate power to detect effects in the model, with binary X and continuous M variables, required effect sizes of the mediation paths to be medium or large. Possible extensions of the model are also considered.

Child maltreatment, adaptive functioning, and polygenic risk: A structural equation mixture model.

This study used a structural equation mixture model to examine associations between child maltreatment, polygenic risk, and indices of adaptive functioning. Children aged 6 to 13 years (N = 1,004), half maltreated, half nonmaltreated, were recruited to attend a research day camp. Multi-informant indicators of prosocial behavior, antisocial behavior, withdrawn behavior, and depression were collected and used in a latent class analysis. Four classes emerged, characterizing "well-adjusted," "externalizing," "internalizing," and "socially dominant" groups. Twelve genetic variants, previously reported in the Gene × Environment literature, were modeled as one weighted polygenic risk score. Large main effects between maltreatment and adaptive functioning were observed (Wald = 35.3, df = 3, p < .0001), along with evidence of a small Gene × Environment effect (Wald = 13.5, df = 3, p = .004), adjusting for sex, age, and covariate interaction effects.