Executive Functioning, Daily Self-Regulation, and Diabetes Management while Transitioning into Emerging Adulthood.

BACKGROUND: Executive functioning (EF) predicts better Type 1 diabetes (T1D) management in the high-risk years after high school, but the daily self-regulation processes involved are unclear. PURPOSE: To examine whether EF is associated with daily self-regulation that minimizes one's exposure or buffers adverse reactions to daily diabetes problems, and to determine whether these patterns become stronger during the transition out of high school. METHODS: A measurement burst design with convenience sampling was used. Seniors in high school with T1D (N = 207; 66% female) completed self-report (i.e., Behavioral Rating Inventory of Executive Functioning) and performance measures of EF (i.e., Delis-Kaplan Executive Function System). A 14-day daily diary assessing self-regulation failures, diabetes problems, affect, and indicators of diabetes management was completed at baseline and 1 year later. RESULTS: Correlations and multilevel modeling were conducted. Lower self-reported EF problems were associated with lower average levels of daily self-regulation failures, and these variables were associated with fewer daily diabetes problems. In contrast, better EF performance was unrelated to average daily self-regulation failures, and was unexpectedly associated with more frequent diabetes problems in year 2. Equally across years, on days participants reported lower than their average levels of daily self-regulation failures, they had fewer diabetes problems, regardless of EF. On days with lower than average diabetes problems, participants reported better diabetes management indicators. EF generally did not buffer daily associations in either year. CONCLUSIONS: Regardless of EF, promoting daily self-regulation may prevent diabetes problems and promote T1D management in daily life at this high-risk transitional time.

Type 1 diabetes (T1D) requires daily self-regulation (e.g., remembering to check blood glucose; regulating emotions, thoughts, and behaviors when diabetes problems arise). These processes draw on executive function (EF) abilities, which may be challenged after high school, when youth experience many life transitions while managing diabetes more independently from parents. The study examined how EF is associated with daily diabetes management as youth transition out of high school. Seniors in high school with T1D completed measures of EF and two 14-day daily diaries, one in the senior year and one the following year. Each evening, participants completed an online survey reporting on self-regulation failures (e.g., forgetting to test blood glucose), diabetes problems, and diabetes management over the past 24 hr. Those with better self-reported EF had lower self-regulation failures and fewer diabetes problems on average. On days with lower self-regulation failures, participants had fewer diabetes problems. On days with fewer diabetes problems, participants reported lower negative emotions, higher confidence in diabetes management, and better self-care behaviors and blood glucose levels. These daily associations occurred regardless of EF. Providing youth with training in self-regulation to prevent daily diabetes problems may promote T1D management during this high-risk transition.

Trans Adults Amidst the COVID-19 Pandemic: Quality of Life, Pandemic Impact, and Vaccine Preferences.

The ongoing COVID-19 pandemic is disproportionately impacting marginalized communities, such as Black, Indigenous, and people of color (BIPOC), disabled individuals, and transgender/nonbinary (i.e., trans) individuals. As trans individuals may be multiply marginalized, it is necessary to examine within group differences among trans individuals of different genders, races, socioeconomic statuses, and abilities. This study examines the following research questions: (1) What is the quality of life of trans adults during the COVID-19 pandemic? (2) How does the self-reported impact of the pandemic vary across groups within the trans community? (3) What preferences do trans adults have regarding receiving a COVID-19 vaccine? Survey data were collected in August/September of 2020. Among a sample of 449 trans adults, findings suggest that the profound impact of the pandemic was not consistent across all community members. Being a woman predicted a higher self-reported impact of the pandemic while being a masc(uline) white respondent tended to predict a lower impact of the pandemic. Higher income was associated with a higher quality of life and being a disabled white respondent predicted a lower quality of life. The majority (99%) of the sample reported wanting to receive a COVID-19 vaccine should one become available. Implications for practice include the importance of considering the holistic experiences of clients and community members, as opposed to having homogenized perspectives of even subsets of the trans community. Future research related to barriers faced when attempting to access a vaccine is needed to inform future public health responses to epidemics/pandemics impacting this community.

A Bayesian Structural Equation Modeling Factor Analysis of the UCLA Posttraumatic Stress Disorder Reaction Index for DSM-5 in a Polyvictimized Sample of Adolescents.

The revised criteria for posttraumatic stress disorder (PTSD) in the fifth edition of the Diagnostic and Statistical Manual necessitated the development of new screening tools for youth, one of the most widely used of which is the UCLA Posttraumatic Stress Disorder Reaction Index for DSM-5 (RI-5). Thus far, the few studies that have investigated the RI-5's factor structure have supported a four-factor model. However, to date this research has been limited to youth with histories of exposure to single-event traumatic stressors, a significant limitation as evidence suggests many trauma-exposed youth report exposure to multiple types of traumatic stressors, or polyvictimization. It is imperative to determine the generalizability of previous factor models to specific populations which they are purported to represent. We investigated whether the RI-5's four-factor model replicated in a sample of 455 polyvictimized justice-involved adolescents. Initial confirmatory factor analysis demonstrated that the four-factor model did not converge. Therefore, we utilized Bayesian Structural Equations Modeling (BSEM) to determine why the previously proposed factor structure did not converge. The BSEM model suggested that the global factor structure was acceptable and did not require addition or subtraction of any factor or cross-factor loadings. However, small and moderate residual covariances resulted in model misspecification, suggesting there may be additional associations not captured by the current DSM-5 model for polyvictimized youth. Future work should continue examining the RI-5's factor structure in order to better understand whether the current results are unique and how measurements assessing DSM-5 PTSD symptom criteria perform in diverse trauma-exposed youth populations.

A dynamical systems approach to examining the efficacy of suicide-focused interventions.

OBJECTIVE: Suicide risk is a nonlinear temporal process, but the ways in which suicide-focused interventions have statistically examined risk effects have ignored these nonlinearities. This paper highlights the potential benefits of using data analytic methods that account for nonlinear change patterns. METHOD: Using a dynamical systems perspective, interventions are framed in terms of attractor dynamics. An attractor has three primary qualities where an intervention can have an effect. These correspond to contextual differences, shifts in the underlying temporal patterns, and changes in the stability of the temporal pattern. RESULTS/CONCLUSIONS: It is argued that the ideal effect is one in which there is both an observed change in stability and a shift in the underlying temporal pattern toward less risk. Other types of intervention effects can have alternate explanations that are less desirable. Mean, variance, and growth differences are discussed within a systems context, and an example model is provided using Latent Change Score Modeling (McArdle, Annual Review of Psychology, 60, 2009, 577-605).

Ghost hunting in the nonlinear dynamic machine.

Integrating dynamic systems modeling and machine learning generates an exploratory nonlinear solution for analyzing dynamical systems-based data. Applying dynamical systems theory to the machine learning solution further provides a pathway to interpret the results. Using random forest models as an illustrative example, these models were able to recover the temporal dynamics of time series data simulated using a modified Cusp Catastrophe Monte Carlo. By extracting the points of no change (set points) and the predicted changes surrounding the set points, it is possible to characterize the topology of the system, both for systems governed by global equation forms and complex adaptive systems. RESULTS: The model for the simulation was able to recover the cusp catastrophe (i.e. the qualitative changes in the dynamics of the system) even when applied to data that have a significant amount of error variance. To further illustrate the approach, a real-world accelerometer example was examined, where the model differentiated between movement dynamics patterns by identifying set points related to cyclic motion during walking and attraction during stair climbing. These example findings suggest that integrating machine learning with dynamical systems modeling provides a viable means for classifying distinct temporal patterns, even when there is no governing equation for the nonlinear dynamics. Results of these integrated models yield solutions with both a prediction of where the system is going next and a decomposition of the topological features implied by the temporal dynamics.

Gender differences in spatial navigation: Characterizing wayfinding behaviors.

Men show a consistent spatial navigation advantage over women, which is often attributed to their increased use of survey spatial strategies. But what about men's navigation gives them an advantage? One possibility is that the way in which men explore environments is fundamentally different, leading to better navigational performance. To test this possibility, this study investigated whether there are gender differences in wayfinding behaviors during navigation that relate to navigational success in a real-world, large-scale, unconstrained navigation task. West Point cadets were given a masked GPS tracker and sent into a large-scale, natural environment to locate targets indicated on maps. We assessed how they explored the environment by computing three measures from the GPS tracks and related these measures to their ability to find the assigned target locations. We also tested whether their self-reported spatial ability related to navigational success. Results showed that males performed better than females, which replicates prior work. Further, traveling longer distances without changing course, pausing less, and fewer returns to previously visited locations were significantly related to the ability to locate the correct target. Consistent with full mediation, the significant relationship between gender and navigational success is fully accounted for by men and women producing different wayfinding behaviors, which in turn predict differences in navigational success. Further, there was no unique relationship between self-reported spatial skills and navigational success. This study is a first step toward showing the relationship between gender, wayfinding behaviors, and navigational success in a natural, real-world navigation task.

Keeping parents connected in early emerging adulthood: Diabetes-related disclosure and solicitation.

Emerging adults with Type 1 diabetes benefit when parents remain knowledgeable of their self-management. Yet how early emerging adults remain connected with parents while they experience normative declines in involvement and move out of the parental home is unclear. The present study examined how disclosure to, and solicitation from, parents may (a) be a way that emerging adults and parents remain connected, (b) occur with different methods of contact (i.e., face-to-face; non-face-to-face), and (c) associate with diabetes management differently for those living in versus outside of the parental home. Early emerging adults with Type 1 diabetes (N = 202; Mage = 18.81 years; 66% female) completed measures of their methods of contact with parents; diabetes-related disclosure to, and solicitation from, parents; and diabetes management as part of a 14-day daily diary. General linear models found that face-to-face contact was associated with greater disclosure to parents, for both those living in and out of the parental home. Individuals who lived outside the parental home used more non-face-to-face contact (e.g., texting) than those in the parental home. Multilevel models revealed that higher disclosure to mothers on a daily basis (within-persons) and to mothers and fathers overall (between-persons) was associated with better diabetes management similarly for those living in versus out of the parental home. Results suggest that face-to-face contact may be most effective for keeping parents "in the know" about diabetes management. Moreover, disclosure and solicitation continue to support diabetes management even as individuals move out of the parental home. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Parental Involvement and Executive Function in Emerging Adults with Type 1 Diabetes.

OBJECTIVE: To examine (a) changes in parental involvement across early emerging adulthood, (b) whether yearly fluctuations in parental involvement were associated with adherence and glycated hemoglobin (HbA1c) over time, and (c) whether higher involvement was more beneficial for those with poorer executive function (EF). METHODS: A total of 228 high school seniors (M age = 17.76) with type 1 diabetes reported on mothers' and fathers' acceptance, knowledge of diabetes activities, disclosure to mothers and fathers regarding diabetes, and adherence at four yearly time points. At baseline, participants completed performance-based measures of EF. HbA1c was collected from assay kits. RESULTS: Growth curve models revealed significant declines in disclosure to fathers and mothers' and fathers' knowledge of diabetes activities; no changes were found in mothers' or fathers' acceptance nor disclosure to mothers. Multilevel models indicated significant between-person effects for nearly all aspects of parental involvement with more acceptance, knowledge, and disclosure associated with better HbA1c and adherence. Within-person effects for disclosure to fathers, and mothers' and fathers' knowledge indicated that in years when emerging adults perceived higher amounts of these types of involvement (compared with their own average), HbA1c was lower. Within-person effects were found for acceptance to mothers, disclosure to mothers and fathers, and mothers' diabetes knowledge for adherence. Disclosure to fathers and mothers' knowledge of diabetes activities were especially beneficial for HbA1c for those with poorer EF performance. CONCLUSIONS: Parental involvement in diabetes management remains important during the high-risk time of emerging adulthood, especially for those with poorer EF.

Evaluating Emotional and Biological Sensitivity to Maternal Behavior among Self-injuring and Depressed Adolescent Girls Using Nonlinear Dynamics.

High sensitivity and reactivity to behaviors of family members characterizes several forms of psychopathology, including self-inflicted injury (SII). We examined mother-daughter behavioral and psychophysiological reactivity during a conflict discussion using nonlinear dynamics to assess asymmetrical associations within time-series data. Depressed, SII, and control adolescents and their mothers participated (n=76 dyads). We expected that (1) mothers' evocative behaviors would affect behavioral and psychophysiological reactivity among depressed and, especially, SII adolescents, (2) adolescents' behaviors would not evoke mothers' behavioral or physiological reactivity, and (3) control teens and mothers would be less reactive, with no dynamic associations in either direction. Convergent cross-mapping with dewdrop regression, which identifies directional associations, indicated that mothers' behaviors evoked behavioral responses among depressed and SII participants, but psychophysiological reactivity for SII teens only. There were no effects of adolescents' behavior on mothers' reactivity. Results are interpreted based upon sensitivity theories and directions for further research are outlined.