Psychological Distress Among Older Adults During the First Wave of SARS-CoV-2 Pandemic: Survey of Health, Ageing, and Retirement in Europe.

Objective: To investigate the individual and country-level characteristics associated with the presence and worsening of psychological distress during the first wave of the pandemic among the elderly in Europe. Methods: In June-August 2020, 52,310 non-institutionalized people aged 50+ in 27 SHARE participating countries reported whether feeling depressed, anxious, lonely, and having sleep problems. For this analysis, we combined these symptoms into a count variable reflecting psychological distress. Binary measures of the worsening of each symptom were used as secondary outcomes. Multilevel zero-inflated negative binomial and binary logistic regressions were used to assess the associations. Results: Female sex, low education, multimorbidity, fewer social contacts, and higher stringency of policy measures were associated with increased distress. The worsening of all 4 distress symptoms was associated with younger age, poor health, loss of work due to the pandemic, low social contact, and high national mortality rates from COVID-19. Conclusion: The pandemic exacerbated distress symptoms for socially disadvantaged older adults and those who were already struggling with mental health. The death toll of COVID-19 in a country played a role in symptom worsening.

Association Between Parental Supply of Alcohol and Later Adolescent Alcohol Use in a Highly Permissive Context.

OBJECTIVE: Many children and adolescents get their first experience with alcohol in a family setting. Evidence suggests that parental supply of alcohol is a risk factor for drinking later in life. However, most of the previous studies have been conducted in Western countries. The Czech Republic has among the highest alcohol consumption per capita, including among adolescents, and providing their own children with sips of alcohol is widely considered by parents to be a good way to introduce children to safe drinking. This study examined whether the parental supply of alcohol is associated with later use among adolescents in an Eastern European alcohol-permissive context. METHOD: The sample included children (49% female) assessed at age 11 (n = 2,202) and age 15 (n = 1,279) from the European Longitudinal Study of Parents and Children (ELSPAC). The outcome was adolescent alcohol use at age 15, reported by adolescents and pediatricians. Predictors included different sources of alcohol (parents, family member, friend, own supply, or other sources) reported by adolescent at age 11. RESULTS: Parental supply of alcohol consistently emerged as a robust longitudinal predictor of adolescent alcohol use, with adjusted odds ratios of self-reported and pediatrician-reported frequent drinking at age 15 of 2.34 [1.19, 4.44] and 2.37 [1.02, 5.47], respectively. It also mediated the association between parental drinking and adolescent alcohol use. CONCLUSIONS: Parental supply of alcohol is an important risk factor for later adolescent alcohol use in the high alcohol-permissive population of the Czech Republic, suggesting that the association might not be context dependent.

Understanding the Intergenerational Cycle of Trauma and Violence: Maternal Adverse Childhood Experiences and Parent-to-Child Aggression Risk.

Adverse childhood experiences (ACEs), such as exposure to maltreatment and household dysfunction, are major risk factors for physical and mental health problems across the lifespan. While the relationship between ACEs and health outcomes is well established, what effects ACEs might have on parent-to-child aggression are less known. The negative consequences of ACEs on parental aggression can be even more pronounced with multiple exposures to different patterns of ACEs. This study examined the association between patterns of maternal ACEs and subsequent parent-child aggression risk. A diverse sample of young women (N = 329; mean age = 26.3 years) was recruited at a large, urban university medical center. Participants completed self-report measures of the ACEs Questionnaire and the Adult-Adolescent Parenting Inventory-2. Latent class analysis was used to identify classes of women with similar patterns of exposure to ACEs and to examine the associations between ACEs classes and parent-to-child aggression risk. Three latent classes, characterized by distinct patterns of maternal ACEs, were identified: Low ACEs (63% of the sample), High Parental Separation/Divorce (20%), and High/Multiple ACEs classes (17%). Women in the High/Multiple ACEs class were more likely to report higher levels of parent-to-child aggression risk (i.e., inappropriate expectations, belief in corporal punishment, lack of empathy) than those in the other classes (Wald(2) = 8.63, p = .013). Preventive interventions targeting parental attitudes and behaviors among young women exposed to ACEs may decrease the risk for further perpetuation of aggression in the next generations.

Prenatal psychosocial stress and children's sleep problems: Evidence from the ELSPAC-CZ study.

Prenatal exposure to maternal stress may increase the risk of developing sleep problems in childhood. This study examined the association between prenatal stressful life events (PSLE) and children's sleep problems, taking into consideration their trajectory over time. Data were obtained from the Czech portion of the European Longitudinal Cohort Study of Pregnancy and Childhood (ELSPAC-CZ; N = 4,371 children). Mothers reported PSLE using an inventory of 42 life events and child sleep problems at five time-points (child age of 1.5, 3, 5, 7, and 11 years). The association was tested by a Poisson latent growth model, controlling for maternal and family demographics, birth characteristics, maternal depression, and alcohol use in pregnancy. The average rate of sleep problems was 2.06 (p < 0.001) at the age of 1.5 years and the rate of sleep problems decreased in a linear fashion over time (estimate = -0.118; p < 0.001). A higher number of PSLE was associated with a higher rate of sleep problems at the age of 1.5 years (incidence rate ratio [IRR] per interquartile range = 1.08, 95% confidence interval [CI] 1.05-1.12, p < 0.001) and with a reduced rate of decrease in sleep problems between the ages of 1.5 and 11 years (p < 0.001). Thus, PSLE were associated with chronicity of sleep problems in addition to their amount during early childhood. Prenatal exposure to stress may predispose individuals to the development of sleep problems in later life.

Job loss and lower healthcare utilisation due to COVID-19 among older adults across 27 European countries.

BACKGROUND: Older adults are at greater risk for becoming severely ill from COVID-19; however, the impact of the pandemic on their economic activity and non-COVID-19-related healthcare utilisation is not well understood. The aim of this study was to examine the prevalence and predictors of COVID-19-related unemployment and healthcare utilisation in a sample of older adults across 27 European countries. METHODS: We used data from the Survey of Health, Ageing and Retirement in Europe COVID-19 Survey, collected between June and August 2020. Participants (n=52 061) reported whether they lost a job, forwent medical treatment and whether their appointment was postponed due to COVID-19. Three-level models were estimated for each outcome to test the effects of individual, household and country-level characteristics. RESULTS: The mean prevalence of reported job loss, and forgone and postponed medical care was 19%, 12% and 26%, respectively. Job loss was associated with female sex, lower education and household income, and older age in women. For example, the OR of job loss, comparing primary versus tertiary (college) education, was 1.89 (95% CI 1.59 to 2.26). Forgone and postponed medical care was associated with older age in men, female sex and higher education. At the country level, postponed medical care was associated with more stringent governmental anti-COVID measures. CONCLUSION: Job loss and lower healthcare utilisation for non-COVID-19-related reasons were common among older adults and were associated with several sociodemographic characteristics. Job loss appeared to disproportionally affect already economically vulnerable individuals, raising concerns about the exacerbation of social inequalities.

Maternal adverse childhood experiences and postpartum depressive symptoms in young, low-income women.

OBJECTIVES: Exposure to adverse childhood experiences (ACEs), such as child maltreatment and family dysfunction, is highly prevalent. Previous research has shown an association between ACEs and adult depression. The aim of the current study was to expand the existing literature by testing the association between ACEs and postpartum depression (PPD) symptoms in an urban, ethnically diverse sample of women. METHODS: Participants (N = 746; ages 18-47; mean age = 27.3) were recruited at a large, urban university medical center as part of the Longitudinal Infant and Family Environment (LIFE) study. The association between ACEs and PPD symptoms were tested via hierarchical linear regression models. RESULTS: The majority of the participants (61%) reported experiencing at least one type of ACEs prior to age 18. ACEs were positively associated with PPD symptoms (ß = .29, p < .001), controlling for maternal race/ethnicity, age, educational attainment, marital status, household income, and infant gender and birth order. CONCLUSIONS: The results showed that exposure to ACEs was related to PPD symptoms among low-income women. Screenings for ACEs during prenatal checkups may help identify women at risk of depression and facilitate timely prevention and treatment efforts.

Cross-National Associations Among Cyberbullying Victimization, Self-Esteem, and Internet Addiction: Direct and Indirect Effects of Alexithymia.

The relationship among cyberbullying victimization, lower self-esteem, and internet addiction has been well-established. Yet, little research exists that explains the nature of these associations, and no previous work has considered the inability to identify or describe one's emotions, namely, alexithymia, as a potential mediator of these links. The present study sought to investigate the indirect effects of cyberbullying victimization on self-esteem and internet addiction, mediated by alexithymia. The sample consisted of 1,442 participants between 12 and 17 years (M age = 14.17, SD = 1.38, 51.5% male) from Germany, the Netherlands, and the United States. Results showed a direct relationship between cyberbullying victimization and self-esteem and an indirect association mediated by alexithymia in the Dutch sample. However, in the German and U.S. samples, only an indirect relationship via alexithymia, but not a direct effect of cyberbullying victimization on self-esteem, was found. Consistent across the three country samples, cyberbullying victimization and internet addiction were directly and also indirectly associated via alexithymia. In sum, findings indicate that alexithymia might help better understand which detrimental effects cyberbullying victimization has on adolescent psychological health. Thus, cyberbullying prevention programs should consider implementing elements that educate adolescents on the ability to identify and describe their own emotions.

Childhood maltreatment and problematic alcohol use in young adulthood: the roles of cognitive vulnerability to depression and depressive symptoms.

BACKGROUND: Childhood maltreatment (CM) has been repeatedly linked to future problem drinking. Depression has been identified as a potential factor contributing to problematic alcohol use in maltreated individuals. However, depression has been operationalized as the presence or number of depression symptoms in the majority of previous studies. The role of other relevant measures of depression, such as depressive implicit associations, is not well understood. OBJECTIVES: The present study addresses this gap in the literature by examining the mediating role of both depression symptoms and depressive implicit associations. METHODS: A community sample of young adults (N = 208, mean age = 19.7, 78.4% females) completed self-report measures of CM, depression symptoms, and problem drinking. Depressive implicit associations were assessed by a computer-based implicit association test (IAT). Structural equation modeling (SEM) was used to examine the direct link between CM and problem drinking as well as indirect links through depression symptoms and depressive implicit associations. RESULTS: CM was significantly associated with both depression symptoms (ß = 0.35, p < .001) and depressive implicit associations (ß = 0.36, p < .001). Additionally, CM was associated with problem drinking indirectly via depression symptoms during young adulthood (ß = .06, p = .019). CONCLUSION: Our study provides evidence for the role of depression symptoms, but not for depressive implicit associations, in linking CM and problem drinking. Treating depression in individuals with a history of CM may help to prevent problem drinking in this vulnerable population.

Childhood Sleep Functioning as a Developmental Precursor of Adolescent Adjustment Problems.

Sleep has been linked to adjustment difficulties in both children and adolescents; yet little is known about the long-term impact of childhood sleep on subsequent development. This study tested whether childhood sleep problems, sleep quantity, and chronotype predicted internalizing and externalizing problems during adolescence. Latent Growth Modeling using the Czech portion of the European Longitudinal Study of Pregnancy and Childhood (N = 4393) was utilized to test the developmental trajectories of sleep characteristics (from 1.5 to 7 years) as predictors of adjustment problems trajectories (from 11 to 18 years). Findings provided evidence that children with higher levels of sleep problems at 1.5 years (and throughout childhood) reported higher levels of internalizing and externalizing problems at age 11. Additionally, greater eveningness at age 1.5 predicted a greater increase in externalizing problems from ages 11 to 18 years. The results emphasize the importance of childhood sleep problems in evaluating the risk of future adjustment difficulties.

National ethnic and racial disparities in disciplinary practices: A contextual analysis in American secondary schools.

Previous research has documented ethnic/racial disparities in the implementation of school discipline, including exclusionary practices. The current study focused on ethnic/racial disparities in four types of school exclusionary policies through the Civil Rights Data Collection (2013-2014) based on 15,901 middle and 18,303 high schools from the United States. Consistent with an ecological model of multi-contextual influences, school- and region-level characteristics were tested in a multi-level analytic model. Sex, disability status, and ethnicity/race were estimated at level 1, with the following school-level predictors at level 2: proportion of youth eligible for free or reduced lunch, school size, diversity (percentage of students of different ethnicities/races in school), urban/suburban/rural locale, and region (Northeast, Midwest, South, and West). Findings provided robust evidence of persistent discrepancies in disciplinary practices across ethnic/racial groups. Specifically, African American students and students self-identifying as two or more races were found to be at greater risk for school discipline actions across all disciplinary measures in both middle and high schools. Regarding school-level variables, students from lower SES schools and smaller schools were at greater risk for some disciplinary measures. Unexpected findings were found for regional differences, as Midwestern schools had significantly higher rates for most disciplinary measures as compared to Southern schools. Moreover, ethnic/racial discrepancies were moderated by school-level characteristics, such that African American students and students self-identifying with two or more races were more likely to be disciplined at low SES schools and at schools with greater diversity.

Adverse Childhood Experiences and E-Cigarette Use During Young Adulthood.

BACKGROUND AND OBJECTIVES: E-cigarette use among young people is highly prevalent. Individuals exposed to adverse childhood experiences such as childhood maltreatment (CM) may be at particular risk, as CM has been linked to nicotine dependence. Studies testing the association between CM and e-cigarette use are lacking, including research that examines pathways linking CM to e-cigarette use. METHODS: Using a community sample of young adults (N = 208; ages 18-21), we examined the relationship between CM and e-cigarette use and explored the potential role of impulsivity in linking CM to e-cigarette use via a series of structural equation models controlling for demographic characteristics. RESULTS: CM was significantly associated with lifetime e-cigarette use. Furthermore, CM was associated with negative urgency (NU), whereas NU and sensation seeking were significantly related to lifetime e-cigarette use. NU fully mediated the relationship between CM and lifetime e-cigarette use. CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE: Our results suggest that young adults with a history of CM might be vulnerable to e-cigarette use and that NU played a significant role in linking CM to lifetime e-cigarette use. Addressing NU in young adults with a history of CM might be a useful avenue for preventing e-cigarette use in this population. (Am J Addict 2019;28:303-310).

Multi-contextual influences on adolescent pregnancy and sexually transmitted infections in the United States.

RATIONALE: Rates of adolescent pregnancy and sexually transmitted infections (STIs) in the United States remain high. Norms and beliefs about sex and the use of contraception have been identified as potential contributors to these. OBJECTIVE: The current study examined multi-contextual links between norms and beliefs about sex and contraception, and adolescent pregnancies and STIs. METHOD: Hierarchical linear modeling (HLM) was used to test the study questions in the historical data from Add Health dataset (Wave I, 1994-1995, and Wave II, 1995-1996). Measures of beliefs about sex and contraception were administered to adolescents and their caregivers; pregnancies and STIs were reported by adolescents (N = 13,568; level 1). School-reported data (N = 132; level 2) included sexuality education and prevalence of pregnancies at schools. Community data included the density of family planning providers in each county. RESULTS: Adolescents negative beliefs about contraception were associated with a higher likelihood of pregnancies and STIs via their association with contraception use. The opposite effect was found for negative beliefs about sex. Parental disapproval of contraception was associated with a decreased likelihood of STIs, but with an increased likelihood of pregnancies. A greater number of pregnancies at school was associated with a greater likelihood of STIs. Unexpectedly, the number of county-level family planning providers was associated with a higher likelihood of STIs. CONCLUSION: Adolescent individual beliefs emerged as the most salient predictors of both pregnancies and STIs.

Sleep Quantity and Problems as Mediators of the Eveningness-Adjustment Link during Childhood and Adolescence.

Chronotype, or morningness/eveningness, has been associated with adjustment in both children and adolescents. Specifically, eveningness has been linked to adjustment difficulties; however, the mechanism underlying this association is poorly understood. The purpose of this study was to test whether the associations between eveningness and adjustment difficulties could be explained by an unfavorable impact of eveningness on sleep. Links from chronotype to internalizing problems and problem behaviors via sleep quantity and sleep problems were tested in a sample from the European Longitudinal Study of Pregnancy and Childhood (N = 3485; 48.8% female), both when the participants were children (7 years at T1, 11 at T2) and when they were adolescents (15 years at T1, 18 at T2). The findings provided evidence that eveningness predicted greater sleep problems and lower sleep quantity; however, only sleep problems predicted internalizing problems and problem behaviors. Sleep quantity did not mediate the eveningness-adjustment link, and sleep problems did so only in children. The findings show that sleep problems appear to be more important in explaining the eveningness-adjustment link rather than altered sleep quantity, commonly associated with eveningness.

Sleep, low self-control, and deviance: Direct and indirect links across immigrant groups and socioeconomic strata.

Sleep functioning is concurrently and longitudinally associated with norm-violating behaviors; however, the specific correlates contributing to these links remain unknown. Moreover, despite known mean-level differences in sleep functioning across immigrant and non-immigrant youth as well as socioeconomic strata, it is largely unknown whether links between sleep and norm-violating behaviors vary across groups. The current study tested the direct effects of sleep problems and sleep quantity on measures of deviance, as well as the indirect links via low self-control. It also tested moderating effects by immigrant and SES groups, indicated by parental education, on the associations and mean-level differences in sleep functioning. Results from structural equation models based on cross-sectional data from a national probability sample of Swiss adolescents (N = 6,866) provided evidence of both direct as well as indirect links between sleep and deviance, via low self-control. Despite mean-level differences, the tested links were invariant across immigrant and SES groups, with one modest exception in the magnitude of effect.

A cross-national study of direct and indirect effects of cyberbullying on cybergrooming victimization via self-esteem / Estudio internacional de los efectos directos e indirectos del ciberacoso en la victimización por acoso sexual cibernético mediados por la autoestima

The present study reports frequency rates of cybergrooming, profiled characteristics of cybergrooming perpetrators, and examine direct and indirect associations between cyberbullying victimization, self-esteem, and cybergrooming victimization. The study sample included 2,162 adolescents between 11 and 19 years from three Western (Germany, the Netherlands, the United States) countries and one Southeast Asian country (Thailand). Across countries, 18.5% of participants reported having had contact with a cybergroomer. Western girls, as compared to boys, were at greater risk to have been contacted by a cybergroomer. No significant sex difference was found for Southeast Asian adolescents. Also, Southeast Asian adolescents reported higher rates of cybergroomer contact as compared to Western adolescents. Cybergroomers were most often males and older than victims. Both cyberbullying victimization and low self-esteem increased the probability of coming into contact with a cybergroomer, and self-esteem mediated the effects of cyberbullying victimization on cybergrooming victimization. The results are discussed in relation to practical implications and future research

El presente estudio muestra la frecuencia de acoso sexual cibernético y perfiles característicos de los acosadores y examina la asociación directa e indirecta entre la victimización por cyberbullying, auto-estima y victimización por acoso sexual cibernético. La muestra del estudio incluye 2.162 adolescentes entre 11 y 19 años de edad provenientes de tres países occidentales (Alemania, Holanda, Estados Unidos) y un país del sureste asiático (Tailandia). El 18.5% de los participantes de los todos países de la muestra manifestaron haber tenido algún contacto con un acosador sexual cibernético. Las chicas occidentales comparadas con los chicos tienen más riesgo de contacto con un acosador sexual cibernético. No se encontraron diferencias de sexo en los jóvenes del sureste de Asia. Además, los participantes del sureste asiático tuvieron mayor frecuencia de contactos con acosadores sexuales cibernéticos comparado con los adolescentes occidentales. Los acosadores sexuales cibernéticos son en su mayoría hombres mayores que las víctimas. Tanto la victimización por cyberbullying como la baja auto-estima incrementan la probabilidad de entrar en contacto con un acosador sexual cibernético y la auto-estima sirve como mediador de los efectos de la victimización por cyberbullying en la victimización por acoso sexual cibernético. Se comentan los resultados en cuanto a las implicaciones prácticas del estudio e investigaciones futuras