Coping with type 1 diabetes through emerging adulthood: Longitudinal associations with perceived control and haemoglobin A1c

Objective: This study, which is part of a larger longitudinal study focusing on the biopsychosocial functioning of emerging adults with type 1 diabetes, examined how perceived personal control, coping and HbA_1c relate to one another over time.

Design and main outcome measures: Emerging adults with type 1 diabetes (18–30 years old) participated in a two-wave longitudinal study spanning five years (N = 164 at Time 1). At both times, patients completed questionnaires on perceived control and coping (i.e. diabetes integration, avoidant coping and passive resignation). HbA_1c values were obtained from treating clinicians. We investigated the directionality of effects using cross-lagged path analysis.

Results: Higher HbA_1c values predicted relative decreases in diabetes integration and increases in avoidant coping five years later. Feeling less in control over diabetes predicted the use of passive coping over time. Passive coping predicted a relative decrease in perceived control five years later.

Conclusion: These findings indicate that tackling poor glycaemic control is not only important to avoid medical complications but also to prevent patients from resorting to more avoidant coping strategies. Furthermore, given the longitudinal interplay between perceived control and passive coping, it is important that intervention efforts include both cognitive and behavioural components to be effective.     

A Population-Based Study of Children’s Well-Being and Health: The Relative Importance of Social Relationships,Health-Related Activities,and Income

This study investigated how various risk and protective factors interface with child health and well-being at the population level. Specifically, we examined the association of income, social-contextual variables, and indicators of health-related habits and activities to children’s life satisfaction and perceived overall health. Child data were collected via a self-report survey, the Middle Years Development Instrument, which was administered in three demographically diverse Canadian school districts to 5026 grade 4 students (83 % of the students had complete data and were included in the analyses). Multiple regression and mediation analyses were conducted to examine the joint associations of social relationships with adults and peers, nutrition and sleep habits, and after school sports activities with children’s satisfaction with life and perceived health. Results indicate that peer belonging and relationships with adults at home and school were the strongest predictors of life satisfaction. Furthermore, the (small) association between income and life satisfaction was mediated by social relationship variables. Child reports of perceived health were predicted by peer belonging, adult relationships (home, school, neighborhood), after-school team sports, and nutrition habits. The (small) association between income and health was mediated by social relationships and team sports participation. Findings are discussed in light of previous research on social determinants and socio-economic gradients of children’s health and life satisfaction.     

Temporal precedence of emotion over attention modulations in the lateral amygdala: Intracranial ERP evidence from a patient with temporal lobe epilepsy

Previous fMRI studies have reported mixed evidence for the influence of selective attention on amygdala responses to emotional stimuli, with some studies showing “automatic” emotional effects to threat-related stimuli without attention (or even without awareness), but other studies showing a gating of amygdala activity by selective attention with no response to unattended stimuli. We recorded intracranial local field potentials from the intact left lateral amygdala in a human patient prior to surgery for epilepsy and tested, with a millisecond time resolution, for neural responses to fearful faces appearing at either task-relevant or task-irrelevant locations. Our results revealed an early emotional effect in the amygdala arising prior to, and independently of, attentional modulation. However, at a later latency, we found a significant modulation of the differential emotional response when attention was directed toward or away from fearful faces. These results suggest separate influences of emotion and attention on amygdala activation and may help reconcile previous discrepancies concerning the relative responsiveness of the human amygdala to emotional and attentional factors.     

Differentiating emotional processing and attention in psychopathy with functional neuroimaging

Individuals with psychopathy are often characterized by emotional processing deficits, and recent research has examined the specific contexts and cognitive mechanisms that underlie these abnormalities. Some evidence suggests that abnormal features of attention are fundamental to emotional deficits in persons with psychopathy, but few studies have demonstrated the neural underpinnings responsible for such effects. Here, we use functional neuroimaging to examine attention–emotion interactions among incarcerated individuals (n = 120) evaluated for psychopathic traits using the Hare Psychopathy Checklist–Revised (PCL-R). Using a task designed to manipulate attention to emotional features of visual stimuli, we demonstrate effects representing implicit emotional processing, explicit emotional processing, attention-facilitated emotional processing, and vigilance for emotional content. Results confirm the importance of considering mechanisms of attention when evaluating emotional processing differences related to psychopathic traits. The affective-interpersonal features of psychopathy (PCL-R Factor 1) were associated with relatively lower emotion-dependent augmentation of activity in visual processing areas during implicit emotional processing, while antisocial-lifestyle features (PCL-R Factor 2) were associated with elevated activity in the amygdala and related salience network regions. During explicit emotional processing, psychopathic traits were associated with upregulation in the medial prefrontal cortex, insula, and superior frontal regions. Isolating the impact of explicit attention to emotional content, only Factor 1 was related to upregulation of activity in the visual processing stream, which was accompanied by increased activity in the angular gyrus. These effects highlight some important mechanisms underlying abnormal features of attention and emotional processing that accompany psychopathic traits.     

Offspring Effects of Prenatal Alcohol Exposure from Birth to 25 Years: The Seattle Prospective Longitudinal Study

Before alcohol was generally known to cause birth defects, NIAAA in 1974 began funding a population-based Seattle study on alcohol use and pregnancy outcome. Women receiving prenatal care by mid-pregnancy were recruited (N = 1,529) and interviewed at home. Approximately 500 offspring exposed to a range of alcohol levels were examined on 11 occasions between day 1 and 25 years. Neuropsychological and neurobehavioral performance measures are correlated with prenatal alcohol dose, without substantial confounding by socio-demographic or rearing conditions, smoking, nutrition, or other drugs. Deficits in attention, arithmetic skill, spatial-visual memory, and IQ, as well as increased alcohol problems and psychiatric disorders are among offspring outcomes correlated at several ages with maternal drinking during and before pregnancy recognition. Findings are not confined to women who believed they had alcohol problems. Not all exposed offspring appear affected.     

Social Anxiety and Peer Relations in Early Adolescence: Behavioral and Cognitive Factors

This study investigated factors associated with social anxiety during early adolescence using multiple informants, including self and peer perspectives, teacher ratings, and direct observations. Negative social performance expectations, maladaptive coping strategies, and social skill deficits were examined as correlates of social anxiety and mediators linking social anxiety with poor peer relations. Participants were 84 middle school students (47 girls, 37 boys) over-sampled for elevated social anxiety. Analyses revealed correlations linking social anxiety with decreased peer acceptance and increased peer victimization. Path analysis indicated that negative social performance expectations and social withdrawal-disengagement accounted for the association between social anxiety and decreased peer acceptance. Social anxiety, self-directed coping strategies, and social withdrawal-disengagement were each directly linked with increased peer victimization for boys. The results replicate findings based on clinical samples, extend understanding of cognitive, social, and behavioral factors associated with social anxiety in middle school, and provide new information regarding gender differences in the correlates of social anxiety.     

PLACING PREMENSTRUAL SYNDROME IN PERSPECTIVE

In a longitudinal prospective study, mood fluctuations were assessed for evidence of premenstrual syndrome (PMS) as well as other menstrual, day of week, and lunar cyclicity. Volunteer participants from the community (60 women and 10 men) provided daily data for 12 to 18 weeks. Significant mood fluctuation was determined by a new nonparametric method using each individual's own standard deviation as a measure of marked change. Cyclicity was the norm; two thirds of both the women and men had one or more menstrual or lunar phases or days of the week that were markedly positive and/or negative, relative to their own range, but few experienced stereotypical cyclicity (PMS, Monday blues, full moon). About half the women whose prospective data met conservative criteria for PMS, met liberal criteria, or met neither criteria said they had PMS, and half in each group said they did not.     

WHO FILLS OUT A LESBIAN QUESTIONNAIRE?

Most research on lesbians has used self-report questionnaires, and assumed that respondents who complete a lesbian questionnaire self-identify as lesbians and engage in sexual relationships with women. The present study examined the degree to which 2,393 women who answered a Lesbian Wellness Survey are distributed on five aspects of lesbian sexuality and the coming-out process. The five aspects were: (a) Sexual Orientation (numerical rating of sexual identity from exclusively lesbian/gay to exclusively heterosexual); (b) Years Out (length of time of self-identity as lesbian/gay/bisexual); (c) Outness/Disclosure (amount of disclosure of sexual orientation to others); (d) Sexual Experience (proportion of sexual relationships with women); and (e) Lesbian Activities (extent of participation in lesbian community events). Mild but significant correlations were found among these dimensions, indicating that being lesbian is not a homogeneous experience. Closer examination by the demographic characteristics of race/ethnicity and age revealed a diversity of experience. African American, Native American, and Latina respondents had moderate correlations among these aspects of lesbian experience, whereas White and Asian American respondents evidenced only mild or nonsignificant correlations. The results indicate that researchers who are studying one aspect of the lesbian experience (e.g., outness to others) need to ensure that they are not assuming such behavior based on other dimensions (such as frequent participation in lesbian community activities or years of being out), especially among White and Asian American lesbians.     

Kinship Support and Academic Efficacy Among College Students: A Cross-Sectional Examination

The study examined whether relationships with extended kin were related to higher levels of mental health and academic functioning among college students. Specifically, the study tested whether perceived emotional support from extended (non-nuclear) family was related to self-esteem, psychological distress, and academic efficacy and dedication above and beyond relationships with one’s primary caregivers, and whether these associations varied by class year in college. The sample consisted of 530 students (average age = 20.82), at a public, four-year university. The results revealed that freshmen and seniors who reported high levels of positive relationships with their extended kin also reported higher levels of academic-efficacy and dedication, as well as lower levels of psychological distress. However, the relation between kin emotional support and these outcomes were not significant for sophomores and juniors. There was also a significant association between kinship support and self-esteem for participants in all four class levels. The study underscores the need to examine extended social support systems among college students, above and beyond those maintained with primary caregivers, as well as the dynamic nature of family support during young adulthood.