Living with painful diabetic neuropathy: insights from focus groups into fears and coping strategies

Objective: Painful diabetic neuropathy (PDN) is known to negatively affect quality of life. Being physically active is a crucial part of successful diabetes self-management, but regimen adherence is often low. Coping strategies and fears have shown to be related to less physical activity (PA). The aim of the present study was to obtain more in-depth information on psychological risk factors leading to less PA in persons with PDN.

Design: Three semi-structured focus group interviews were conducted with a representative sample of persons with PDN (N?=?12). Data were transcribed verbatim and analysed using a hybrid method of thematic analyses and a grounded theory approach.

Main Outcome Measures: Fears and coping strategies related to PA in persons with PDN.

Results: Several specific fears were identified; fear of hypoglycaemia, fear of pain increase, fear of total exhaustion, fear of physical injury, fear of falling, fear of loss of identity, and fear of negative evaluation by others. To cope with these fears, avoidance, remaining active, cognitive distraction, and acceptance strategies were described.

Conclusion: In persons with PDN, diabetes-related fears and pain-related fears play a role in less engagement in PA, indicating the need for new methods for improving self-management in persons with PDN.     

The relationship between sociocultural factors and autobiographical memories from childhood: the role of formal schooling

ABSTRACT

Cross-cultural differences in autobiographical memory (AM) are associated with cultural variations. In models of the self and parental reminiscing style, but not many studies have analysed the relationship between AM and specific cultural practices such as formal schooling. Theoreticians like [Greenfield, P. M. (2009). Linking social change and developmental change: Shifting. pathways of human development. Developmental Psychology, 45, 401–418. doi:10.1037/a0014726; Ka?itçiba?i, C. (2005). Autonomy and relatedness in cultural context. Implications for self and family. Journal of Cross-Cultural Psychology, 36, 403–422. doi:10.1177/0022022105275959] and [Keller, H. (2007). Children development across cultures. New York: Lawrence Erlbaum Associates] have considered formal schooling as an engine towards the model of independence; however, the empirical evidence in this regard is inconclusive: while some studies found evidence of a relation between formal schooling and characteristics of AM, others did not. To solve this inconsistency, the present study compared orally narrated childhood memories of Mexican adults with three different levels of education (from rudimentary literacy to university). Results support a relationship between formal schooling and AM in the predicted direction: More educated participants reported longer, more specific and more self-oriented memories than those with less schooling experience did. Some gender differences were also observed, with males generally reporting more individually and less socially oriented memories than females, except for university level participants. We conclude that these results support Greenfield’s theory about formal schooling as a sociocultural factor that promotes the cultural pathway to independence, as well as complexity and context-boundedness of gender differences in AM.     

Prevalence and predictors of expulsion in home-based child care settings

This study explored the prevalence of expulsion in home-based child care (HBCC) settings using a nationally representative sample of HBCC providers from the National Survey of Early Care and Education. In addition to prevalence, enrollment and provider characteristics that predicted expulsion were examined. Although there is increasing awareness of the prevalence of early childhood suspension and expulsion in early care and education settings and the negative effects it has on children's development, few studies have included or focused on HBCC, where many children receive care. This study highlights that many home-based providers, especially listed providers, report that they expelled at least one child within the last year. Significant predictors of expulsion emerged, including enrollment characteristics such as caring for children with disabilities, enrolling more children, and caring for children unrelated to the provider. Provider characteristics, including years of experience, provider education, and provider age, also predicted provider report of expulsion. These results provide insight as to possible strategies that may be effective in reducing expulsion rates in this caregiving context.     

From terrible twos to sassy sixes: The development of vocabulary and executive functioning across early childhood

Across the early childhood period of development, young children exhibit considerable growth in their executive functioning (EF) and vocabulary abilities. Understanding the developmental trajectory of these seemingly interrelated processes is important as both early vocabulary and EF have been shown to predict critical academic and socio-emotional outcomes later in childhood. Although previous research suggests that EF and vocabulary are correlated in early childhood, much of the existing longitudinal research has focused on unidirectional relations among preschool child samples. The current large-scale study, therefore, sought to examine whether children's vocabulary and EF abilities are bidirectionally related over time across four measurement waves in early childhood (i.e., at ages 2, 3, 4, and 6). At each timepoint, children's vocabulary skills were positively correlated with their concurrent EF abilities. After controlling for child sex and maternal education status, the best-fitting, cross-lagged panel model was a unidirectional model whereby children's early vocabulary scores predicted their later EF performance at each timepoint. Although age 2 EF significantly predicted age 3 vocabulary size, this association was no longer significant after accounting for maternal education status. Our results illustrate that vocabulary size plays an important role in predicting children's later EF performance across various timepoints in early childhood, even after controlling for children's initial EF scores. These findings have important implications for intervention research as fostering early vocabulary acquisition may serve as a possible avenue for improving EF outcomes in young children.

Research Highlights

• Children's vocabulary size is positively correlated with their concurrent executive functioning skill at ages 2, 3, 4, and 6
• Young children's early vocabulary scores predict their later EF performance across measurement waves, even after controlling for initial EF skill
• There is stability in children's relative vocabulary size and executive functioning performance over time in early childhood

     

Does surgency moderate the relationship between parenting and children's aggression in middle childhood?

Parenting and child temperament have both been linked to aggression among children. This study explores the moderating effects of children's surgency and sex and paternal/maternal parenting practices on aggressive behaviour in middle childhood. We analyse whether the moderating effects observed fit a Diathesis-Stress, Differential Susceptibility or Vantage Sensitivity model. Participants were 203 school children aged 7–8 years (M = 92.42 months, SD = 3.52) from southern Spain. Maternal inconsistency and coercion and paternal hostility and indulgence, had a direct effect on children's aggressive behaviour. The effects of maternal hostility and anticipatory problem solving on children's aggression were moderated by surgency (Diathesis-Stress), as was the effect of paternal coercion on aggression (Vantage Sensitivity). Children's sex was not found to moderate any effect. It therefore seems that not all children are equally sensitive to the influence of parenting on their aggression levels, and that this influence depends on their temperament.

Highlights

• This study explores the moderating effects of children's surgency and sex and paternal/maternal parenting practices on aggressive behavior.
• Children's surgency moderated the effect of maternal hostility and anticipatory problem solving on children's aggression, with both effects fitting a Diathesis-Stress model.
• Children's surgency moderated the effect of paternal coercion on children's aggression, with this effect fitting a Vantage Sensitivity model.

     

Triangulating causality between childhood obesity and neurobehavior: Behavioral genetic and longitudinal evidence

Childhood obesity is a serious health concern that is not yet fully understood. Previous research has linked obesity with neurobehavioral factors such as behavior, cognition, and brain morphology. The causal directions of these relationships remain mostly untested. We filled this gap by using the Adolescent Brain Cognitive Development study cohort comprising 11,875 children aged 9–10. First, correlations between the age- and sex-specific 95th BMI percentile (%BMIp95) and neurobehavioral measures were cross-sectionally analyzed. Effects were then aggregated by neurobehavioral domain for causal analyses. Behavioral genetic Direction of Causation modeling was used to test the direction of each relationship. Findings were validated by longitudinal cross-lagged panel modeling. %BMIp95 correlated with impulsivity, motivation, psychopathology, eating behavior, and cognitive tests (executive functioning, language, memory, perception, working memory). Greater %BMIp95 was also associated with reduced cortical thickness in frontal and temporal brain areas but with increased thickness in parietal and occipital areas. Similar although weaker patterns emerged for cortical surface area and volume. Behavioral genetic modeling suggested causal effects of %BMIp95 on eating behavior (β = 0.26), cognition (β = 0.05), cortical thickness (β = 0.15), and cortical surface area (β = 0.07). Personality/psychopathology (β = 0.09) and eating behavior (β = 0.16) appeared to influence %BMIp95. Longitudinal evidence broadly supported these findings. Results regarding cortical volume were inconsistent. Results supported causal effects of obesity on brain functioning and morphology. The present study highlights the importance of physical health for brain development and may inform interventions aimed at preventing or reducing pediatric obesity.

Research Highlights

• A continuous measure related to obesity, %BMIp95, has correlations with various measures of brain functioning and structure
• Behavioral genetic and longitudinal modeling suggest causal links from personality, psychopathology, and eating behavior to %BMIp95
• Results also indicate directional links from %BMIp95 to eating behavior, cognition, cortical thickness, and cortical surface area
• Obesity may play a role for healthy brain development during childhood