Search

BackgroundThe mobile phone app, TrackYourStress (TYS), is a new crowdsensing mobile health platform for ecological momentary assessments of perceived stress levels. ObjectiveIn this pilot study, we aimed to investigate the time trend of stress levels while using TYS for the entire population being studied and whether the individuals’ perceived stress reactivity moderates stress level changes while using TYS. MethodsUsing TYS, stress levels were measured repeatedly with the 4-item version of the Perceived Stress Scale (PSS-4), and perceived stress reactivity was measured once with the Perceived Stress Reactivity Scale (PSRS). A total of 78 nonclinical participants, who provided 1 PSRS assessment and at least 4 repeated PSS-4 measurements, were included in this pilot study. Linear multilevel models were used to analyze the time trend of stress levels and interactions with perceived stress reactivity. ResultsAcross the whole sample, stress levels did not change while using TYS (P=.83). Except for one subscale of the PSRS, interindividual differences in perceived stress reactivity did not influence the trajectories of stress levels. However, participants with higher scores on the PSRS subscale reactivity to failure showed a stronger increase of stress levels while using TYS than participants with lower scores (P=.04). ConclusionsTYS tracks the stress levels in daily life, and most of the results showed that stress levels do not change while using TYS. Controlled trials are necessary to evaluate whether it is specifically TYS or any other influence that worsens the stress levels of participants with higher reactivity to failure.

BackgroundHand-washing is regarded as a potentially important behavior for preventing transmission of respiratory infection, particularly during a pandemic. ObjectiveThe objective of our study was to evaluate whether a Web-based intervention can encourage more frequent hand-washing in the home, and to examine potential mediators and moderators of outcomes, as a necessary first step before testing effects of the intervention on infection rates in the PRIMIT trial (PRimary care trial of a website based Infection control intervention to Modify Influenza-like illness and respiratory infection Transmission). MethodsIn a parallel-group pragmatic exploratory trial design, 517 nonblinded adults recruited through primary care were automatically randomly assigned to a fully automated intervention comprising 4 sessions of tailored motivational messages and self-regulation support (n = 324) or to a no-intervention control group (n = 179; ratio 2:1). Hand-washing frequency and theory of planned behavior cognitions relating to hand-washing were assessed by online questionnaires at baseline (in only half of the control participants, to permit evaluation of effects of baseline assessment on effect sizes), at 4 weeks (postintervention; all participants), and at 12 weeks. ResultsHand-washing rates in the intervention group were higher at 4 weeks than in the control group (mean 4.40, n = 285 and mean 4.04, n = 157, respectively; P < .001, Cohen d = 0.42) and remained higher at 12 weeks (mean 4.45, n = 282 and mean 4.12, n = 154, respectively; P < .001, Cohen d = 0.34). Hand-washing intentions and positive attitudes toward hand-washing increased more from baseline to 4 weeks in the intervention group than in the control group. Mediation analyses revealed positive indirect effects of the intervention on change in hand-washing via intentions (coefficient = .15, 95% confidence interval [CI], .08–.26) and attitudes (coefficient = 0.16, 95% CI, .09–.26). Moderator analyses confirmed that the intervention was similarly effective for men and women, those of higher and lower socioeconomic status, and those with higher and lower levels of perceived risk. ConclusionsThis study provides promising evidence that Web-based interventions could potentially provide an effective method of promoting hand hygiene in the home. Data were collected during the 2010 influenza pandemic, when participants in both groups had already been exposed to extensive publicity about the need for hand hygiene, suggesting that our intervention could add to existing public health campaigns. However, further research is required to determine the effects of the intervention on actual infection rates. TrialInternational Standard Randomized Controlled Trial Number (ISRCTN): 75058295; http://www.controlled-trials.com/ISRCTN75058295 (Archived by WebCite at http://www.webcitation.org/62KSbkNmm)

Fiction reading is a popular leisure activity associated with a variety of pleasurable experiences, including suspense, narrative transportation, and--as indicated by recent empirical studies--also flow. In the context of fiction reading, flow--generally defined as a pleasurable state of mind experienced during an optimally stimulating activity--is specifically related to an optimal balance between text-driven challenges and the reader's capabilities in constructing a mental story model. The experimental study reported here focused on the psychophysiological underpinnings of flow in the reading context. Cardiovascular data were collected from 84 participants both during a relaxation baseline prior to reading and during reading. Participants were randomly assigned to read one of three versions of a chapter from Homer's "Odyssey." According to statistical readability indices, these versions were low, intermediate, or high in readability, and hence in cognitive challenge. Flow was measured immediately after reading with a self-report scale that was tailored to assess reading-specific flow experiences. Regression analyses revealed that cardiovascular activation patterns measured before reading that are reflective of parasympathetic dominance--that is, an inner state associated with relaxation and cognitive fluency--moderated flow experiences during reading. In line with the stipulations of flow theory in regard to matching challenge levels being the key determinant for flow, this pattern supported subsequent flow experiences only in response to text versions of high or intermediate, but not of low cognitive challenge. Differences in cardiac vagal tone during reading were, however, not sensitive to our experimental modifications and not predictive of flow experiences.

Studies investigating the prevalence, cause, and consequence of multiple sclerosis (MS) fatigue typically use single measures that implicitly assume symptom-stability over time, neglecting information about if, when, and why severity fluctuates. We aimed to examine the extent of moment-to-moment and day-to-day variability in fatigue in relapsing-remitting MS and healthy individuals, and identify daily life determinants of fluctuations. Over 4 weekdays, 76 participants (38 relapsing-remitting MS; 38 controls) recruited from multiple sites provided real-time self-reports six times daily (n = 1661 observations analyzed) measuring fatigue severity, stressors, mood, and physical exertion, and daily self-reports of sleep quality. Fatigue fluctuations were evident in both groups. Fatigue was highest in relapsing-remitting MS, typically peaking in late-afternoon. In controls, fatigue started lower and increased steadily until bedtime. Real-time stressors and negative mood were associated with increased fatigue, and positive mood with decreased fatigue in both groups. Increased fatigue was related to physical exertion in relapsing-remitting MS, and poorer sleep quality in controls. In relapsing-remitting MS, fatigue fluctuates substantially over time. Many daily life determinants of fluctuations are similar in relapsing-remitting MS and healthy individuals (stressors, mood) but physical exertion seems more relevant in relapsing-remitting MS and sleep quality most relevant in healthy individuals., Author(s): Daniel J. H. Powell [sup.1] [sup.2] , Christina Liossi [sup.2] , Wolff Schlotz [sup.2] [sup.3] , Rona Moss-Morris [sup.2] [sup.4] Author Affiliations: (1) Aberdeen Health Psychology Group, Institute of [...]

Objective: To summarize the advantages and limitations of general population, high-risk and "natural experiment" longitudinal studies for studying psychological change. The English and Romanian Adoptees study is used as an example of a "natural experiment," and detailed findings are provided. Method: What is new is a focus on the young people who spent the whole of their life in institutional care up to the time of adoption and who did not show subnutrition. The results were compared with a composite comparison group who had not experienced institutional care or who were adopted before the age of 6 months. The outcomes were assessed in terms of previously established deprivation-specific patterns (DSPs). Results: "Pure" psychosocial deprivation was associated with a substantial increase in the rate of DSPs. It was not associated with significantly impaired head growth if institutional care lasted less than 6 months, whereas thereafter there was a 2.5 standard deviation reduction. Subnutrition differed in being accompanied by impaired head and body growth even with institutional care lasting less than 6 months. In the pure psychosocial deprivation group, 45.5% showed a DSP at 15 years compared with 1.3% in the comparison group. Conclusion: "Pure" psychosocial deprivation (in the absence of subnutrition) had a profound effect on psychological functioning in the form of DSPs. Subnutrition had a surprisingly small effect on DSPs. (Contains 4 figures.)

There is accumulating evidence that individual differences in stress reactivity contribute to the risk for stress-related disease. However, the assessment of stress reactivity remains challenging, and there is a relative lack of questionnaires reliably assessing this construct. We here present the Perceived Stress Reactivity Scale (PSRS), a 23-item questionnaire with 5 subscales and 1 overall scale, based on an existing German-language instrument. Perceived stress reactivity and related constructs were assessed in N = 2,040 participants from the United Kingdom, the United States, and Germany. The 5-factor structure of the PSRS was found to be similar in the 3 countries. In the U.S. sample the questionnaire was applied using 2 modes of administration (paper-pencil and computerized), and measures were repeated after 4 weeks. Measurement invariance analyses demonstrated full invariance across mode of administration and partial invariance across gender and countries. Scale scores differed between countries and genders, with women scoring higher on most scales. Overall, reliability analysis suggested good stability of PSRS scores over a 4-week period, and validation analysis showed expected associations with related constructs such as self-efficacy, neuroticism, chronic stress, and perceived stress. Perceived stress reactivity was also associated with depressive symptoms and sleep. These associations were particularly strong when individuals scoring high on perceived stress reactivity were exposed to chronic stress. In sum, our findings suggest that the PSRS is a useful and easy-to-administer instrument to assess perceived stress reactivity. (Contains 3 figures and 5 tables.)

Background: A common polymorphism in the serotonin transporter gene (SLC6A4, 5HTT) has been repeatedly shown to moderate the influence of childhood adversity and stressful life events on the development of psychopathology. Using data from the English and Romanian Adoptee Study, a prospective-longitudinal study of individuals (n = 125) exposed to severe early institutional deprivation (ID), we tested whether the effect of ID on adolescent emotional problems is moderated by 5HTT genotype and stressful life events in adolescence. Methods: Emotional problems were assessed using questionnaire data (age 11), and on the basis of the CAPA diagnostic interview (age 15). Additionally, the number of stressful life events was measured. Results: There was a significant effect for genotype (p = 0.003) and a gene x environment interaction (p = 0.008) that was independent of age at testing. Carriers of the s/l and s/s genotype who experienced severe ID showed the highest emotional problem scores, while l/l homozygotes in the severe ID group showed the lowest overall levels. Furthermore, s/s carriers in the severe ID group who experienced a high number of stressful life events between 11 and 15 years had the largest increases in emotional problem scores, while a low number of stressful life events was associated with the largest decrease (4-way interaction: p = 0.05). Conclusions: The effects of severe early ID on emotional problems in adolescence are moderated by 5HTT genotype, and influenced by stressful life events in adolescence.

Background: Maternal nutrition during pregnancy has been linked with fetal brain development and psychopathology in the offspring. We examined for associations of maternal folate status and dietary intake during pregnancy with brain growth and childhood behavioural difficulties in the offspring. Methods: In a prospective cohort study, maternal red blood cell folate (RCF) was measured at 14 weeks of pregnancy and total folate intake (TFI) from food and supplements was assessed in early and late pregnancy. The offspring's head circumference and body weight were measured at birth and in infancy, and 100 mothers reported on children's behavioural difficulties at a mean age of 8.75 years using the Strengths and Difficulties Questionnaire. Results: Lower maternal RCF and TFI in early pregnancy were associated with higher childhood hyperactivity (RCF: beta = -0.24; p = 0.013; TFI: beta = -0.24; p = 0.022) and peer problems scores (RCF: beta = -0.28; p = 0.004; TFI: beta = -0.28; p = 0.009) in the offspring. Maternal gestational RCF was positively associated with head circumference at birth (adjusted for gestational age), and mediation analyses showed significant inverse indirect associations of RCF with hyperactivity/inattention and peer problems via fetal brain growth. Adjustment for mother's smoking and drinking alcohol during pregnancy did not change the results. Conclusions: Although the associations are small and residual confounding is possible, our data provide preliminary support for the hypothesis that lower folate status in early pregnancy might impair fetal brain development and affect hyperactivity/inattention and peer problems in childhood.

The authors' previous work and the data reported in the preceding chapters of this monograph provide conclusive evidence of the persistent nature of the negative impact of early severe deprivation. Institutional deprivation, despite the good outcomes for many, was often associated with substantial impairment and disorder across a wide range of psychopathological domains at all follow-up ages. In this chapter, the authors note that the biological concomitants are not confined to deprivation-specific psychological patterns (DSPs) although they apply most strongly to them. The implication is that the non-DSP categories probably include some DSP components that have been excluded because their criteria are too restrictive. They cannot exclude the possibility that there are institutional deprivation effects that operate through some other mediating mechanism, but they have no evidence to indicate that this is likely. (Contains 4 tables and 5 figures.)

The development of conduct and emotional problems involves a complex interplay between environmental and genetic factors. The child-rearing environment contributes to this process. Gross deviations, such as those seen in abusive or neglectful homes, or where the parent has serious mental health problems, have been shown to contribute to the initial onset and persistence of emotional and conduct problems during childhood and adolescence. In this chapter, the authors consider whether, in their sample, conduct, emotional, and peer-relationship problems are in fact truly independent of institutional deprivation. They find that they are not. (Contains 5 tables and 4 figures.)

This monograph is concerned with the mid adolescent follow-up of a group of adoptees from Romania and from within the United Kingdom who were first assessed at the age of 4 years (or 6 years in the case of the oldest children). Chapter I provides the background as it applied at the time that the study began, and then goes on to outline the overall research strategy and the measures relevant for the first assessment at age 4 years. It then goes on to summarize, briefly, some of the key findings from the follow-ups undertaken up to the age of 11 years. In the authors' published papers on the age 4-, 6-, and 11-year assessments, they mainly dealt with findings in relation to key outcome variables. In this monograph, they have adopted a different strategy that capitalizes on the unique features of their study. Their study is the only investigation with detailed interview and observation measures, together with psychometric assessments, spanning a 10-year follow-up period. Most especially, their study is unique in having systematic, standardized measurements of key behavioral patterns that seem to be specific to institutional deprivation. Accordingly, the authors have been able to focus on the crucial issue of the extent to which these patterns account for the deficits and problems that have persisted to age 15 years. In order to do that, it was first necessary both to determine which patterns met criteria for specificity to institutional deprivation and to determine their boundaries. This topic is tackled in Chapter III, after outlining the methods and measures in Chapter II. Chapter IV builds on the authors' prospective data over the course of a decade in order to describe the developmental course of the deprivation-specific psychological patterns (DSPs) defined in Chapter III. To facilitate this, the several apparently DSPs are pooled, having noted the major overlap among them. Chapter V considers disturbances of emotion, conduct and peer relations--that is, the three major domains of psychopathology that, up to age 11 years, appeared "not" to follow a DSPs. Chapter VI takes as its starting point the major catch-up found in cognitive functioning following adoption and goes on to ask how far cognitive findings vary according to specific cognitive function and how far cognitive gains up to age 11 have been translated into meaningful educational attainments at age 15-16 years. Chapter VII reevaluates these findings in the light of the age 15 results and examines the physical growth and maturational effects of institutional deprivation. It considers how far the findings differ according to the presence/absence of institutional deprivation-specific features. Chapter VIII reexamines the issue of possible postadoption environmental mediators, paying attention to key methodological challenges. Throughout their study, there has been abundant evidence of heterogeneity in outcome. Chapter IX seeks to pull together the relevant findings with respect to possible biological moderators and mediators. There is reexamination of the apparently protective role of minimal language skills, of genetic influences on environmental susceptibility, of possible effects of social cognitive features, of the role of subnutrition, and of impaired head growth. Finally, Chapter X provides an overview of the findings at age 15, together with the theoretical and practical implications of these findings. (Contains 48 tables and 21 figures.)

Background: Inverse associations of fetal growth with behavioural problems in childhood have been repeatedly reported, suggesting long-term effects of the prenatal developmental environment on behaviour later in life. However, no study so far has examined effects on temperament and potential developmental pathways. Temperamental traits may be particularly susceptible to neurodevelopmental alterations, and they are linked to behavioural problems. Therefore, we tested for associations of fetal growth with behavioural problems in children and tested if temperament mediated such effects. Methods: One hundred and thirty-nine mother-child pairs were recruited in early pregnancy. Weight, head circumference and gestational age were measured at birth, and the mother reported on their child's behavioural problems and temperament at age 7 to 9 years. Results: Birth weight and head circumference at birth adjusted for gestational age (i.e., fetal growth) were inversely associated with hyperactivity and total behavioural problems, and positively associated with the temperamental trait Effortful Control. Path analyses showed that Effortful Control mediated the effects of fetal growth on hyperactivity and total behavioural problems. Conclusions: Our results suggest that an adverse fetal environment is associated with behavioural problems in childhood, in particular in those children that show a low capacity for attentional and behavioural regulation. An adverse fetal environment might induce vulnerability for behavioural problems, or it might induce changes in temperament and behavioural problems independently, representing a common cause. Pathways are likely to be based on long-lasting neurodevelopmental alterations due to prenatal adversity.

Fiction reading is a popular leisure activity associated with a variety of pleasurable experiences, including suspense, narrative transportation, and—as indicated by recent empirical studies—also flow. In the context of fiction reading, flow—generally defined as a pleasurable state of mind experienced during an optimally stimulating activity—is specifically related to an optimal balance between text‐driven challenges and the reader's capabilities in constructing a mental story model. The experimental study reported here focused on the psychophysiological underpinnings of flow in the reading context. Cardiovascular data were collected from 84 participants both during a relaxation baseline prior to reading and during reading. Participants were randomly assigned to read one of three versions of a chapter from Homer's Odyssey. According to statistical readability indices, these versions were low, intermediate, or high in readability, and hence in cognitive challenge. Flow was measured immediately after reading with a self‐report scale that was tailored to assess reading‐specific flow experiences. Regression analyses revealed that cardiovascular activation patterns measured before reading that are reflective of parasympathetic dominance—that is, an inner state associated with relaxation and cognitive fluency—moderated flow experiences during reading. In line with the stipulations of flow theory in regard to matching challenge levels being the key determinant for flow, this pattern supported subsequent flow experiences only in response to text versions of high or intermediate, but not of low cognitive challenge. Differences in cardiac vagal tone during reading were, however, not sensitive to our experimental modifications and not predictive of flow experiences. [ABSTRACT FROM AUTHOR]

Parents of 165 children adopted from Romania and 52 children adopted from within the United Kingdom rated the success of the adoptions when the children were 11 years old. As was the case at two earlier study waves, satisfaction was found to be extremely high. Both positive and negative assessments were generally stable between ages 6 and 11, although for the children who had more problems there was an increase in negative evaluation, albeit within an overall positive picture. Parents' evaluations were somewhat more negative for this group of children; however, parents reported that having the child as part of their family was very rewarding. Negative evaluation was not directly related to age at placement, but appeared to be a reflection of the later-placed children's higher rates of problem behavior. As found at earlier assessment waves, child factors, in particular conduct problems and inattention or overactivity, were key in predicting parental evaluations at age 11, as were four domains closely associated with institutional deprivation, namely cognitive impairment, quasi-autistic patterns, inattention or overactivity, and disinhibited attachment. The findings emphasize the need for early intervention for children in severely deprived conditions, and for access to postadoption services that target the particular problem behaviors the children may exhibit. Keywords: Romania, adoption, outcome, risk factors DOI: 10.1037/a0017262