Showing papers by "Lilly Shanahan published in 2023"
TL;DR: In this article , the authors examined the correlation between self-reported and hair toxicology and the prevalence of illicit and non-medical substance use in a large urban cohort study of young adults.
Abstract: Large-scale epidemiological research often uses self-reports to determine the prevalence of illicit substance use. Self-reports may suffer from inaccurate reporting but can be verified with objective measures. This study examined the following: the prevalence of illicit and non-medical substance use with self-reports and hair toxicology, the convergence of self-reported and objectively quantified substance use, and the correlates of under- and overreporting.The data came from a large urban cohort study of young adults (n = 1,002, mean age = 20.6 years, 50% female). The participants provided 3 cm of hair (covering the previous 3 months) and reported their illicit and non-medical substance use and their sociodemographic, psychological, and behavioral characteristics. Hair toxicology analyses targeted cannabinoids, ketamine, opiates/opioids, stimulants including 3,4-methylenedioxymethamphetamine, and relevant metabolites.Self-reports underestimated the prevalence of most substances by 30% to 60% compared to hair tests. The average detection ratio (hair test/self-report) was 1.50. Hair tests were typically more sensitive than self-reports. Underreporting was associated with a low level of that substance in hair. Self-reported delinquency and psychopathology were correlated with an increased likelihood of concordant positive self-reports and hair tests compared to underreporting. Overreporting was associated with infrequent self-reported use.Our study suggests that self-reports underestimate young adults' exposure to illicit substances and non-medical use of prescription drugs. Consequently, estimates of associations between substance use and risk factors or outcomes are likely biased. Combining self-reports with hair tests may be most beneficial in study samples with occasional substance use. Researchers can use specific factors (eg, detection ratios) to adjust prevalence estimates and correlations based on self-reports.
6 citations
TL;DR: For example, this article found that approximately 19-35% of young adults reported better well-being in the first few months of the COVID-19 pandemic than before, while the worst aspects included disruptions and changes to daily life; social distancing and restrictions of freedoms; negative emotions that arose in the pandemic situation, including uncertainty about the future; and the growing polarization of society.
Abstract: Historic declines in young people's mental health began to emerge before the COVID-19 pandemic. In the face of this youth mental health crisis, the pandemic constituted a naturalistic stressor paradigm that came with the potential to uncover new knowledge for the science of risk and resilience. Surprisingly, approximately 19-35% of people reported better well-being in the first few months of the COVID-19 pandemic than before. Therefore, in May and September 2020, we asked N=517 young adults from a cohort study to describe the best and the worst aspects of their pandemic lives (N=1,462 descriptions). Inductive thematic analysis revealed that the best aspects included the deceleration of life and a greater abundance of free time, which was used for hobbies, healthy activities, strengthening relationships, and for personal growth and building resilience skills. Positive aspects also included a reduction in educational pressures and work load and temporary relief from climate change concerns. The worst aspects included disruptions and changes to daily life; social distancing and restrictions of freedoms; negative emotions that arose in the pandemic situation, including uncertainty about the future; and the growing polarization of society. Science that aims to reverse the youth mental health crisis must pay increased attention to sources of young people's distress that are not commonly measured (e.g., their educational, work, and time pressures; their fears and uncertainties about their personal, society's, and the global future), and also to previously untapped sources of well-being - including those that young people identified for themselves while facing the COVID-19 pandemic.The online version contains supplementary material available at 10.1007/s42844-023-00096-y.
1 citations
TL;DR: In this paper , structural equation modeling was used to evaluate hypothesized relationships among observed and latent variables, and then regressed Wave V (2016-2018) suicidality, heavy drinking, marijuana use, prescription drug misuse, and illicit drug use on latent despair.
Abstract: Despite considerable scientific interest in documenting growing despair among U.S. adults, far less attention has been paid to defining despair and identifying appropriate measures. Emerging perspectives from social science and psychiatry outline a comprehensive, multidimensional view of despair, inclusive of individuals’ cognitive, emotional, biological and somatic, and behavioral circumstances. The current study assesses the structure and plausibility of this framework based on longitudinal data spanning early to middle adulthood. We identified 40 measures of different dimensions of despair in Wave IV (2008–2009) of the National Longitudinal Study of Adult to Adolescent Health (n = 9149). We used structural equation modeling to evaluate hypothesized relationships among observed and latent variables; we then regressed Wave V (2016–2018) suicidality, heavy drinking, marijuana use, prescription drug misuse, and illicit drug use on latent despair. Our analyses find that models for separate dimensions of despair and overall despair demonstrated excellent fit. Overall despair was a significant predictor of Wave V outcomes, especially suicidality, accounting for 20% of its variation, as compared to 1%–7% of the variation in substance use. Suicidality was consistently associated with all domains of despair; behavioral despair explained the most variation in substance use. Given these results we contend that, lacking direct measures, latent despair can be modeled using available survey items; however, some items are likely better indicators of latent dimensions of despair than others. Moreover, the association between despair and key health behaviors varies considerably, challenging its status as a mechanism simultaneously underlying increased substance use and suicide mortality in the United States. Critically, further validation of measures in other surveys can improve the operationalization of despair and its associated conceptual and theoretical frameworks, thus advancing our understanding of this concept.
1 citations
TL;DR: In this paper , the authors used a mobile app to gather positive prospective mental imagery (PPMIs) generated by young adults during the COVID-19 pandemic and analyzed content, characteristics, and associations with depressive symptoms.
Abstract: Positive prospective mental imagery plays an important role in mental well-being, and depressive symptoms have been associated with difficulties in generating positive prospective mental images (PPMIs). We used a mobile app to gather PPMIs generated by young adults during the COVID-19 pandemic and analyzed content, characteristics, and associations with depressive symptoms.This is a secondary analysis of a randomized controlled trial with 95 healthy young adults allocated into two groups (intervention and control). Participants used the mobile app decreasing mental health symptoms for seven consecutive days. Fifty participants in the intervention group reported PPMIs at least three times per day using a mobile app inducing PPMI generation. We categorized entries into themes and applied moderation models to investigate associations between PPMI characteristics and depressive symptoms.We distinguished 25 PPMI themes. The most frequent were related to consuming food and drinks, watching TV/streaming platforms, and doing sports. Vividness and ease of generation of PPMIs, but not their anticipation, pleasure intensity or number of engagements with the app were associated with fewer depressive symptoms.We identified PPMI themes in young adults and found significant negative associations between depressive symptoms and vividness and generation ease of PPMIs. These results may inform prevention and intervention science, including the design of personalized interventions. We discuss implications for future studies and treatment development for individuals experiencing diminished PPMI.The online version contains supplementary material available at 10.1007/s10608-023-10378-5.
1 citations
TL;DR: In this article , the impact of parental supervision on their children's income two decades later adjusting for parental economic and educational status was found to be positively associated with children's household income at age 35.
Abstract: Importance Upward income mobility is associated with better health outcomes and reduced stress. However, opportunities are unequally distributed, particularly so for those in rural communities and whose family have lower educational attainment. Objective To test the impact of parental supervision on their children’s income two decades later adjusting for parental economic and educational status. Design This study is a longitudinal, representative cohort study. From 1993–2000, annual assessments of 1,420 children were completed until age 16, then followed up at age 35, 2018–2021, for further assessment. Models tested direct effects of parental supervision on child income, and indirect effects via child educational attainment. Setting This study is an ongoing longitudinal population-based study of families in 11 predominately rural counties of the Southeastern U.S. Participants About 8% of the residents and sample are African American and fewer than 1% are Hispanic. American Indians make up 4% of the population in study but were oversampled to make up 25% of the sample. 49% of the 1,420 participants are female. Main outcomes and measures 1258 children and parents were assessed for sex, race/ethnicity, household income, parent educational attainment, family structure, child behavioral problems, and parental supervision. The children were followed up at age 35 to assess their household income and educational attainment. Results Parental educational attainment, income, and family structure were strongly associated with their children’s household income at age 35 (e.g., r = .392, p < .05). Parental supervision of the child was associated with increased household income for the child at age 35, adjusting for SES of the family of origin. Children of parents who did not engage in adequate supervision earned approximately $14,000 less/year (i.e., ~13% of the sample’s median household income) than those who did. The association of parental supervision and child income at 35 was mediated by the child’s educational attainment. Conclusion and relevance This study suggests adequate parental supervision during early adolescence is associated with children’s economic prospects two decades later, in part by improving their educational prospects. This is particularly important in areas such as rural Southeast U.S.
TL;DR: In this article , the authors examined early adolescent predictors of later distress and adaptive coping in early adulthood, using data from a prospective longitudinal cohort study (n = 786) and found that early adolescent internalizing symptoms predicted lower well-being, more hopelessness, and perceived lifestyle disruptions in early adolescence, during the first COVID-19-related Swiss national lockdown.
Abstract: We examined early adolescent predictors of later distress and adaptive coping in early adulthood, using data from a prospective longitudinal cohort study (n = 786). In early adolescence (age 13), we assessed indicators of mental health (internalizing symptoms), stressor exposure (cumulative stressful life events), and family socialization (supportive parent–child interactions). In early adulthood (age 22), during the first COVID-19-related Swiss national lockdown, we assessed cumulative pandemic-related stressors, distress (poor well-being, hopelessness, and perceived disruptions to life) and adaptive coping. Early adolescent internalizing symptoms predicted lower well-being, more hopelessness, and perceived lifestyle disruptions in early adulthood, during the pandemic. Cumulative stressful life events during early adolescence moderated the association between cumulative pandemic-related stressors and perceived lifestyle disruptions. Supportive parent–child interactions fostered subsequent engagement in adaptive coping, which, in turn, predicted less hopelessness and better well-being. Findings reveal that early adolescent development is linked with distress and adaptive coping in later periods.
TL;DR: In this article , the authors examined longitudinal links between several dimensions of parent-child relationship and adolescent substance use, and tested the role of self-control in mediating these, finding that aversive parenting, low child disclosure, low positive parenting, and low parental involvement at age 11 predicted substance use at different stages of adolescence.
Abstract: Abstract This study examined longitudinal links between several dimensions of parent–child relationship and adolescent substance use, and tested the role of self-control in mediating these. Data came from the Zurich Project on the Social Development from Childhood to Adulthood. Validated questionnaires were used to measure parent–child domains at age 11, self-control at age 13, and substance use at ages 13, 15, 17, and 20. Low positive parenting and parental supervision, as well as aversive parenting, correlated with substance use. Linear regression model revealed that aversive parenting, low child disclosure, low positive parenting, and low parental involvement at age 11 predicted substance use at different stages of adolescence. These associations were mediated by low self-control at age 13. Involving parents and increasing their knowledge about desirable parental practices and ways to help their children to develop adequate self-control could be an effective element in substance use prevention strategies.
TL;DR: A randomized controlled trial that aims to recruit 354 breast cancer survivors from the inpatient and outpatient oncology departments in public and private hospitals in Sindh, Hyderabad, Lahore, Multan, and Rawalpindi in Pakistan is presented in this article .
Abstract: Objective: The diagnosis and treatment of breast cancer is associated with significant distress that has huge impact on survivors’ quality of life. The objective of this study is to assess the effectiveness of an integrated intervention “Moving on After Breast Cancer (ABC) Plus culturally adapted Cognitive Behavior Therapy” (Moving on ABC Plus). Method: This is a randomized controlled trial that aims to recruit 354 breast cancer survivors from the inpatient and outpatient oncology departments in public and private hospitals in Karachi, Hyderabad, Lahore, Multan, and Rawalpindi in Pakistan. Patients scoring 10 or above on either the Patient Health Questionnaire—9 and/or the Generalized Anxiety Disorder scale (GAD-7) will be recruited. Baseline assessments will include Functional Assessment of Cancer Therapy—Breast; EuroQol-5D; Multidimensional Scale for Perceived Social Support; Intrusive Thoughts Scale; and Rosenberg Self-Esteem Scale. Participants randomized into intervention arm, Moving on ABC Plus, will receive 12 individual therapy sessions over 4 months. Follow-up will be completed at 4- and 6-month post-randomization, using all baseline instruments along with the Client Satisfaction Questionnaire (CSQ-8). We will also explore the participants’, their family members’, and the therapists’ experiences of the trial and intervention. Results: We will be assessing the effectiveness of intervention in reducing depression and anxiety in breast cancer survivors as a primary outcome of the trial. The secondary outcomes will include effectiveness of intervention in terms of reduction in intrusive thoughts and improvement in health-related quality of life, self-esteem, and perceived social support. Conclusion: The results of the study will inform the design of a future larger randomized control trial with long-term follow-up.