The feasibility of daily monitoring in adolescents and young adults with mild intellectual disability or borderline intellectual functioning

BACKGROUND: It is unclear whether the limitations of young persons with a mild intellectual disability or borderline intellectual functioning preclude feasibility of the daily diary method.METHOD: For 60 consecutive days, 50 participants (M age  = 21.4, 56% male) who receive care in an ambulatory, residential, or juvenile detention setting, self-rated both standardised and personalised diary questions through an app. Diary entries were used for feedback in treatment. Interviews were used to explore acceptability. RESULTS: Average compliance was 70.4%, while 26% of participants dropped out. Compliance was good in ambulatory (88.9%) and residential care (75.6%), but not in the juvenile detention setting (19.4%). The content of self-selected diary items varied widely. Participants deemed the method acceptable.CONCLUSIONS: Daily monitoring is feasible for individuals with a mild intellectual disability or borderline intellectual functioning receiving ambulatory or residential care, and can provide scientists and practitioners with important insights into day-to-day behavioural patterns.</p

The Interaction Between Pubertal Timing and Peer Popularity for Boys and Girls: An Integration of Biological and Interpersonal Perspectives on Adolescent Depression

Abstract The transition to adolescence marks a time of sharply increased vulnerability to the development of depression, particularly among girls. Past research has examined isolated risk factors from individual theoretical models (e.g., biological, interpersonal, and cognitive) of depression, but few have examined integrative models. This study investigated the conjoint effects of early pubertal timing and popularity in the longitudinal prediction of depressive symptoms. A total of 319 girls and 294 boys (ages 11-14) provided information on their pubertal status, depressive symptoms, and the social status (i.e., popularity) of their peers. Adolescents completed a second measure of depressive symptoms 11 months after the initial time point. Findings supported an integrated biological-interpersonal model in explaining the development of depressive symptoms during adolescence. Early pubertal development was associated with increase in depressive symptoms only when accompanied by low levels of popularity. High levels of popularity buffered the association between early pubertal development and later depressive symptoms. Unexpectedly, these results were significant both for girls and boys. Results are discussed in terms of dynamic systems theories

Similarities in drinking behavior of twin's friends: moderation of heritability of alcohol use

Previous research has indicated that friends' drinking may influence alcohol use in adolescents and young adults. We explored whether similarities in the drinking behavior of friends of twins influence the genetic architecture of alcohol use in adolescence and young adulthood. Survey data from The Netherlands Twin Register were available for 1,526 twin pairs aged 16-25 years. We categorized the twin pairs as concordant (both report similar alcohol use in their friends) or discordant for the alcohol use of their friends. Genetic moderator models were tested by carrying out multi-group analyzes in Mplus. Findings showed a significant moderation effect. Genetic factors were more and common environment less important in the explanation of variation in alcohol use in twins discordant for alcohol use of friends than in twins concordant for alcohol use of friend

Predictors of problem drinking in adolescence and young adulthood. A longitudinal twin-family study

We examined drinking behavior of parents, siblings, and friends of twins as predictors of adolescent and young adult problem drinking over a period of 2 and a period of 7 years. Data of 12 to 30-year-old twins and their family members from the Netherlands Twin Register were analyzed. Problem drinking in twins was assessed in 1995 and 2000 and was defined based on the CAGE and amount of drinking. Data on alcohol use of parents, siblings and friends were collected in 1993. Multinomial logistic regression analyses were used to examine the short-term (1993-1995; n = 2,994) and the long-term longitudinal predictors (1993-2000; n = 1,796) of problem drinking. Age, sex and own alcohol use in 1993 explained 25% of the variance in adolescent and young adult problem drinking. Moreover, adolescents and young adults with fathers who drank frequently and with a large numbers of drinking friends, were at the highest risk for problem drinking 2 years later. Over a period of 7 years the number of drinking friends was no longer a risk factor, but few times a week or daily alcohol use of fathers remained a risk factor for later problem drinking. Drinking behavior of mother and siblings did not substantially predict problem drinking. Sex and age did not moderate these effect

Targeting young drinkers online: the effectiveness of a web-based brief alcohol intervention in reducing heavy drinking among college students: study protocol of a two-arm parallel group randomized controlled trial

Contains fulltext : 99751.pdf (publisher's version ) (Open Access)Background: The prevalence of heavy drinking among college students and its associated health related consequences highlights an urgent need for alcohol prevention programs targeting 18 to 24 year olds. Nevertheless, current alcohol prevention programs in the Netherlands pay surprisingly little attention to the drinking patterns of this specific age group. The study described in this protocol will test the effectiveness of a web-based brief alcohol intervention that is aimed at reducing alcohol use among heavy drinking college students aged 18 to 24 years old. Methods/Design: The effectiveness of the What Do You Drink web-based brief alcohol intervention will be tested among 908 heavy drinking college students in a two-arm parallel group randomized controlled trial. Participants will be allocated at random to either the experimental (N = 454: web-based brief alcohol intervention) or control condition (N = 454: no intervention). The primary outcome measure will be the percentage of participants who drink within the normative limits of the Dutch National Health Council for low-risk drinking. These limits specify that, for heavy alcohol use, the mean consumption cannot exceed 14 or 21 glasses of standard alcohol units per week for females and males, respectively, while for binge drinking, the consumption cannot exceed five or more glasses of standard alcohol units on one drinking occasion at least once per week within one month and six months after the intervention. Reductions in mean weekly alcohol consumption and frequency of binge drinking are also primary outcome measures. Weekly Ecological Momentary Assessment will measure alcohol-related cognitions, that is, attitudes, self-efficacy, subjective norms and alcohol expectancies, which will be included as the secondary outcome measures. Discussion: This study protocol describes the two-arm parallel group randomized controlled trial developed to evaluate the effectiveness of a web-based brief alcohol intervention. We expect a reduction of mean weekly alcohol consumption and frequency of binge drinking in the experimental condition compared to the control condition as a direct result of the intervention. If the website is effective, it will be implemented in alcohol prevention initiatives, which will facilitate the implementation of the protocol.8 p

The Interaction Between Pubertal Timing and Peer Popularity for Boys and Girls: An Integration of Biological and Interpersonal Perspectives on Adolescent Depression

The transition to adolescence marks a time of sharply increased vulnerability to the development of depression, particularly among girls. Past research has examined isolated risk factors from individual theoretical models (e.g., biological, interpersonal, and cognitive) of depression, but few have examined integrative models. This study investigated the conjoint effects of early pubertal timing and popularity in the longitudinal prediction of depressive symptoms. A total of 319 girls and 294 boys (ages 11–14) provided information on their pubertal status, depressive symptoms, and the social status (i.e., popularity) of their peers. Adolescents completed a second measure of depressive symptoms 11 months after the initial time point. Findings supported an integrated biological-interpersonal model in explaining the development of depressive symptoms during adolescence. Early pubertal development was associated with increase in depressive symptoms only when accompanied by low levels of popularity. High levels of popularity buffered the association between early pubertal development and later depressive symptoms. Unexpectedly, these results were significant both for girls and boys. Results are discussed in terms of dynamic systems theories

DRINKING BY PARENTS, SIBLINGS, AND FRIENDS AS PREDICTORS OF REGULAR ALCOHOL USE IN ADOLESCENTS AND YOUNG ADULTS: A LONGITUDINAL TWIN-FAMILY STUDY

Abstract — Aims: The aim of this study was to examine whether the drinking habits of parents, siblings, and friends were related to regular drinking in adolescents and young adults, cross-sectionally as well as longitudinally. Methods: Data of 12–30-yearold twins from the Netherlands Twin Register were analysed. Information on regular drinking was collected in 1993, 1995, and 2000. Logistic regression analyses were conducted on cross-sectional data of 1993 (N = 3760), short-term longitudinal data of 1993–95 (N = 2919), and the long-term longitudinal data of 1993–2000 (N = 1779). Results: Results show that age, sex, and one’s own previous drinking habits were important predictors of later-life regular drinking. Drinking habits of parents showed small but persistent positive associations. Alcohol use of the co-twin was strongly related to alcohol use of the participants, especially in the cross-sectional analyses, while alcohol use of additional siblings other than the co-twin was relatively unimportant. Cross-sectionally, friends ’ alcohol use showed a high association with regular drinking, but this association decreased over time. Conclusion: Crosssectional analyses showed that a substantial part (29%) of the variance in regular drinking habits of adolescents and young adults was explained by the drinking habits of family members and friends, in particular, by drinking of co-twins and friends. But, over time, drinking by family members and friends could only explain a relatively small part (4–5%) of the variance in adolescents ’ and young adults ’ alcohol use

A complex systems perspective on chronic aggression and self-injury: case study of a woman with mild intellectual disability and borderline personality disorder

Abstract Background Challenging behaviors like aggression and self-injury are dangerous for clients and staff in residential care. These behaviors are not well understood and therefore often labeled as “complex”. Yet it remains vague what this supposed complexity entails at the individual level. This case-study used a three-step mixed-methods analytical strategy, inspired by complex systems theory. First, we construed a holistic summary of relevant factors in her daily life. Second, we described her challenging behavioral trajectory by identifying stable phases. Third, instability and extraordinary events in her environment were evaluated as potential change-inducing mechanisms between different phases. Case presentation A woman, living at a residential facility, diagnosed with mild intellectual disability and borderline personality disorder, who shows a chronic pattern of aggressive and self-injurious incidents. She used ecological momentary assessments to self-rate challenging behaviors daily for 560 days. Conclusions A qualitative summary of caretaker records revealed many internal and environmental factors relevant to her daily life. Her clinician narrowed these down to 11 staff hypothesized risk- and protective factors, such as reliving trauma, experiencing pain, receiving medical care or compliments. Coercive measures increased the chance of challenging behavior the day after and psychological therapy sessions decreased the chance of self-injury the day after. The majority of contemporaneous and lagged associations between these 11 factors and self-reported challenging behaviors were non-significant, indicating that challenging behaviors are not governed by mono-causal if-then relations, speaking to its complex nature. Despite this complexity there were patterns in the temporal ordering of incidents. Aggression and self-injury occurred on respectively 13% and 50% of the 560 days. On this timeline 11 distinct stable phases were identified that alternated between four unique states: high levels of aggression and self-injury, average aggression and self-injury, low aggression and self-injury, and low aggression with high self-injury. Eight out of ten transitions between phases were triggered by extraordinary events in her environment, or preceded by increased fluctuations in her self-ratings, or a combination of these two. Desirable patterns emerged more often and were less easily malleable, indicating that when she experiences bad times, keeping in mind that better times lie ahead is hopeful and realistic

Demographic characteristics and outcome measures at baseline (<i>N = </i>907).

<p><i>Note.</i> All differences between conditions were non-significant (<i>p</i> > 0.05). SD: standard deviation. HBO: Higher Professional Education. ^a Readiness to change alcohol consumption was assessed through one item asking the participants which statement applied best to them. Participants selecting “I want to reduce drinking alcohol within the upcoming six months” or “I want to reduce drinking alcohol within the upcoming month” were considered to be in the contemplation stage of change, meaning that they were willing to reduce their alcohol consumption in the near future. ^b The mean number of glasses of standard alcohol units consumed in the past seven days. ^c The number of days in the past week drinking five or more glasses of standard alcohol units per occasion. ^d Drinking > 14 and > 21 glasses of standard units of alcohol per week for females and males, respectively. One standard alcohol unit represents ten grams of ethanol.</p