Criterion validity of the Short Mood and Feelings Questionnaire and one- and two-item depression screens in young adolescents

<p>Abstract</p> <p>Background</p> <p>The use of short screening questionnaires may be a promising option for identifying children at risk for depression in a community setting. The objective of this study was to assess the validity of the Short Mood and Feelings Questionnaire (SMFQ) and one- and two-item screening instruments for depressive disorders in a school-based sample of young adolescents.</p> <p>Methods</p> <p>Participants were 521 sixth-grade students attending public middle schools. Child and parent versions of the SMFQ were administered to evaluate the child's depressive symptoms. The presence of any depressive disorder during the previous month was assessed using the Diagnostic Interview Schedule for Children (DISC) as the criterion standard. First, we assessed the diagnostic accuracy of child, parent, and combined scores of the full 13-item SMFQ by calculating the area under the receiver operating characteristic curve (AUC), sensitivity and specificity. The same approach was then used to evaluate the accuracy of a two-item scale consisting of only depressed mood and anhedonia items, and a single depressed mood item.</p> <p>Results</p> <p>The combined child + parent SMFQ score showed the highest accuracy (AUC = 0.86). Diagnostic accuracy was lower for child (AUC = 0.73) and parent (AUC = 0.74) SMFQ versions. Corresponding versions of one- and two-item screens had lower AUC estimates, but the combined versions of the brief screens each still showed moderate accuracy. Furthermore, child and combined versions of the two-item screen demonstrated higher sensitivity (although lower specificity) than either the one-item screen or the full SMFQ.</p> <p>Conclusions</p> <p>Under conditions where parents accompany children to screening settings (e.g. primary care), use of a child + parent version of the SMFQ is recommended. However, when parents are not available, and the cost of a false positive result is minimal, then a one- or two-item screen may be useful for initial identification of at-risk youth.</p

Brief motivational interventions for college student drinking may not be as powerful as we think: An individual participant-level data meta-analysis

Background For over two decades, brief motivational interventions (BMIs) have been implemented on college campuses to reduce heavy drinking and related negative consequences. Such interventions include in-person motivational interviews (MIs), often incorporating personalized feedback (PF), and stand-alone PF interventions delivered via mail, computer, or the Web. Both narrative and meta-analytic reviews using aggregate data from published studies suggest at least short-term efficacy of BMIs, although overall effect sizes have been small. Method The present study was an individual participant-level data (IPD) meta-analysis of 17 randomized clinical trials evaluating BMIs. Unlike typical meta-analysis based on summary data, IPD meta-analysis allows for an analysis that correctly accommodates the sampling, sample characteristics, and distributions of the pooled data. In particular, highly skewed distributions with many zeroes are typical for drinking outcomes, but have not been adequately accounted for in existing studies. Data are from Project INTEGRATE, one of the largest IPD meta-analysis projects to date in alcohol intervention research, representing 6,713 individuals each with two to five repeated measures up to 12 months post-baseline. Results We used Bayesian multilevel over-dispersed Poisson hurdle models to estimate intervention effects on drinks per week and peak drinking, and Gaussian models for alcohol problems. Estimates of overall intervention effects were very small and not statistically significant for any of the outcomes. We further conducted post hoc comparisons of three intervention types (Individual MI with PF, PF only, and Group MI) vs. control. There was a small, statistically significant reduction in alcohol problems among participants who received an individual MI with PF. Short-term and long-term results were similar. Conclusions The present study questions the efficacy and magnitude of effects of BMIs for college drinking prevention and intervention and suggests a need for the development of more effective intervention strategies

Causal Models for Mediation Analysis: An Introduction to Structural Mean Models

<div><p>Mediation analyses are critical to understanding why behavioral interventions work. To yield a causal interpretation, common mediation approaches must make an assumption of “sequential ignorability.” The current article describes an alternative approach to causal mediation called structural mean models (SMMs). A specific SMM called a rank-preserving model (RPM) is introduced in the context of an applied example. Particular attention is given to the assumptions of both approaches to mediation. Applying both mediation approaches to the college student drinking data yield notable differences in the magnitude of effects. Simulated examples reveal instances in which the traditional approach can yield strongly biased results, whereas the RPM approach remains unbiased in these cases. At the same time, the RPM approach has its own assumptions that must be met for correct inference, such as the existence of a covariate that strongly moderates the effect of the intervention on the mediator and no unmeasured confounders that also serve as a moderator of the effect of the intervention or the mediator on the outcome. The RPM approach to mediation offers an alternative way to perform mediation analysis when there may be unmeasured confounders.</p></div

E‐cigarette use is associated with subsequent cigarette use among young adult non‐smokers, over and above a range of antecedent risk factors: a propensity score analysis

Background and AimsThere is a public health concern that the use of e‐cigarettes among non‐smoking young adults could be associated with transition to combustible cigarette use. The current study is a quasi‐experimental test of the relationship between e‐cigarette use and subsequent combustible cigarette use among young adult non‐smokers, accounting for a wide range of common risk factors.DesignLogistic regression was used to predict combustible cigarette use on three or more occasions at age 23 years based on age 21 e‐cigarette use. Inverse probability weighting (IPW) was used to account for confounding variables.SettingData were drawn from the Community Youth Development Study (CYDS), a cohort study of youth recruited in 2003 in 24 rural communities in seven US. statesParticipantsYouth in the CYDS study (n = 4407) were surveyed annually from ages 11 to 16, and at ages 18, 19, 21 and 23 years (in 2016). The sample was gender balanced (50% female) and ethnically diverse (20% Hispanic, 64% white, 3% black and 12% other race or ethnicity). The current study was limited to participants who had never used combustible cigarettes by age 21 (n = 1825).MeasurementsAge 21 use of e‐cigarettes and age 23 use of combustible cigarettes (three or more occasions) were included in the regression analysis. Age 11–19 measures of 22 common predictors of both e‐cigarette and combustible cigarette use (e.g. pro‐cigarette attitudes, peer smoking, family monitoring) were used to create IPWs.FindingsAfter applying IPW, e‐cigarette use at age 21 was associated with a twofold increase in odds of combustible cigarette use on three or more occasions 2 years later (odds ratio = 2.16, confidence interval 1.23, 3.79).ConclusionsAmong previously never‐smoking US young adults, e‐cigarette use appears to be strongly associated with subsequent combustible cigarette smoking, over and above measured preexisting risk factors.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/167475/1/add15317.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/167475/2/add15317_am.pd

Suicide-related behavior and firearm access among perpetrators of domestic violence subject to domestic violence protection orders

Perpetrators of domestic violence (DV) may be a population at elevated risk of suicide. Domestic violence protection orders (DVPOs) can include the removal of firearms from the individual subjected to the order (i.e., the respondent) to protect the victim-survivor. While removal of firearms in a DVPO is designed to protect the victim-survivor; it may also prevent suicide of the respondent by reducing access to lethal means. Therefore, we examined the association of respondent suicide-related behaviors with firearm possession and weapon use in DV among a sample of granted DVPO petitions in King County, Washington (WA), United States from 2014 to 2020 (n = 2,537). We compared prevalence ratios (PR) of respondent firearm possession and use of firearms or weapons to threaten or harm by suicide-related behavior. Overall, respondent suicide-related behavior was commonly reported by petitioners (46 %). Approximately 30 % of respondents possessed firearms. This was similar between respondents with and without a history of suicide-related behavior (PR: 1.03; 95 % CI: 0.91–1.17). Respondents with a history of suicide-related behavior were 1.33 times more likely to have used firearms or weapons to threaten/harm in DV compared to those without a history of suicide-related behavior (44.1 % vs. 33.8 %; 95 % CI: 1.20–1.47). In conclusion, both firearm possession and suicide-related behaviors were common among DVPO respondents. History of suicide-related behavior may be a marker for firearm-related harm to the victim-survivor. Evaluations of DVPO firearm dispossession should consider both firearm-related injury of the victim-survivor and suicide of the respondent