Willingness to Expend Effort for Reward and Substance Use Outcomes in Treatment

Individuals in substance use (SU) disorder treatment are attempting to maintain abstinence, but the positive rewards associated with abstinence are uncertain. Understanding how individuals weigh reward probability (RP) and reward magnitude (RM) in decision making is salient for understanding the factors associated with continued abstinence. This study sought to test associations between effort expenditure for reward and SU outcomes among individuals entering outpatient SU treatment, and if SU moderates relationships between effort expenditure from pre-treatment to 3-month follow-up. Participants (N=86) completed the Effort Expenditure for Rewards Task (EEfRT) and the Timeline Followback (TLFB) at baseline and 3-month follow-up assessments. The independent variables in both primary and moderation analyses were proportion of hard choices for low and medium probability of reward. The primary DV was percent of days of any SU at 3-month follow-up, and the DV in moderation analyses was proportion of hard choices on the EEfRT at 3-month follow-up for low and medium probability of reward. Results of hierarchical linear regressions yielded no significant relationships between percent of hard choices at any level of reward probability at baseline and SU frequency at 3-month follow-up. Likewise, the association between effort expenditure for reward at baseline and the 3-month follow-up was not significantly moderated by SU between assessments.Bachelor of Scienc

The relationship between responsive caregiving and child outcomes: evidence from direct observations of mother-child dyads in Pakistan

Abstract Background Responsive caregiving, or interactions in which caregivers give appropriate responses to a child’s signals, is linked to improved psychosocial, cognitive and physical outcomes in children. However, much remains unknown about how responsive caregiving affects child development across cultural and socioeconomic contexts. The purpose of this study is to examine predictors of maternal responsive caregiving and investigate how these interactions are associated with children’s development. Methods Data for the current analyses came from a longitudinal study designed to follow mothers from the third trimester through the first three years of the child’s life. To assess responsive caregiving, the Observation of Mother-Child Interaction (OMCI) measure was used to examine maternal and child behaviors during a 5-min picture book activity at 24 months. Outcomes included child height-for-age z-score and child socioemotional development, using the Ages and Stages Questionnaire-Socioemotional (ASQ-SE) in which lower scores demonstrated better development. Using mean comparisons, the effects of baseline sociodemographic factors and maternal depression on responsive caregiving were tested. Analyses utilized hierarchical linear regressions to examine cross-sectional associations between responsive caregiving and child development outcomes at 24 months. Additional analyses controlled for the Home Observation for Measurement of the Environment (HOME), a common measure in low-income contexts of caregiving, to assess whether OMCI was uniquely predictive of child outcomes. Results Higher maternal education attainment, lower number of children, greater socioeconomic assets, and lack of maternal depression were associated with higher levels of observed responsive caregiving behaviors. Higher total OMCI scores were associated with positive child socioemotional outcomes in adjusted models (β: -0.84, 95% CI [− 1.40, − 0.29]). The finding was statistically significant, even after controlling for HOME score (β: -0.83, 95% CI [− 1.38, − 0.27]). There was no association between OMCI scores and child linear growth. Conclusions Responsive caregiving is linked to positive child socioemotional development in rural Pakistan. Our findings suggest that incorporating responsive caregiving into child health interventions in LMIC may have valuable impacts on child socioemotional development. The OMCI may be useful in identifying important pathways for change to responsive caregiving behaviors and may be of service for future interventions that optimize child development through responsive caregiving. Trial registration NCT02111915 (09/18/2015); NCT02658994 (01/22/2016). Trials were prospectively registered

Maternal adverse childhood experiences on child growth and development in rural Pakistan: An observational cohort study

Maternal adverse childhood experiences (ACEs) have significant impacts on the next generation with links to negative birth outcomes, impaired cognitive development, and increased socioemotional problems in children. However, not all types or levels of adversity are similarly deleterious and research from diverse contexts is needed to better understand why and how intergenerational transmission of adversity occurs. We examined the role of maternal ACEs on children’s growth, cognitive, and socioemotional development at 36 months postpartum in rural Pakistan. We used data from 877 mother-child dyads in the Bachpan Cohort, a birth cohort study. Maternal ACEs were captured using an adapted version of the ACE-International Questionnaire. Outcomes at 36 months of age included child growth using the WHO growth z-scores, fine motor and receptive language development assessed with the Bayley Scales of Infant and Toddler Development, and socioemotional and behavioral development measured with the Ages and Stages Questionnaire: Socioemotional and Strengths and Difficulties Questionnaire. To estimate the associations between maternal ACEs and child outcomes, we used multivariable generalized linear models with inverse probability weights to account for sampling and loss to follow-up. Over half of mothers in our sample (58%) experienced at least one ACE. Emotional abuse, physical abuse, and emotional neglect were the most commonly reported ACEs. We found null relationships between the number of maternal ACEs and child growth. Maternal ACEs were associated with higher fine motor and receptive language development and worse socioemotional and behavioral outcomes. Maternal ACE domains had similarly varying relationships with child outcomes. Our findings highlight the complexity of intergenerational associations between maternal ACEs and children’s growth and development. Further work is necessary to examine these relationships across cultural contexts and identify moderating factors to mitigate potential negative intergenerational effects

Effectiveness of a peer-delivered, psychosocial intervention on maternal depression and child development at 3 years postnatal: a cluster randomised trial in Pakistan

Maternal depression has a recurring course that can influence offspring outcomes. Evidence on how to treat maternal depression to improve longer-term maternal outcomes and reduce intergenerational transmission of psychopathology is scarce, particularly for task-shifted, low-intensity, and scalable psychosocial interventions. We evaluated the effects of a peer-delivered, psychosocial intervention on maternal depression and child development at 3 years postnatal

Effectiveness of a peer-delivered, psychosocial intervention on maternal depression and child development at 3 years of age: a cluster randomized trial in Pakistan

Background Maternal depression has a recurring course that can influence offspring outcomes. Evidence on how to treat maternal depression to improve longer-term maternal outcomes and reduce intergenerational transmission of psychopathology is scarce, particularly for task-shifted, low-intensity, and scalable psychosocial interventions. We evaluated the effects of a peer-delivered, psychosocial intervention on maternal depression and child development at 3 years postnatal. Methods 40 village clusters in Pakistan were randomly allocated using a computerised randomisation sequence to receive a group-based, psychosocial intervention and enhanced usual care for 36 months, or enhanced usual care alone. Pregnant women (≥18 years) were screened for moderate or severe symptoms of depression (patient health questionnaire-9 [PHQ-9] score ≥10) and were recruited into the trial (570 participants), and a cohort without depression (PHQ-9 score <10) was also enrolled (584 participants). Including the non-depressed dyads enabled us to determine how much of the excess risk due to maternal depression exposure the intervention could mitigate. Research teams responsible for identifying, obtaining consent, and recruiting trial participants were blind to the allocation status throughout the duration of the study, and principal investigators, site coordinators, statisticians, and members of the trial steering committee were also blinded to the allocation status until the analysis of 6-month data for the intervention. Primary outcomes were maternal depression symptoms and remission (PHQ-9 score <10) and child socioemotional skills (strengths and difficulties questionnaire [SDQ-TD]) at 36-months postnatal. Analyses were by intention to treat. This trial is registered with ClinicalTrials.gov, NCT02658994. Findings From Oct 15, 2014 to Feb 25, 2016 46 village clusters were assessed for eligibility, of which 40 (including 1910 mothers were enrolled. After exclusions, 288 women were randomly assigned to the enhanced usual care group and 284 to the intervention group, and 1159 women were included in a group without prenatal depression. At 36-months postnatal, complete data were available from 889 mother-child dyads: 206 (72·5%) in the intervention group, 216 (75·3%) in the enhanced usual care group, and 467 (80·0%) women who did not have prenatal-depression. We did not observe significant outcome differences between the intervention group and the enhanced usual care group for the primary outcomes. The standardised mean difference of PHQ-9 total score was −0·13 (95% CI −0·33 to 0·07), relative risk of patient health questionnaire-9 remission was 1·00 (95% CI 0·88 to 1·14), and the SDQ-TD treatment estimate was −0·10 (95% CI −1·39 to 1·19). Interpretation Reduced symptom severity and high remission rates were seen across both the intervention and enhanced usual care groups, possibly masking any effects of the intervention. A multi-year, psychosocial intervention can be task-shifted via peers but might be susceptible to reductions in fidelity and dosage over time (which were not among the outcomes of this trial). Early intervention efforts might need to rely on multiple models (eg, collaborative care), be of greater intensity, and potentially targeted at mothers who are at high risk for depression to reduce the intergenerational transmission of psychopathology from mothers to children. Funding National Institutes of Health

Measurement of Human Stress: A Multidimensional Approach

Stress is a multi-dimensional construct that is comprised of exposure to events, perceptions of stress, and physiological responses to stress. Research consistently demonstrates a strong association between stress and a myriad of physical and mental health concerns, resulting in a pervasive and interdisciplinary agreement on the importance of investigating the relationship between stress and health. Developing a holistic understanding of stress requires assessment of the three domains vital to the study of stress: 1) the presence of environmental stressors, 2) psychological and biological reactions to stressors, and 3) the length of time over which the stressor or stress response occurs. Self-reports allow for subjective evaluations of stress that illuminate the duration and severity of the psychological response to stressors. Biomarkers, in turn, capture a more objective measure of stress and create a deeper understanding of the biological response to chronic and acute stress. Finally, the use of digital biomarkers allows for further exploration of the physiological fluctuations caused by stress by measuring the changes occurring at the same time as the stressor. Future research on stress and health should favor a multi-dimensional approach that creates a triangulated picture of stress, drawing from each of the three aforementioned method groups

Historical development of accelerometry measures and methods for physical activity and sedentary behavior research worldwide: A scoping review of observational studies of adults.

This scoping review identified observational studies of adults that utilized accelerometry to assess physical activity and sedentary behavior. Key elements on accelerometry data collection were abstracted to describe current practices and completeness of reporting. We searched three databases (PubMed, Web of Science, and SPORTDiscus) on June 1, 2021 for articles published up to that date. We included studies of non-institutionalized adults with an analytic sample size of at least 500. The search returned 5686 unique records. After reviewing 1027 full-text publications, we identified and abstracted accelerometry characteristics on 155 unique observational studies (154 cross-sectional/cohort studies and 1 case control study). The countries with the highest number of studies included the United States, the United Kingdom, and Japan. Fewer studies were identified from the continent of Africa. Five of these studies were distributed donor studies, where participants connected their devices to an application and voluntarily shared data with researchers. Data collection occurred between 1999 to 2019. Most studies used one accelerometer (94.2%), but 8 studies (5.2%) used 2 accelerometers and 1 study (0.6%) used 4 accelerometers. Accelerometers were more commonly worn on the hip (48.4%) as compared to the wrist (22.3%), thigh (5.4%), other locations (14.9%), or not reported (9.0%). Overall, 12.7% of the accelerometers collected raw accelerations and 44.6% were worn for 24 hours/day throughout the collection period. The review identified 155 observational studies of adults that collected accelerometry, utilizing a wide range of accelerometer data processing methods. Researchers inconsistently reported key aspects of the process from collection to analysis, which needs addressing to support accurate comparisons across studies

Description of observational studies of adults collecting accelerometry (n = 155).

Description of observational studies of adults collecting accelerometry (n = 155).</p

Description of accelerometer placement and attachment method used by observational studies of adults (n = 166).

Description of accelerometer placement and attachment method used by observational studies of adults (n = 166).</p

Checklist of reporting elements from Montoye et al. [13].

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