We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.
To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure no-reply@cambridge.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
The COVID-19 pandemic has disproportionately affected women's mental health. However, most evidence has focused on mental illbeing outcomes, and there is little evidence on the mechanisms underlying this unequal impact.
Aims
To investigate gender differences in the long-term trajectories of life satisfaction, how these were affected during the pandemic and the role of time-use differences in explaining gender inequalities.
Method
We used data from 6766 (56.2% women) members of the 1970 British Cohort Study (BCS70). Life satisfaction was prospectively assessed between the ages of 26 (1996) and 51 (2021) years, using a single question with responses ranging from 0 (lowest) to 10 (highest). We analysed life satisfaction trajectories with piecewise latent growth curve models, and investigated whether gender differences in the change in the life satisfaction trajectories with the pandemic were explained by self-reported time spent doing different paid and unpaid activities.
Results
Women had consistently higher life satisfaction than men before the pandemic (Δintercept,unadjusted = 0.213, 95% CI 0.087–0.340; P = 0.001) and experienced a more accelerated decline with the pandemic onset (Δquad2,unadjusted = −0.018, 95% CI −0.026 to −0.011; P < 0.001). Time-use differences did not account for the more accelerated decrease in women's life satisfaction levels with the pandemic (Δquad2,adjusted = −0.016, 95% CI −0.031 to −0.001; P = 0.035).
Conclusions
Our study shows pronounced gender inequalities in the impact of the pandemic on the long-term life satisfaction trajectories of adults in their 50s, with women losing their pre-pandemic advantage over men. Self-reported time-use differences did not account for these inequalities. More research is needed to tackle gender inequalities in population mental health.
Public health data available for research are booming with the expansion of Big Data. This reshapes the data sources for DOHaD enquiries while offering ample opportunities to advance epidemiological modelling within the DOHaD framework. However, Big Data also raises a plethora of methodological challenges related to accurately characterising population health trajectories and biological mechanisms, within heterogeneous and dynamic sociodemographic contexts, and a fast-moving technological landscape. In this chapter, we explore the methodological challenges of research into the causal mechanisms of the transgenerational transfer of disease risks that characterise the DOHaD research landscape and consider these challenges in the light of novel technologies within artificial intelligence (AI) and Big Data. Such technologies could push further the collating of multidimensional data, including electronic health records and tissue banks, to offer new insights. While such methodological and technological innovations may drive clearer and reproducible evidence within DOHaD research, as we argue, many challenges remain, including data quality, interpretability, generalisability, and ethics.
This cross-sectional study employs structural equation modelling (sEM) to explore both direct and indirect effects of parental level of education and child individual factors on the length-for-age outcomes in children aged 6–24 months assisted by the Bolsa Família Program in the State of Alagoas. A total of 1448 children were analysed by the sEM technique. A negative standardised direct effect (sDE) of the children’s younger age (sDE: −0·06; P = 0·017), the use of bottle feeding (sDE: −0·11; P < 0·001) and lack of a minimum acceptable diet (sDE: −0·09; P < 0·001) on the length-for-age indicator was found. Being female (SDE: 0·08; P = 0·001), a higher birth weight (SDE: 0·33; P < 0·001), being ever breastfed (sdE: 0·07; P = 0·004) and a higher level of parental education (SDE: 0·09; P < 0·001) showed a positive SDE effect on the child’s length-for-age. The model also demonstrated a negative standardised indirect effect (SIE) of the sweet beverage consumption (SIE: −0·08; P = 0·003) and a positive effect of being ever breastfed (SIE: 0·06; P = 0·017) on the child’s length-for-age through parental level of education as a mediator. This research underscores the crucial role of proper feeding practices and provides valuable insights for the development of targeted interventions, policies and programmes to improve nutritional well-being and promote adequate linear growth and development among young children facing similar challenges.
Global views of the police (often termed “legitimacy”, “trust”, “satisfaction” or “support”) are frequently regarded as the product of micro-level, police-related consideration: beliefs about what the police are doing and how they are doing it. Studies taking a sociological or political perspective have revealed that views unrelated to policing, such as satisfaction with the government, may also be important predictors of global views of the police. However, police-related and non-police-related considerations are frequently not considered together as antecedents of macro-level views of the police. This study aims to illuminate the respective roles of police-related versus non-police-related considerations in shaping citizens’ diffused support for the police while utilizing the context of the COVID-19 pandemic. Data from a panel survey carried out during the first and third peaks of the pandemic in Israel reveal that the only factor which had a direct effect on the drop in diffused support for the police was the public’s assessment of the government’s (not the police’s) performance in handling the pandemic. We conclude by calling for more sophisticated measurement and interpretation of public approval of the police and its antecedents.
There is substantial variation in patient symptoms following psychological therapy for depression and anxiety. However, reliance on endpoint outcomes ignores additional interindividual variation during therapy. Knowing a patient's likely symptom trajectories could guide clinical decisions. We aimed to identify latent classes of patients with similar symptom trajectories over the course of psychological therapy and explore associations between baseline variables and trajectory class.
Methods
Patients received high-intensity psychological treatment for common mental health problems at National Health Service Improving Access to Psychological Therapies services in South London (N = 16 258). To identify trajectories, we performed growth mixture modelling of depression and anxiety symptoms over 11 sessions. We then ran multinomial regressions to identify baseline variables associated with trajectory class membership.
Results
Trajectories of depression and anxiety symptoms were highly similar and best modelled by four classes. Three classes started with moderate-severe symptoms and showed (1) no change, (2) gradual improvement, and (3) fast improvement. A final class (4) showed initially mild symptoms and minimal improvement. Within the moderate-severe baseline symptom classes, patients in the two showing improvement as opposed to no change tended not to be prescribed psychotropic medication or report a disability and were in employment. Patients showing fast improvement additionally reported lower baseline functional impairment on average.
Conclusions
Multiple trajectory classes of depression and anxiety symptoms were associated with baseline characteristics. Identifying the most likely trajectory for a patient at the start of treatment could inform decisions about the suitability and continuation of therapy, ultimately improving patient outcomes.
Randomised controlled trials are often inappropriate for many forms of preventative children’s services; as such, observational studies using administrative data can be valuable for evidence-based policymaking. However, estimates of effectiveness can be confounded by differences in thresholds of intervention and national policies that exert pressure on local trends. This study adjusted for these factors using methods developed in clinical psychology to control for individual traits and developmental trajectories, Autoregressive Latent Trajectory Models with Structured Residuals, to analyse the relationship between local authority preventative spending and Children in Need (CIN) rates in England. Higher spending was associated with significant decreases in CIN rates between 2010/11 and 2014/15, but not from 2014/15 onwards. In the first half of the decade, 1% increases in expenditure were associated with between 0.07% and 0.157% decreases in CIN rates. Based on average local authority spending cuts, this translates to an additional 13,000 to 16,500 children and young people put or kept at risk of developmental or health impairments nationally for each year between 2011 and 2015. These findings highlight the potential of early help/family support policies and concerns around how their effectiveness has changed consequent to prolonged austerity and a deliberate policy focus on ‘what works’.
Low self-esteem (LSE) has been associated with several psychiatric disorders, and is presumably influenced by transdiagnostic factors. Our study was based both on investigations of the relationship between depression and LSE (vulnerability, scar, reciprocal models) and on theories of cognitive factors contributing to the development and maintenance of LSE, such as Melanie Fennell’s model, the catalyst model and the Self-Regulatory Executive Function model.
Aims:
Based on the theories above, in our cross-sectional study we aimed at understanding more specifically the transdiagnostic factors that can maintain LSE in a heterogeneous clinical sample.
Method:
Six hundred and eleven out-patients were assessed by SCID-I and self-report questionnaires. The model was tested by structural equation modelling.
Results:
Based on the fit indices, the hypothesis model did not fit the data; therefore, a modified transdiagnostic model was emerged. This model made a good fit to the data [χ2 (12, n=611)=76.471, p<.001; RMSEA=.080, CFI=.950, TLI=.913] with a strong explanatory power (adj R2=.636). Severe stressful life events and depressive symptoms lead to LSE indirectly. Self-blame, perfectionism, seeking love and hopelessness have been identified as mediating factors in the relationship between depressive symptoms and LSE. Although there was a significant correlation between state-anxiety and LSE, as well as LSE and rumination, these two factors did not fit into the model.
Conclusions:
The new transdiagnostic model of LSE has great potential in the treatment of various mental conditions and may serve as a guide to developing more focused and more effective therapeutic interventions.
Psychological models of posttraumatic stress disorder (PTSD) and prolonged grief disorder (PGD) make predictions about the role of unhelpful coping strategies in maintaining difficulties by blocking self-correction of negative appraisals and memory integration following stressful life events like bereavement. However, few studies have tested these predictions directly.
Method
We used counterfactually based causal mediation to assess whether unhelpful coping strategies mediated the relationship between (1) loss-related memory characteristics and/or (2) negative grief-related appraisals and symptoms of PGD, PTSD and depression using a three-wave longitudinal sample (N = 275). Appraisals and memory characteristics were measured at time point 1, unhelpful coping strategies at T2, and symptom variables at T3. Additionally, multiple mediation analyses within a structural equation modelling (SEM) framework assessed which types of coping strategies differentially mediated symptoms of PGD, PTSD and depression.
Results
Coping strategies mediated the relationship between negative appraisals and memory characteristics and symptoms of PGD, PTSD and depression after adjusting for demographics and loss characteristics. Sensitivity analyses suggested that these results were most robust for PGD, followed by PTSD and then depression. Multiple mediation analyses suggested that all four subscales (avoidance, proximity seeking, loss rumination and injustice rumination) individually mediated the effect of memory characteristics and appraisals on PGD.
Conclusions
These results suggest that core predictions of the cognitive model for PTSD and the cognitive behavioural model of PGD are useful in predicting symptoms of post-loss mental health problems in the first 12–18 months after loss. Targeting unhelpful coping strategies is likely to reduce symptoms of PGD, PTSD and depression.
Social inequality is ubiquitous in contemporary human societies, and has deleterious social and ecological impacts. However, the factors that shape the emergence and maintenance of inequality remain widely debated. Here we conduct a global analysis of pathways to inequality by comparing 408 non-industrial societies in the anthropological record (described largely between 1860 and 1960) that vary in degree of inequality. We apply structural equation modelling to open-access environmental and ethnographic data and explore two alternative models varying in the links among factors proposed by prior literature, including environmental conditions, resource intensification, wealth transmission, population size and a well-documented form of inequality: social class hierarchies. We found support for a model in which the probability of social class hierarchies is associated directly with increases in population size, the propensity to use intensive agriculture and domesticated large mammals, unigeniture inheritance of real property and hereditary political succession. We suggest that influence of environmental variables on inequality is mediated by measures of resource intensification, which, in turn, may influence inequality directly or indirectly via effects on wealth transmission variables. Overall, we conclude that in our analysis a complex network of effects are associated with social class hierarchies.
Wildlife reintroduction projects often face resistance from local residents who see potential conflicts with the species or lack trust or confidence in the agencies and professionals involved in reintroduction. Yet the linkages between trust, confidence, risk perceptions, attitudes towards the species and local support for its reintroduction are not well known. The Dual-Mode Model of Cooperation and Cognitive Hierarchy Model were theoretical frameworks used to shed light on these linkages by exploring the potential roles trust and confidence play as mediators between risk perceptions and attitudes towards, and support for, reintroduced elk in Tennessee (USA). A mail survey of 1005 residents living in the five-county area surrounding the North Cumberland Elk Restoration Zone assessed resident attitudes and risk perceptions towards the reintroduced elk, trust towards the managing wildlife agency and support for continued conservation efforts. A structural equation model revealed that trust and confidence play positive roles in mitigating risk perceptions and improving support for the reintroduction of elk. The findings confirm the roles public trust and confidence play in wildlife reintroductions and should help agencies work towards building local trust and confidence, minimizing risks, improving attitudes and increasing the chances for successful outcomes for the species and people.
To determine the temporal directionality of the association between food insecurity and maternal depression.
Design:
Food insecurity was measured at two time points using the eighteen-item USDA Food Security Scale. Maternal depression was measured at two time points using the fifteen-item Composite International Diagnostic Interview-Short Form. Two structural equation models were utilised to evaluate the impact of food insecurity on maternal depression (model 1) and the impact of maternal depression on food insecurity (model 2). Both models controlled for socio-demographic and parenting characteristics and child behaviour problems, along with prior measures of the dependent variable and concurrent measures of the independent variable.
Setting:
Fragile Families and Child Wellbeing (FFCW) study, twenty cities across the USA.
Participants:
4897 mothers who participated in two waves of the FFCW study.
Results:
On average, 17 % (time 1) and 15 % (time 2) of mothers experienced food insecurity and 21 % (time 1) and 17 % (time 2) of mothers experienced depression over time. Maternal depression at time 1 was associated with 53 % increased odds (OR = 1·53; B = 0·43; P < 0·001) of food insecurity at time 2, controlling for time 1 food insecurity, concurrent depression and covariates. Food insecurity at time 1 was associated with 36 % increased odds (OR = 1·36; B = 0·31; P < 0·001) of maternal depression at time 2, controlling for time 1 depression, concurrent food insecurity and covariates.
Conclusions:
We found a bidirectional relationship between food insecurity and maternal depression. A holistic approach that combines food assistance and mental health services may be an efficacious approach to reducing both depressive symptoms and food insecurity among low-income mothers.
Few studies are focused on sugar consumption around the first 1000 d of life. Thus, this work modelled the pathways linking the consumption of sugary drinks in pregnancy and maternal pre-gestational BMI to early child’s exposure to products with high sugar content and to BMI z-score in the second year of life.
Design:
BRISA cohort, São Luís, Brazil was used from the baseline to the follow-up at the second year of life.
Setting:
A theoretical model was constructed to analyse associations between variables from prenatal period (socio-economic status, age, frequency of sugary drinks consumption during pregnancy and pre-gestational BMI), birth weight, exclusive breast-feeding and two outcomes: higher calories from products with added sugar as a percentage of the total daily energy intake and BMI z-score at follow-up at the first 2 years of life, using structural equation modelling.
Participants:
Data of pregnant women (n 1136) and their offspring.
Results:
Higher pre-gestational BMI (standardised coefficient (SC) = 0·100; P = 0·008) and higher frequency of sugary drinks consumption during pregnancy (SC = 0·134; P < 0·001) resulted in high percentage of daily calories from products with added sugar in the second year of child, although no yet effect was observed on offspring weight at that time.
Conclusions:
Maternal obesity and sugary drinks consumption in pregnancy increased the risk of early exposure (before to 2 years) and high exposure of child to added sugar, showing perpetuation of the unhealthy dietary behaviours in the first 1000 d of life.
Cardiac rehabilitation (CR) is a multi-disciplinary intervention designed to stabilise, slow, or reverse CVD, restore health following a cardiac event and facilitate the prevention of further events. The Model of Therapeutic Engagement (MTE) is a comprehensive conceptual model for explaining the process of engagement in rehabilitation. Of concern is that the role of socio-environmental factors is absent from explaining individual engagement in the MTE. There is also a lack of prospective studies investigating the impact of socio-environmental barriers on engagement in CR programs over time. This study aimed to expand the MTE, by illuminating the role of socio-environmental barriers in a three-stage process of engagement in CR programs. A prospective study was conducted, with 217 individuals recruited from the Cardiology Ward in the Gold Coast University Hospital (GCUH) and the Robina Cardiac Rehabilitation Centre. The collected data were examined using a structural equation model that added socio-environmental factors into the MTE, using multi-group analyses. In this study, we found that socio-environmental factors were not associated with intention to engage in the CR program, but were related to actual attendance and maintenance of participation in CR programs. Knowing how these socio-environmental barriers affect the process of engagement at different stages may help to tailor more accessible CR programs for the population.
Maladaptive perfectionism and controlled motivation are vulnerability factors for burnout. This study examined the relationships between two aspects of perfectionism (high standards, discrepancy), four academic motivational orientations (intrinsic, identified, introjected, extrinsic), and academic burnout. The target population was 12th graders in South Korea, and a total of 950 participants were recruited using cluster sampling. Data were collected from three waves of longitudinal study. In particular, the mediating role of academic motivation (T2) in the link between perfectionism (T1) and academic burnout (T3) was tested using structural equation modelling. The results indicated that introjected motivation mediated the relationship between perfectionism and burnout. Specifically, both high standards and discrepancy were positively associated with introjected motivation, and in turn, introjected motivation was positively associated with burnout. The theoretical and practical implications of these findings are discussed.
The quality of life (QOL) of patients with schizophrenia has been found to be positively correlated with the social network and empowerment, and negatively correlated with stigma and depression. However, little is known about the way these variables impact on the QOL. The study aims to test the hypothesis that the social network, stigma and empowerment directly and indirectly by contributing to depression influence the QOL in patients with schizophrenia and schizoaffective disorders.
Method:
Data were collected on demographic and clinical variables, internalized stigma, perceived devaluation and discrimination, empowerment, control convictions, depression and QOL. Structural equation modelling (SEM) was applied to examine the impact of the above-mentioned constructs on QOL.
Results:
The influences of the social network, stigma, empowerment and depression on QOL were supported by the SEM. A poor social network contributed to a lack of empowerment and stigma, which resulted in depression and, in turn, in poor QOL. Interestingly, however, the social network and stigma did not show a direct effect on QOL.
Conclusions:
Following a recovery approach in mental health services by focusing on the improvement of the social network, stigma reduction and especially on the development of personal strength has the potential to reduce depression in patients with psychosis and improving their QOL.
Researchers tried to explain the overlap between anxiety and depression by suggesting that some items of self-administered questionnaires were badly selected and that both constructs should rather be considered as multidimensional. Thus, we hypothesise that the Spielberger trait anxiety inventory (TAI) includes items related to depression.
Method
A non-clinical sample of 193 subjects filled out the TAI and the Hospitalised Anxiety–Depression Scale. Factors were postulated on the basis of item content and submitted to confirmatory factor analysis (CFA).
Results
We found five factors: a 10-item anxiety factor containing three factors, a four-item unsuccessfulness factor correlated with the HADS anhedonia factor, and a six-item happiness factor.
Conclusion
The TAI scale encompasses measures of anxiety, depression and well-being. Consequently, the overlap with other measures of depression may result from item selection. This work awaits replication in independent normal and pathological samples.
Subjective age (SA) is a core indicator of the individual ageing experience, with important consequences for successful ageing. The aim of the current study was to investigate the directions of the longitudinal associations between domains of SA and subjective wellbeing and physical functioning in the second half of life. We used three-wave survey data (2002, 2007 and 2017) spanning 15 years from the Norwegian Lifecourse, Ageing and Generation Study, including 6,292 persons born between 1922 and 1961. SA was measured with felt-age and ideal-age discrepancies, wellbeing with the Satisfaction of Life Scale and physical functioning with the Short-Form 12. Three-wave cross-lagged panel models were applied to assess the temporal relationships between the different domains of SA, life satisfaction and physical functioning, adjusted for age, gender and education. Findings indicated that wanting to be younger was negatively associated with life satisfaction and physical functioning over time. Felt-age discrepancies did not predict subsequent wellbeing or physical functioning. The results did not reveal any evidence for reversed effects, i.e. from functioning or life satisfaction to SA. Our findings support the psychological pathway from satisfaction with age(ing) to subjective wellbeing and physical functioning over time. Small ideal-age discrepancies reflect positive self-perceptions of ageing, which may help to accumulate psychological resources, guide behavioural regulation and support health.
The study investigated working memory, executive functions (conceptualized as response inhibition, updating, and shifting), and intelligence in schizophrenia, using structural equation modelling to determine the relationship between working memory and intelligence, testing whether specific executive functions act as a mediator for the association.
Method:
One hundred and twenty-five individuals diagnosed with schizophrenia and 64 healthy participants were included in the study, tested using measures of working memory, intelligence and executive functioning. Structural equation modelling (SEM) was used to estimate direct and indirect associations between main measures.
Results:
The schizophrenia group had significantly lower working memory, executive function and intelligence than the healthy group. The relationship between working memory and intelligence was significantly mediated by inhibition, updating and shifting functions.
Conclusion:
The study indicates a mediating role of executive functions in determining the association between working memory and intellectual function in schizophrenia. It is further proposed that in people with schizophrenia, cognitive remediation approaches targeting working memory through executive functioning may in turn improve intellectual function generally.
Pervez Ghauri, University of Birmingham,Kjell Grønhaug, Norwegian School of Economics and Business Administration, Bergen-Sandviken,Roger Strange, University of Sussex
A huge array of statistical methods are available to the researcher, of variable levels of sophistication, and a comprehensive survey would be well beyond the scope of this textbook. Here we outline three methods which are widely used in business studies research, namely factor analysis, structural equation modelling, and event study analysis. In each case, we explain the key elements of each method, the underlying intuition, and how to interpret the results, and then provide an example from the business literature.
Pervez Ghauri, University of Birmingham,Kjell Grønhaug, Norwegian School of Economics and Business Administration, Bergen-Sandviken,Roger Strange, University of Sussex
A huge array of statistical methods are available to the researcher, of variable levels of sophistication, and a comprehensive survey would be well beyond the scope of this textbook. Here we outline three methods which are widely used in business studies research, namely factor analysis, structural equation modelling, and event study analysis. In each case, we explain the key elements of each method, the underlying intuition, and how to interpret the results, and then provide an example from the business literature.