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The New England Journal of Medicine Jan 2023Limited prospective outcome data exist regarding transgender and nonbinary youth receiving gender-affirming hormones (GAH; testosterone or estradiol). (Observational Study)
Observational Study
BACKGROUND
Limited prospective outcome data exist regarding transgender and nonbinary youth receiving gender-affirming hormones (GAH; testosterone or estradiol).
METHODS
We characterized the longitudinal course of psychosocial functioning during the 2 years after GAH initiation in a prospective cohort of transgender and nonbinary youth in the United States. Participants were enrolled in a four-site prospective, observational study of physical and psychosocial outcomes. Participants completed the Transgender Congruence Scale, the Beck Depression Inventory-II, the Revised Children's Manifest Anxiety Scale (Second Edition), and the Positive Affect and Life Satisfaction measures from the NIH (National Institutes of Health) Toolbox Emotion Battery at baseline and at 6, 12, 18, and 24 months after GAH initiation. We used latent growth curve modeling to examine individual trajectories of appearance congruence, depression, anxiety, positive affect, and life satisfaction over a period of 2 years. We also examined how initial levels of and rates of change in appearance congruence correlated with those of each psychosocial outcome.
RESULTS
A total of 315 transgender and nonbinary participants 12 to 20 years of age (mean [±SD], 16±1.9) were enrolled in the study. A total of 190 participants (60.3%) were transmasculine (i.e., persons designated female at birth who identify along the masculine spectrum), 185 (58.7%) were non-Latinx or non-Latine White, and 25 (7.9%) had received previous pubertal suppression treatment. During the study period, appearance congruence, positive affect, and life satisfaction increased, and depression and anxiety symptoms decreased. Increases in appearance congruence were associated with concurrent increases in positive affect and life satisfaction and decreases in depression and anxiety symptoms. The most common adverse event was suicidal ideation (in 11 participants [3.5%]); death by suicide occurred in 2 participants.
CONCLUSIONS
In this 2-year study involving transgender and nonbinary youth, GAH improved appearance congruence and psychosocial functioning. (Funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development.).
Topics: Adolescent; Child; Female; Humans; Gender Identity; Prospective Studies; Psychosocial Functioning; Testosterone; Transgender Persons; Estradiol; Gonadal Steroid Hormones; Young Adult; Male
PubMed: 36652355
DOI: 10.1056/NEJMoa2206297 -
Developmental Psychology Jan 2023In this article, the author initially highlights three broad goals for her time as Editor-in-Chief at the journal. In addition, she introduces herself so that readers...
In this article, the author initially highlights three broad goals for her time as Editor-in-Chief at the journal. In addition, she introduces herself so that readers can get a sense of the point of view, and biases, that she brings to the position of Editor. It is her hope that her successor will be able to build on the journal's work to create an even stronger legacy for and Developmental Psychology. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
PubMed: 36603117
DOI: 10.1037/dev0001511 -
International Journal of Nursing Studies Jun 2023Up to one third of all stroke patients suffer from one or more psychosocial impairments. Recognition and treatment of these impairments are essential in improving...
BACKGROUND
Up to one third of all stroke patients suffer from one or more psychosocial impairments. Recognition and treatment of these impairments are essential in improving psychosocial well-being after stroke. Although nurses are ideally positioned to address psychosocial well-being, they often feel insecure about providing the needed psychosocial care. Therefore, we expect that providing nurses with better knowledge to deliver this care could lead to an improvement in psychosocial well-being after stroke. Currently it is not known which interventions are effective and what aspects of these interventions are most effective to improve psychosocial well-being after stroke.
OBJECTIVE
To identify potentially effective interventions - and intervention components - which can be delivered by nurses to improve patients' psychosocial well-being after stroke.
METHODS
A systematic review and data synthesis of randomized controlled trials and quasi experimental studies was conducted. Papers were included according to the following criteria: 1) before-after design, 2) all types of stroke patients, 3) interventions that can be delivered by nurses, 4) the primary outcome(s) were psychosocial. PubMed, Embase, PsychInfo, CINAHL and Cochrane library were searched (August 2019-April 2022). Articles were selected based on title, abstract, full text and quality. Quality was assessed by using Joanna Briggs Institute checklists and a standardized data extraction form developed by Joanna Brigss Institute was used to extract the data.
RESULTS
In total 60 studies were included, of which 52 randomized controlled trials, three non-randomized controlled trials, four quasi-experimental studies, and one randomized cross-over study. Nineteen studies had a clear psychosocial content, twenty-nine a partly psychosocial content, and twelve no psychosocial content. Thirty-nine interventions that showed positive effects on psychosocial well-being after stroke were identified. Effective intervention topics were found to be mood, recovery, coping, emotions, consequences/problems after stroke, values and needs, risk factors and secondary prevention, self-management, and medication management. Active information and physical exercise were identified as effective methods of delivery.
DISCUSSION
The results suggest that interventions to improve psychosocial well-being should include the intervention topics and methods of delivery that were identified as effective. Since effectiveness of the intervention can depend on the interaction of intervention components, these interactions should be studied. Nurses and patients should be involved in the development of such interventions to ensure it can be used by nurses and will help improve patients' psychosocial well-being.
FUNDING AND REGISTRATION
This study was supported by the Taskforce for Applied Research SIA (RAAK.PUB04.010). This review was not registered.
Topics: Humans; Randomized Controlled Trials as Topic; Stroke; Psychosocial Functioning; Treatment Outcome
PubMed: 37084476
DOI: 10.1016/j.ijnurstu.2023.104492 -
Frontiers in Psychiatry 2022
PubMed: 36699494
DOI: 10.3389/fpsyt.2022.1130118 -
New Directions For Child and Adolescent... Jul 2020
Topics: Adolescent; Adolescent Development; Child; Child Development; Humans; Periodicals as Topic; Psychology, Developmental; Research Design
PubMed: 33017093
DOI: 10.1002/cad.20373 -
Annual Review of Psychology Jan 2021Social groups are a pervasive feature of human life. One factor that is often understudied in the literature on person perception and social categorization is language.... (Review)
Review
Social groups are a pervasive feature of human life. One factor that is often understudied in the literature on person perception and social categorization is language. Yet, someone's language (and accent) provides a tremendous amount of social information to a listener. Disciplines across the social and behavioral sciences-ranging from linguistics to anthropology to economics-have exposed the social significance of language. Less social psychological research has historically focused on language as a vehicle for social grouping. Yet, new approaches in psychology are reversing this trend. This article first reviews evidence, primarily from psycholinguistics, documenting how speech provides social information. Next it turns to developmental psychology, showing how young humans begin to see others' language as conveying social group information. It then explores how the tendency to see language as a social cue has vast implications for people's psychological processes (e.g., psychological essentialism and trust) and also for society, including education and the law.
Topics: Cues; Humans; Language; Social Perception; Speech Perception
PubMed: 33400567
DOI: 10.1146/annurev-psych-010418-103034 -
JAMA Surgery Nov 2020Young women with breast cancer are increasingly choosing bilateral mastectomy (BM), yet little is known about short-term and long-term physical and psychosocial...
IMPORTANCE
Young women with breast cancer are increasingly choosing bilateral mastectomy (BM), yet little is known about short-term and long-term physical and psychosocial well-being following surgery in this population.
OBJECTIVE
To evaluate the differential associations of surgery with quality of life (QOL) and psychosocial outcomes from 1 to 5 years following diagnosis.
DESIGN, SETTING, AND PARTICIPANTS
Cohort study.
SETTING
Multicenter, including academic and community hospitals in North America.
PARTICIPANTS
Women age ≤40 when diagnosed with Stage 0-3 with unilateral breast cancer between 2006 and 2016 who had surgery and completed QOL and psychosocial assessments.
EXPOSURES (FOR OBSERVATIONAL STUDIES)
Primary breast surgery including breast-conserving surgery (BCS), unilateral mastectomy (UM), and BM.
MAIN OUTCOMES AND MEASURES
Physical functioning, body image, sexual health, anxiety and depressive symptoms were assessed in follow-up.
RESULTS
Of 826 women, mean age at diagnosis was 36.1 years; most women were White non-Hispanic (86.7%). Regarding surgery, 45% had BM, 31% BCS, and 24% UM. Of women who had BM/UM, 84% had reconstruction. While physical functioning, sexuality, and body image improved over time, sexuality and body image were consistently worse (higher adjusted mean scores) among women who had BM vs BCS (body image: year 1, 1.32 vs 0.64; P < .001; year 5, 1.19 vs 0.48; P < .001; sexuality: year 1, 1.66 vs 1.20, P < .001; year 5, 1.43 vs 0.96; P < .001) or UM (body image: year 1, 1.32 vs 1.15; P = .06; year 5, 1.19 vs 0.96; P = .02; sexuality: year 1, 1.66 vs 1.41; P = .02; year 5, 1.43 vs 1.09; P = .002). Anxiety improved across groups, but adjusted mean scores remained higher among women who had BM vs BCS/UM at 1 year (BM, 7.75 vs BCS, 6.94; P = .005; BM, 7.75 vs UM, 6.58; P = .005), 2 years (BM, 7.47 vs BCS, 6.18; P < .001; BM, 7.47 vs UM, 6.07; P < .001) and 5 years (BM, 6.67 vs BCS, 5.91; P = .05; BM, 6.67 vs UM, 5.79; P = .05). There were minimal between-group differences in depression levels in follow-up.
CONCLUSIONS AND RELEVANCE
While QOL improves over time, young breast cancer survivors who undergo more extensive surgery have worse body image, sexual health, and anxiety compared with women undergoing less extensive surgery. Ensuring young women are aware of the short-term and long-term effects of surgery and receive support when making surgical decisions is warranted.
Topics: Adult; Age Factors; Anxiety; Body Image; Breast Neoplasms; Cancer Survivors; Cohort Studies; Depression; Female; Humans; Mastectomy; Psychosocial Functioning; Quality of Life
PubMed: 32936216
DOI: 10.1001/jamasurg.2020.3325 -
JAMA Pediatrics Dec 2021Hybrid closed-loop (HCL) therapy has improved glycemic control in children and adolescents with type 1 diabetes; however, the efficacy of HCL on glycemic and... (Randomized Controlled Trial)
Randomized Controlled Trial
IMPORTANCE
Hybrid closed-loop (HCL) therapy has improved glycemic control in children and adolescents with type 1 diabetes; however, the efficacy of HCL on glycemic and psychosocial outcomes has not yet been established in a long-term randomized clinical trial.
OBJECTIVE
To determine the percentage of time spent in the target glucose range using HCL vs current conventional therapies of continuous subcutaneous insulin infusion or multiple daily insulin injections with or without continuous glucose monitoring (CGM).
DESIGN, SETTING, AND PARTICIPANTS
This 6-month, multicenter, randomized clinical trial included 172 children and adolescents with type 1 diabetes; patients were recruited between April 18, 2017, and October 4, 2019, in Australia. Data were analyzed from July 25, 2020, to February 26, 2021.
INTERVENTIONS
Eligible participants were randomly assigned to either the control group for conventional therapy (continuous subcutaneous insulin infusion or multiple daily insulin injections with or without CGM) or the intervention group for HCL therapy.
MAIN OUTCOMES AND MEASURES
The primary outcome was the percentage of time in range (TIR) within a glucose range of 70 to 180 mg/dL, measured by 3-week masked CGM collected at the end of the study in both groups. Secondary outcomes included CGM metrics for hypoglycemia, hyperglycemia, and glycemic variability and psychosocial measures collected by validated questionnaires.
RESULTS
A total of 135 patients (mean [SD] age, 15.3 [3.1] years; 76 girls [56%]) were included, with 68 randomized to the control group and 67 to the HCL group. Patients had a mean (SD) diabetes duration of 7.7 (4.3) years and mean hemoglobin A1c of 64 (11) mmol/mol, with 110 participants (81%) receiving continuous subcutaneous insulin infusion and 72 (53%) receiving CGM. In the intention-to-treat analyses, TIR increased from a mean (SD) of 53.1% (13.0%) at baseline to 62.5% (12.0%) at the end of the study in the HCL group and from 54.6% (12.5%) to 56.1% (12.2%) in the control group, with a mean adjusted difference between the 2 groups of 6.7% (95% CI, 2.7%-10.8%; P = .002). Hybrid closed-loop therapy also reduced the time that patients spent in a hypoglycemic (<70 mg/dL) range (difference, -1.9%; 95% CI, -2.5% to -1.3%) and improved glycemic variability (coefficient of variation difference, -5.7%; 95% CI, -10.2% to -0.9%). Hybrid closed-loop therapy was associated with improved diabetes-specific quality of life (difference, 4.4 points; 95% CI, 0.4-8.4 points), with no change in diabetes distress. There were no episodes of severe hypoglycemia or diabetic ketoacidosis in either group.
CONCLUSIONS AND RELEVANCE
In this randomized clinical trial, 6 months of HCL therapy significantly improved glycemic control and quality of life compared with conventional therapy in children and adolescents with type 1 diabetes.
TRIAL REGISTRATION
ANZCTR identifier: ACTRN12616000753459.
Topics: Adolescent; Child; Diabetes Mellitus, Type 1; Female; Glycemic Control; Humans; Male; Outcome Assessment, Health Care; Psychosocial Functioning
PubMed: 34633418
DOI: 10.1001/jamapediatrics.2021.3965 -
PsyCh Journal Aug 2022In recent decades, life history theory (LHT) has provided an important theoretical framework for understanding human individual differences and their developmental... (Review)
Review
In recent decades, life history theory (LHT) has provided an important theoretical framework for understanding human individual differences and their developmental processes. The conceptual complexity and multidisciplinary connections involved in the LH research, however, might appear daunting to psychologists whose research might otherwise benefit from the LH perspective. The main purpose of this review, therefore, is to introduce the evolutionary biological backgrounds and basic principles of LHT as well as their applications in developmental psychology. This review is organized into five parts, starting with an overview of key concepts in LHT, which clarifies the relationship among LH strategy, LH-related traits, and the fast-slow paradigm of LH variation. We proceed to review theoretical and empirical work related to four basic LH trade-offs, summarized by an integrated descriptive model of LH trade-offs that shape different LH strategies in humans. We then explain the effects of four aspects of environmental risks (morbidity-mortality threats, competition, resource scarcity, and unpredictability) on human LH strategy. This is followed by a discussion of LH calibration models in evolutionary developmental psychology that explicates the environmentally sensitive developmental processes that contribute to variation and plasticity in LH-related traits and ultimately human LH strategies. Finally, we highlight a few outstanding questions and future directions for LH research in psychology and conclude with why we think it is important that developmental psychology should embrace the LH approach.
Topics: Biological Evolution; Humans; Life History Traits; Psychology, Developmental
PubMed: 35599317
DOI: 10.1002/pchj.561 -
Current Issues in Personality Psychology 2023From Bill Kessen's idea of the child as a "cultural invention" (Kessen, 1983) it follows that developmental psychology cannot function fruitfully without historical... (Review)
Review
From Bill Kessen's idea of the child as a "cultural invention" (Kessen, 1983) it follows that developmental psychology cannot function fruitfully without historical analysis. Developmentalists should stop "positivistic dreaming" and develop a historical developmental psychology. The history of childhood shows how a historical process of infantilization has taken place since Rousseau and the 19th century pedagogical and educational theories and institutions. In the 20th century a new process of de-infantilization took place, caused mainly by the modern mass media (Postman, 1982). It is demonstrated how this led to the "disappearance of childhood". Babies no longer were considered and studied as "empty-headed" (William James' conception of the baby experiencing "one great blooming, buzzing confusion"): impressive new research methods and data "filled the baby's brain" and made the baby much more human than ever before in history. With the narrowing of the gap between childhood and adulthood adolescence as a bridge is less necessary than before. Not only the disappearance of childhood is going on; at the same time there is a correlated disappearance of adolescence. The conclusion must be that the study of cognitive, social and personality development should take into consideration the cultural historical embeddedness.
PubMed: 38013941
DOI: 10.5114/cipp/159600