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1.
Fam Process ; 59(4): 1672-1689, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-31802491

RESUMO

Family-level conflict and cohesion are well-established predictors of adolescent mental health. However, traditional approaches focusing on between-family differences in cohesion and conflict may overlook daily intrafamily variability that might provide important new information. We used data from a 21-day daily diary protocol in a sample of 151 caregivers (95.3% female) and their adolescent child (61.5% female) in two-caregiver families to test whether daily changes in family functioning are associated with daily changes in adolescent well-being and whether adolescent well-being depends on average levels of family functioning. We examined family cohesion and conflict in relation to adolescent angry, depressed, and anxious mood, as well as happiness, life satisfaction, and meaning and purpose in life in multilevel models. Both cohesion and conflict exhibited meaningful daily variation. Adolescent-reported cohesion and conflict had unique within-family associations with all six adolescent outcomes. Models using parent reports of family functioning yielded fewer associations than models with adolescent reports; however, several findings remained. Cross-level interactions indicated that within-family variations in cohesion were only associated with adolescent depression in families with lower average levels of cohesion across days. In sum, this study provides compelling evidence that families exhibit meaningful variability from day to day and that daily variation has important implications for adolescent well-being.


El conflicto y la cohesión a nivel familiar son predictores bien establecidos de la salud mental adolescente. Sin embargo, los enfoques tradicionales que se centran en diferencias interfamiliares en la cohesión y el conflicto pueden pasar por alto la variabilidad intrafamiliar diaria que podría proporcionar información importante y nueva. Utilizamos datos de un protocolo de registro diario de 21 días en una muestra de 151 cuidadores (el 95.3 % de sexo femenino) y su hijo adolescente (el 61.5% de sexo femenino) en familias de dos cuidadores para evaluar si los cambios diarios en el funcionamiento familiar están asociados con los cambios diarios en el bienestar de los adolescentes, y si el bienestar de los adolescentes depende de los niveles promedio de funcionamiento familiar. Analizamos la cohesión y el conflicto familiar en relación con los estados de ánimo de enojo, depresión y ansiedad así como de felicidad, satisfacción con la vida, y significado y propósito en la vida en modelos multinivel. Tanto la cohesión como el conflicto demostraron una variación diaria significativa. La cohesión y el conflicto informados por los adolescentes tuvieron asociaciones únicas dentro de las familias con los seis resultados de los adolescentes. Los modelos que utilizaron informes de los padres del funcionamiento familiar indicaron menos asociaciones que los modelos con informes de los adolescentes, sin embargo, quedaron varios hallazgos. Las interacciones a nivel transversal indicaron que las variaciones en la cohesión intrafamiliar estuvieron solamente asociadas con la depresión de los adolescentes en las familias con niveles promedio más bajos de cohesión a lo largo de los días. En resumen, este estudio ofrece pruebas convincentes de que las familias demuestran una variabilidad significativa día a día y de que la variación diaria tiene importantes implicancias para el bienestar de los adolescentes.


Assuntos
Comportamento do Adolescente/psicologia , Afeto , Conflito Familiar/psicologia , Relações Familiares/psicologia , Saúde Mental , Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multinível
2.
Nicotine Tob Res ; 22(3): 408-414, 2020 03 16.
Artigo em Inglês | MEDLINE | ID: mdl-30452739

RESUMO

INTRODUCTION: Network theories of psychopathology highlight that, rather than being indicators of a latent disorder, symptoms of disorders can causally interact with one another in a network. This study examined tobacco withdrawal from a network perspective. METHODS: Participants (n = 525, 50.67% female) completed the Minnesota Tobacco Withdrawal Scale four times (2 weeks prior to a target quit day, on the target quit day, and 4 and 8 weeks after the target quit day) over the course of 8 weeks of treatment with nicotine patch and behavioral counseling within a randomized clinical trial testing long-term nicotine patch therapy in treatment-seeking smokers. The conditional dependence among seven withdrawal symptoms was estimated at each of the four measurement occasions. Influential symptoms of withdrawal were identified using centrality indices. Changes in network structure were examined using the Network Comparison Test. RESULTS: Findings indicated many associations among the individual symptoms of withdrawal. The strongest associations that emerged were between sleep problems and restlessness, and associations among affective symptoms. Restlessness and affective symptoms emerged as the most central symptoms in the withdrawal networks. Minimal differences in the structure of the withdrawal networks emerged across time. CONCLUSIONS: The cooccurrence of withdrawal symptoms may result from interactions among symptoms of withdrawal rather than simply reflecting passive indicators of a latent disorder. Findings encourage greater consideration of individual withdrawal symptoms and their potential interactions and may be used to generate hypotheses that may be tested in future intensive longitudinal studies. IMPLICATIONS: This study provides a novel, network perspective on tobacco withdrawal. Drawing on network theories of psychopathology, we suggest that the cooccurrence of withdrawal symptoms may result from interactions among symptoms of withdrawal over time, rather than simply reflecting passive indicators of a latent disorder. Results indicating many associations among individual symptoms of withdrawal are consistent with a network perspective. Other results of interest include minimal changes in the network structure of withdrawal across four measurement occasions prior to and during treatment with nicotine patch and behavioral counseling.


Assuntos
Terapia Comportamental/métodos , Nicotina/administração & dosagem , Fumantes/psicologia , Abandono do Hábito de Fumar/métodos , Rede Social , Síndrome de Abstinência a Substâncias/prevenção & controle , Dispositivos para o Abandono do Uso de Tabaco , Adolescente , Adulto , Terapia Combinada , Redes Comunitárias , Aconselhamento , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Minnesota , Síndrome de Abstinência a Substâncias/psicologia , Tabagismo/psicologia , Adulto Jovem
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