AIMS:Little is known about how different aspects of social relationships relate to diabetes self-management and glycaemic outcomes in young adults with type 1 diabetes (T1D). We examined relationships of general and diabetes-specific social variables with diabetes self-management and HbA1c. We hypothesized diabetes-specific factors would more strongly associate with self-management and HbA1c than general social factors. METHODS:We analysed baseline data from 100 young adults with T1D (Mage = 19.9 ± 1.3 years) enrolled in a randomized controlled trial of a paediatric to adult care transition intervention. We examined associations of self-reported general and diabetes-specific social factors with self-reported self-management behaviours and HbA1c in 4 separate multiple regression models. Models controlled for demographic and medical variables with significant bivariate correlations. RESULTS:In the general social factor models, the only significant predictor of self-management behaviours was general emotional support (Β = 0.208); there were no significant predictors associated with HbA1c. In the diabetes-specific social factor models, getting help with diabetes (Β = 0.37) and pandemic-related diabetes support (Β = -0.33) significantly predicted self-management behaviours and getting help with diabetes (Β = -0.26) and diabetes disclosure/social support (Β = 0.24) significantly predicted HbA1c. CONCLUSIONS:Diabetes-specific social support is important for medical and behavioural diabetes outcomes in young adults with T1D during this transitional period. Preparation for transfer may benefit from assisting young adults in seeking direct help with diabetes management from family and friends. More research is needed on how to help young adults acquire practical diabetes support to enhance clinical care.

Objective: Emerging adults with chronic medical conditions (CMCs) are at elevated risk for internalizing (i.e., anxious/depressive) symptoms. Previous research shows illness-related stigma contributes to risk, and illness uncertainty is also associated with poorer adjustment. However, potential indirect effects of these factors have not been examined. Participants: College students (n = 564; 77.0% White, 80.5% female, Mage = 19.57) with a self-reported CMC were recruited from August 2017 to July 2021. Methods: Participants completed measures of illness-related stigma (SS-R), illness uncertainty (MUIS-C), and anxious/depressive symptoms (SAS/CES-D). Results: There were significant correlations between all measures (ps < .001). Illness uncertainty mediated illness-related stigma's impact on internalizing symptoms with a direct path between illness-related stigma and internalizing symptoms remaining significant in the overall model (ps < .001). Conclusions: Findings suggest illness uncertainty helps explain the relationship between illness-related stigma/internalizing symptoms for emerging adults with a CMC, providing additional context for this population's risk.

•Describes methods and protocol of mHealth intervention for self-management in adolescents with IBD.•Provides description of ways to reduce health care barriers to self-management intervention utilizing technology.•Adolescents may prefer mobile health apps for intervention dissemination.

Background: Chronic migraines result in debilitating pain requiring complex and multifaceted daily management, including acting purposefully to attenuate symptoms and decrease impairment. Experiencing migraines may be more psychologically challenging for adolescent and young adult (AYA) women due to complex and recurrent stressors.Purpose: This study examined the relationships between illness specific cognitive appraisal mechanisms (i.e., illness uncertainty and illness intrusiveness) and psychological adjustment (i.e., anxious and depressive symptoms) in AYA women with self-reported chronic migraines.Methods: AYA women (N = 74, M-age = 20.19, SD = 3.41) with chronic migraines completed measures of illness uncertainty, illness intrusiveness, anxious, and depressive symptoms.Results: Two hierarchical regression analyses indicated that illness uncertainty (B = .44, p < .001) and intrusiveness (B = .27, p = .026) significantly predicted anxious, F(4, 68) = 12.83, p < .001, and depressive symptoms, F(4, 68) = 8.48, p < .001, B = .31, p = .021 and B = .27, p = .037.Discussion: Greater illness uncertainty and illness intrusiveness were associated with greater anxious and depressive symptoms. Thus, it may be that AYA women who experience chronic migraines have increased perceptions of ambiguity, unpredictability, and disruption to their life that significantly contribute to their psychological adjustment outcomes.Translation to Health Education Practice: This study demonstrates a need for health education on the role of illness related cognitive appraisal mechanisms for AYA women with chronic migraines.

BackgroundClinical disease activity associated with inflammatory bowel disease (IBD) can place physical limitations on youths' activities of daily living. In turn, functional limitations potentially contribute to youths' heightened experience of IBD-induced intrusions on a wide range of routine and valued activities (i.e., illness intrusiveness), which can increase their risk for depressive symptoms. The present study examined the contributions of clinical disease activity, functional disability, and illness intrusiveness to depressive symptoms in youth with IBD.MethodsYouth (N = 180) completed the Functional Disability Inventory (FDI), Illness Intrusiveness Scale-Child (IIS-C), and Children's Depression Inventory-2 (CDI-2). Physicians completed the Physicians Global Assessment of disease activity (PGA).ResultsResults revealed a mediating effect for functional disability in the association between disease activity and depressive symptoms (PGA -> FDI -> CDI-2); illness intrusiveness mediated the association between functional disability and depressive symptoms (i.e., FDI -> IIS-C -> CDI-2). Serial mediation revealed that clinical disease activity conferred an indirect effect on youth depressive symptoms through the sequential effects of functional disability and illness intrusiveness (i.e., PGA -> FDI -> IIS-C -> CDI-2).ConclusionsTaken together, these findings indicate that youth who encounter more physical limitations as a function of clinical disease activity are more likely to experience an amplified sense of IBD-related intrusions on their ability to participate in meaningful activities. In turn, heightened illness intrusiveness increases the likelihood of depressive symptoms. Clinical interventions that help youth maintain adequate functional ability in the face of IBD disease activity and encourage involvement in positively valued activities could decrease the negative impact of IBD on youths' emotional adjustment. What is Known Youth with IBD often exhibit significant depressive symptoms that are not entirely explained by clinical disease activity. IBD-induced intrusions into routine functioning are associated with youth depressive symptoms.What is New Our findings highlight the indirect influence of functional disability and illness-induced lifestyle disruptions on the association between clinical disease activity and depressive symptoms. Efforts to assist youth in maintaining involvement in their day-to-day activities appear to lessen the negative impact of IBD-related functional disability on youths' illness experience and subsequent depressive symptoms.

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Adolescents with food allergy remain a medically at-risk population that is less likely to carry emergency medication and experiences higher rates of anaphylaxis, including fatal reactions. It is unclear how this compares to other younger children and if there is concordance between parent and adolescent perception of food allergy management. Families of children with food allergy were recruited in 2021 at an allergy clinic in the Midwest. Participants included 112 caregivers and 34 children (with 20 adolescents aged 13 to 17 years old) who completed self-reported measures regarding food allergy management and impact on quality of life. Chi-square tests and logistic regression examined the association between demographics and food allergy related behaviors. Per parent report, 36% of adolescents always carried their epinephrine compared to 57% of younger children. The probability of carrying epinephrine decreased by 33% every 5 years from 0 to 17 years old (OR=0.67 [95% CI: 0.45, 0.99], p=0.047). Comparing adolescent-parent dyads, a large majority of adolescents had ingested foods without labels (parent report 70%; adolescent report 75%) and almost all required parental help in avoiding their allergens (parent report 95%, adolescent report 95%). Adolescents and their parents agree adolescents are less likely to carry their epinephrine auto-injectors, less adherent to recommended food avoidance practices, and still require significant parental support for management. These are likely contributing factors to a higher risk for food-induced anaphylaxis and adolescents may benefit from food allergy specific transitions of care guidelines and tailored patient education to decrease this risk.

Adolescents who have food allergies, many of which may be life threatening, experience psychosocial difficulties, specifically embarrassment and stigma. Negative perceptions can increase non-adherence to recommended allergen avoidance practices, which may explain their increased risk for severe reactions. This study examined factors associated with adolescent perceptions of stigma related to their food allergy diagnosis. Children with food allergies and their caregivers (N=112; including adolescents aged 13-17, N=20) from a Midwestern allergy clinic completed questionnaires on their beliefs about food allergy, including perceived stigma associated with having a food allergy, and demographic characteristics (age, income level, gender). Chi-square tests and regression analysis examined demographic characteristics associated with increased stigma. Among adolescent respondents only, 60% felt different from their peers because of their food allergy. Adolescents from higher (vs. lower) income families were more likely to feel different (100% vs 42.9%, p = 0.017). Almost half (45%) of adolescents kept their food allergy a secret from their peers, and 45% avoided talking about their food allergies. Females (vs. males) were 4.3 times more likely (95% CI [1.02, 18.38] p=0.047) to report keeping their food allergies a secret. Approximately half of adolescents with food allergies experience stigma due to their food allergy and reported reluctance to disclose their food allergy with peers. Gender and household income were significantly associated with perceived stigma. While larger cohorts are necessary to validate these preliminary findings, this suggests that targeted interventions to address the stigma of food allergies among adolescents may be essential to reducing their risk.

OBJECTIVE:Illness stigma, or perceived stigma related to a chronic health condition, is pervasive among youth with inflammatory bowel disease (IBD). However, no studies exist examining the psychometric properties of illness stigma measures in this population. Using a modified version of the Child Stigma Scale originally developed for youth with epilepsy, the current study investigated the factor structure and validity of this adapted measure (i.e., Stigma Scale - Child; SS-C) in youth with IBD.METHODS:Factor analyses were conducted to determine the most parsimonious factor structure for the adapted 8-item Stigma Scale - Child in a sample of 180 youth with IBD. Correlations were conducted to assess convergent validity, and a multiple regression was conducted to further evaluate the measure's predictive validity of child depressive symptoms.RESULTS:The most parsimonious model for the SS-C is a one-factor solution with an error covariance between the two items assessing concealment/disclosure of IBD diagnosis.CONCLUSIONS:The SS-C is a psychometrically sound illness stigma measure in pediatric IBD that demonstrates strong convergent validity with psychosocial adjustment factors such as thwarted belongingness, illness uncertainty, and illness intrusiveness, as well as strong predictive validity with youth depressive symptoms. The SS-C is a viable option for use as a brief screener in youth with IBD across clinical and research settings.

Pediatric Allergy and ImmunologyVolume 34, Issue 4 e13946 LETTER TO THE EDITOR Experiences of caregivers of children with food allergy during the COVID-19 pandemic Caroline M. Roberts, Caroline M. Roberts orcid.org/0000-0002-6921-1282 Center for Pediatric Psychology, Department of Psychology, Oklahoma State University, Stillwater, Oklahoma, USASearch for more papers by this authorTaylor M. Dattilo, Taylor M. Dattilo Center for Pediatric Psychology, Department of Psychology, Oklahoma State University, Stillwater, Oklahoma, USASearch for more papers by this authorShahan Stutes, Shahan Stutes Oklahoma Allergy and Asthma Clinic, Oklahoma City, Oklahoma, USASearch for more papers by this authorDean Atkinson, Dean Atkinson Oklahoma Allergy and Asthma Clinic, Oklahoma City, Oklahoma, USASearch for more papers by this authorCarrick Carter, Carrick Carter University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USASearch for more papers by this authorJessica MacDougall, Jessica MacDougall University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USASearch for more papers by this authorYamini V. Virkud, Yamini V. Virkud University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USASearch for more papers by this authorLarry L. Mullins, Larry L. Mullins Center for Pediatric Psychology, Department of Psychology, Oklahoma State University, Stillwater, Oklahoma, USASearch for more papers by this authorAlayna P. Tackett, Corresponding Author Alayna P. Tackett [email protected] The Ohio State University Wexner Medical Center, Columbus, Ohio, USA Correspondence Alayna P. Tackett, The Ohio State University Wexner Medical Center, 3650 Olentangy River RD, Columbus, OH 43214, USA. Email: [email protected]Search for more papers by this author Caroline M. Roberts, Caroline M. Roberts orcid.org/0000-0002-6921-1282 Center for Pediatric Psychology, Department of Psychology, Oklahoma State University, Stillwater, Oklahoma, USASearch for more papers by this authorTaylor M. Dattilo, Taylor M. Dattilo Center for Pediatric Psychology, Department of Psychology, Oklahoma State University, Stillwater, Oklahoma, USASearch for more papers by this authorShahan Stutes, Shahan Stutes Oklahoma Allergy and Asthma Clinic, Oklahoma City, Oklahoma, USASearch for more papers by this authorDean Atkinson, Dean Atkinson Oklahoma Allergy and Asthma Clinic, Oklahoma City, Oklahoma, USASearch for more papers by this authorCarrick Carter, Carrick Carter University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USASearch for more papers by this authorJessica MacDougall, Jessica MacDougall University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USASearch for more papers by this authorYamini V. Virkud, Yamini V. Virkud University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USASearch for more papers by this authorLarry L. Mullins, Larry L. Mullins Center for Pediatric Psychology, Department of Psychology, Oklahoma State University, Stillwater, Oklahoma, USASearch for more papers by this authorAlayna P. Tackett, Corresponding Author Alayna P. Tackett [email protected] The Ohio State University Wexner Medical Center, Columbus, Ohio, USA Correspondence Alayna P. Tackett, The Ohio State University Wexner Medical Center, 3650 Olentangy River RD, Columbus, OH 43214, USA. Email: [email protected]Search for more papers by this author First published: 10 April 2023 https://doi.org/10.1111/pai.13946 Editor: Alexandra Santos Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Open Research PEER REVIEW The peer review history for this article is available at https://www.webofscience.com/api/gateway/wos/peer-review/10.1111/pai.13946. REFERENCES 1Gupta RS, Warren CM, Smith BM, et al. The public health impact of parent-reported childhood food allergies in the United States. Pediatrics. 2018; 142(6):e20181235. 2 FARE. State-By-State Data for Food Allergy. 2022 Accessed July 4, 2022. https://www.foodalergy.org/resources/state-state-data-food-allergy 3Abrams EM, Greenhawt M, Shaker M, Pinto AD, Sinha I, Singer A. The COVID-19 pandemic: adverse effects on the social determinants of health in children and families. Ann Allergy Asthma Immunol. 2022; 128(1): 19- 25. 4Leddy AM, Weiser SD, Palar K, Seligman H. A conceptual model for understanding the rapid COVID-19–related increase in food insecurity and its impact on health and healthcare. Am J Clin Nutr. 2020; 112(5): 1162- 1169. 5Tackett AP, Roberts CM, Farrow M, McQuaid EL. Food insecurity and caregiver perceptions of food allergen risk by food purchase location in children with food allergies. Transl Behav Med. 2019; 9(3): 404- 412. 6Dilley MA, Rettiganti M, Christie L, et al. Impact of food allergy on food insecurity and health literacy in a tertiary care pediatric allergy population. Pediatr Allergy Immunol. 2019; 30(3): 363- 369. 7Scurlock AM, Brown E, Davis CM. Food insecurity in children and adults with food allergies. Ann Allergy Asthma Immunol. 2022; 129(4): 424- 429. 8 Service, U.F.a.N. SNAP Eligibility. 2022. Accessed June 15, 2022. https://www.fns.usda.gov/snap/recipient/eligibility 9 Priorities, C.o.B.a.P. Policy Basics: The Supplemental Nutrition Assistance Program (SNAP). 2022. Accessed June 15, 2022. https://www.cbpp.org/research/food-assistance/the-supplemental-nutrition-assistance-program-snap 10Petts RJ, Carlson DL, Pepin JR. A gendered pandemic: childcare, homeschooling, and parents' employment during COVID-19. Gend Work Organ. 2021; 28: 515- 534. 11 Data, K.s. Change in Caregiver's Employment During Pandemic. Accessed December 22, 2022. https://www.kidsdata.org/topic/2349/covid19-employment-change/pie#fmt=2888&loc=2&tf=157&ch=1533,1532,1534&pdist=211 12Garrison ST, Rampold SD, Vasquez K, Gillen M, Baker LM. Parents' employment, income, and finances before and during the COVID-19 pandemic. J Consum Aff. 2022; 56(1): 276- 291. 13Parker K, Horowitz JM, Brown A. About Half of Lower-Income Americans Report Household Job or Wage Loss Due to COVID-19. 2020. Accessed June 20, 2022. https://www.pewsocialtrends.org/2020/04/21/about-half-of-lower-income-americans-report-household-job-or-wage-loss-due-to-covid-19/ 14Lebrun-Harris LA, Sappenfield OR, Warren MD. Missed and delayed preventive health care visits among US children due to the COVID-19 pandemic. Public Health Rep. 2022; 137(2): 336- 343. 15Morales DX, Morales SA, Beltran TF. Food insecurity in households with children amid the COVID-19 pandemic: evidence from the household pulse survey. Social Currents. 2021; 8(4): 314- 325. 16Keith-Jennings B, Nchako C, Llobrera J. Number of Families Struggling to Afford Food Rose Steeply in Pandemic and Remains High, Especially Among Children and Households of Color. Center on Budget and Policy Priorities; 2021. 17Perry BL, Aronson B, Pescosolido BA. Pandemic precarity: COVID-19 is exposing and exacerbating inequalities in the American heartland. Proc Natl Acad Sci USA. 2021; 118(8):e2020685118. 18Mueller JT, McConnell K, Burow PB, Pofahl K, Merdjanoff AA, Farrell J. Impacts of the COVID-19 pandemic on rural America. Proc Natl Acad Sci USA. 2021; 118(1):2019378118. 19Lauren BN, Silver ER, Faye AS, et al. Predictors of households at risk for food insecurity in the United States during the COVID-19 pandemic. Public Health Nutr. 2021; 24(12): 3929- 3936. 20Chen CY-C, Byrne E, Vélez T. Impact of the 2020 pandemic of COVID-19 on families with school-aged children in the United States: roles of income level and race. J Fam Issues. 2022; 43(3): 719- 740. 21Santos MJL, Merrill KA, Gerdts JD, Ben-Shoshan M, Protudjer JLP. Food allergy education and management in schools: a scoping review on current practices and gaps. Nutrients. 2022; 14(4): 732. Volume34, Issue4April 2023e13946 This article also appears in:COVID-19 and Allergic Diseases ReferencesRelatedInformation

Inclusion of evidence-based behavior change techniques (e.g., self-monitoring) in mobile health apps has the potential to promote adherence to inflammatory bowel disease treatment. While inflammatory bowel disease management apps exist, the extent to which they incorporate behavior change techniques remains unknown. The present study systematically evaluated the content and quality of free, commercially available inflammatory bowel disease management apps. Apps were identified using a systematic search of the Apple App and Google Play stores. Apps were evaluated using Abraham and Michie’s taxonomy of 26 behavior change techniques. A literature search was conducted to identify behavior change techniques specific and relevant for people with inflammatory bowel disease. App quality was assessed using the Mobile App Rating Scale with scores ranging from 1 (Inadequate) to 5 (Excellent). A total of 51 inflammatory bowel disease management apps were evaluated. Apps included 0–16 behavior change techniques (Mean = 4.55) and 0–10 inflammatory bowel disease management behavior change techniques (Mean = 3.43). App quality ranged from 2.03 to 4.62 (Mean = 3.39) out of 5.00. Two apps, My IBD Care: Crohn’s Colitis and MyGiHealth GI Symptom Tracker, included the highest number of overall and inflammatory bowel disease management behavior change techniques along with high-quality scores. Bezzy IBD was the only app with a high number of overall and inflammatory bowel disease management behavior change techniques with a primary focus on social support/change. Most inflammatory bowel disease management apps reviewed included evidence-based inflammatory bowel disease management behavior change techniques.

ObjectivesMobile health apps may be an effective way to increase sleep management skills. Although little has been documented about the content and quality of available sleep management apps, providers often make app recommendations to help with sleep self-management. The objective of this study was to systematically evaluate the content and quality of commercially available sleep apps.MethodsFollowing a systematic search of the Apple App and Google Play stores, 56 sleep management apps were evaluated. App content was evaluated using the taxonomy of behavior change techniques (BCTs), and app quality was assessed using the Mobile App Rating Scale.ResultsSleep management apps included 0-15 BCTs (M = 6.89) and 0-9 sleep BCTs (M = 4.87). App quality ranged from 2.51 to 4.80 (M = 3.78) out of 5.00. Sleepiest Sleep Sounds Stories, ShutEye: Sleep Tracker, and Mintal Tracker: Sleep Recorder included the highest number of sleep BCTs and highest quality scores.ConclusionsWhile the content and quality of sleep management apps is variable, the findings are promising as many apps included a high number of BCTs and high quality. Although evidence of efficacy through randomized controlled trials is necessary to establish efficacy, this review can aid in app selection in the interim.

Dating anxiety (i.e., anxiety experienced when initiating and/or maintaining a romantic connection) is prevalent in the college student population. Dating anxiety may contribute to psychological distress and diminished life satisfaction and has been found to be associated with depressive symptoms. The COVID-19 pandemic has necessitated preventative strategies that may negatively impact college students' ability to socialize and thus potentially worsen their mental health. The current study examined whether the relationship between dating anxiety and depressive symptoms was moderated by perceived impact of COVID-19. Participants included college students (N = 225) enrolled at a large Midwestern university and were 18-23 years of age (M-age = 18.95). Participants completed self-report measures of demographics, dating anxiety, perceived impact of COVID-19, and depressive symptoms. Depressive symptoms were significantly associated with dating anxiety, beta = .40, 95% CI [.292, .513], and COVID-19 impact, beta = .33, 95% CI [.220, .436]. The interaction term (Dating Anxiety x COVID-19 Impact) was significant, beta = .15, 95% CI [.062, .240], such that the relationship between higher dating anxiety and greater depressive symptoms strengthened as COVID-19 impact increased. Our findings demonstrate that increased dating anxiety is related to increased depressive symptoms, which are worsened by the impact of the COVID-19 pandemic. College students more strongly impacted by COVID-19 may have increased dating anxiety because of decreased exposure to social situations.

Traumatic brain injury (TBI) is associated with greater ‘brain age’ that may be caused by atrophy in grey and white matter. Here, we investigated ‘brain age’ in a chronic TBI (≥10 years) sample. We examined whether ‘brain age’ increases with years post injury, and whether it is associated with injury severity, cognition and functional outcome. We recruited 102 participants with moderate to severe TBI aged between 40 and 85 years. TBI participants were assessed on average 22 years post-injury. Seventy-seven healthy controls were also recruited. Participants’ ‘brain age’ was determined using T1-weighted MRI images. TBI participants were estimated to have greater ‘brain age’ compared to healthy controls. ‘Brain age’ gap was unrelated to time since injury or long-term functional outcome on the Glasgow Outcome Scale-Extended. Greater brain age was associated with greater injury severity measured by post traumatic amnesia duration and Glasgow Coma Scale. ‘Brain age’ was significantly and inversely associated with verbal memory, but unrelated to visual memory/ability and cognitive flexibility and processing speed. A longitudinal study is required to determine whether TBI leads to a ‘one-off’ change in ‘brain age’ or progressive ageing of the brain over time.

ABSTRACT: Objective: The impact of parent-reported stigma due to their child's disorder/difference of sex development (DSD) on parent psychosocial adjustment is poorly understood. In other pediatric populations, perceived interference of medical conditions into daily activities (i.e., illness intrusiveness) mediates the relationship of stigma to adjustment. This study assessed relationships between parent-focused and child-focused stigma → illness intrusiveness → depressive and anxious symptoms. Exploratory analyses sought to identify patient characteristics associated with stigma. Method: Caregivers (59 women and 43 men) of 63 children diagnosed with a DSD up to age 4 years completed measures of demographics, parent-focused and child-focused stigma, illness intrusiveness, and depressive and anxious symptoms. Results: Increased parent-focused and child-focused stigma were associated with increased illness intrusiveness, which, in turn, was associated with increased depressive and anxious symptoms for parents nested within dyads. Among children with DSD family histories, parents reported greater child-focused stigma. Conclusion: Parents who experience DSD-related stigma report greater interference of their child's DSD into their daily activities, which is associated with poorer psychosocial adjustment. Findings support developing clinical interventions related to parents' perceptions of stigma and illness intrusiveness to improve parent adjustment.

BACKGROUND:Elevated depressive symptoms are observed in a significant number of youth with inflammatory bowel disease (IBD) and have been linked to illness stigma and social isolation. Body image dissatisfaction is an understudied variable in the pediatric IBD literature that may be related to both stigma and social difficulties. It is suspected that, due to the stigmatizing nature of IBD, some youth may feel self-conscious about their body image, which contributes to decreased feelings of social belongingness and ultimately depressive symptoms. The current study tested an illness stigma→ body image dissatisfaction→ thwarted belongingness→ depressive symptoms serial mediation model, in which IBD stigma was hypothesized to indirectly influence youth depressive symptoms through the sequential effects of stigma on body image dissatisfaction and thwarted social belongingness.METHODS:Youth with IBD (N = 75) between 10 and 18 years old were recruited from a pediatric gastroenterology clinic and completed psychosocial measures. Disease severity was assessed by a physician global assessment. Current medications and BMI data were collected.RESULTS:Analyses revealed significant direct effects among the modeled variables and a significant serial indirect path for illness stigma→ body image dissatisfaction→ thwarted belongingness→ depressive symptoms, controlling for sex, BMI and prednisone medication.CONCLUSIONS:Youth who perceive greater IBD stigma are more likely to experience increased body image dissatisfaction due to their IBD, which may engender feelings of social estrangement and ultimately elevated depressive symptoms. Depressive symptoms and the psychosocial challenges faced by youth should be routinely monitored as part of comprehensive IBD management.

BACKGROUND AND OBJECTIVES:Traumatic brain injury (TBI) has been promoted as a risk factor for Alzheimer disease (AD). There is evidence of elevated β-amyloid (Aβ) and tau, the pathologic hallmarks of AD, immediately following TBI. It is not clear whether Aβ and tau remain elevated in the chronic period. To address this issue, we assessed Aβ and tau burden in long-term TBI survivors and healthy controls using PET imaging.METHODS:Using a cross-sectional design, we recruited individuals following a single moderate to severe TBI at least 10 years previously from an inpatient rehabilitation program. A demographically similar healthy control group was recruited from the community. PET data were acquired using 18F-NAV4694 (Aβ) and 18F-MK6240 (tau) tracers. Aβ deposition was quantified using the Centiloid scale. Tau deposition was quantified using the standardized uptake value ratio (SUVR) in 4 regions of interest (ROIs). As a secondary measure, PET scans were also visually read as positive or negative. We examined PET data in relation to time since injury and age at injury. PET data were analyzed in a series of regression analyses.RESULTS:The sample comprised 87 individuals with TBI (71.3% male; 28.7% female; mean 57.53 years, SD 11.53) and 59 controls (59.3% male; 40.7% female; mean 60.34 years, SD 11.97). Individuals with TBI did not have significantly higher 18F-NAV4694 Centiloid values (p = 0.067) or 18F-MK6240 tau SUVRs in any ROI (p ≤ 0.001; SUVR greater for controls). Visual assessment was consistent with the quantification; individuals with TBI were not more likely than controls to have a positive Aβ (p = 0.505) or tau scan (p = 0.221). No associations were identified for Aβ or tau burden with time since injury (p = 0.057 to 0.332) or age at injury.DISCUSSION:A single moderate to severe TBI was not associated with higher burden of Aβ or tau pathologies in the chronic period relative to healthy controls. Aβ and tau burden did not show a significant increase with years since injury, and burden did not appear to be greater for those who were older at the time of injury.

INTRODUCTION:Adolescents and young adults (AYA) with a chronic medical condition (CMC) attending college must learn to manage their own healthcare (i.e., transition readiness). Maturity has been linked to positive outcomes in AYAs. Research has established a positive relationship between transition readiness and quality of life. The current study aimed to examine a model of perceived maturityàtransition readinessàmental and physical quality of life. METHOD:AYA (N = 153) with a CMC completed self-report questionnaires. RESULTS:The perceived maturity→transition readiness→mental quality of life indirect path was significant (ab = 1.96, 95% CI = 0.53 to 3.62). The perceived maturity→transition readiness→physical quality of life direct and indirect paths were not significant. DISCUSSION:Results showed that maturity and transition readiness are positively associated. Transition readiness may be one mechanism by which maturity results in enhanced quality of life. PRACTICE IMPLICATIONS:Findings highlight the value of enhancing strengths such as maturity to promote AYA independence/autonomy.