A Longitudinal Study of Adolescents’ Pornography Use Frequency,Motivations, and Problematic Use Before and During the COVID-19 Pandemic

Archives of Sexual Behavior - Since the beginning of the COVID-19 pandemic, an increase in pornography use has been reported based on cross-sectional findings, raising concerns about associated...     

Americans’ Health Priorities During the COVID-19 Pandemic

ObjectivesThis study aimed to examine how Americans’ opinions of the seriousness of various health-related problems have changed over time and to quantify the public’s preferences for research prioritization.MethodsWe conducted a survey that asked respondents to rate the seriousness of 80 health-related problems on a 4-point Likert scale (“very serious problem,” “somewhat serious problem,” “not too serious of a problem,” or “not a problem at all”). Results were compared with past surveys from 2001 and 2013 that examined the same set of health-related problems (with the exception of COVID-19). The survey also included best-worst scaling questions that asked respondents to select, from 20 health problems, those they considered most and least important for research funding. Respondents were recruited from the KnowledgePanel, a nationally representative sample of American households.ResultsA total of 768 adults completed the survey between September 3, 2020, and September 14, 2020. The health-related problems that Americans consider to be “very serious” generally align with the leading causes of death and noncommunicable diseases such as heart disease, diabetes, and mental health; nevertheless, several social determinants of health are also identified. COVID-19 was an unsurprising top priority, whereas cancer remains the highest and a persistent priority for research funding.ConclusionsAmericans consider a diverse set of health-related problems to be “very serious,” with recognition of social determinants of health rising. Our findings offer guidance as to the disease areas for which the public would value further public and private investment in treatment innovations.     

Changes in Young Adults’ Alcohol and Marijuana Use,Norms, and Motives From Before to During the COVID-19 Pandemic

PurposeAlongside the SARS-CoV-2 virus, the COVID-19 pandemic is associated with several secondary health effects. There is concern for increased substance use motivated by coping with stress, anxiety, depression, and boredom–all of which may be elevated during the pandemic. The current study examined intraindividual changes (from pre-COVID to during COVID) in young adults’ alcohol and marijuana use, perceptions of peers’ use (i.e., norms), and motives for use.MethodsA community sample of young adults (N = 572; M_age = 25.14; 60.8% women) was recruited in Washington State. By using a repeated-measures design, data were collected prior to the COVID-19 pandemic (January 2020) and again during the initial acute phase of the pandemic (April/May of 2020).ResultsYoung adults, on average, increased alcohol use frequency but decreased the amount consumed per drinking occasion. No changes in marijuana use were identified. Young adults (on average) perceived that peers had increased the frequency and total amount of alcohol use and perceived that peers were engaging in heavier marijuana use than prior to COVID-19. For alcohol use motives, there was a significant increase in depression coping motives and significant decreases in social, enhancement, and conformity motives. Boredom motives for marijuana use significantly increased, while celebration motives decreased.ConclusionsUsing a prospective design with a sample initially recruited in Washington State, these data indicate that (a) young adults’ patterns of alcohol use may have changed, (b) young adults tend to think that peers are engaging in heavier alcohol/marijuana use than before the pandemic, and (c) motives for using alcohol/marijuana may have changed during the pandemic.     

Shortages of Staff in Nursing Homes During the COVID-19 Pandemic: What are the Driving Factors?

ObjectivesDuring the Coronavirus Disease 2019 (COVID-19) pandemic, US nursing homes (NHs) have been under pressure to maintain staff levels with limited access to personal protection equipment (PPE). This study examines the prevalence and factors associated with shortages of NH staff during the COVID-19 pandemic.DesignWe obtained self-reported information on staff shortages, resident and staff exposure to COVID-19, and PPE availability from a survey conducted by the Centers for Medicare and Medicaid Services in May 2020. Multivariate logistic regressions of staff shortages with state fixed-effects were conducted to examine the effect of COVID-19 factors in NHs.Setting and Participants11,920 free-standing NHs.MeasuresThe dependent variables were self-reported shortages of licensed nurse staff, nurse aides, clinical staff, and other ancillary staff. We controlled for NH characteristics from the most recent Nursing Home Compare and Certification and Survey Provider Enhanced Reporting, market characteristics from Area Health Resources File, and state Medicaid reimbursement calculated from Truven data.ResultsOf the 11,920 NHs, 15.9%, 18.4%, 2.5%, and 9.8% reported shortages of licensed nurse staff, nurse aides, clinical staff, and other staff, respectively. Georgia and Minnesota reported the highest rates of shortages in licensed nurse and nurse aides (both >25%). Multivariate regressions suggest that shortages in licensed nurses and nurse aides were more likely in NHs having any resident with COVID-19 (adjusted odds ratio [AOR] = 1.44, 1.60, respectively) and any staff with COVID-19 (AOR = 1.37, 1.34, respectively). Having 1-week supply of PPE was associated with lower probability of staff shortages. NHs with a higher proportion of Medicare residents were less likely to experience shortages.Conclusions/ImplicationsAbundant staff shortages were reported by NHs and were mainly driven by COVID-19 factors. In the absence of appropriate staff, NHs may be unable to fulfill the requirement of infection control even under the risk of increased monetary penalties.     

Do Loneliness and Perceived Social Isolation Reduce Expected Longevity and Increase the Frequency of Dealing with Death and Dying? Longitudinal Findings based on a Nationally Representative Sample

ObjectivesLoneliness and social isolation are important factors for morbidity and mortality. However, little is known about whether increases in loneliness and perceived social isolation contribute to decreased expectations of longevity and an increased frequency of dealing with death and dying. Consequently, our aim was to clarify these relationships.DesignLongitudinal data were derived from a nationally representative sample of individuals ≥40 years (analytical sample, n=7952 observations).Setting and ParticipantsCommunity-dwelling individuals aged ≥40 years.MethodsLoneliness and perceived social isolation were both measured using well-established tools. In accordance with other large cohort studies, the expectations of longevity were assessed using the question “What age do you think you will live to?” Moreover, the frequency of dealing with death and dying (from 1 = never to 5 = very often) served as outcome measure. In regression analysis, it was adjusted for several sociodemographic and health-related factors.ResultsFixed effects regressions showed that both increases in loneliness (β = –0.99, P < .001) and in perceived social isolation (β = –0.59, P < .05) were associated with decreases in expectations of longevity. Furthermore, both loneliness [incidence rate ratio (IRR) = 1.02, P < .05] and perceived social isolation (IRR = 1.02, P < .05) were associated with increases in the frequency of dealing with death and dying.Conclusions and ImplicationsBeyond the impact of various covariates, findings still point to a longitudinal association between both perceived social isolation and loneliness and lower expectations of longevity as well as an increased frequency of dealing with death and dying. Efforts in reducing loneliness and perceived social isolation can contribute to increased expected longevity and a decreased frequency of dealing with death and dying which ultimately can contribute to longevity in older age.     

Changes in Adults’ Eating Behaviors During the Initial Months of the COVID-19 Pandemic: A Narrative Review

Factors such as regulations and health concerns shifted daily habits, including eating behaviors, during the early months of the coronavirus disease 2019 (COVID-19) pandemic. This comprehensive narrative review synthesizes research on eating behavior changes during the early months of the pandemic (February to June 2020), including changes in amount, rate, and timing of food consumption, types and healthfulness of foods consumed, the occurrence of other specified eating behaviors (eg, restrained eating or binging), and reasons for eating (eg, stress or cravings), among adults. A literature search using three EBSCOhost databases and Google Scholar was conducted to identify relevant articles made available in 2020. A total of 71 articles representing 250,715 individuals from more than 30 countries were reviewed. Findings show eating behaviors changed little during the early COVID-19 pandemic for most participants. Among those whose eating behaviors changed, increases in both intake and frequency of eating meals and snacks were more common than decreases. Findings on timing of eating and healthfulness of food consumed showed mixed results. However, when changes occurred in the type of food consumed, increases were more common for snacks, homemade pastries, white bread/pasta, legumes, and fruits/vegetables; decreases were more common for meats, seafood/fish, frozen foods, fast food, dark breads/grains, and dark leafy green vegetables. During the pandemic, binging, uncontrolled eating, and overeating increased, meal skipping decreased, and restrictive eating had mixed findings. Changes in factors such as emotions and mood (eg, depression), cravings, and environmental factors (eg, food insecurity) were related to changes in eating behaviors. Findings can inform clinical practitioners in efforts to mitigate disruptions to normal, healthy eating patterns among adults both in and outside of global health catastrophes.     

Nursing Home Workers’ Mental Health During the COVID-19 Pandemic in France

ObjectivesThe present study sought to examine mental health problems among nursing home workers in the context of the COVID-19 pandemic, to investigate COVID-19–related fears, and to identify prepandemic factors associated with current mental health issues.DesignA cross-sectional, online survey was used.Setting and ParticipantsAll employees among 6 nursing homes in southwestern France (N = 455) were solicited between November, 2020 and June, 2021.MethodsThe survey instrument was developed within the World Mental Health consortium to screen for COVID-related fears, probable generalized anxiety, panic attacks, depression, posttraumatic stress and substance use disorders in the past 30 days.ResultsThe survey was completed by 127 workers (89.0% female, mean age = 43.42 years, SD = 11.29), yielding a 28.5% response rate. Overall, 48.03% reported experiencing fear of infecting others at least most of the time. One in 8 (14.96%) indicated that close others feared being infected by them. One-third of the sample (34.65%) met criteria for at least 1 probable current mental disorder. Panic attacks (22.05%) were the most frequently reported mental health problem, followed by depression (16.54%). In multivariate analyses, the only factor associated with having a current probable mental disorder was the presence of any prepandemic mental health problem (adjusted odds ratio 4.76, 95% CI 2.08-10.89). Type of employment contract, full-time status, and medical vs nonmedical staff status were not significantly associated with mental health status.Conclusions and ImplicationsThe study reveals that one-third of nursing home workers in the sample report current probable mental disorders, and these were largely associated with prepandemic mental health status. Screening for common mental health problems and facilitating access to appropriate care should be prioritized in nursing homes.     

Adolescents’ Time During the First Year of the COVID-19 Pandemic: Evidence From the American Time Use Survey

PurposeThe aim of this study is to examine where and with whom adolescents spent time during the first months of the COVID-19 pandemic compared to 2019.MethodsTime diary data from the May 2019 to December 2020 waves of the American Time Use Survey were used to examine trends in where and with whom a sample of individuals aged 15–18 years (N = 437) spent their time.ResultsOnly 13% of adolescents spent any time at school on a given day during the pandemic (May-December 2020), compared to 36% in the same period in 2019. Average time with friends decreased by 28%. Over the 7.5-month period, this amounts to an average of 204 fewer hours/34 fewer days in school and 86 fewer hours with friends. Time spent sleeping or sleepless did not change.DiscussionTime at school and with friends decreased substantially during the first months of the pandemic.     

Adolescents’ Use of Sexually Explicit Internet Material Over the Course of 2019–2020 in the Context of the COVID-19 Pandemic: A Three-wave Panel Study

Recently, sexual health scholars have expressed concerns regarding adolescents’ use of sexually explicit internet materials (SEIM) during the COVID-19 pandemic. Therefore, using latent growth curve modeling, the current study explored adolescents’ changes in the frequency of SEIM use before, during, and after a strict lockdown period was established in Belgium. Attention was given to individual differences (i.e., gender, gender identity, sexual orientation, pubertal timing, and sensation seeking). A three-wave panel study over a 15-month period among 522 adolescents was used (M_age?=?15.36, SD?=?1.51, 67.1% girls). In general, SEIM use did not significantly increase over a 15-month period in the context of the COVID-19 pandemic. Only gender predicted a change in SEIM use frequencies with girls showing a greater, increasing change of SEIM use than boys. When addressing why adolescents used SEIM during a strict lockdown period, sexual arousal, stress, and boredom regulation motivations emerged as the most prevalent motivations. Loneliness regulation was the least prominent motivation. Individual differences were found regarding the gratifications sought according to adolescents’ gender, pubertal timing, and sensation seeking. The findings offer a response to sexual scholars’ worries in terms of adolescents’ SEIM use during the COVID-19 pandemic.

     

Parental Depressive Symptoms and Children’s School Attendance and Emergency Department Use: A Nationally Representative Study

We sought to assess the association between parental depressive symptoms and school attendance and emergency department (ED) use among children with and without chronic health conditions. Secondary analysis of the 1997–2004 National Health Interview Survey, a nationally representative survey. Parental depressive symptoms were measured by three questions assessing sadness, hopelessness, or worthlessness in the past month. Children with and without asthma or attention-deficit/hyperactivity disorder (ADHD) were identified, and their school attendance and ED visits were reported by adult household respondents. Children with information on parental depressive symptoms, health conditions, and services use were eligible. We incorporated weights available in the survey for each eligible child to reflect the complex sampling design. 104,930 eligible children were identified. The point prevalence of parental depressive symptoms was low (1.8 %, 95 % CI 1.7–2.0), but greater among children with asthma (2.7 %, 95 % CI 2.4–3.0) and ADHD (3.8 %, 95 % CI 3.2–4.4) than among other children (1.6 %, 95 % CI 1.5–1.7). After adjustment for potential confounders, children whose parents reported depressive symptoms most or all of the time were more likely to report an ED visit (adjusted incident rate ratio [IRR] 1.18, 95 % CI 1.06–1.32) or school absence (adjusted IRR 1.36, 95 % CI 1.14–1.63) than children whose parents did not. The effect of parental depressive symptoms was not modified by child health conditions. Parental depressive symptoms were adversely associated with school attendance and ED use in children. These results suggest the importance of measuring depressive symptoms among adult caregivers of children.     

A Descriptive Study of the Implementation of Remote Occupational Rehabilitation Services Due to the COVID-19 Pandemic Within a Workers’ Compensation Context

Journal of Occupational Rehabilitation - Purpose The Coronavirus Disease (COVID-19) pandemic resulted in dramatic changes to avoid virus spread. In Canada, following provincial legislation the...     

Race/Ethnicity–Specific Associations of Urinary Phthalates with Childhood Body Mass in a Nationally Representative Sample

Background: Phthalates have antiandrogenic effects and may disrupt lipid and carbohydrate metabolism. Racial/ethnic subpopulations have been documented to have varying urinary phthalate concentrations and prevalences of childhood obesity.Objective: We examined associations between urinary phthalate metabolites and body mass outcomes in a nationally representative sample of U.S. children and adolescents.Methods: We performed stratified and whole-sample cross-sectional analyses of 2,884 children 6–19 years of age who participated in the 2003–2008 National Health and Nutrition Examination Survey. Multivariable linear and logistic analyses of body mass index z-score, overweight, and obesity were performed against molar concentrations of low-molecular-weight (LMW), high-molecular-weight (HMW), and di-2-ethylhexylphthalate (DEHP) metabolites, controlling for sex, television watching, caregiver education, caloric intake, poverty–income ratio, race/ethnicity, serum cotinine, and age group. We used sensitivity analysis to examine robustness of results to removing sample weighting, normalizing phthalate concentrations for molecular weight, and examining different dietary intake covariates.Results: In stratified, multivariable models, each log unit (roughly 3-fold) increase in LMW metabolites was associated with 21% and 22% increases in odds (95% CI: 1.05–1.39 and 1.07–1.39, respectively) of overweight and obesity, and a 0.090-SD unit increase in BMI z-score (95% CI: 0.003–0.18), among non-Hispanic blacks. Significant associations were not identified in any other racial/ethnic subgroup or in the study sample as a whole after controlling for potential confounders, associations were not significant for HMW or DEHP metabolites, and results did not change substantially with sensitivity analysis.Conclusions: We identified a race/ethnicity–specific association of phthalates with childhood obesity in a nationally representative sample. Further study is needed to corroborate the association and evaluate genetic/epigenomic predisposition and/or increased phthalate exposure as possible explanations for differences among racial/ethnic subgroups.     

Discrimination and Mental Health�CRelated Service Use in a National Study of Asian Americans

Objectives. We examined the association between perceived discrimination and use of mental health services among a national sample of Asian Americans.Methods. Our data came from the National Latino and Asian American Study, the first national survey of Asian Americans. Our sample included 600 Chinese, 508 Filipinos, 520 Vietnamese, and 467 other Asians (n=2095). We used logistic regression to examine the association between discrimination and formal and informal service use and the interactive effect of discrimination and English language proficiency.Results. Perceived discrimination was associated with more use of informal services, but not with less use of formal services. Additionally, higher levels of perceived discrimination combined with lower English proficiency were associated with more use of informal services.Conclusions. The effect of perceived discrimination and language proficiency on service use indicates a need for more bilingual services and more collaborations between formal service systems and community resources.Asian Americans are one of the fastest-growing racial groups in the United States and also one of the most understudied.¹ Recent data from the National Latino and Asian American Study (NLAAS), the first national study of Asian Americans, show that they have a sizeable burden of mental illness, with a 17.30% overall lifetime rate of any psychiatric disorder and a 9.19% 12-month rate.² At the same time, low utilization rates of mental health services by Asian Americans are well documented.^3–7 Nationally, Asian Americans/Pacific Islanders are one third as likely as Whites to use available mental health services.³ Low use rates have been reported for emergency and inpatient services^4–6 as well as outpatient services.^4,7,8In the United States over a 12-month period, only 3.1% of Asian Americans use specialty mental health services, compared with 5.59% of African Americans, 5.94% of Caribbean Blacks, 4.44% of Mexicans, 5.55% of Cubans, and 8.8% of the general population.^9–11 In a study by Abe-Kim et al., only 8.6% of Asian Americans sought any mental health services compared with 17.9% of the general population.¹² Kimerling and Baumrind found that Asian American women were less likely than White women to report perceived need for mental health services, even when accounting for frequency of mental distress. Among women who did perceive a need to seek mental health services, Asian American women were less likely to use services even when health insurance was controlled.¹³Despite low use rates for formal services, research has established that Asian Americans are more likely to use informal support systems for help with mental health issues as to use formal services. Data from the Chinese American Epidemiology Study (CAPES) found that of Chinese Americans experiencing mental health problems in the past 6 months, fewer than 6% saw mental health professionals, 4% saw medical doctors, and 8% saw a minister or priest.¹⁴ A study using data from the Filipino American Community Epidemiological Study (FACES) found that of the 25% of Filipino Americans who used any type of care in the past 12 months, 17% went to the lay system (a friend or relative), 7% used medical doctors, 4% saw a clergy member or indigenous healer, and only 3% saw a mental health specialist.¹⁵ In a study using data from the CAPES, negative attitudes toward formal mental health services were correlated with more informal service use.¹⁶Discrimination is a major stressor experienced by American ethnic groups.¹⁷ Experiences with discrimination shape one''s appraisal of the world and hinder the ability to control one''s environment, thus reinforcing secondary social status and internalizing negative stereotypes.^18–20 There are many well-documented examples of policies and practices that have systematically discriminated against Asian Americans throughout US history.^21,22 Contemporary forms of discrimination include the model minority stereotype (which highlights the aggregation of success indicators while masking the challenges of immigrant populations), hate crimes, racial profiling, and employment discrimination.^23–28 Increasingly, researchers have demonstrated an association between racial discrimination and mental disorders among Asian Americans.^29–38Discrimination also may be a barrier to help seeking among Asian Americans. Indeed, research has found that perceived discrimination is significantly correlated with underuse of mental health care among Asian Americans.³⁹ Further, it is possible that discrimination may interact with other barriers to treatment. For example, Spencer and Chen found that discrimination based on speaking a different language or speaking with an accent was associated with use of more informal services among Chinese Americans.¹⁶ Uba cites racial and cultural biases—such as culturally inappropriate services, differential receipt of services, a history of institutional discrimination, and a suspicion of the service delivery system—as critical barriers to service use for Asian Americans.⁴⁰Other immigrant-related factors are important correlates of service use. For example, rates of use were found to vary by generation: US-born, third-generation or later Asian Americans had higher rates of use of specialty mental health services than did first- or second-generation individuals.¹² Other studies that have examined correlates of service use among Asian Americans have identified cultural factors, such as shame and loss of face^41–44; lack of ethnic match between provider and client, bilingual providers, knowledge of available services, and insurance coverage; socioeconomic factors; and neighborhood poverty.^{12,25,45–49} Language is a particularly important correlate of service use for Asian Americans: those who have poor English skills may be less likely to use mental health services. For example, a study of East Asian immigrants found that English fluency was positively related to willingness to use psychological services.⁵⁰We examined the association between perceived discrimination and service use, controlling for demographic characteristics, poverty status, immigration status, and barriers to services related to access and attitudes, in a national representative sample of Asian Americans using data from the NLAAS. Specifically, we examined rates of formal and informal service use. We hypothesized that discrimination would be associated with less use of formal services and more use of informal services. We also hypothesized that individuals with low English proficiency in addition to higher rates of self-reported discrimination would be less likely to use formal services and more likely to use informal services for mental health problems.     

Are We Losing the Most Relevant Cases First? Selective Dropout in Two Longitudinal Studies of Adolescent Pornography Use

Archives of Sexual Behavior - In longitudinal studies of pornography use, selective loss of participants who may be more vulnerable to the effects of pornography than their peers is a serious...     

Emerging Adults’ Expectations for Pornography Use in the Context of Future Committed Romantic Relationships: A Qualitative Study

Using qualitative content analysis from the written comments of 404 primarily heterosexual college students, we examined (1) their expectations for pornography use while married or in a committed long-term relationship and (2) variations by gender. Four prominent groups emerged. A majority of men (70.8 %) and almost half of women (45.5 %) reported circumstances (alone or with their partners) wherein pornography use was acceptable in a relationship and several conditions for, and consequences associated with, such use also emerged. Another group (22.3 % men; 26.2 % women) viewed pornography use as unacceptable because of being in a committed relationship whereas a third group (5.4 % men; 12.9 % women) reported that pornography use was unacceptable in any context or circumstance. A final group emerged of a few women (10.4 %) who stated that a partner’s use of pornography was acceptable, but they did not expect to use it personally. Implications for relationship education among emerging adults and future research on pornography use within the context of romantic relationships are discussed.