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Simple Summary: Moderately hypofractionated radiotherapy (HFRT) has been shown to be isoeffective compared to conventional regimens in the treatment of prostate cancer (PCa). In addition, dose-escalation improves biochemical or metastasis control with minimal toxicity, although no overall survival benefit has been demonstrated. This work reports the results of HFRT on biochemical control, overall survival, toxicity and quality of life in patients with localized PCa treated with a dose-escalated schedule (66 Gy, 3 Gy/fraction) using volume modulated arc therapy (VMAT). This retrospective study aimed to provide some clinical outcomes regarding effectiveness, toxicity, and quality of life in PCa patients treated with dose-escalated moderately hypofractionated radiation therapy (HFRT). Patients received HFRT to a total dose of 66 Gy in 22 fractions (3 Gy/fraction) delivered via volume modulated arc therapy (VMAT) in 2011–2016. Treatment effectiveness was measured by the biochemical failure-free survival rate. Toxicity was assessed according to the criteria of the Radiation Therapy Oncology Group (RTOG) and quality of life according to the criteria of the European Organization for Research and Treatment of Cancer (EORTC). In this regard, quality of life (QoL) was measured longitudinally, at a median of 2 and 5 years after RT. Enrolled patients had low-risk (40.2%), intermediate-risk (47.5%), and high-risk (12.3%) PCa. Median follow-up was 75 months. The biochemical failure-free survival rate was 94.2%. The incidence of acute grade 2 or higher gastrointestinal (GI) and genitourinary (GU) toxicity was 9.84% and 28.69%, respectively. The incidence rate of late grade 2 or higher GI and GU toxicity was 1.64% and 4.10%, respectively. Expanded Prostate Cancer Index Composite (EPIC) scores showed that the majority of patients maintained their QoL. HFRT to 66 Gy with VMAT was associated with adequate biochemical control, low toxicity and good reported GU and GI quality of life. [ABSTRACT FROM AUTHOR]

This study aims to analyze the psychometric properties of the new Brazilian-Portuguese version of the Brief Resilience Scale (B-BRS) in older adults. A sample of 1251 participants (54.20% women; M = 68.02 years, SD = 6.52) completed the B-BRS and seven scales on successful aging and mental health. Confirmatory factor analysis was used to study the B-BRS dimensionality. Convergent and divergent validity was analyzed by means of examining the relationships of B-BRS with scales on successful aging and mental health. The results supported the unidimensionality of the B-BRS after controlling for wording method, as well as satisfactory reliability (ω =.79). B-BRS structure remained invariant across education level and income groups. B-BRS scores positively correlated with successful aging factors and negatively with psychopathology symptoms. To conclude, our findings provide some evidence on the reliability and validity of the B-BRS, as well as its validation for use in the senior population. [ABSTRACT FROM AUTHOR]

Background: The concept of European psychologisation of depression versus somatisation in non-European populations has been the basis of several studies of cultural psychopathology in the general population. Little is currently known about cross-cultural differences and similarities in late-life depression symptom reporting. We cross-culturally compared symptom reporting in the context of Major Depressive Disorder (MDD) among community-dwelling older adults from Spain and Nigeria.Methods: We relied on data from two household multistage probability samples comprising 3,715 persons aged 65 years or older in the Spanish and Nigerian populations. All participants underwent assessments for MDD using the World Mental Health Survey version of the Composite International Diagnostic Interview. Cross-cultural comparison of broad somatic and psychological categories as well as relationship and influence of individual symptoms were analysed using the Symptom Network Analysis approach.Results: Current MDD was diagnosed in 232 and 195 older persons from Spain and Nigeria, respectively. The symptom network of the two samples were invariant in terms of global strength, S(GSPAIN , GNIGERIA ) = 7.56, P = .06, with psychological and somatic symptoms demonstrating centrality in both countries. However, country-specific relationships and influence of individual symptoms were found in the network structure of both samples, M(GSPAIN , GNIGERIA ) = 2.95, P < .01.Conclusion: Broad somatic and psychological symptoms categories contributed to the structural network of older Africans and their peers from the Spanish population. Variations in the relationship and influence of individual symptoms suggests that the functional and "communicative" role of individual symptoms may be differentiated by context specific imperatives. J Am Geriatr Soc 68:-, 2020. [ABSTRACT FROM AUTHOR]

Background and Objectives There is a link between sensory and cognitive functioning across old age. However, there are no integrative measures for assessing common determinants of sensory-cognitive functioning. This study aims to develop a combined measure of sensory-cognitive functioning, and to identify heterogeneous trajectories and associated risk factors. Research Design and Methods Two thousand two hundred and fifty-five individuals aged 60 years and over selected from the first six waves (2002–2012) of the English Longitudinal Study of Ageing completed a set of five self-reported visual and hearing functioning items and four cognitive items. Several health-related outcomes were also collected. Results The common cause model presented longitudinal factorial invariance (Tucker-Lewis index [TLI] = 0.989; Comparative Fit Index [CFI] = 0.991; Root Mean Square Error of Approximation [RMSEA] = 0.026). A common factor explained 32%, 36%, and 26% of the visual, hearing, and cognitive difficulties, respectively. The developed sensory-cognitive measure predicted incident dementia over 10 years (area under the curve =.80; 95% confidence interval [CI] =.75,.86). A three-trajectory model was proved to fit better, according to growth mixture modeling. Low levels of education and household wealth, disability, diabetes, high blood pressure, depressive symptoms, and low levels of physical activity were risk factors associated with the classes showing trajectories with a steeper increase of sensory-cognitive difficulties. Discussion and Implications A time-invariant factor explains both sensory and cognitive functioning over 8 years. The sensory-cognitive measure derived from this factor showed a good performance for predicting dementia 10 years later. Several easily identifiable socioeconomic and health-related risk factors could be used as early markers of subsequent sensory-cognitive decline. Therefore, the proposed latent measure could be useful as a cost-effective indicator of sensory-cognitive functioning. [ABSTRACT FROM AUTHOR]

Background: The long-term trajectory of depressive symptoms has a heterogeneous pattern. Identifying factors associated with different trajectories and outcomes may have important theoretical and clinical implications. This study explored patterns of depressive symptom trajectory from adolescence to adulthood, and their relationship with subsequent psychiatric disorders.Method: A sample of 816 participants (58.8% girls; M = 16.58 years old at baseline, SD = 1.21) from a large community sample were interviewed four times during adolescence and adulthood. Depressive symptoms were also assessed. Symptom trajectory identification was based on latent class mixed modeling. Logistic regression was used for predicting emotional and drug use disorder over age 30.Results: Three trajectories of depressive symptoms were identified: "decreasing symptom" (decreasing trajectory of symptoms; 15.1% of participants), "increasing symptom" (initially decreasing pattern of symptoms and then increasing; 6.1% of participants), and "normative symptom" (consistently low symptom levels; 78.8% of participants). Predictors of the increasing symptom trajectory were high level of loneliness and state anxiety, presence of an emotional disorder, and low involvement in physical exercise at baseline. This trajectory membership predicted the development of anxiety disorders over age 30. Predictors of the decreasing symptom class were being female and high level of worry at baseline.Conclusions: Long-term trajectories of depressive symptoms are heterogeneous, with each trajectory having different predictors and are associated with different outcomes during adulthood. [ABSTRACT FROM AUTHOR]

Objectives Although visual and hearing impairments have been found to be associated with cognitive decline in the old age, the mechanism underlying this relationship remains unclear. This study aimed at assessing the predictive role of visual and hearing difficulties on subsequent cognitive functioning. Method From the cohort of the first (2002) and fifth waves (2010) of the English Longitudinal Study of Ageing (ELSA), 3,508 individuals aged 60 and older were included in the study. Five self-reported visual and hearing functioning items were used to assess sensory functioning at baseline. Cognition was assessed 8 years later by means of four measured tests covering immediate and delayed recall, verbal fluency, and processing speed. A Multiple Indicators Multiple Causes approach was used to assess the longitudinal associations of visual and hearing functioning with cognitive difficulties. A multigroup longitudinal measurement invariance was used to estimate latent change in cognitive difficulties across groups of participants presenting either visual, hearing, or dual sensory impairment (i.e. those reporting difficulties in both visual and hearing functioning items). Results Visual (β = 0.140, p <.001) and hearing (β = 0.115, p <.001) difficulties predicted cognitive difficulties 8 years later. The latent increase in cognitive difficulties was steeper in people with visual impairment (d = 0.52, p <.001), hearing impairment (d = 0.50, p <.001), and dual-sensory impairment (d = 0.68, p <.001) than those non-impaired (d = 0.12, p <.001). Discussion Visual and hearing difficulties were identified as predictors of subsequent cognitive decline in the old age. Interventions to prevent visual and hearing difficulties may have a substantial impact to slow down subsequent age-related cognitive decline. [ABSTRACT FROM AUTHOR]

Many physiological systems are multistable, i.e. they operate at different time scales under an allometric control process. The multistability of affective fluctuations has been clearly illustrated in a sample of adults, but little is known about their dynamics in adolescents. The main aim of this study was to determine whether affective fluctuations in adolescents show multistability and to explore their relationship with anxiety symptomatology and temperamental factors. Twenty-five early adolescents self-reported their daily mood, anxiety and worry levels twice a day over a 100-day period. The time series were analysed using the allometric aggregation method to obtain the scaling exponent h. Almost all the (Hurst) scaling exponents were 0.5 > h > 1. The worry exponents were related to temperament factors, whereas the anxiety exponents were related to social phobia symptoms. The results substantiate that affective fluctuations in adolescents are multistable, lending support to the presence of allometric control mechanisms. [ABSTRACT FROM AUTHOR]

Daily life entails having to cope with many stressful situations. Although stress-related reactions could sometimes provoke impairments in physiological processes due to the frequency of exposure or the stress burden of the event, physiological recovery after coping with stressors is highly implied in the aversive consequences of stress. To analyze the effects of listening to relaxing music (generated by the Melomics computer system) on the cardiovascular recovery and subjective feelings of anxiety after undergoing an acute-stress episode, a double-blind randomized controlled trial was conducted in healthy adults (N = 24; M = 23.05 years, SD = 2.97). Participants reported their levels of psychiatric symptomatology and anxiety and were then exposed to a stress induction protocol. Afterward, they underwent a period of recovery where they would be exposed to either a relaxing music track or silence, depending on a random assignation. Heart-derived functioning and self-reported anxiety were monitored throughout the study stages. All the participants showed stress-related reactions throughout the study stages, as it was shown for the study outcomes. Regarding the effect of listening to music, participants who listened to relaxing music during the recovery stage showed higher levels of sample entropy than controls, highlighting a large effect size on this difference (η2partial =.59). Relaxing music promotes more adaptive emotional regulation after coping with an acutely stressful event. This study aims to shed light on the actual effects of music interventions, and encourage the use of music-based interventions on health services. [ABSTRACT FROM AUTHOR]

Introduction. High comorbidity between borderline personality disorder (BPD) and eating disorders (ED) shows the necessity of developing transdiagnostic models, where impulsivity could play a relevant role in the manifestations of self-injurious behaviour. Objectives: 1) To compare the levels of impulsivity and self-injurious behaviour among people with BPD, people with ED and controls. 2) To predict the presence of self-injurious behaviour based on impulsivity and other relevant clinical variables, such as the experience of traumatic events and sensitivity to rejection. Methods. 108 women (23 controls; 29 with a diagnosis of restrictive ACT (rED); 21 with a diagnosis of purgative ACT (pED); and 35 with a diagnosis of BPD) were assessed using the Barratt Impulsivity Scale, the Traumatic Experiences Questionnaire and the Sensitivity to Rejection Questionnaire. Information about self-injurious behaviour was collected through interview and clinical history. Results. Differences in impulsivity and self-injurious behaviour scores were found between the groups, with higher impulsivity in the BPD and pED groups, and higher rates of self-injurious behaviour in the BPD group followed by both ED groups. On the other hand, impulsivity predicted suicide attempts, and together with sensitivity to interpersonal rejection predicted nonsuicidal self-harm (NSSH). Conclusion. Impulsivity is a dimensional variable in BPD and ED, which in turn plays a relevant role in the prediction of self-injurious behaviour. [ABSTRACT FROM AUTHOR]

High comorbidity between borderline personality disorder (BPD) and eating disorders (ED) shows the necessity of developing transdiagnostic models, where impulsivity could play a relevant role in the manifestations of self-injurious behaviour.

Background: Alterations in cognitive performance have been described in patients with major depressive disorder (MDD). However, the specific risk factors of these changes are not yet known. This study aimed to explore whether inmunometabolic parameters are related to cognitive performance in MDD in comparison to healthy controls (HC) METHODS: Sample consisted of 84 MDD patients and 78 HC. Both groups were compared on the results of cognitive performance measured with the Cambridge Neuropsychological Test Automated Battery (CANTAB), the presence of metabolic syndrome (MetS) and an inflammatory/oxidative index calculated by a principal component analysis of peripheral biomarkers (tumor necrosis factor, C-reactive protein and 4-hydroxynonenal). A multiple linear regression was carried out, to study the relationship between inmunometabolic variables and the global cognitive performance, being the latter the dependent variable., Results: Significant differences were obtained in the inflammatory/oxidative index between both groups (F (1157) = 12.93; p < .001), also in cognitive performance (F (1157) = 56.75; p < .001). The inmunometabolic covariate regression model (i.e., condition (HC/MDD), sex, age and medication loading, MetS, inflammatory/oxidative index and the interaction between MetS and inflammatory/oxidative index) was statistically significant (F (7157) = 11.24; p < .01) and explained 31% of variance. The condition, being either MDD or HD, (B=-0.97; p < .001), age (B=-0.28; p < .001) and the interaction between inflammatory/oxidative index and MetS (B=-0.38; p = .02) were factors associated to cognitive performance., Limitations: Sample size was relatively small. The cross-sectional design of the study limits the possibilities of analysis., Conclusions: Our results provide evidence on the conjoint influence of metabolic and inflammatory dysregulation on cognitive dysfunction in MDD patients. In this way, our study opens a line of research in immunometabolic agents to deal with cognitive decline associated with MDD., (Copyright © 2021. Published by Elsevier Ltd.)

Introduction: Adolescence is a critical developmental stage for the initiation of substance use worldwide. However, the prevalence of various types of substances consumed by adolescents living in low- and middle- income countries (LMICs) across different continents is not fully understood.The aims of the present study were to estimate the prevalence of regular and problematic substance use among adolescents in 73 LMICs across different continents and to explore the role of country-specific factors on this prevalence., Method: Data of 314,187 adolescents (52.79% girls; median age = 15 years old) who participated in the Global School-based Student Health Survey (GSHS) were analysed. After estimating the weighted prevalence for each country, multilevel models were used to examine the influence of country-specific factors on the prevalence of substance use across 73 LMICs., Results: The results indicated that problematic alcohol use was more prevalent in LMICs with higher income levels. The prevalence of regular alcohol use was the highest in Zambia. Regular and problematic alcohol use was the least prevalent in Senegal and Myanmar. The findings also revealed that smoking and the consumption of marijuana and amphetamine were the most common among adolescents in Samoa, whereas the prevalences for these substances were the lowest in Laos., Conclusion: Economic wealth, religion and geographical factors seem to have a role in determining the prevalence of substance use among adolescents in LMICs., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Crown Copyright © 2021 Published by Elsevier Ltd.)

Substance use is a common public health problem among adolescents in low- and middle-income countries (LMICs), however, factors that are associated with this condition are not clearly understood. The aim of the present study was to examine personal and interpersonal factors that contribute to risk for substance use among adolescents in six ASEAN (Association of Southeast Asian Nations) LMICs (i.e., Indonesia, Laos, Malaysia, Myanmar, Philippines and Thailand). Data of 57,825 adolescents (52.64% girls; median age = 14 years old) who participated in the Global School-based Student Health Survey (GSHS) were analysed. After the weighted prevalence was estimated for each country, multilevel models were employed to examine the influence of the risk factors on the prevalence of substance use across the countries. The results indicated a high prevalence of substance use among adolescents in all these six ASEAN LMICs. Alcohol use, smoking and drug use were more prevalent among adolescents in Thailand, Laos and Philippines. Adolescents who were bullied and who had no close friends had a high prevalence of alcohol and drug use. Problematic drinking and smoking were more prevalent among older adolescents, and smoking and drug use were more prevalent among boys. Furthermore, frequent worry, loneliness and regular physical activity were found to predict adolescents' heavy and binge drinking. This study contributed to knowledge on risk factors for specific substance use among adolescents and drew attention for the urgent need to strengthen the intervention, law policies and professional support for reducing substance use in ASEAN LMICs., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2021 The Authors.)

Background: Public health measures to contain the spread of COVID-19 have resulted in adverse effects, including high level of psychological distress, anxiety, and depression., Aims: This study explored adolescent psychopathological profiles at age 17, and their role in predicting the impact of the COVID-19 pandemic at age 19., Methods: The analyses used a sample of 904 participants (mean age = 19.17 years) from the Millennium Cohort Study (MCS) sweep 7 who completed the mental health questions from January 2018 to March 2019 (mean age = 17.18 years) and the COVID-19 Survey in May 2020. Adolescent psychopathological profiles were identified by means of latent class analysis., Results: Four psychopathological profiles were identified: "low-symptom class" (60.17% of participants), "high-symptom class" (23.01% of participants), "substance/behavioural addictions class" (12.03% of participants), and "emotion-dysregulation class" (4.79% of participants). Adolescents in the high-symptom and emotional-dysregulation classes had the worst outcome during the lockdown. Specifically, they experienced more stress, conflict and loneliness, and lower levels of perceived social support than adolescents in the other psychopathological classes. Adolescents in the emotional-dysregulation class also consumed more alcohol and had worse financial situation during the lockdown compared to pre- lockdown period., Conclusion: Adolescent psychopathological profiles predicted mental health impacts of the COVID-19 outbreak., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Background: Research efforts to measure the concept of healthy ageing have been diverse and limited to specific populations. This diversity limits the potential to compare healthy ageing across countries and/or populations. In this study, we developed a novel measurement scale of healthy ageing using worldwide cohorts., Methods: In the Ageing Trajectories of Health-Longitudinal Opportunities and Synergies (ATHLOS) project, data from 16 international cohorts were harmonized. Using ATHLOS data, an item response theory (IRT) model was used to develop a scale with 41 items related to health and functioning. Measurement heterogeneity due to intra-dataset specificities was detected, applying differential item functioning via a logistic regression framework. The model accounted for specificities in model parameters by introducing cohort-specific parameters that rescaled scores to the main scale, using an equating procedure. Final scores were estimated for all individuals and converted to T-scores with a mean of 50 and a standard deviation of 10., Results: A common scale was created for 343 915 individuals above 18 years of age from 16 studies. The scale showed solid evidence of concurrent validity regarding various sociodemographic, life and health factors, and convergent validity with healthy life expectancy (r = 0.81) and gross domestic product (r = 0.58). Survival curves showed that the scale could also be predictive of mortality., Conclusions: The ATHLOS scale, due to its reliability and global representativeness, has the potential to contribute to worldwide research on healthy ageing., (© The Author(s) 2020. Published by Oxford University Press on behalf of the International Epidemiological Association.)

Background: The domains of functioning affected by first episode of psychosis (FEP) could be analysed as forming a network of interacting or even reinforcing elements. The reasons why longer duration of untreated psychosis (DUP) might be related to higher disability are not still clear. The aim of the present study is to evaluate how different areas of functioning are inter-related according to the length of DUP in patients with FEP, with a particular focus on studying the relative influence of each other according to lengthy delays in initial treatment., Method: 441 participants in an epidemiological and intervention program of first episode psychosis (PAFIP) were included in our study. Functioning problems at baseline were assessed with the WHO Disability Assessment Schedule (DAS). Three networks of functioning domains have been estimated according to the length of DUP., Results: All the DAS items took part in the different networks. We have not found differences across the edge weights in the short, medium and long DUP groups. The domains "social withdrawal", "participation in the household activities", "general interest and information", and "low level of activity" seem to act as bridge items with other areas of functioning in people with longer DUP., Conclusions: Our results could have clinical implications for patients with longer DUP, in which case, social withdrawal, household activities, level of activity and general interest in the world around them, could be high-priority target areas of treatment, since they seem to be mediating the relation between others areas of functioning., (Copyright © 2020. Published by Elsevier Ltd.)

This study aimed to examine how loneliness contributes to metabolic dysregulation among older adults with depression and determine the relative contribution of loneliness to the development of chronic diseases in late adulthood. Harmonised data from the Ageing Trajectories of Health: Longitudinal Opportunities and Synergies (ATHLOS) project were used. Concretely, the sample comprised 6195 participants (53.95% women; M = 61.30 years, SD = 7.11) from three European cohorts. Three groups were considered: control group (CG); depressive symptom episode group (DEP); and a group with depression and loneliness (DEP + LONE). A metabolic score was estimated using anthropometric and blood indicators, by means of multi-indicator multi-causes (MIMIC) modelling and after controlling for sociodemographic and health-related covariates. Group-comparison was based on measurement-invariance procedures. Multimorbidity development was predicted at follow-up considering the study group and relevant covariates. All the analyses were sex-specific. As a result, measurement invariance revealed the influence of group (ΔCFI = -0.017 for male participants and ΔCFI = -0.009 for female ones) on metabolic scores in both sexes. Metabolic scores were significantly lower (i.e., they had more metabolic risk) in DEP + LONE women in comparison to women from the other groups. DEP men showed the lowest metabolic scores but those from the DEP + LONE group showed meaningfully lower scores than CG men (d = 1.35). In terms of multimorbidity prediction, DEP + LONE group membership significantly predicted the outcome in both sexes; DEP group membership significantly predicted multimorbidity at follow-up in women. In summary, these results highlight the relevant contribution of loneliness in depression-related metabolic dysregulation in the short- (concurrent metabolic risk) and long-term (chronic condition development). Moreover, sex-specific mechanisms seem to be involved in metabolic alterations of depressed people showing loneliness feelings. This study calls for action to reduce the impact of loneliness in old age and to promote healthy ageing., (Crown Copyright © 2020. Published by Elsevier Ltd. All rights reserved.)

Background: Substance use disorders (SUD) represent one of the most important public health problems which has an onset in adolescence. Although substantial data exist on adolescent substance use, studies examining the role of parental psychopathological profiles on adolescent offspring SUD are lacking. Thus, this study aimed to identify parental psychopathological profiles, and to examine the extent to which these profiles are associated with SUD in their offspring., Method: Our analytic sample comprised 5887 adolescents (48.60% boys; M = 15.07 years, SD = 1.46) from the National Comorbidity Survey Replication Adolescent Supplement (NCS-A), whose biological parents responded to the Parent Self-Administered Questionnaire. Parental psychopathological profiles were identified by means of latent class analysis., Results: Different psychopathological profiles were identified in fathers and mothers. Among fathers, two psychopathological profiles were found: "normative class" (low psychopathological symptoms and drug use) and "high psychopathology class" (high psychopathological symptoms and drug use). Among mothers, three psychopathological profiles were found: "normative class" (low psychopathological symptoms and drug use), "high psychopathology class" (high psychopathological symptoms and drug use), and "suicide class" (low psychopathological symptoms and drug use, but high on suicidal ideation or suicidal attempt). Father's high psychopathology profile was significantly associated with adolescent's illicit drug abuse. Mother's high psychopathology profile was significantly associated with adolescent's nicotine dependence, alcohol or illicit drug abuse., Conclusions: Family-based interventions should include skills training in reducing parental SUD and other mental health problems., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Ageing well involves individuals continuing participating in personal, social and civic affairs even in older age. From this standpoint, limitations in individual's functioning (beyond the mere absence of disease) may drastically impact on how well people becoming older. This study aimed to identify functional status profiles in a nationally representative sample of older adults, using latent class analysis methods. Moreover, it intended to study the how identified classes would be related to health-related outcomes later in life, as a way to provide some evidence on predictive validity. Data from a nationally representative sample of Spanish older adults (N = 2,118; 56.18% women; M = 71.50 years, SD = 7.76), were used. Profiles were identified according to a large set of functioning indicators from multiple domains using latent class analysis. Outcomes were studied over a 3-year follow-up, considering both the individual (quality of life, well-being and mortality) and institutional level (health service utilisation). As a result, seven profiles were identified: normative profile (showed by most participants), limited cognitive functioning class, limited global functioning class, limited mental and mobility functioning class, poor self-reported health class, limited sensory functioning class and limited objective functioning class. All the profiles with limitations across domains showed poor outcomes. Multidimensional limitations were related to the worst outcomes, especially when psychosomatic complaints and high feelings of loneliness were reported. To sum up, latent class analysis constitutes a suitable alternative to study population heterogeneity, providing relevant evidence to help making decision in public and community health., (© 2020 John Wiley & Sons Ltd.)

Background: The concept of European psychologisation of depression versus somatisation in non-European populations has been the basis of several studies of cultural psychopathology in the general population. Little is currently known about cross-cultural differences and similarities in late-life depression symptom reporting. We cross-culturally compared symptom reporting in the context of Major Depressive Disorder (MDD) among community-dwelling older adults from Spain and Nigeria., Methods: We relied on data from two household multistage probability samples comprising 3,715 persons aged 65 years or older in the Spanish and Nigerian populations. All participants underwent assessments for MDD using the World Mental Health Survey version of the Composite International Diagnostic Interview. Cross-cultural comparison of broad somatic and psychological categories as well as relationship and influence of individual symptoms were analysed using the Symptom Network Analysis approach., Results: Current MDD was diagnosed in 232 and 195 older persons from Spain and Nigeria, respectively. The symptom network of the two samples were invariant in terms of global strength, S(G SPAIN , G NIGERIA ) = 7.56, P = .06, with psychological and somatic symptoms demonstrating centrality in both countries. However, country-specific relationships and influence of individual symptoms were found in the network structure of both samples, M(G SPAIN , G NIGERIA ) = 2.95, P < .01., Conclusion: Broad somatic and psychological symptoms categories contributed to the structural network of older Africans and their peers from the Spanish population. Variations in the relationship and influence of individual symptoms suggests that the functional and "communicative" role of individual symptoms may be differentiated by context specific imperatives. J Am Geriatr Soc 68:-, 2020., (© 2020 John Wiley & Sons Ltd.)

There is a growing consensus regarding the multidimensional nature of successful aging (SA), including both the biomedical and psychosocial domains of the aging process. The Successful Aging Scale (SAS) is a self-rated instrument addressing both of these components. The aim of this study was to analyze the psychometric properties of the Brazilian Portuguese version of the SAS (SAS-B) with regard to reliability and validity in 949 Brazilian community-dwelling older adults (53.60% women; M = 69.49 years; standard deviation = 7.67). Confirmatory factorial analysis (CFA) was performed to provide evidence on its structural validity. Convergent and divergent validity was studied by means of examining the relationships of SAS-B with scales concerning resilience, life satisfaction, self-esteem, social support, perceived stress, and health, as well as mental health. The CFA showed that the SAS-B is multidimensional with three correlated factors (χ 2 /df = 2.74; standardized root mean square residual = 0.03; root mean square error approximation = 0.04; comparative fit index = 0.91), and its factors showed adequate reliability (ω = 0.70 for Healthy living habits, ω = 0.69 for Adaptive coping, and ω = 0.70 for Engagement with Life). Convergent and divergent validity was endorsed by correlations with related factors. The SAS-B is a reliable and valid self-rated instrument to measure the SA from a multidimensional perspective., (© 2020 Wiley Periodicals LLC.)

The risk of suffering anxiety disorders is associated with sustained subthreshold symptoms of anxiety. This study evaluated the stability of anxiety scores (high, moderate or low) across a six-month period in early adolescents (N = 95). The associations between sustained anxiety, vagally-mediated heart rate variability (vmHRV), sympathetic activity, and heart rate fractal dynamics in everyday life conditions were analyzed. The anxiety scores from 71.50% of participants remained at the same level. The linear correlations between anxiety and cardiac measures were weak but a group-based approach revealed that the fractal dimension (FD) from stable-low anxiety participants was higher than the FD from participants with stable-moderate anxiety scores but not higher than the FD from the stable-high anxiety group. The short-term correlations' exponent a1 from the stable-high anxiety group was higher than the a1 from the stable-moderate anxiety group but not higher than the exponent from the stable-low anxiety group. No differences were found in the vmHRV nor sympathetic activity. The lack of a direct association between the complexity of the heart rate and the level of sustained anxiety suggests a nonlinear pattern of associations that would be in accordance with the optimum variability principle.

This study assessed the effects of a psychological group intervention based on positive psychology in women with breast cancer. 175 women were randomly assigned either to an experimental group, receiving the 14-session intervention (n = 87), or to a wait list group (n = 88) that did not receive any type of intervention. For treatment, a group intervention was applied, based on improving psychological strengths and enhancing positive psychology-based styles of coping. Strength-related outcomes, self-esteem, well-being, and happiness were assessed before and after the intervention. The experimental group showed higher scores on all of the study variables after the intervention. Participants reported improved self-esteem, emotional intelligence-related abilities, resilience, and optimism, as well as positive affectivity, well-being, and happiness. The results show a beneficial effect of this psychological intervention based on positive psychology on female breast cancer patients' psychological health.