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Introduction: In previous longitudinal studies in the US, lower socioeconomic status (SES) was associated with more emotional and behavioral problems. It remains unclear whether these findings can be generalized outside the US, as different countries vary in their health care systems and prevention of psychopathology in youth. Therefore, we studied the same associations in a comparable sample in The Netherlands and directly tested for differences between the US and The Netherlands.Methods: The US (N=833) and Dutch (N=708) population samples were followed-up for 9 years. Age at baseline ranged from 8 to 16 years. Parents filled out behavior checklists.Results: Analyses revealed very few differences between the two countries. In both countries, SES predicted syndrome scores and cumulative prevalence rates for internalizing and externalizing problems (withdrawn and aggressive behavior) and for thought and attention Problems. The SES gradient in syndrome scores was stable over time. Only for withdrawn behavior, the gradient was larger in young adulthood.Conclusion: Although the health care systems differ between the US and The Netherlands, the socioeconomic disparities in emotional and behavioral problems were similar. [ABSTRACT FROM AUTHOR]

An investigation was carried out to determine whether there were significant changes in the intake of dietary fibre (NSP) and phytate of adult men and women in the UK from 1982 (aged 36 years) to 1999 (aged 53 years). The 1253 subjects studied were members of the Medical Research Council National Survey of Health and Development; a longitudinal study of a nationally representative cohort of births in 1946. Food intake was recorded in a 5 d diary at age 36 years in 1982, 43 years in 1989 and 53 years in 1999. The food composition database was amended with revised values for phytate. Outcome measures were mean intakes of total NSP and phytate by year, sex and food source. There were significant changes in total NSP and phytate intake over the three time points. Intakes of NSP rose significantly between 1982 and 1999 for men and women but phytate intakes rose significantly only between 1989 and 1999. Cereal foods were the most important source of both NSP and phytate. Between 1989 and 1999 there was a significant increase in the contribution from pasta, rice and other grains. The present study shows that an increase in dietary fibre that is in accordance with dietary guidelines would almost inevitably be accompanied by a rise in phytate. The increased dietary phytate is discussed in relation to its recognised inhibition of mineral absorption and its merits with regard to protection against some cancers and other diseases of an ageing population. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Evidence shows education positively impacts cognitive ability. However, researchers have given little attention to the potential impact of adult education on cognitive ability, still malleable in midlife. The primary study aim was to examine whether there were continuing effects of education over the life course on midlife cognitive ability. METHODS: This study used data from the Medical Research Council National Survey of Health and Development, also known as the British 1946 birth cohort, and multivariate regression to estimate the continuing effects of adult education on multiple measures of midlife cognitive ability. RESULT: Educational attainment completed by early adulthood was associated with all measures of cognitive ability in late midlife. The continued effect of education was apparent in the associations between adult education and higher verbal ability, verbal memory, and verbal fluency in late midlife. We found no association between adult education and mental speed and concentration. Discussion: Associations between adult education and midlife cognitive ability indicate wider benefits of education to health that may be important for social integration, well-being, and the delay of cognitive decline in later life. [ABSTRACT FROM AUTHOR]

Background: In the general population, most individuals with mental disorders are not treated with psychotropic medications. The objective of this study was to identify factors associated with psychotropic medication use over a 17 year period in a birth cohort.Method: Members of the 1946 British birth cohort (n=2,928 in 1999) reported psychotropic medication use in 1982 at age 36, in 1989 at age 43, and in 1999 at age 53. At each of the three time points, several factors were investigated for their association with antidepressant, anxiolytic or hypnotic medication use.Results: After adjusting for severity of symptoms of depression and anxiety, clinical factors such as suicidal ideation, sleep difficulty and poor physical health were strongly associated with antidepressant, anxiolytic or hypnotic medication use in 1982 and 1989, but not in 1999. Non-clinical factors were infrequently associated with antidepressant, anxiolytic or hypnotic medication use in 1982 and 1989 after adjusting for severity of symptoms, however several non-clinical factors were associated with antidepressant, anxiolytic or hypnotic medication use in 1999 including being female (OR=1.4, 95% CI: 1.0, 1.9), unemployment (OR=2.9, 95% CI: 2.1, 4.1), living alone (OR=2.6, 95% CI: 1.7, 3.9), and being divorced, separated or widowed (OR=1.5, 95% CI: 1.1, 2.3).Limitations: Data were not available on help-seeking behaviour.Conclusions: Treatment of mental disorder with psychotropic medications is strongly associated with clinical factors. However, non-clinical factors continue to be significant, and may influence both treatment-seeking and prescribing behaviour. [ABSTRACT FROM AUTHOR]

Despite the added value of multisystem (relative to traditional single-system) approaches for characterizing biological processes linked to risk for psychopathology (e.g., neuroendocrine stress responsivity; Buss et al., 2019; Quas et al., 2014), no study to date has evaluated whether multisystem processes may serve as viable biological targets of intervention. Utilizing a multiple-levels-of-analysis approach (Cicchetti & Dawson, 2002), this person-centered study examined whether stress-adapted patterns of hypothalamus-pituitary-adrenal (HPA) axis and sympathetic-adrenomedullary (SAM) system co-activation were amenable to change following the Building a Strong Identity and Coping Skills intervention (BaSICS; Wadsworth et al., 2022). Preadolescents exposed to concentrated poverty ( n = 112, M age = 11.78 years, 57.1% female, 54% assigned to intervention; 40% Hispanic, 63% Black, 20% White) completed questionnaires and the Trier Social Stress Test at both pre- and posttest. Multitrajectory modeling of cortisol and alpha-amylase levels identified four pretest and posttest HPA-SAM co-activation profiles. At pretest, youth exhibiting Asymmetric Nos. 1 & 2 HPA-SAM co-activation reported greater maladjustment relative to youth with Symmetric Nos. 1 & 2 co-activation. Youth exhibiting Asymmetric No. 1 co-activation at pretest were more likely to exhibit Symmetric No. 1 co-activation following BaSICS relative to control. Findings highlight the potential of BaSICS to restore neuroendocrine stress response function in impoverished youth, pointing to HPA-SAM co-activation as a potential biological target of preventive intervention in this population.

Even though alternative RNA splicing was discovered nearly 50 years ago (1977), we still understand very little about most isoforms arising from a single gene, including in which tissues they are expressed and if their functions differ. Human gene annotations suggest remarkable transcriptional complexity, with approximately 252,798 distinct RNA isoform annotations from 62,710 gene bodies (Ensembl v109; 2023), emphasizing the need to understand their biological effects. For example, 256 gene bodies have ≥50 annotated isoforms and 30 have ≥100, where one protein-coding gene ( MAPK10 ) even has 192 distinct RNA isoform annotations. Whether such isoform diversity results from biological redundancy or spurious alternative splicing (i.e., noise), or whether individual isoforms have specialized functions (even if subtle) remains a mystery for most genes. Recent studies by Aguzzoli-Heberle et al., Leung et al., and Glinos et al. demonstrated long-read RNAseq enables improved RNA isoform quantification for essentially any tissue, cell type, or biological condition ( e.g., disease, development, aging, etc.), making it possible to better assess individual isoform expression and function. While each study provided important discoveries related to RNA isoform diversity, deeper exploration is needed. We sought to quantify and characterize real isoform usage across tissues (compared to annotations). We used long-read RNAseq data from 58 GTEx samples across nine tissues (three brain, two heart, muscle, lung, liver, and cultured fibroblasts) generated by Glinos et al. and found considerable isoform diversity within and across tissues. Cerebellar hemisphere was the most transcriptionally complex tissue (22,522 distinct isoforms; 3,726 unique); liver was least diverse (12,435 distinct isoforms; 1,039 unique). We highlight gene clusters exhibiting high tissue-specific isoform diversity per tissue ( e.g. , TPM1 expresses 19 in heart's atrial appendage). We also validated 447 of the 700 new isoforms discovered by Aguzzoli-Heberle et al. and found that 88 were expressed in all nine tissues, while 58 were specific to a single tissue. This study represents a broad survey of the RNA isoform landscape, demonstrating isoform diversity across nine tissues and emphasizes the need to better understand how individual isoforms from a single gene body contribute to human health and disease., Competing Interests: Competing interests The authors report no competing interests.

Determining whether the RNA isoforms from medically relevant genes have distinct functions could facilitate direct targeting of RNA isoforms for disease treatment. Here, as a step toward this goal for neurological diseases, we sequenced 12 postmortem, aged human frontal cortices (6 Alzheimer disease cases and 6 controls; 50% female) using one Oxford Nanopore PromethION flow cell per sample. We identified 1,917 medically relevant genes expressing multiple isoforms in the frontal cortex where 1,018 had multiple isoforms with different protein-coding sequences. Of these 1,018 genes, 57 are implicated in brain-related diseases including major depression, schizophrenia, Parkinson's disease and Alzheimer disease. Our study also uncovered 53 new RNA isoforms in medically relevant genes, including several where the new isoform was one of the most highly expressed for that gene. We also reported on five mitochondrially encoded, spliced RNA isoforms. We found 99 differentially expressed RNA isoforms between cases with Alzheimer disease and controls., (© 2024. The Author(s).)

There is an absence of mechanism-driven interventions equipped to reduce the large mental health disparities that exist for preadolescent youth living in poverty. Building a Strong Identity and Coping Skills (BaSICS) is a preventive intervention designed to target multiple aspects of poverty-related stress adaptation, including altered neuroendocrine function. The purpose of the current study was to examine whether pre-post shifts in preadolescent hypothalamic-pituitary-adrenal (HPA) activation could longitudinally predict internalizing outcomes and to determine whether BaSICS could buffer such HPA-related risk for psychopathology. Low-income youth (n = 112) ages 11-12 years were randomized to the 16-session intervention or assessment-only control (53% intervention; 54% female; 40% Hispanic, 63% Black, 20% White). Youth completed questionnaires and the Trier Social Stress Test, and provided cortisol via saliva at six timepoints during the 90-minute assessment. Adjusting for pre-intervention Cortisol Area Under the Curve-Ground (CAUCg) scores and internalizing problems, post-intervention CAUCg and intervention main and interactive effects were modeled as predictors of internalizing outcomes across post-intervention, 6-month, and 12-month follow-up assessments using multilevel regression methods. A significant post-intervention CAUCg by intervention interaction emerged (B=1.198, SE=0.433, p = .006). For control youth, baseline-adjusted decreases in cortisol output were associated with increases in internalizing problems that remained stably elevated across follow-up assessments. For BaSICS youth, however, internalizing problems decreased and remained stably low following program delivery, irrespective of post-intervention increases or decreases in cortisol output. Findings illustrate how BaSICS may buffer against HPA-related risk for internalizing psychopathology and provide support for interventions targeting biological mechanisms of risk for low-income preadolescents., Competing Interests: Declaration of Competing Interest 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., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Due to alternative splicing, human protein-coding genes average over eight RNA isoforms, resulting in nearly four distinct protein coding sequences per gene. Long-read RNAseq (IsoSeq) enables more accurate quantification of isoforms, shedding light on their specific roles. To assess the medical relevance of measuring RNA isoform expression, we sequenced 12 aged human frontal cortices (6 Alzheimer's disease cases and 6 controls; 50% female) using one Oxford Nanopore PromethION flow cell per sample. Our study uncovered 53 new high-confidence RNA isoforms in medically relevant genes, including several where the new isoform was one of the most highly expressed for that gene. Specific examples include WDR4 (61%; microcephaly), MYL3 (44%; hypertrophic cardiomyopathy), and MTHFS (25%; major depression, schizophrenia, bipolar disorder). Other notable genes with new high-confidence isoforms include CPLX2 (10%; schizophrenia, epilepsy) and MAOB (9%; targeted for Parkinson's disease treatment). We identified 1,917 medically relevant genes expressing multiple isoforms in human frontal cortex, where 1,018 had multiple isoforms with different protein coding sequences, demonstrating the need to better understand how individual isoforms from a single gene body are involved in human health and disease, if at all. Exactly 98 of the 1,917 genes are implicated in brain-related diseases, including Alzheimer's disease genes such as APP (Aβ precursor protein; five), MAPT (tau protein; four), and BIN1 (eight). As proof of concept, we also found 99 differentially expressed RNA isoforms between Alzheimer's cases and controls, despite the genes themselves not exhibiting differential expression. Our findings highlight the significant knowledge gaps in RNA isoform diversity and their medical relevance. Deep long-read RNA sequencing will be necessary going forward to fully comprehend the medical relevance of individual isoforms for a "single" gene., Competing Interests: Competing interests The authors report no competing interests.

Investigating the co-activation of hypothalamic-pituitary-adrenal (HPA) and sympathetic-adrenomedullary (SAM) responses to acute stress can provide insight into how risk might become biologically embedded during early adolescence and improve understanding of what distinguishes physiological dysregulation from normative/expected physiological responses to stress. Evidence has thus far been mixed as to whether symmetric or asymmetric co-activation patterns are associated with higher exposure to chronic stress and poorer mental health outcomes during adolescence. This study expands on a prior multisystem, person-centered analysis of lower-risk, racially homogenous youth by focusing on HPA-SAM co-activation patterns in a higher-risk, racially diverse sample of early adolescents from low-income families (N = 119, M age =11.79 years, 55.5% female, 52.7% mono-racial Black). The present study was conducted by performing secondary analysis of data from the baseline assessment of an intervention efficacy trial. Participants and caregivers completed questionnaires; youth also completed the Trier Social Stress Test-Modified (TSST-M) and provided six saliva samples. Multitrajectory modeling (MTM) of salivary cortisol and alpha-amylase levels identified four HPA-SAM co-activation profiles. In accordance with the asymmetric-risk model, youth exhibiting Low HPA-High SAM (n = 46) and High HPA-Low SAM (n = 28) profiles experienced more stressful life events, posttraumatic stress, and emotional and behavioral problems relative to Low HPA-Low SAM (n = 30) and High HPA-High SAM (n = 15) youth. Findings highlight potential differences in biological embedding of risk during early adolescence based on individuals' exposure to chronic stress and illustrate the utility of multisystem and person-centered approaches in understanding how risk might get "underneath the skin" across systems., Competing Interests: Declaration of Competing Interest 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., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Though correspondence across the affective experience and physiologic arousal levels of the stress response is thought to support efficacious coping and buffer against internalizing problems, little evidence has demonstrated such correspondence. Using a community sample of preadolescents (N=151, Mage=10.33 years, Minage=8.92, Maxage=12.00, 51.7% male), this person-centered study examined internalizing problem and coping-linked variability in psychobiological stress response correspondence. Preadolescents were exposed to the Trier Social Stress Test and self-reported negative affect (NA) and salivary cortisol (SC) levels were assessed. Multitrajectory modeling revealed four subgroups. Relative to In-Touch (i.e., Moderate NA-Moderate SC; n=65), Unmindful (i.e., Moderate NA-Low SC; n=49) were more likely to present with parent-reported but not self-reported internalizing problems; Vigilant (i.e., High NA-Low SC; n=13) were more likely to present with self- and parent-reported internalizing problems, less likely to use engagement coping, and more likely to use wishful thinking (e.g., "I wish problems would just go away."); Denial (i.e., Low NA-High SC; n=24) self-reported similarly low internalizing problems, but were also more likely to report reliance on denial (e.g., "I pretend problems don't exist."). Findings illustrate meaningful heterogeneity in preadolescent psychobiological correspondence with implications for multimodal assessment and outcome monitoring in coping-based preventative interventions.

Objective: This study used a randomized clinical trial design to evaluate the success with which The Building a Strong Identity and Coping Skills intervention (BaSICS) engaged the proximal mechanisms of poverty-related stress's impact on the psychosocial functioning and mental health of young adolescents living in high poverty contexts., Method: 129 youth from very low-income families were randomized to receive the 32-hour group-based intervention or no-treatment control - 16 of these families withdrew before the intervention groups began. The remaining 113 youth aged 11-12 (53% assigned to intervention; 54% female; 40% Hispanic, 63% Black, 20% White) participated in the study, which included four assessment waves: pretest, posttest, 6-month follow-up and 12-month follow-up assessments. Primary control, secondary control, and disengagement coping were assessed via a combination of parent and youth reports as well as via interviews and questionnaires. Hypothalamic-pituitary-adrenal axis (HPA) reactivity was assessed via salivary cortisol responses occurring during a lab-based stress induction (Trier Social Stress Test)., Results: Multilevel regression models with repeated measures nested within subjects revealed that in comparison to controls, intervention youth had sustained significant increases in their knowledge about primary control coping (e.g., problem solving, emotion modulation), knowledge and utilization of secondary control (e.g., cognitive restructuring) coping, as well as decreased reliance on disengagement coping. These were accompanied by decreased cortisol reactivity in intervention versus control youth., Conclusions: These findings support that BaSICS engages several proximal mechanisms of poverty-related stress' impact on early adolescent mental health - coping skills and HPA reactivity - during the neurodevelopmentally plastic pubertal period.

If performance goals (i.e., motivation to prove ability) increase children's vulnerability to depression (Dykman, 1998), why are they overlooked in the psychopathology literature? Evidence has relied on self-report or observational methods and has yet to articulate how this vulnerability unfolds across levels of analysis implicated in stress-depression linkages; for example, hypothalamic-pituitaryadrenal axis (HPA), sympathetic nervous system (SNS). Utilizing a multiple-levels-of-analysis approach (Cicchetti, 2010), this experimental study tested Dykman's goal orientation model of depression vulnerability in a community sample of preadolescents (N = 121, Mage = 10.60 years, Range = 9.08-12.00 years, 51.6% male). Self-reports of performance goals, attachment security, and subjective experience of internalizing difficulties were obtained in addition to objective behavioral (i.e., task persistence) and physiologic arousal (i.e., salivary cortisol, skin conductance level) responses to the Trier Social Stress Test (TSST) and two randomly assigned coping conditions: avoidance, distraction. Children with performance goals reported greater internalizing difficulties and exhibited more dysregulated TSST physiologic responses (i.e., HPA hyperreactivity, SNS protracted recovery), yet unexpectedly displayed greater TSST task persistence and more efficient physiologic recovery during avoidance relative to distraction. These associations were stronger and nonsignificant in the context of insecure and secure attachment, respectively. Findings illustrate a complex matrix of in-the-moment, integrative psychobiological relationships linking performance goals to depression vulnerability.

Models that recapitulate the complexity of human tumors are urgently needed to develop more effective cancer therapies. We report a bank of human patient-derived xenografts (PDXs) and matched organoid cultures from tumors that represent the greatest unmet need: endocrine-resistant, treatment-refractory and metastatic breast cancers. We leverage matched PDXs and PDX-derived organoids (PDxO) for drug screening that is feasible and cost-effective with in vivo validation. Moreover, we demonstrate the feasibility of using these models for precision oncology in real time with clinical care in a case of triple-negative breast cancer (TNBC) with early metastatic recurrence. Our results uncovered a Food and Drug Administration (FDA)-approved drug with high efficacy against the models. Treatment with this therapy resulted in a complete response for the individual and a progression-free survival (PFS) period more than three times longer than their previous therapies. This work provides valuable methods and resources for functional precision medicine and drug development for human breast cancer., (© 2022. The Author(s).)

Coping that is adaptive in low-stress environments can be ineffective or detrimental in the context of poverty. Identifying coping profiles among adolescents facing varying levels of stress can increase understanding of when and for whom coping may be most adaptive. The present study applied latent profile analysis (LPA) to identify coping profiles in two distinct samples of adolescents: a community sample of youth aged 11-16 years (N = 374, M age  = 13.14, 53% girls), and a low-SES sample of youth aged 12-18 years (N = 304, M age  = 14.56, 55% girls). The ten coping subscales of the Responses to Stress Questionnaire were included as indicators in the LPAs (problem solving, emotion regulation, emotion expression, acceptance, positive thinking, cognitive restructuring, distraction, denial, wishful thinking, and avoidance). Five profiles were identified in the community sample: Inactive, Low Engagement, Cognitive, Engaged, and Active Copers. All but the Low Engagement Copers profile were also identified in the low-SES sample, suggesting that adolescents employ similar coping strategies across contexts, but fewer low-SES adolescents engage in lower levels of coping. Profiles differed by gender and symptoms of internalizing psychopathology. Inactive copers in both samples were more likely to be male. Engaged Copers reported the lowest symptom levels whereas Active Copers reported higher symptoms. Cognitive Copers reported higher levels of anxious and depressive symptoms in the low-SES sample only, suggesting that this pattern of coping may be protective only in less stressful contexts. Elucidating within-person coping patterns is a promising avenue for targeting interventions to those most likely to benefit.

This proof-of-concept study tests the initial efficacy of the Building a Strong Identity and Coping Skills (BaSICS) intervention, a selective prevention of internalizing problems program for early adolescents exposed to high levels of poverty-related stress. Eighty-four early adolescents (M age  = 11.36 years) residing in very low-income neighborhoods were randomized to receive the 16-session intervention (n = 44) or to an assessment-only control condition (n = 40). BaSICS teaches coping skills, social identity development, and collective social action to empower youth with the ability to connect with members of their communities and cope with poverty-related stress in positive and collaborative ways. Pretest-posttest analyses showed that intervention adolescents acquired problem-solving and cognitive-restructuring skills and reduced their reliance on avoidant coping. In addition, HPA reactivity was significantly reduced in the intervention youth, but not controls. Finally, intervention youth's internalizing and somatic symptoms as reported by both youth and their parents, showed significant reductions over time, whereas control youth had no such changes. Results provide strong support for this approach to strength-building and symptom reduction in a population of early adolescents exposed to poverty-related stress., (© 2019 Society for Community Research and Action.)

Objective: This study tested the Adaptation to Poverty-Related Stress (APRS) model's proposed relationships between poverty-related stress (PRS), ethnic identity affirmation (EI), social support, engagement coping, and depression in a racial/ethnically diverse sample of low-income parents., Method: Path analysis was used to test the APRS model in a sample of 602 parents living at or below 200% of the federal poverty line (50% male, mean age = 32.55 years, SD = 8.78, 34.8% White). Multigroup path analysis tested moderation by gender and race/ethnicity., Results: Path analysis revealed that PRS was indirectly associated with higher depressive symptoms through less social support and less use of engagement coping operating in parallel and sequentially in a three-path mediated sequence. Conversely, EI was indirectly associated with lower depressive symptoms through greater social support and greater use of engagement coping operating in parallel and sequentially. However, PRS remained a direct predictor of higher depressive symptoms. Moderation by gender and race/ethnicity was not found., Conclusion: Overall, the findings provide empirical support for the APRS model. This study suggests that clinical and preventive interventions targeting depression in low-income parents could benefit from focusing on improving low-income parent's use of engagement coping and perceived social support. Ethnic identity is a promising target as it to protects against PRS' negative impact on coping and social support. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Understanding co-activation patterns of the hypothalamic-pituitary-adrenal axis (HPA) and sympathetic adrenal medullary (SAM) during early adolescence may illuminate risk for development of internalizing and externalizing problems. The present study advances empirical work on the topic by examining SAM-HPA co-activation during both the reactivity and recovery phases of the stress response following acute stress exposure. Fourth and fifth grade boys and girls (N = 149) provided cortisol and alpha-amylase via saliva at seven times throughout a 95-min assessment in which they were administered the modified Trier Social Stress Test. Parents reported on adolescents' life stress, pubertal development, medication use, and externalizing problems. Adolescents reported their own internalizing symptoms. Multiple linear regressions tested both direct and interactive effects of SAM and HPA reactivity and recovery on internalizing and externalizing problems. Results from these analyses showed that whereas SAM and HPA reactivity interacted to predict internalizing symptoms, it was their interaction during the recovery phase that predicted externalizing. Concurrent high SAM and HPA reactivity scores predicted high levels of internalizing and concurrently low SAM and HPA recovery scores predicted high levels of externalizing. Implications of the findings for further study and clinical application are discussed., (© 2019 Wiley Periodicals, Inc.)

The toxic stress model posits that extended activation of stress response systems in the absence of a supportive relationship with an adult may over time lead to physiological alterations to these same systems, and ultimately to poorer physical and mental health outcomes. However, empirical tests of model hypotheses in adolescence, a critical period of development, are lacking. This study expands the toxic stress model to include more developmentally-appropriate risk and protective factors for adolescents experiencing overwhelming and uncontrollable stressors. Data were collected for a study of early adolescents from urban low-income households (N = 101; 10-12 years old; 59% female). Participants and a caregiver completed questionnaires; youths completed the modified Trier Social Stress Task alone and provided six saliva samples. Using latent profile analysis, three profiles of cortisol reactivity were identified in early adolescents exposed to chronic environmental stress: Elevated and Reactive (11%), Moderate and Non-Reactive (26%), and Blunted and Non-Reactive (63%). In accordance with the toxic stress model, exposure to more community violence and less family support were associated with blunted cortisol reactivity, and Reactive profile membership was associated with fewer trauma symptoms. Overall, the findings provide empirical support for the extension of the toxic stress model in early adolescence through the application of developmentally-sensitive measures and provide implications for future interventions., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

This article aims to integrate theory and empirical findings about understanding and fostering the process of resilience and adaptation in children and families who live in poverty. In this article, we draw from multiple, somewhat distinct, scholarly streams to identify sources of protection, integrating across the literatures on stress and coping, psychophysiology, cultural identity development, and empowerment theory. Because living in poverty cuts across other dimensions of social differentiation and structural inequality, intersectionality theory frames our discussion of how to leverage poverty-affected youths' diverse experiences. We present a framework to guide intervention and research on resiliency promotion, describe the Building a Strong Identity and Coping Skills intervention stemming from the framework, and suggest possible avenues and next steps for both interventions and research.

This Special Section showcases cutting-edge, theory-driven research, which elucidates how multiple physiologic stress-response systems and neural networks that support social behavior operate together to affect psychological processes across from infancy to adolescence. The 8 papers included in the Special Section represent cutting-edge efforts to understand how multiple physiological systems jointly influence behavior. They raise new questions, highlight issues that remain unresolved, and suggest additional directions for research. It is our hope that they will stimulate theory building and new, integrative studies that will advance knowledge about the coordinated effects of neural, endocrine, and autonomic systems on social, emotional, and cognitive development. (PsycINFO Database Record, ((c) 2018 APA, all rights reserved).)

This random assignment experimental study examined the intersection of children's coping and physiologic stress reactivity and recovery patterns in a sample of preadolescent boys and girls. A sample of 82 fourth-grade and fifth-grade (M age  = 10.59 years old) child-parent dyads participated in the present study. Children participated in the Trier Social Stress Test and were randomly assigned to one of two post-Trier Social Stress Test experimental coping conditions-behavioral distraction or cognitive avoidance. Children's characteristic ways of coping were examined as moderators of the effect of experimental coping condition on cortisol reactivity and recovery patterns. Multilevel modeling analyses indicated that children's characteristic coping and experimental coping condition interacted to predict differential cortisol recovery patterns. Children who characteristically engaged in primary control engagement coping strategies were able to more quickly down-regulate salivary cortisol when primed to distract themselves than when primed to avoid, and vice versa. The opposite pattern was true for characteristic disengagement coping in the context of coping condition, suggesting that regulatory fit between children's characteristic ways of coping and cues from their coping environment may lead to more and less adaptive physiologic recovery profiles. This study provides some of the first evidence that coping "gets under the skin" and that children's characteristic ways of coping may constrain or enhance a child's ability to make use of environmental coping resources.

Parenting in the context of poverty is accompanied by heightened stress and heightened stakes. How parents respond to poverty-related stress has important implications for family functioning, but research investigating individual differences in low-income mothers' and fathers' responses to financial stress and their associations with parents' concurrent psychosocial adaptation is lacking. A better understanding of differences in stress responses among low-income parents is required to develop and tailor prevention programs that meet these families' needs. This study applies latent profile analysis (LPA) to identify and describe profiles of financial stress responses (problem solving, emotion regulation, emotion expression, cognitive restructuring, positive thinking, acceptance, distraction, denial, avoidance, wishful thinking, rumination, intrusive thoughts, emotional arousal, physiologic arousal, impulsive action, emotional numbing, cognitive interference, escape, and inaction) and examines associations between profile membership and psychosocial functioning in low-income parents. Five profiles were identified that were distinguished by self-reported voluntary and involuntary financial stress responses: active (32% of sample), low (11%), high (11%), negative cognitive (NC; 17%), and average (29%) responders. Notable differences emerged on measures of life stress, economic hardship, psychopathology, and social support, with individuals in the NC responders profile reporting the most difficulty and members of the active responders profile reporting the greatest adaptation. These findings offer a more nuanced understanding of how mothers and fathers respond to chronic poverty-related stress and have valuable implications for intervention efforts to promote adaptive stress responses and psychosocial functioning in low-income families. (PsycINFO Database Record, ((c) 2018 APA, all rights reserved).)

Introduction: Mitochondrial genetics are an important but largely neglected area of research in Alzheimer's disease. A major impediment is the lack of data sets., Methods: We used an innovative, rigorous approach, combining several existing tools with our own, to accurately assemble and call variants in 809 whole mitochondrial genomes., Results: To help address this impediment, we prepared a data set that consists of 809 complete and annotated mitochondrial genomes with samples from the Alzheimer's Disease Neuroimaging Initiative. These whole mitochondrial genomes include rich phenotyping, such as clinical, fluid biomarker, and imaging data, all of which is available through the Alzheimer's Disease Neuroimaging Initiative website. Genomes are cleaned, annotated, and prepared for analysis., Discussion: These data provide an important resource for investigating the impact of mitochondrial genetic variation on risk for Alzheimer's disease and other phenotypes that have been measured in the Alzheimer's Disease Neuroimaging Initiative samples., (Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.)

This study adopted a person-centered approach to identify preadolescent salivary cortisol (sC) and alpha-amylase (sAA) co-activation response patterns and examine links to behavioral functioning and coping. Children (N = 151, 51.7% male) were exposed to the Trier Social Stress Test (TSST) and one of two randomly-assigned, post-TSST coping conditions: distraction or avoidance. Multi-trajectory modeling yielded four child subgroups. Child internalizing and externalizing positively predicted High sC-High sAA relative to Low sC-Low sAA and Low sC-High sAA relative to High sC-Low sAA subgroup membership, respectively. Low sC-Low sAA children demonstrated more efficient sC recovery when primed with distraction and more protracted sC recovery when primed with avoidance. For High sC-High sAA, internalizing children, the opposite was true. Findings illustrate adjustment-linked variability in preadolescent sC-sAA co-activation response patterns that further articulates for whom effortful coping works to effectively manage stressor-induced neuroendocrine activation., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Background and Objectives: Developmental theorists posit that temperament contributes to preadolescent's stress response styles. Findings from empirical studies, however, have yielded mixed results, thus indicating a need to consider moderators of this relation. Utilizing an analytic framework guided by resiliency theory [Zimmerman, M. A. (2013). Resiliency theory: A strengths-based approach to research and practice for adolescent health. Health Education & Behavior, 40, 381-383], this study examined achievement goal orientation as a moderator of the relation between temperament and stress response styles., Methods: 96 preadolescent-parent dyads (M age  = 10.30 years, range = 9-12 years) participated in the study. Preadolescents reported on their achievement goal orientation, coping and involuntary stress responses (ISRs) styles and a parent reported on children's temperament., Results: Multiple regressions revealed that effortful control positively predicted preadolescent's predominant use of engagement coping and negatively predicted predominance of ISRs, but only for children with a predominant mastery goal orientation. For preadolescents with a predominant performance goal orientation, effortful control negatively predicted the predominant use of engagement coping and positively predicted predominance of ISRs. Negative affectivity and its interaction with goal orientation did not predict coping or ISR styles., Conclusions: Findings suggest that a predominant mastery goal orientation may function as a promotive factor by enhancing the contribution of effortful control to engagement coping styles and buffering against unmanaged reactivity.

This study examined recent stress exposure and effortful coping effects on salivary cortisol (sC) response patterns in preadolescent boys and girls (N = 121, M age  = 10.60 years). Children were exposed to the Trier Social Stress Test (TSST) and one of two randomly assigned, post-TSST coping conditions: distraction and avoidance. Piecewise growth multilevel modeling did not link children's recent stressful life events or hair cortisol (hC) levels to sC reactivity, though each interacted with coping condition to predict sC recovery patterns. Children with elevated life stressor and hC levels demonstrated protracted sC recovery when primed with distraction, yet more efficient sC recovery when primed with avoidance. Findings challenge assumptions about universally "good" and "bad" coping by highlighting contexts where each succeed and fail in helping children manage acute stress physiology., (© 2017 Wiley Periodicals, Inc.)

Background: Analyzing next-generation sequencing data is difficult because datasets are large, second generation sequencing platforms have high error rates, and because each position in the target genome (exome, transcriptome, etc.) is sequenced multiple times. Given these challenges, numerous bioinformatic algorithms have been developed to analyze these data. These algorithms aim to find an appropriate balance between data loss, errors, analysis time, and memory footprint. Typical analysis pipelines require multiple steps. If one or more of these steps is unnecessary, it would significantly decrease compute time and data manipulation to remove the step. One step in many pipelines is PCR duplicate removal, where PCR duplicates arise from multiple PCR products from the same template molecule binding on the flowcell. These are often removed because there is concern they can lead to false positive variant calls. Picard (MarkDuplicates) and SAMTools (rmdup) are the two main softwares used for PCR duplicate removal., Results: Approximately 92 % of the 17+ million variants called were called whether we removed duplicates with Picard or SAMTools, or left the PCR duplicates in the dataset. There were no significant differences between the unique variant sets when comparing the transition/transversion ratios (p = 1.0), percentage of novel variants (p = 0.99), average population frequencies (p = 0.99), and the percentage of protein-changing variants (p = 1.0). Results were similar for variants in the American College of Medical Genetics genes. Genotype concordance between NGS and SNP chips was above 99 % for all genotype groups (e.g., homozygous reference)., Conclusions: Our results suggest that PCR duplicate removal has minimal effect on the accuracy of subsequent variant calls.

Introduction: Ebbert et al. reported gene-gene interactions between rs11136000-rs670139 (CLU-MS4A4E) and rs3865444-rs670139 (CD33-MS4A4E). We evaluate these interactions in the largest data set for an epistasis study., Methods: We tested interactions using 3837 cases and 4145 controls from Alzheimer's Disease Genetics Consortium using meta-analyses and permutation analyses. We repeated meta-analyses stratified by apolipoprotein E (APOE) ε4 status, estimated combined odds ratio (OR) and population attributable fraction (cPAF), and explored causal variants., Results: Results support the CLU-MS4A4E interaction and a dominant effect. An association between CLU-MS4A4E and APOE ε4 negative status exists. The estimated synergy factor, OR, and cPAF for rs11136000-rs670139 are 2.23, 2.45, and 8.0, respectively. We identified potential causal variants., Discussion: We replicated the CLU-MS4A4E interaction in a large case-control series and observed APOE ε4 and possible dominant effect. The CLU-MS4A4E OR is higher than any Alzheimer's disease locus except APOE ε4, APP, and TREM2. We estimated an 8% decrease in Alzheimer's disease incidence without CLU-MS4A4E risk alleles and identified potential causal variants., (Copyright © 2016 The Alzheimer's Association. Published by Elsevier Inc. All rights reserved.)

Purpose: Treatment regimens for locally advanced non-small cell lung cancer (NSCLC) give suboptimal clinical outcomes. Technological advancements such as radiation therapy, the backbone of most treatment regimens, may enable more potent and effective therapies. The objective of this study was to escalate radiation therapy to a tumoricidal hypofractionated dose without exceeding the maximally tolerated dose (MTD) in patients with locally advanced NSCLC., Methods and Materials: Patients with stage II to IV or recurrent NSCLC and Eastern Cooperative Oncology Group performance status of 2 or greater and not candidates for surgical resection, stereotactic radiation, or concurrent chemoradiation were eligible. Highly conformal radiation therapy was given to treat intrathoracic disease in 15 fractions to a total of 50, 55, or 60 Gy., Results: Fifty-five patients were enrolled: 15 at the 50-Gy, 21 at the 55-Gy, and 19 at the 60-Gy dose levels. A 90-day follow-up was completed in each group without exceeding the MTD. With a median follow-up of 12.5 months, there were 93 grade ≥ 3 adverse events (AEs), including 39 deaths, although most AEs were considered related to factors other than radiation therapy. One patient from the 55- and 60-Gy dose groups developed grade ≥ 3 esophagitis, and 5, 4, and 4 patients in the respective dose groups experienced grade ≥ 3 dyspnea, but only 2 of these AEs were considered likely related to therapy. There was no association between fraction size and toxicity (P = .24). The median overall survival was 6 months with no significant differences between dose levels (P = .59)., Conclusions: Precision hypofractionated radiation therapy consisting of 60 Gy in 15 fractions for locally advanced NSCLC is generally well tolerated. This treatment regimen could provide patients with poor performance status a potent alternative to chemoradiation. This study has implications for the cost effectiveness of lung cancer therapy. Additional studies of long-term safety and efficacy of this therapy are warranted., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Health disparities are rooted in childhood and stem from adverse early environments that damage physiologic stress-response systems. Developmental psychobiological models of the effects of chronic stress account for both the negative effects of a stress-response system calibrated to a dangerous and unpredictable environment from a health perspective, and the positive effects of such an adaptively calibrated stress response from a functional perspective. Our research suggests that contexts that produce functionally adapted physiologic responses to stress also encourage a functionally adapted coping response-coping that can result in maladjustment in physical and mental health, but enables children to grow and develop within those contexts. In this article, I highlight the value of reframing maladaptive coping as functional adaptation to understand more completely the development of children's coping in different contexts, and the value of such a conceptual shift for coping-based theory, research, and intervention.

Cerebrospinal fluid (CSF) 42 amino acid species of amyloid beta (Aβ42) and tau levels are strongly correlated with the presence of Alzheimer's disease (AD) neuropathology including amyloid plaques and neurodegeneration and have been successfully used as endophenotypes for genetic studies of AD. Additional CSF analytes may also serve as useful endophenotypes that capture other aspects of AD pathophysiology. Here we have conducted a genome-wide association study of CSF levels of 59 AD-related analytes. All analytes were measured using the Rules Based Medicine Human DiscoveryMAP Panel, which includes analytes relevant to several disease-related processes. Data from two independently collected and measured datasets, the Knight Alzheimer's Disease Research Center (ADRC) and Alzheimer's Disease Neuroimaging Initiative (ADNI), were analyzed separately, and combined results were obtained using meta-analysis. We identified genetic associations with CSF levels of 5 proteins (Angiotensin-converting enzyme (ACE), Chemokine (C-C motif) ligand 2 (CCL2), Chemokine (C-C motif) ligand 4 (CCL4), Interleukin 6 receptor (IL6R) and Matrix metalloproteinase-3 (MMP3)) with study-wide significant p-values (p<1.46×10-10) and significant, consistent evidence for association in both the Knight ADRC and the ADNI samples. These proteins are involved in amyloid processing and pro-inflammatory signaling. SNPs associated with ACE, IL6R and MMP3 protein levels are located within the coding regions of the corresponding structural gene. The SNPs associated with CSF levels of CCL4 and CCL2 are located in known chemokine binding proteins. The genetic associations reported here are novel and suggest mechanisms for genetic control of CSF and plasma levels of these disease-related proteins. Significant SNPs in ACE and MMP3 also showed association with AD risk. Our findings suggest that these proteins/pathways may be valuable therapeutic targets for AD. Robust associations in cognitively normal individuals suggest that these SNPs also influence regulation of these proteins more generally and may therefore be relevant to other diseases.

Background: Since the advent of next-generation sequencing many previously untestable hypotheses have been realized. Next-generation sequencing has been used for a wide range of studies in diverse fields such as population and medical genetics, phylogenetics, microbiology, and others. However, this novel technology has created unanticipated challenges such as the large numbers of genetic variants. Each caucasian genome has more than four million single nucleotide variants, insertions and deletions, copy number variants, and structural variants. Several formats have been suggested for storing these variants; however, the variant call format (VCF) has become the community standard., Results: We developed new software called the Variant Tool Chest (VTC) to provide much needed tools to work with VCF files. VTC provides a variety of tools for manipulating, comparing, and analyzing VCF files beyond the functionality of existing tools. In addition, VTC was written to be easily extended with new tools., Conclusions: Variant Tool Chest brings new and important functionality that complements and integrates well with existing software. VTC is available at https://github.com/mebbert/VariantToolChest.

This study tests key tenets of the Adaptation to Poverty-related Stress Model. This model (Wadsworth, Raviv, Santiago, & Etter, 2011 ) builds on Conger and Elder's family stress model by proposing that primary control coping and secondary control coping can help reduce the negative effects of economic strain on parental behaviors central to the family stress model, namely, parental depressive symptoms and parent-child interactions, which together can decrease child internalizing and externalizing problems. Two hundred seventy-five co-parenting couples with children between the ages of 1 and 18 participated in an evaluation of a brief family strengthening intervention, aimed at preventing economic strain's negative cascade of influence on parents, and ultimately their children. The longitudinal path model, analyzed at the couple dyad level with mothers and fathers nested within couple, showed very good fit, and was not moderated by child gender or ethnicity. Analyses revealed direct positive effects of primary control coping and secondary control coping on mothers' and fathers' depressive symptoms. Decreased economic strain predicted more positive father-child interactions, whereas increased secondary control coping predicted less negative mother-child interactions. Positive parent-child interactions, along with decreased parent depression and economic strain, predicted child internalizing and externalizing over the course of 18 months. Multiple-group models analyzed separately by parent gender revealed, however, that child age moderated father effects. Findings provide support for the adaptation to poverty-related stress model and suggest that prevention and clinical interventions for families affected by poverty-related stress may be strengthened by including modules that address economic strain and efficacious strategies for coping with strain.

Social support and vagal regulatory capacity (VRC), an index of flexible vagal responses during various types of stress, are linked to attenuated stress responding and positive health outcomes. Guided by the polyvagal perspective, we tested whether children's VRC is associated with attenuated sympathetic nervous system (SNS) stress reactivity in socially supportive conditions. Sixty-one 4- to 5-year-old children living in poverty underwent two standardized laboratory stress induction procedures. Cardiac vagal reactivity (respiratory sinus arrhythmia) to a first set of stressors (social, cognitive, physical, and emotional) indexed VRC. During a second set of stressors, participants were randomly assigned to a supportive or nonsupportive social context, and cardiac sympathetic reactivity (preejection period) was assessed. We hypothesized VRC would predict lower SNS stress reactivity, but only in the socially supportive context. Children with high VRC showed attenuated SNS stress reactivity in the socially supportive context compared to children with high VRC in the nonsupportive context and children with low VRC in either context. Individual differences in VRC predict attenuated SNS stress reactivity in socially supportive conditions. Understanding how social support and VRC jointly mitigate SNS stress reactivity may further efforts to prevent negative health outcomes. Implications for biological sensitivity to context and differential susceptibility theories are discussed.

This study tested how poverty-related stress (PRS), psychological distress, and responses to stress predicted future effortful coping and involuntary stress responses one year later. In addition, we explored age, sex, ethnicity, and parental influences on responses to stress over time. Hierarchical linear modeling analyses conducted with 98 low-income families (300 family members: 136 adults, 82 school-aged children, 82 adolescents) revealed that primary control coping, secondary control coping, disengagement, involuntary engagement, and involuntary disengagement each significantly predicted future use of that response. Primary and secondary control coping also predicted less maladaptive future responses to stress, while involuntary responses to stress undermined the development of adaptive responding. Age, sex, and interactions among PRS and prior coping were also found to predict certain responses to stress. In addition, child subgroup analyses demonstrate the importance of parental modeling of coping and involuntary stress responses, and warmth/nurturance and monitoring practices. Results are discussed with regard to the implications for preventive interventions with families in poverty.

The field of couples relationship education has come to a critical junction. We have generally demonstrated that our interventions work (at least in the short run) but to what extent have we shown that the skills and processes we teach are in fact responsible for the success of the intervention? In this paper we review progress made in understanding mechanisms of change in relationship education, explore limitations of this body of research, explicate the barriers that interfere with progress in understanding mechanisms of change in intervention research, and present recommendations on how to proceed from here. Although our goal in this paper is to focus more on issues in the field rather than to present a comprehensive review of the literature, we provide overarching research summaries to illustrate some of our points. We conclude with offering recommendations for the next generation of research in the couples relationship education field., (Copyright © 2011. Published by Elsevier Ltd.)

This article reports pre-post intervention results from a randomized controlled trial evaluating the initial efficacy of a couples-based intervention aimed at teaching skills for coping with stress and improving relationship skills in a sample of 173 ethnically diverse low-income co-resident mothers and fathers who were raising at least one child together. Couples were randomly assigned to one of three interventions or to an assessment-only control condition. The Fatherhood, Relationship, and Marriage Education (FRAME) intervention is a 14-h psychoeducation intervention developed specifically to strengthen the ability of low-income mothers and fathers to reduce conflict, cope with stress, and co-parent effectively. Three versions of FRAME were assessed: a men-only group, a women-only group, and a couple's group. The pre-post intervention analyses revealed reductions in financial stress, disengagement coping, and involuntary disengagement responses, as well as improvements in problem solving. These pre-post changes on stress and coping variables were both statistically significant and reliable as assessed by the Reliable Change Index (Jacobson and Truax 1991). Results were particularly strong for the couples' and women's groups. In addition, positive pre-post changes on stress and coping variables were associated with pre-post reductions on symptoms of depression for participants assigned to an intervention. The results demonstrate that participants in FRAME acquire some of the key skills taught in the intervention, and skills acquisition appears to translate into symptom reduction. In addition, this study highlights the value of an intervention aiming to improve the capacity of parents with economic hardship to cope effectively with stress.

This study examined family and cultural influences on adjustment among 90 low-income Latino middle school children (46% girls; average age = 11.38, SD = .66) and their primary caregivers (93% female; average age = 36.12, SD = 6.13). All participants identified as Hispanic/Latino, with 75% of families identifying as Mexican-origin Latino, and 77% of parents and 32% of children identifying as immigrants. Hierarchical linear modeling analyses revealed that family reframing interacted with familism, with high levels of both associated with fewer psychological symptoms, whereas passive appraisal is linked to worse functioning. Results are discussed with regard to the implications of this research for preventive interventions with families in poverty.

This study tested the Adaptation to Poverty-related Stress Model and its proposed relations between poverty-related stress, effortful and involuntary stress responses, and symptoms of psychopathology in an ethnically diverse sample of low-income children and their parents. Prospective Hierarchical Linear Modeling analyses conducted with 98 families (300 family members: 136 adults, 82 adolescents and preadolescents, 82 school-age children) revealed that, consistent with the model, primary and secondary control coping were protective against poverty-related stress primarily for internalizing symptoms. Conversely, disengagement coping exacerbated externalizing symptoms over time. In addition, involuntary engagement stress responses exacerbated the effects of poverty-related stress for internalizing symptoms, whereas involuntary disengagement responses exacerbated externalizing symptoms. Age and gender effects were found in most models, reflecting more symptoms of both types for parents than children and higher levels of internalizing symptoms for girls.

Objectives: Raised glycosylated haemoglobin (HbA(1c)) concentration is a recognized risk factor for diabetes, the incidence of which is rising worldwide. The intake of certain foods has been related to HbA(1c) concentration. The aim of this study was to investigate whether nutrient intake, sourced by these foods, was predictive of raised glycosylated haemoglobin (HbA(1c)) concentration in a British cohort., Subjects: The subjects were 495 men and 570 women who were members of the Medical Research Council National Survey of Health and Development, 1946 birth cohort.Diet was assessed from 5-day records in 1982, 1989 and 1999. HbA(1c) was measured in blood samples collected in 1999. Individuals in whom concentration of HbA(1c) was > or =6.3% were identified as being 'at risk' and their nutrient intake was compared with those whose concentration of HbA(1c) was within the normal range (< or =6.2%)., Results: Lower intakes of protein, carbohydrate, non-starch polysaccharide, iron, folate, vitamin B(12) and a higher percentage energy from fat in 1989 were significantly predictive of high HbA(1c) status in 1999. In 1999, there were no nutrient intakes that were predictive of HbA(1c) status. Global tests of whether the intakes of energy, carbohydrate, sodium, iron, riboflavin and vitamin B(12) at all three time points were related to HbA(1c) status in 1999, were significant., Conclusion: An increased intake of energy, carbohydrate, sodium, iron, riboflavin and vitamin B(12) over 10 years was predictive of raised HbA(1c) status. Increased energy intake may have resulted in increase in body weight, which is a risk factor for diabetes.

This study examined predictors of symptom trajectories of 93 adult survivors of Hurricane Katrina who were displaced and relocated to Colorado. Survivors were interviewed within six months of the hurricane and then again six months later. Four symptom trajectories were identified for clinical levels of depression and post-traumatic stress: resilient, recovered, delayed onset, and chronic. High levels of adaptive coping and coping efficacy characterized the resilient groups and low levels of both characterized the chronic groups. The recovered groups were characterized by low levels of adaptive coping coupled with high coping efficacy, and the delayed groups were characterized by high secondary control coping in the presence of low primary control coping, though some symptom-specific differences were found for these two groups. African American (67%) participants did not differ from European American (28%) participants in terms of membership in trajectory groups, though analyses revealed that displacement stress and positive religious coping were especially relevant predictors for African American participants. The results are interpreted in light of the Conservation of Resources Theory (Hobfoll, 2001) and implications for treatment and preventive intervention are discussed.