Shu Xu

Clinical Associate Professor of Biostatistics

Professional overview

Dr. Shu Xu’s work represents a balance of both statistical and applied aspects of quantitative methodology. Her primary quantitative interests include evaluating and developing statistical methods for longitudinal data analysis. Specifically, Dr. Xu’s research focuses on various aspects of latent growth models, missing data methods, and causal inference models.

Dr. Xu has collaborated with substance use, family, and health researchers to advance and share her knowledge of quantitative methodology and pursue a better understanding of the social sciences and public health. She has conducted research with the Family Translational Research Group at NYU and the Methodology Center at the Pennsylvania State University.

Education

BS, Psychology, East China Normal University, Shanghai, China

MS, Quantitative Psychology, University of California, Davis

PhD, Quantitative Psychology, University of California, Davis

Areas of research and study

Biostatistics

Family research

Longitudinal Data Analysis

Missing Data Methods

Mixture Models

Quantitative Research

Publications

Publications

Native Hawaiian and Other Pacific Islanders: Disparities in the Prevalence of Multiple Chronic Conditions

Role of social-cognitive factors in the relationship between e-cigarette use and subsequent cigarette smoking among U.S. youth: A causal mediation analysis

Longitudinal association between e-cigarette use and respiratory symptoms among US adults: Findings from the Population Assessment of Tobacco and Health Study Waves 4–5

Prevalence and risk factors of PTSD symptoms: a 3-month follow-up study

The impact of the 2014 military conflict in the east of Ukraine and the Autonomous Republic of the Crimea among patients receiving opioid agonist therapies

Association of Racial Discrimination With Adiposity in Children and Adolescents

Cuevas, A. G., Krobath, D. M., Rhodes-Bratton, B., Xu, S., Omolade, J. J., Perry, A. R., & Slopen, N. (n.d.).

Publication year

2023

Journal title

JAMA network open

Volume

6

Issue

7

10.1001/jamanetworkopen.2023.22839

Abstract

Abstract

IMPORTANCE Childhood obesity is a major public health issue and is disproportionately prevalent among children from minority racial and ethnic groups. Personally mediated racism (commonly referred to as racial discrimination) is a known stressor that has been linked to higher body mass index (BMI; calculated as weight in kilograms divided by height in meters squared) in adults, but little is known about the association of racial discrimination and childhood and adolescent adiposity. OBJECTIVE To assess the prospective association between self-reported experiences of racial discrimination and adiposity (BMI and waist circumference) in a large sample of children and adolescents in the Adolescent Brain Cognitive Development (ABCD) study. DESIGN, SETTING, AND PARTICIPANTS This cohort study used complete data from the ABCD study (2017 to 2019), involving a total of 6463 participants. The ABCD study recruited a diverse sample of youths from across the US, with rural, urban, and mountain regions. Data were analyzed from January 12 to May 17, 2023. EXPOSURE The child-reported Perceived Discrimination Scale was used to quantify racial discrimination, reflecting participants’ perceptions of being treated unfairly by others or unaccepted by society based on their race or ethnicity. MAIN OUTCOMES AND MEASURES Weight, height, and waist circumference were measured by trained research assistants. BMI z scores were computed by applying the US Centers for Disease Control and Prevention’s age and sex-specific reference standards for children and adolescents. Waist circumference (inches) was quantified as the mean of 3 consecutive measures. Measurements were taken from time 1 (ie, 2017 to 2019) and time 2 (ie, 2018 to 2020). RESULTS Of the 6463 respondents with complete data, 3090 (47.8%) were female, and the mean (SD) age was 9.95 (0.62) years. Greater racial discrimination exposure at time 1 was associated with higher BMI z score in both unadjusted (β, 0.05; 95% CI, 0.02-0.08) and adjusted regression models (β, 0.04; 95% CI, 0.01-0.08). Discrimination at time 1 was associated with higher waist circumference in unadjusted (β, 0.35; 95% CI, 0.15-0.54) and adjusted (β, 0.24; 95% CI, 0.04-0.44) models. CONCLUSIONS AND RELEVANCE In this cohort study of children and adolescents, racial discrimination was positively associated with adiposity, quantified by BMI z score and waist circumference. Interventions to reduce exposure to racial discrimination in early life may help reduce the risk of excess weight gain across throughout life.

Examining the effects of cumulative environmental stressors on Gulf Coast child and adolescent health

Meltzer, G. Y., Merdjanoff, A. A., Xu, S., Gershon, R., Emrich, C. T., & Abramson, D. M. (n.d.).

Publication year

2023

Journal title

Population and Environment

Volume

45

Issue

3

10.1007/s11111-023-00436-1

Abstract

Abstract

This study examines how community-level cumulative environmental stress affects child and adolescent emotional distress and chronic health conditions both directly and indirectly through stressors at the household, family, and individual levels. Data comes from the Women and their Children’s Health (WaTCH) Study, which sought to understand the health implications of exposure to the 2010 Deepwater Horizon oil spill (DHOS) among a cohort of 596 mothers with children ages 10 to 17 in southeastern Louisiana. Community-level environmental stress was measured using a newly developed geospatial index. Household-level stressors included previous hurricane impacts, impacts of DHOS, degree of financial difficulty, and degree of housing physical decay. Family stressors included maternal depression, self-rated physical health, and degree of parenting stress. Child stress was based on perceived stress; child mental health was based on serious emotional disturbance; and child physical health was based on diagnosis of chronic illness. Structural equation modeling used weighted least squares means and variance and theta parameterization. Results showed a significant negative direct path between community-level cumulative environmental stress and child/adolescent serious emotional disturbance and chronic illness. However, the indirect relationship through household, family, and individual-level stressors was significant and positive for both child/adolescent serious emotional disturbance and chronic illness. These findings point to the centrality of the household and family in determining child and adolescent physical and mental health outcomes in communities exposed to frequent disasters and ongoing environmental stressors.

Predictors of Crosscutting Patterns of Psychological Health and Family Maltreatment

Tutorial on Causal Mediation Analysis With Binary Variables: An Application to Health Psychology Research

Use of electronic nicotine delivery system (ENDS) devices among U.S. Youth and adults: Findings from the Population Assessment of Tobacco and Health Study Waves 1–5

Cigar Use Progression Among New Cigar Initiators: A Two-Part Growth Curve Analysis Among a Youth and Young Adult Cohort

Passive exposure to e-cigarette emissions is associated with worsened mental health

Recurrent Injecting Drug Use as a Mediator between Psychiatric Disorder and Non-Fatal Overdose

Barnes, D. M., Xu, S., Cleland, C. M., McKnight, C., & Des Jarlais, D. (n.d.).

Publication year

2022

Journal title

Substance Use and Misuse

Volume

57

Issue

8

Page(s)

1248-1256

10.1080/10826084.2022.2076877

Abstract

Abstract

Background: Unintentional drug overdose has increased markedly in the United States. Studies document an association between psychiatric disorder and unintentional overdose; we extend this research through a preliminary test of a causal model of recurrent injection drug use mediating this relationship. Methods: In a cross-sectional study of 241 adults in New York City with a possible current substance use disorder, we conducted conventional and Imai’s mediation analyses to examine if psychiatric disorder is associated with increased prevalence of ever overdosing and if recurrent injection drug use mediates this association. Our cross-sectional data permit the first step of assessing causal models: testing if statistical associations are consistent with the model. Results: Fifty-eight percent of the sample endorsed previous psychiatric disorder diagnosis and 35.7% reported ever overdosing. Imai’s mediation analysis showed that, adjusting for covariates, the total association between psychiatric diagnosis and ever overdosing (adjusted prevalence difference [aPD] = 0.16, 95% CI 0.04–0.28) was composed of a direct effect (aPD = 0.09, 95% CI −0.03 − 0.21, p = 0.136) and an indirect effect (aPD = 0.07, 95% CI 0.02–0.13). Recurrent injecting drug use contributed to 42% (ratio of indirect effect to total effect; 95% CI 12 − 100%, p = 0.02) of the association between psychiatric diagnosis and ever overdosing. Conventional mediation analysis produced similar results. Conclusions: Our results provide a warrant for taking the necessary next step for assessing a causal model using longitudinal data, potentially providing a strong rationale for intervening on psychiatric disorders to stem overdose.

Relationships Between E-cigarette Use and Subsequent Cigarette Initiation Among Adolescents in the PATH Study: an Entropy Balancing Propensity Score Analysis

The Mediating Effect of E-Cigarette Harm Perception in the Relationship between E-Cigarette Advertising Exposure and E-Cigarette Use

Youth E-Cigarette Use and Functionally Important Respiratory Symptoms: The Population Assessment of Tobacco and Health (PATH) Study Waves 3 and 4

Cannabis Use and the Onset of Cigarette and E-cigarette Use: A Prospective, Longitudinal Study among Youth in the United States

E-cigarette use, systemic inflammation, and depression

Self-report measures of coercive process in couple and parent–child dyads.

High Sensitivity and Specificity Screening for Clinically Significant Intimate Partner Violence

Psychology of wearing face masks to prevent transition of COVID-19

The lump-versus-split dilemma in couple observational coding: A multisite analysis of rapid marital interaction coding system data.

Using Security Questions to Link Participants in Longitudinal Data Collection

A Randomized, Controlled Trial of the Impact of the Couple CARE for Parents of Newborns Program on the Prevention of Intimate Partner Violence and Relationship Problems

Patterns of psychological health problems and family maltreatment among United States Air Force members