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Morrison M, Pettus C, Drake B, Roth K, Renn T. Trauma and Incarceration: A Latent Class Analysis of Lifetime Trauma Exposures for Individuals in Prison. J Trauma Dissociation 2024; 25:168-184. [PMID: 38083864 DOI: 10.1080/15299732.2023.2289189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 06/12/2023] [Indexed: 01/30/2024]
Abstract
This paper aims to contribute to the knowledge base about the lives of individuals who experience incarceration in the U.S. in order to advance post-release intervention services. Research has shown that among the millions of Americans who cycle through prisons and jails each year, the majority are poor, in poor health, living in contexts of chronic violence, often with mental illness, and more than half are people of color. Of particular concern for this population are high rates of trauma exposure and PTSD, though the research in this area is underdeveloped, particularly for men. Using survey data gathered during a large (n = 1,516, 90% male) multi-state randomized control trial of a reentry intervention, this study used latent class analysis (LCA) to explore types and timing of trauma exposures across the life course. LCA has been found to be an effective statistical tool in intervention research for identifying high-risk groups and for informing the tailoring of interventions. This study found three latent classes: 1) Lifetime Interpersonal Polyvictimization, 2) Lifetime Environmental Exposures, and 3) Low Exposure. About one third of the sample fell within each class. Study findings indicate that not only should trauma-informed and trauma-specific interventions be the norm in reentry services, including for men, but that these interventions should target both individual and environmental factors.
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Affiliation(s)
- Maria Morrison
- School of Social Work, Saint Louis University, St. Louis, MO, USA
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2
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Mambro A, Afshar A, Leone F, Dussault C, Stoové M, Savulescu J, Rich JD, Rowan DH, Sheehan J, Kronfli N. Reimbursing incarcerated individuals for participation in research: A scoping review. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2024; 123:104283. [PMID: 38109837 DOI: 10.1016/j.drugpo.2023.104283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 11/18/2023] [Accepted: 11/29/2023] [Indexed: 12/20/2023]
Abstract
BACKGROUND Little is known about global practices regarding the provision of reimbursement for the participation of people who are incarcerated in research. To determine current practices related to the reimbursement of incarcerated populations for research, we aimed to describe international variations in practice across countries and carceral environments to help inform the development of more consistent and equitable practices. METHODS We conducted a scoping review by searching PubMed, Cochrane library, Medline, and Embase, and conducted a grey literature search for English- and French-language articles published until September 30, 2022. All studies evaluating any carceral-based research were included if recruitment of incarcerated participants occurred inside any non-juvenile carceral setting; we excluded studies if recruitment occurred exclusively following release. Where studies failed to indicate the presence or absence of reimbursement, we assumed none was provided. RESULTS A total of 4,328 unique articles were identified, 2,765 were eligible for full text review, and 426 were included. Of these, 295 (69%) did not offer reimbursement to incarcerated individuals. A minority (n = 13; 4%) included reasons explaining the absence of reimbursement, primarily government-level policies (n = 7). Among the 131 (31%) studies that provided reimbursement, the most common form was monetary compensation (n = 122; 93%); five studies (4%) offered possible reduced sentencing. Reimbursement ranged between $3-610 USD in total and 14 studies (11%) explained the reason behind the reimbursements, primarily researchers' discretion (n = 9). CONCLUSIONS The majority of research conducted to date in carceral settings globally has not reimbursed incarcerated participants. Increased transparency regarding reimbursement (or lack thereof) is needed as part of all carceral research and advocacy efforts are required to change policies prohibiting reimbursement of incarcerated individuals. Future work is needed to co-create international standards for the equitable reimbursement of incarcerated populations in research, incorporating the voices of people with lived and living experience of incarceration.
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Affiliation(s)
- Andrea Mambro
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Avideh Afshar
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Frederic Leone
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Camille Dussault
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Mark Stoové
- Burnet Institute, School of Public Health and Preventative Medicine, Monash University, Melbourne, Victoria, Australia
| | - Julian Savulescu
- Oxford Uehiro Centre for Practical Ethics, University of Oxford, Oxford, United Kingdom; Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Josiah D Rich
- Center for Health and Justice Transformation, The Miriam and Rhode Island Hospitals, Departments of Medicine and Epidemiology, Brown University, Providence, Rhode Island, USA
| | - Daniel H Rowan
- Division of Infectious Disease, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, USA
| | | | - Nadine Kronfli
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada; Department of Medicine, Division of Infectious Disease and Chronic Viral Illness Service, McGill University, Montreal, Quebec, Canada.
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Fradley MF, Kathryn Allison M, Steely Smith MK, Bossard M, Zielinski MJ. Justice-Involved, Sexually Victimized Women's Perspectives on the Acceptability of Receiving Trauma-Focused Therapy in Prison. Violence Against Women 2023; 29:2964-2985. [PMID: 37674415 DOI: 10.1177/10778012231200480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/08/2023]
Abstract
Incarcerated women report high rates of sexual victimization. Interviews with 63 previously incarcerated women survivors of sexual violence explored perceptions toward receiving trauma-focused therapy while incarcerated and postrelease trauma-focused therapy utilization. Nearly all participants (97%) recommended that trauma-focused therapy be available to incarcerated women. Most believed that prisons are acceptable places to receive trauma-focused therapy, without qualification (65%); some reported mixed feelings or indicated acceptability but identified factors that would increase acceptability (33%). Notably, most were currently experiencing trauma-related symptoms, but few had attended trauma-focused therapy following release. Findings indicate that access to prison-based trauma-focused therapy is necessary and acceptable.
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Affiliation(s)
- Marley F Fradley
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - M Kathryn Allison
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Mollee K Steely Smith
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - MeeSoh Bossard
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Melissa J Zielinski
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR, USA
- Department of Psychological Science, University of Arkansas, Fayetteville, AR, USA
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Malik N, Facer-Irwin E, Dickson H, Bird A, MacManus D. The Effectiveness of Trauma-Focused Interventions in Prison Settings: A Systematic Review and Meta-Analysis. TRAUMA, VIOLENCE & ABUSE 2023; 24:844-857. [PMID: 34711095 DOI: 10.1177/15248380211043890] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
BACKGROUND Posttraumatic stress disorder (PTSD) is overrepresented in prison relative to community populations and can be difficult to manage in an environment which can inherently exacerbate trauma-related symptomology. Little is known about the effectiveness of trauma-focused interventions in prison and less is known about factors that moderate the effectiveness of these interventions. AIM/METHODS We examined the effectiveness of trauma-focused interventions in prison relative to prison controls using meta-analytic techniques. We further used meta-regression analysis to examine treatment, methodological and participant-level moderators to determine factors that increased the effectiveness of these interventions. RESULTS From 16 studies eligible for the meta-analysis, we found a small but significant effect size for trauma-focused interventions. Phase 2 trauma processing interventions and interventions delivered individually led to greater reductions in PTSD symptoms. Studies utilizing an active treatment control resulted in smaller effect sizes than those using waitlist or no contact controls. Treatment length, study quality, outcome type, and gender were not significant moderators of treatment effectiveness. CONCLUSION Findings from this review are encouraging but should be interpreted with caution. Results suggest that trauma processing therapies, and individual modality trauma-focused interventions can be effective and delivered successfully in prison. However, inadequate comparison groups do not allow a firm conclusion to be drawn. There is a need for high quality Randomized Controlled Trial's that additionally measure Complex PTSD, utilize a modular treatment approach, and include treatments recommended in the National Institute for health and Care Excellence (NICE) guidelines such as Trauma-focused CBT and Eye Movement Desensitization Reprocessing (EMDR).
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Affiliation(s)
- Nabeela Malik
- Forensic and Neurodevelopmental Sciences Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- Older Adults Psychiatry, North East London Foundation NHS Trust, London, England, United Kingdom
| | - Emma Facer-Irwin
- Forensic and Neurodevelopmental Sciences Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- Department of Clinical Psychology, School of Health and Social Care, University of Essex, Colchester, United Kingdom
- Joint first author
| | - Hannah Dickson
- Forensic and Neurodevelopmental Sciences Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Annie Bird
- Forensic and Neurodevelopmental Sciences Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Deirdre MacManus
- Forensic and Neurodevelopmental Sciences Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- Consultant Forensic Psychiatrist; HMP Wandsworth, South London and Maudsley NHS Trust, London, England, United Kingdom
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Updyke A, Ghose T. "We're the CHATS old-heads": Engaging with evidence-based practice in a reentry agency. JOURNAL OF COMMUNITY PSYCHOLOGY 2023; 51:945-961. [PMID: 36383698 DOI: 10.1002/jcop.22964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 10/04/2022] [Accepted: 10/17/2022] [Indexed: 06/16/2023]
Abstract
Philadelphia has one of the country's largest populations re-entering society after incarceration. Reentry services have been critiqued for their ineffectiveness. Scholars note the lack of evidence-based practices (EBPs) in the field, and the challenges of translating them. Through a case study of one reentry agency implementing an EBP, we examine engagement with the intervention by clients and service providers. Qualitative interviews were conducted with clients and staff (n = 35). A grounded theory using sensitizing concepts approach was used to analyze the data. Productive engagement with the intervention was facilitated by: (1) translatability of the core EBP elements so that they addressed client and staff needs, (2) accessibility to the intervention by enhancing subjective ownership and successfully navigating logistical barriers, and (3) collectivity among participants and staff that helped them address societal and structural barriers. Productive engagement with an EBP can resist carceral processes in reentry service-provision.
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Affiliation(s)
- Alison Updyke
- Department of Graduate Social Work, West Chester University, West Chester, Pennsylvania, USA
| | - Toorjo Ghose
- School of Social Policy and Practice, University of Pennsylvania, Pennsylvania, Philadelphia, USA
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Criss J, John A. Therapeutic Interventions for Mental Wellness in Correctional Facilities: A Systematic Review. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2023:306624X231159884. [PMID: 36896879 DOI: 10.1177/0306624x231159884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
The article includes a systematic review of therapeutic interventions being used to improve mental health of males and females incarcerated in U.S. jails and prisons. Using pertinent keywords, we searched the following databases: SocINDEX, CINAHL Complete, Medline Complete, PsychINFO, Psychology and Behavioral Sciences Collection, and Criminal Justice Abstracts with Full Text for studies published between 2010 and 2021. The initial search yielded 9,622 articles. After screening, 28 articles met the inclusion criteria and were reviewed. Review indicated use of a diverse range of interventions to address mental health outcomes including, but not limited to, PTSD, depression, and anxiety. A few studies did not focus on specific mental health outcomes, but rather on behavioral outcomes such as distress, affect, mood, time spent in the hospital, number of acts of self-injury, competency restoration, and wellbeing of the participants. The review includes implications for future research and practice.
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Affiliation(s)
| | - Aesha John
- Texas Christian University, Fort Worth, USA
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Banz L, Stefanovic M, von Boeselager M, Schäfer I, Lotzin A, Kleim B, Ehring T. Effects of current treatments for trauma survivors with posttraumatic stress disorder on reducing a negative self-concept: a systematic review and meta-analysis. Eur J Psychotraumatol 2022; 13:2122528. [PMID: 36325255 PMCID: PMC9621279 DOI: 10.1080/20008066.2022.2122528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 08/15/2022] [Accepted: 08/22/2022] [Indexed: 12/02/2022] Open
Abstract
Background: A negative self-concept is characterised by dysfunctional cognitions about the self and has been suggested to be a key factor involved in the development and maintenance of posttraumatic stress disorder (PTSD). In addition, the current definitions of PTSD according to DSM-5 and the new ICD-11 diagnosis of Complex PTSD (CPTSD) include aspects of negative self-concept in their diagnostic criteria. Objective: The aim of this meta-analysis was to synthesise the currently available evidence on the effects of psychological interventions for PTSD on negative self-concept. Methods: PubMed, PsychINFO, PSYNDEX, PTSDpubs and Cochrane Library were searched for randomised controlled trials (RCTs) of psychological treatments for PTSD symptoms in adults, published up to February 2021. A systematic review and meta-analysis were conducted, with risk of bias assessed by the Cochrane Risk of Bias Assessment Tool. Results: A total of 25 RCTs (N = 2585) were included in the meta-analysis. Results showed that psychological interventions significantly improve a negative self-concept with a moderate to large controlled effect size (k = 30, g = 0.67, 95% CI [0.31, 1.02], p < .001) at post-treatment. Heterogeneity between studies was large but could not be accounted for by moderators included in the current analysis, i.e. different types of interventions (e.g. with vs. without a cognitive restructuring component, trauma-focused vs. not). Conclusions: Current treatments for PTSD are effective in reducing a negative self-concept. However, more research is needed to identify moderators of this effect and identify interventions that are most effective for reducing negative self-concept.
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Affiliation(s)
| | | | | | - Ingo Schäfer
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Annett Lotzin
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Birgit Kleim
- Division of Experimental Psychopathology and Psychotherapy, Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Thomas Ehring
- Department of Psychology, LMU Munich, Munich, Germany
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8
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Messina NP, Esparza P. Poking the bear: The inapplicability of the RNR principles for justice-involved women. J Subst Abuse Treat 2022; 140:108798. [DOI: 10.1016/j.jsat.2022.108798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 03/30/2022] [Accepted: 05/04/2022] [Indexed: 11/26/2022]
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9
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Pettus C, Renn T, Tripodi S, Tamburri S. Study protocol paper for the multisite randomized controlled trial of comprehensive trauma informed reentry services for moderate to high-risk young males releasing from state prisons. Contemp Clin Trials 2022; 117:106766. [DOI: 10.1016/j.cct.2022.106766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 04/15/2022] [Accepted: 04/15/2022] [Indexed: 11/03/2022]
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10
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Molina G, Whittaker A. Treatment of post-traumatic stress disorder and substance use disorder in adults with a history of adverse childhood experiences: A systematic review of psychological interventions. DRUG AND ALCOHOL DEPENDENCE REPORTS 2022; 2:100028. [PMID: 36845903 PMCID: PMC9948894 DOI: 10.1016/j.dadr.2022.100028] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 12/12/2021] [Accepted: 01/17/2022] [Indexed: 11/18/2022]
Abstract
Background Adverse childhood experiences (ACEs) have long-term effects on adult health, including unresolved trauma and substance use disorder (SUD). There are hypotheses of a mediating role of emotion regulation. This systematic literature review and narrative synthesis assessed the effectiveness of psychological interventions on emotion regulation, PTSD and SUD symptoms. Methods Searches were conducted using the Cochrane Handbook for Systematic Reviews methodology. Eligible studies were randomised controlled trials (RCTs) and quasi-experimental psychological interventions published between 2009 and 2019. Study characteristics, results and methodological quality were systematically analysed. Results Thirteen studies, including nine RCTs, were selected. Integrated SUD and PTSD treatments consisted of Seeking Safety, exposure-based treatment, Trauma Recovery and Empowerment Model, and integrated cognitive behavioural therapy. Two studies reported emotion regulation. Five studies found a small to medium positive effect size of psychological interventions on PTSD outcomes. Two studies had a small positive effect size on SUD outcomes and two a small negative effect size. Attrition was high across most studies. Characteristics likely to affect the applicability of the review were described. Conclusion The review found some evidence of a small inconsistent positive effect of psychological interventions on PTSD outcomes, and no evidence of effect on SUD outcomes. The range of theoretical models was narrow. Overall quality was low with high clinical heterogeneity and missing key information, particularly on emotion regulation, an important transdiagnostic feature. Further research is required to establish interventions that can treat these multiple conditions with a focus on effectiveness, acceptability, and implementation in real life clinical practice.
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Key Words
- ACEs, adverse childhood experiences
- AEs, adverse events
- ATREM, Attachment-informed TREM
- CBT, Cognitive–Behavioural Therapy
- CI, confidence intervals
- CPTSD, complex PTSD
- DERS, Difficulties in Emotion Regulation Scale
- EMDR, eye movement desensitisation and reprocessing
- ER, emotion regulation
- FSP, family and social problems
- ICBT, Integrated CBT
- M, mean
- OR, odds ratio
- PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses
- PTSD, post-traumatic stress disorder
- RCT, randomised control trial
- SD, standard deviation
- SS, Seeking Safety
- SUD, substance use disorder
- SWiM, Synthesis Without Meta-Analysis
- TREM, Trauma Recovery and Empowerment Model
- adverse childhood experiences
- emotion regulation
- posttraumatic stress disorder
- psychological interventions
- substance use disorder
- systematic review
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Affiliation(s)
- Genevieve Molina
- CeGIDD, Pôle Santé Publique et Médecine Sociale, CHU Toulouse, Hôpital La Grave, TSA 60033, 31059 Toulouse Cedex 9, France
- Corresponding author.
| | - Anne Whittaker
- NMAHP Research Unit, Faculty of Health Sciences and Sport, Pathfoot Building, University of Stirling, FK9 4LA, Stirling, Scotland, UK
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11
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Zielinski MJ, Karlsson ME, Bridges AJ. "I'm not alone, my story matters": Incarcerated women's perspectives on the impact and acceptability of group psychotherapy involving imaginal exposure to sexual assault memories. HEALTH & JUSTICE 2021; 9:25. [PMID: 34591180 PMCID: PMC8482612 DOI: 10.1186/s40352-021-00148-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 07/28/2021] [Indexed: 05/27/2023]
Abstract
BACKGROUND Although it is clear that incarcerated women need access to effective therapies for trauma sequelae, some have argued that one of the most effective treatments - exposure therapy - should not be provided in carceral settings due to the presumed lack of safety and stability making such an intervention inappropriate. Group therapy, the typical mode of intervention in prisons, has also been presumed to be unacceptable for exposure-based processing due to assumptions that hearing others' trauma narratives would be traumatizing and unhelpful to listeners. However, there is a lack of data to support either of the aforementioned assumptions. This study examined the acceptability of an exposure-based group therapy for women survivors of sexual violence who were currently incarcerated (N = 61) by asking women themselves about their experiences completing an exposure-based group therapy protocol (SHARE; Survivors Healing from Abuse: Recovery through Exposure) while incarcerated. We assessed women's reasons for enrolling in the group, satisfaction with various therapy components (e.g., exposure, skill-building) and the treatment overall, and experiences of both sharing and listening to trauma narratives using a feedback survey that included a mix of multiple-choice and open-ended questions. Treatment dropout was examined as an additional index of acceptability. RESULTS Treatment completion was very high (88.8%). Nearly all women who completed the group reported that they would recommend it to other incarcerated women (96.7%, with the remaining 3.3% reporting "it depends"). Qualitative results revealed overwhelmingly positive feedback about the effect of the group and indicated that sharing and listening to trauma narratives in a group setting serve discrete but dually important functions. Specifically, women almost universally experienced listening to others' trauma narratives (i.e., exposures) in the SHARE group context as helpful-making them feel less alone and normalizing their experiences. Sharing one's own story primarily provided an emotional release and/or transformation (i.e., an intrapersonal rather than interpersonal function). CONCLUSIONS Our findings challenge common concerns about the appropriateness of 1) prison as a context for trauma-focused treatments, including exposure and 2) sharing trauma narratives in a group setting. Unless empirical evidence demonstrating harm is uncovered, best practices for PTSD and other trauma-related sequelae-those recommended in reputable treatment guidelines and interventions like SHARE that incorporate components shown to be effective (e.g., cognitive challenging, exposure)-should be offered to incarcerated women as part of standard of care.
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Affiliation(s)
- Melissa J Zielinski
- Psychiatric Research Institute, University of Arkansas for Medical Sciences, 4301 W. Markham Street Little Rock, Little Rock, AR, 72205, USA.
- Department of Psychological Sciences, University of Arkansas, AR, Fayetteville, USA.
| | - Marie E Karlsson
- Centre for Sexology and Sexuality Studies, Malmö University, Malmö, Sweden
| | - Ana J Bridges
- Department of Psychological Sciences, University of Arkansas, AR, Fayetteville, USA
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Richardson JB, Wical W, Kottage N, Bullock C. Shook Ones: Understanding the Intersection of Nonfatal Violent Firearm Injury, Incarceration, and Traumatic Stress Among Young Black Men. Am J Mens Health 2021; 14:1557988320982181. [PMID: 33356779 PMCID: PMC7768853 DOI: 10.1177/1557988320982181] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Violent injury is a leading cause of death and disability among young Black men, with the highest rates occurring in low-income urban populations. Hospital-based violence intervention programs (HVIPs) offer a promising opportunity to address the biopsychosocial factors that adversely affect this population. However, there are major gaps between the needs of young Black male survivors of violent injury and the forms of care provided by HVIPs. Patient-centered outcomes research provides a useful mode of inquiry to develop strategies to decrease these differences. Care for survivors, including treatment for traumatic stress disorders, must be reconceptualized to center the lived experiences of young Black men. This paper qualitatively explores how these survivors of gun violence express symptoms of traumatic stress and the ways in which their narratives can inform the implementation of the biopsychosocial model in HVIPs. A phenomenological variant ecological systems theory framework was used to analyze participant narratives to aid in understanding their symptoms of traumatic stress and post-injury affective changes as both psychologically and socially important experiences. Such insight may inform changes to HVIP practice to address persistent health disparities related to violence.
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Affiliation(s)
- Joseph B Richardson
- Joel and Kim Feller Professor of African-American Studies and Anthropology, Department of African-American Studies and the Department of Anthropology, College of Behavioral and Social Sciences, University of Maryland College Park, College Park, MD, USA
| | - William Wical
- Department of Anthropology and the Department of African-American Studies, Transformative Research and Applied Violence Intervention Lab (TRAVAIL), College of Behavioral and Social Sciences, University of Maryland College Park, College Park, MD, USA
| | - Nipun Kottage
- Department of Anthropology and the Department of African-American Studies, Transformative Research and Applied Violence Intervention Lab (TRAVAIL), College of Behavioral and Social Sciences, University of Maryland College Park, College Park, MD, USA
| | - Che Bullock
- Department of African-American Studies, Transformative Research and Applied Violence Intervention Lab (TRAVAIL), College of Behavioral and Social Sciences, University of Maryland College Park, College Park, MD, USA
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13
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Zielinski MJ, Allison MK, Roberts LT, Karlsson ME, Bridges AJ, Kirchner JE. Implementing and Sustaining SHARE: An Exposure-Based Psychotherapy Group for Incarcerated Women Survivors of Sexual Violence. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2021; 67:76-88. [PMID: 32985702 PMCID: PMC7969368 DOI: 10.1002/ajcp.12461] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Although incarcerated women are a highly victimized population, therapy for sexual violence victimization (SVV) sequela is not routinely offered in prison. SHARE is a group therapy for SVV survivors that was successfully implemented and sustained in a women's correction center. Here, we aimed to identify implementation factors and strategies that led to SHARE's success and describe incarcerated women's perspectives on the program. We conducted a retrospective process evaluation using interviews structured according to EPIS, a well-established implementation science framework. Participants (N = 22) were incarcerated women, members of the SHARE treatment team, and members of the correction center's leadership, therapeutic team, and volunteer program. Factors that facilitated SHARE implementation varied by EPIS phase and organization. Positive inter-organizational and interpersonal relationships were key across phases, as were the synergies between both the strengths and needs of each organization involved in implementation. Incarcerated women reported a strong need for SHARE and did not report any concerns about receiving trauma therapy in a carceral setting. Therapy for SVV sequelae, including exposure-based therapy, is possible to implement and sustain in carceral settings. Community-academic partnerships may be a particularly feasible way to expand access to SVV therapy for incarcerated women.
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Affiliation(s)
| | | | | | | | | | - JoAnn E. Kirchner
- University of Arkansas for Medical Sciences
- Central Arkansas Veterans Healthcare System
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14
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Simpson AIF, Gerritsen C, Maheandiran M, Adamo V, Vogel T, Fulham L, Kitt T, Forrester A, Jones RM. A Systematic Review of Reviews of Correctional Mental Health Services Using the STAIR Framework. Front Psychiatry 2021; 12:747202. [PMID: 35115956 PMCID: PMC8806032 DOI: 10.3389/fpsyt.2021.747202] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Accepted: 12/13/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Rising demand for correctional mental health services (CMHS) in recent decades has been a global phenomenon. Despite increasing research, there are major gaps in understanding the best models for CMHS and how to measure their effectiveness, particularly studies that consider the overall care pathways and effectiveness of service responses. The STAIR (Screening, Triage, Assessment, Intervention, and Re-integration) model is an evidence-based framework that defines and measures CMHS as a clinical pathway with a series of measurable, and linked functions. METHOD We conducted a systematic review of the reviews of CMHS elements employing PRISMA guidelines, organized according to STAIR pillars. We assessed the quality of included studies using the AMSTAR-2 criteria. Narrative reviews were read and results synthesized. RESULTS We included 26 review articles of which 12 were systematic, metaanalyses, and 14 narrative reviews. Two systematic reviews and seven narrative reviews addressed screening and triage with strong evidence to support specific screening and triage systems. There was no evidence for standardised assessment approaches. Eight systematic reviews and seven narrative reviews addressed interventions providing some evidence to support specific psychosocial interventions. Three systematic reviews and six narrative reviews addressed reintegration themes finding relatively weak evidence to support reintegration methods, with interventions often being jurisdictionally specific and lacking generalizability. CONCLUSIONS The STAIR framework is a useful way to organize the extant literature. More research is needed on interventions, assessment systems, care pathway evaluations, and reintegration models.
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Affiliation(s)
- Alexander I F Simpson
- Forensic Psychiatry, Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada
| | - Cory Gerritsen
- Department of Forensic Psychiatry, Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada
| | | | - Vito Adamo
- Department of Forensic Psychiatry, Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada
| | - Tobias Vogel
- Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Lindsay Fulham
- Department of Forensic Psychiatry, Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada
| | - Tamsen Kitt
- Department of Psychology, Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada
| | - Andrew Forrester
- Forensic Psychiatry, Department of Psychological Medicine and Clinical Neursciences, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - Roland M Jones
- Department of Forensic Psychiatry, Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada
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15
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Martin RA, Couture R, Tasker N, Carter C, Copeland DM, Kibler M, Whittle JS. Emergency medical care of incarcerated patients: Opportunities for improvement and cost savings. PLoS One 2020; 15:e0232243. [PMID: 32339213 PMCID: PMC7185724 DOI: 10.1371/journal.pone.0232243] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Accepted: 04/11/2020] [Indexed: 11/18/2022] Open
Abstract
In the United States (US), the lifetime incidence of incarceration is 6.6%, exceeding that of any other nation. Compared to the general US population, incarcerated individuals are disproportionally affected by chronic health conditions, mental illness, and substance use disorders. Barriers to accessing medical care are common in correctional facilities. We sought to characterize the local incarcerated patient population and explore barriers to medical care in these patients. We conducted a retrospective, observational cohort study by reviewing the medical records of incarcerated patients presenting to the adult emergency department (ED) of a single academic, tertiary care facility with medical or psychiatric (med/psych) and trauma-related emergencies between January 2012 and December 2014. Data on demographics, medical complexity, trauma intentionality, and barriers to medical care were analyzed using descriptive statistics, unpaired student’s t-test or one-way analysis of variance for continuous variables, and chi-square analysis or Fisher’s exact test as appropriate. Trauma patients were younger with fewer medical comorbidities and were less likely to be admitted to the hospital than med/psych patients. 47.8% of injuries resulted from violence or were self-inflicted. Most trauma-related complaints were managed by the emergency medicine physician in the ED. While barriers to medical care were not correlated with hospital admission, 5.4% of med/psych and 2.9% of trauma patients reported barriers as a contributing factor to the ED encounter. Med/psych patients commonly reported a lack of access to medications, while trauma patients reported a delay in medical care. Trauma-related presentations were less medically complex than med/psych-related complaints. Medical management of most injuries required no hospital resources outside of the ED, indicating a potential role for outpatient management of trauma-related complaints. Additional opportunities for health care improvement and cost savings include the implementation of programs that target violence, prevent injuries, and promote the continuity of medical care while incarcerated.
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Affiliation(s)
- Rebecca A. Martin
- Department of Emergency Medicine, The University of Tennessee Health Science Center College of Medicine at Chattanooga, Chattanooga, Tennessee, United States of America
- Erlanger Health System, Chattanooga, Tennessee, United States of America
- * E-mail:
| | - Rosanna Couture
- Department of Emergency Medicine, The University of Tennessee Health Science Center College of Medicine at Chattanooga, Chattanooga, Tennessee, United States of America
- Erlanger Health System, Chattanooga, Tennessee, United States of America
| | - Nicole Tasker
- Department of Emergency Medicine, The University of Tennessee Health Science Center College of Medicine at Chattanooga, Chattanooga, Tennessee, United States of America
- Erlanger Health System, Chattanooga, Tennessee, United States of America
| | - Christine Carter
- The University of Tennessee College of Medicine, Memphis, Tennessee, United States of America
| | - David M. Copeland
- The University of Tennessee College of Medicine, Memphis, Tennessee, United States of America
| | - Mary Kibler
- Erlanger Health System, Chattanooga, Tennessee, United States of America
| | - Jessica S. Whittle
- Department of Emergency Medicine, The University of Tennessee Health Science Center College of Medicine at Chattanooga, Chattanooga, Tennessee, United States of America
- Erlanger Health System, Chattanooga, Tennessee, United States of America
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Holman LF, Ellmo F, Wilkerson S, Johnson R. Quasi‐Experimental Single‐Subject Design: Comparing Seeking Safety and Canine‐Assisted Therapy Interventions Among Mentally Ill Female Inmates. JOURNAL OF ADDICTIONS & OFFENDER COUNSELING 2020. [DOI: 10.1002/jaoc.12074] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Leigh F. Holman
- Department of Counseling, Educational Psychology and ResearchThe University of Memphis
| | - Frances Ellmo
- Department of Counseling, Educational Psychology and ResearchThe University of Memphis
| | - Shelly Wilkerson
- Department of Counseling, Educational Psychology and ResearchThe University of Memphis
| | - Re'Sean Johnson
- Department of Counseling, Educational Psychology and ResearchThe University of Memphis
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Windle E, Tee H, Sabitova A, Jovanovic N, Priebe S, Carr C. Association of Patient Treatment Preference With Dropout and Clinical Outcomes in Adult Psychosocial Mental Health Interventions: A Systematic Review and Meta-analysis. JAMA Psychiatry 2020; 77:294-302. [PMID: 31799994 PMCID: PMC6902231 DOI: 10.1001/jamapsychiatry.2019.3750] [Citation(s) in RCA: 64] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
IMPORTANCE Receiving a preferred treatment has previously been associated with lower dropout rates and better clinical outcomes, but this scenario has not been investigated specifically for psychosocial interventions for patients with a mental health diagnosis. OBJECTIVE To assess the association of patient treatment preference with dropout and clinical outcomes in adult psychosocial mental health interventions via a systematic review and meta-analysis. DATA SOURCES The Cochrane Library, Embase, PubMed, PsychINFO, Scopus, Web of Science, Nice HDAS (Healthcare Databases Advanced Search), Google Scholar, BASE (Bielefeld Academic Search Engine), Semantic Scholar, and OpenGrey were searched from inception to July 20, 2018, and updated on June 10, 2019. STUDY SELECTION Studies were eligible if they (1) were a randomized clinical trial; (2) involved participants older than 18 years; (3) involved participants with mental health diagnoses; (4) reported data from a group of participants who received their preferred treatment and a group who received their nonpreferred treatment or who were not given a choice; and (5) offered at least 1 psychosocial intervention. DATA EXTRACTION AND SYNTHESIS Two researchers extracted study data for attendance, dropout, and clinical outcomes independently. Both assessed the risk of bias according to the Cochrane tool. Data were pooled using random-effects meta-analyses. MAIN OUTCOMES AND MEASURES The following 7 outcomes were examined: attendance, dropout, therapeutic alliance, depression and anxiety outcomes, global outcomes, treatment satisfaction, and remission. RESULTS A total of 7341 articles were identified, with 34 eligible for inclusion. Twenty-nine articles were included in the meta-analyses comprising 5294 participants. Receiving a preferred psychosocial mental health treatment had a medium positive association with dropout rates (relative risk, 0.62; 0.48-0.80; P < .001; I2 = 44.6%) and therapeutic alliance (Cohen d = 0.48; 0.15-0.82; P = .01; I2 = 20.4%). There was no evidence of a significant association with other outcomes. CONCLUSIONS AND RELEVANCE This is the first review, to our knowledge, examining the association of receiving a preferred psychosocial mental health treatment with both engagement and outcomes for patients with a mental health diagnosis. Patients with mental health diagnoses who received their preferred treatment demonstrated a lower dropout rate from treatment and higher therapeutic alliance scores. These findings underline the need to accommodate patient preference in mental health services to maximize treatment uptake and reduce financial costs of premature dropout and disengagement.
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Affiliation(s)
- Emma Windle
- Unit for Social and Community Psychiatry, Queen Mary University of London, London, United Kingdom
| | - Helena Tee
- Unit for Social and Community Psychiatry, Queen Mary University of London, London, United Kingdom
| | - Alina Sabitova
- Unit for Social and Community Psychiatry, Queen Mary University of London, London, United Kingdom
| | - Nikolina Jovanovic
- Unit for Social and Community Psychiatry, Queen Mary University of London, London, United Kingdom
| | - Stefan Priebe
- Unit for Social and Community Psychiatry, Queen Mary University of London, London, United Kingdom
| | - Catherine Carr
- Unit for Social and Community Psychiatry, Queen Mary University of London, London, United Kingdom
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18
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Manyam SB, Davis TL, Mitchell CD. Trauma Group Therapy with African American Children and Adolescents: A 30-plus Year Content Analysis. JOURNAL FOR SPECIALISTS IN GROUP WORK 2019. [DOI: 10.1080/01933922.2019.1699619] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Murphy TM, Dispenza F, Chang CY, Elston N, Rumsey A, Sinclair M, Curtis-Davidson R. Enhancing the Seeking Safety group intervention with trauma-sensitive yoga practice: A program evaluation. Complement Ther Clin Pract 2019; 35:308-315. [PMID: 31003675 DOI: 10.1016/j.ctcp.2019.03.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 02/11/2019] [Accepted: 03/08/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND AND PURPOSE The purpose of this article is to report the results of a qualitative Utilization Focused Program Evaluation on the integration of the Seeking Safety manualized group counseling intervention with Trauma-Sensitive (TS) yoga practice at a community mental health agency. To date, there has been no evaluation of Seeking Safety and TS yoga as complementary therapies. METHOD AND MATERIALS Qualitative data were generated from key informant interviews and focus groups, then coded and analyzed for theme and content. RESULTS Analysis of data indicate that, in this specific setting, the combination of Seeking Safety and TS Yoga was perceived by clients and clinicians as an effective complementary intervention strategy. CONCLUSION The results of this qualitative evaluation are specific to the agency utilizing the interventions. By integrating Seeking Safety with TS yoga many of the inherent weaknesses of the two individual approaches were moderated.
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Affiliation(s)
- Thomas M Murphy
- Department of Counseling, The College of Saint Rose, United States.
| | - Franco Dispenza
- Department of Counseling & Psychological Services, Georgia State University, United States.
| | - Catherine Y Chang
- Department of Counseling & Psychological Services, Georgia State University, United States.
| | - Nikki Elston
- Department of Counseling, Wake Forrest University, United States.
| | - Amanda Rumsey
- Department of Education & Human Development, Clemson University, United States.
| | - Moneta Sinclair
- Positive Impact Health Centers - Decatur, GA, United States.
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20
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Sugarman DE, Reilly ME, Rodolico JM, Greenfield SF. Feasibility and Acceptability of a Gender-Specific Group Treatment for Men with Substance Use Disorders. ALCOHOLISM TREATMENT QUARTERLY 2019. [DOI: 10.1080/07347324.2019.1585217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Affiliation(s)
- Dawn E. Sugarman
- Division of Alcohol and Drug Abuse, McLean Hospital, Belmont, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Meghan E. Reilly
- Division of Alcohol and Drug Abuse, McLean Hospital, Belmont, Massachusetts, USA
| | - John M. Rodolico
- Division of Alcohol and Drug Abuse, McLean Hospital, Belmont, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
- Red Sox Foundation and Home Base Program, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Shelly F. Greenfield
- Division of Alcohol and Drug Abuse, McLean Hospital, Belmont, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
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21
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Abstract
PURPOSE OF REVIEW Posttraumatic stress disorder is a chronic, heterogeneous disorder for which a multitude of psychotherapies, pharmaceuticals, and immerging treatment programs are available. Majority of efficacy studies focus on Caucasian male military populations, which may be a reason why not all patients respond to treatment with long-term positive outcomes. Additionally, effects of treatment on symptom clusters have been neglected. This work reviews treatment of PTSD and its symptom clusters exclusively in civilian populations, which have been historically under-examined in the literature. RECENT FINDINGS Exposure therapy stands at the forefront of successful PTSD treatment and offers a more cost-effective solution to pharmacotherapy; however, refugees and patients with comorbid depression may not experience such strong benefits. For exposure therapy and other forms of psychotherapy, non-inferiority studies point to promise of internet-delivered and telemedicine-based methods for reaching populations that may not have access to in-person care. SSRIs are the most widely used pharmaceutical treatment for PTSD; moderate initial benefits are observed yet long-term retention and outcomes may be enhanced by adjunct treatment. Again, refugees are a group that experiences lesser benefit. Research has begun to explore efficacy of treatments for individual symptom clusters, with hyperarousal benefiting most from currently available modalities. Avoidance, intrusion, negative thoughts and beliefs, and dissociation are symptoms requiring more research for focused interventions. Treatment of PTSD has evolved to (1) include equivalent proportions of men and women, along with focused female-exclusive cohorts; (2) explore novel methods of treatment online and in various cultural contexts; and (3) less focus on medication as evidenced by current clinical trials. In addition to further efficacy and safety studies in more diverse ethnic populations, work is needed to examine what therapies are best for targeting specific symptom clusters of PTSD. This research will drive precision treatment, and such research is beginning to point towards underlying mechanisms of pathology and change.
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22
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Caravaca Sánchez F, Ignatyev Y, Mundt AP. Associations between childhood abuse, mental health problems, and suicide risk among male prison populations in Spain. CRIMINAL BEHAVIOUR AND MENTAL HEALTH : CBMH 2019; 29:18-30. [PMID: 30561144 DOI: 10.1002/cbm.2099] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 05/09/2018] [Accepted: 11/20/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND There are few studies exploring associations between different types of childhood abuse and mental health problems among adult prisoners. AIMS To explore associations between history of childhood abuse, depression or anxiety, and near-lethal suicide attempts among adult prisoners, and test the hypothesis that post-traumatic stress disorder (PTSD) may be a mediator between childhood abuse and adult disorder among prisoners. METHOD We enrolled 943 men from three prisons in Spain. Childhood abuse was assessed with the Childhood Trauma Questionnaire at interview and current symptoms were assessed using the 21-item Depression Anxiety and Stress Scale (DASS-21). Self-reported histories of near-lethal suicide attempts were recorded. RESULTS Overall, 360 (40%) of the men reported at least one type of childhood abuse; 231 (24.5%) described exposure to emotional abuse, 236 (25%) to physical abuse, and 97 (10%) to sexual abuse. Survivors of all types of childhood abuse had over twice the prevalence of severe depression, anxiety, stress disorder, and near-lethal suicide attempts than men who had not been exposed. Survivors of sexual and emotional violence during childhood had more symptoms of PTSD than survivors of physical abuse. Statistically, PTSD had a mediating effect, but it was very small. CONCLUSIONS Although other studies have shown high rates of childhood abuse histories among prisoners, this is the first to link such a history to near-lethal suicide attempts in this population.
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Affiliation(s)
| | - Yuriy Ignatyev
- Department of Psychiatry, Psychotherapy and Psychosomatics, Immanuel Klinik, Brandenburg Medical School Theodor Fontane, Rüdersdorf, Germany
| | - Adrian P Mundt
- Medical Faculty, Diego Portales University, Santiago, Chile
- Medical School, San Sebastián University, Puerto Montt, Chile
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23
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Mahoney A, Karatzias T, Hutton P. A systematic review and meta-analysis of group treatments for adults with symptoms associated with complex post-traumatic stress disorder. J Affect Disord 2019; 243:305-321. [PMID: 30261446 DOI: 10.1016/j.jad.2018.09.059] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 07/23/2018] [Accepted: 09/16/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND No previous meta-analyses have specifically investigated the effectiveness of psychological group therapy for symptoms associated with complex interpersonal trauma, including whether trauma memory processing (TMP) therapies are superior to psychoeducational approaches alone. METHODS A systematic review identified 36 randomised control trials (RCTs) which were included in the meta-analysis. RESULTS Large significant effect sizes were evident for TMP interventions when compared to usual care for three outcome domains including: PTSD (k = 6, g = -0.98, 95% CI -1.53, -0.43), Depression (k = 7, g = -1.12, 95% CI -2.01, -0.23) and Psychological Distress (k = 6, g = -0.98, 95% CI 1.66, -0.40). When TMP and psychoeducation interventions were directly compared, results indicated a small non-significant effect in favour of the former for PTSD symptoms, (k = 4, g = -0.34, 95% CI -1.05, 0.36) and small non-significant effect sizes in favour of the latter for Depression (k = 3, g = 0.29, 95% CI -0.83, 1.4) and Psychological Distress (k = 6, g = 0.19, 95% CI -0.34, 0.71). LIMITATIONS Heterogeneity and a limited number of high quality RCTs, particularly in the Substance Misuse and Dissociation domains, resulted in uncertainty regarding meta-analytical estimates and subsequent conclusions. CONCLUSIONS Results suggest that TMP interventions are useful for traumatic stress whereas non-TMP interventions can be useful for symptoms of general distress (e.g. anxiety and depression). Thus, both TMP and psychoeducation can be useful for the treatment of complex interpersonal trauma symptoms and further research should unravel appropriate sequencing and dose of these interventions.
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Affiliation(s)
- Adam Mahoney
- Psychology Department, HMP & YOI Cornton Vale, Stirling, UK; School of Health & Social Science, Edinburgh Napier University, UK.
| | - Thanos Karatzias
- School of Health & Social Science, Edinburgh Napier University, UK; Rivers Centre for Traumatic Stress, NHS Lothian, UK
| | - Paul Hutton
- School of Health & Social Science, Edinburgh Napier University, UK
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Bowen K, Jarrett M, Stahl D, Forrester A, Valmaggia L. The relationship between exposure to adverse life events in childhood and adolescent years and subsequent adult psychopathology in 49,163 adult prisoners: A systematic review. PERSONALITY AND INDIVIDUAL DIFFERENCES 2018. [DOI: 10.1016/j.paid.2018.04.023] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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25
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Chou CY, Herbst E, Cloitre M, Tsoh JY. An emotion regulation-focused theoretical framework for co-occurring nicotine addiction and PTSD: Comments on existing treatments and future directions. COGENT MEDICINE 2018. [DOI: 10.1080/2331205x.2018.1558731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Affiliation(s)
- Chia-Ying Chou
- Department of Psychiatry, University of California, San Francisco 401 Parnassus Ave, San Francisco, CA 94143, USA
| | - Ellen Herbst
- Department of Psychiatry, University of California, San Francisco 401 Parnassus Ave, San Francisco, CA 94143, USA
- Mental Health Services, San Francisco Veterans Affairs Health Care System, 4150 Clement St, San Francisco, CA 94121, USA
| | - Marylene Cloitre
- National Center for PTSD Dissemination and Training Division, Veterans Affairs Palo Alto Health Care System, 4951 Arroyo Rd., Livermore, CA 94550, USA
| | - Janice Y. Tsoh
- Department of Psychiatry, University of California, San Francisco 401 Parnassus Ave, San Francisco, CA 94143, USA
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Yoon IA, Slade K, Fazel S. Outcomes of psychological therapies for prisoners with mental health problems: A systematic review and meta-analysis. J Consult Clin Psychol 2017; 85:783-802. [PMID: 28569518 PMCID: PMC5518650 DOI: 10.1037/ccp0000214] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
OBJECTIVE Prisoners worldwide have substantial mental health needs, but the efficacy of psychological therapy in prisons is unknown. We aimed to systematically review psychological therapies with mental health outcomes in prisoners and qualitatively summarize difficulties in conducting randomized clinical trials (RCTs). METHOD We systematically identified RCTs of psychological therapies with mental health outcomes in prisoners (37 studies). Effect sizes were calculated and meta-analyzed. Eligible studies were assessed for quality. Subgroup and metaregression analyses were conducted to examine sources of between-study heterogeneity. Thematic analysis reviewed difficulties in conducting prison RCTs. RESULTS In 37 identified studies, psychological therapies showed a medium effect size (0.50, 95% CI [0.34, 0.66]) with high levels of heterogeneity with the most evidence for CBT and mindfulness-based trials. Studies that used no treatment (0.77, 95% CI [0.50, 1.03]) or waitlist controls (0.71, 95% CI [0.43, 1.00]) had larger effect sizes than those that had treatment-as-usual or other psychological therapies as controls (0.21, 95% CI [0.01, 0.41]). Effects were not sustained on follow-up at 3 and 6 months. No differences were found between group and individual therapy, or different treatment types. The use of a fidelity measure was associated with lower effect sizes. Qualitative analysis identified difficulties with follow-up and institutional constraints on scheduling and implementation of trials. CONCLUSIONS CBT and mindfulness-based therapies are modestly effective in prisoners for depression and anxiety outcomes. In prisons with existing psychological therapies, more evidence is required before additional therapies can be recommended. (PsycINFO Database Record
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Affiliation(s)
| | - Karen Slade
- Division of Psychology, Nottingham Trent University
| | - Seena Fazel
- Department of Psychiatry, University of Oxford
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Sánchez FC, Wolff N. The association between substance use and physical victimization among incarcerated men in Spanish prisons. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2017; 50:9-16. [PMID: 27816218 DOI: 10.1016/j.ijlp.2016.09.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Revised: 09/13/2016] [Accepted: 09/29/2016] [Indexed: 06/06/2023]
Abstract
Physical victimization and substance use are common behaviors inside prisons. Yet little is known about whether there is an association between substance use and physical victimization among male inmates. We examined the absolute and relative association between substance use (prior to, during, and both prior to and during incarceration) and physical victimization while incarcerated. For this study, 2484 men (mean age of 36.3years; SD=11.1) were sampled from eight prisons located in Spain. Information was collected using self-report questionnaires probing experiences of physical victimization while incarcerated and substance use prior to prison and during the past six months in prison. We found that the rates and likelihood of physical victimization were greater for male inmates who used substances at any time, compared to non-consumers of substances but were highest for male inmates who used exclusively in prison or both prior to and in prison. These findings suggest the need for immediate prevention steps including comprehensive screening and segregation practices; better drug interdiction practices; and more evidence-based substance abuse treatment with and without integrated trauma treatment to ensure public health and safety.
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Affiliation(s)
- Francisco Caravaca Sánchez
- Department of Criminology, Universidad Católica San Antonio de Murcia, Avenue of Jerónimos, Guadalupe, 30107 Murcia, Spain.
| | - Nancy Wolff
- Bloustein Center for Survey Research, Rutgers, The State University of New Jersey, 33 Livingston Avenue, Office 273, United States
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Berg MK, Hobkirk AL, Joska JA, Meade CS. The role of substance use coping in the relation between childhood sexual abuse and depression among methamphetamine users in South Africa. PSYCHOLOGICAL TRAUMA-THEORY RESEARCH PRACTICE AND POLICY 2016; 9:493-499. [PMID: 27710005 DOI: 10.1037/tra0000207] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Childhood sexual abuse (CSA) is a critical global health issue associated with poor psychosocial outcomes. Individuals with CSA histories are at risk for drug use, which is a growing problem in the Western Cape of South Africa. The present study of methamphetamine users in this region examined whether substance use coping, a contextually relevant type of avoidance-based coping, mediates the relation between CSA and depressive symptoms. METHOD Participants included 161 men and 108 women seeking treatment for methamphetamine use. Participants completed a computer-assisted survey and a face-to-face interview with clinic staff to evaluate history of CSA, current substance use severity and coping, and current depressive symptoms. RESULTS Nearly a third of participants reported a history of CSA, and the average methamphetamine use severity score exceeded the threshold of high risk. A history of CSA was significantly associated with higher substance use coping and more depression symptoms. Substance use coping was a significant mediator of the association between CSA and depression symptoms. CONCLUSIONS In this study of high-risk methamphetamine users, substance use coping emerged as a common means of managing stress, especially for those with a history of CSA, which was further linked to depressive symptoms. These findings underscore the potential benefit of integrating coping interventions and mental health treatment into substance abuse treatment programs, particularly for those with a history of childhood abuse and violence. (PsycINFO Database Record
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Affiliation(s)
| | | | - John A Joska
- Department of Psychiatry and Mental Health, University of Cape Town
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Cordeiro Vasconcelos S, Botelho Sougey E, da Silva Frazão I, Turner NE, Pinheiro Ramos V, Duarte da Costa Lima M. Cross-cultural adaptation of the drug-taking confidence questionnaire drug version for use in Brazil. BMC Med Res Methodol 2016; 16:55. [PMID: 27193075 PMCID: PMC4870810 DOI: 10.1186/s12874-016-0153-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Accepted: 05/04/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Drug-Taking Confidence Questionnaire evaluates a drug user's confidence in his or her ability to resist the urge to consume psychoactive substances in high-risk situations. This study's objective was to develop a cross-cultural adaptation of the eight-item version of the Drug-Taking Confidence Questionnaire (DTCQ-8) for all drugs except alcohol and to verify its content validity and reliability in a pre-test stage. METHODS The following steps were taken: (1) implementation of the translation protocol and transcultural adaptation, (2) validation of the adapted content, and (3) assessment of reliability. Nine experts participated in the process of adaptation, and the trial's sample comprised 40 drug users in treatment at a Psychosocial Care Center for Alcohol and Other Drugs (CAPSad). RESULTS The average indices of semantic agreement (0.989; 0.989; 1.00), idiomatic (0.967), experiential (0.956), conceptual (0.978) and content validity with respect to language clarity (0.972), practice relevance (0.958), theoretical relevance (0.958) and theoretical dimension (1.00) showed that the adaption was successful. The mean total score of the DTCQ-8 version for other drugs was 477.00 + 234.27-SD, and 57.5 % of the users were classified as having moderate self-efficacy to resist the urge to use drugs in high-risk situations. The Cronbach's alpha coefficient was 0.889 for the complete instrument and 0.863-0.890 between items. CONCLUSIONS The DTCQ-8 version for other drugs proved to be easy to use and understand, and its process of adaptation was satisfactory for use in the Brazilian context. In this sample, the questionnaire was adequate to measure users' self-efficacy to resist the urge to consume these substances in high-risk situations.
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Affiliation(s)
| | | | | | - Nigel Ernest Turner
- University of Toronto and Independent Scientist, Center for Addiction and Mental Health, Toronto, Canada
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30
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Roberts NP, Roberts PA, Jones N, Bisson JI. Psychological therapies for post-traumatic stress disorder and comorbid substance use disorder. Cochrane Database Syst Rev 2016; 4:CD010204. [PMID: 27040448 PMCID: PMC8782594 DOI: 10.1002/14651858.cd010204.pub2] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Post-traumatic stress disorder (PTSD) is a debilitating mental health disorder that may develop after exposure to traumatic events. Substance use disorder (SUD) is a behavioural disorder in which the use of one or more substances is associated with heightened levels of distress, clinically significant impairment of functioning, or both. PTSD and SUD frequently occur together. The comorbidity is widely recognised as being difficult to treat and is associated with poorer treatment completion and poorer outcomes than for either condition alone. Several psychological therapies have been developed to treat the comorbidity, however there is no consensus about which therapies are most effective. OBJECTIVES To determine the efficacy of psychological therapies aimed at treating traumatic stress symptoms, substance misuse symptoms, or both in people with comorbid PTSD and SUD in comparison with control conditions (usual care, waiting-list conditions, and no treatment) and other psychological therapies. SEARCH METHODS We searched the Cochrane Depression, Anxiety and Neurosis Group's Specialised Register (CCDANCTR) all years to 11 March 2015. This register contains relevant randomised controlled trials from the Cochrane Library (all years), MEDLINE (1950 to date), EMBASE (1974 to date), and PsycINFO (1967 to date). We also searched the World Health Organization International Clinical Trials Registry Platform and ClinicalTrials.gov, contacted experts, searched bibliographies of included studies, and performed citation searches of identified articles. SELECTION CRITERIA Randomised controlled trials of individual or group psychological therapies delivered to individuals with PTSD and comorbid substance use, compared with waiting-list conditions, usual care, or minimal intervention or to other psychological therapies. DATA COLLECTION AND ANALYSIS We used standard methodological procedures expected by Cochrane. MAIN RESULTS We included 14 studies with 1506 participants, of which 13 studies were included in the quantitative synthesis. Most studies involved adult populations. Studies were conducted in a variety of settings. We performed four comparisons investigating the effects of psychological therapies with a trauma-focused component and non-trauma-focused interventions against treatment as usual/minimal intervention and other active psychological therapies. Comparisons were stratified for individual- or group-based therapies. All active interventions were based on cognitive behavioural therapy. Our main findings were as follows.Individual-based psychological therapies with a trauma-focused component plus adjunctive SUD intervention was more effective than treatment as usual (TAU)/minimal intervention for PTSD severity post-treatment (standardised mean difference (SMD) -0.41; 95% confidence interval (CI) -0.72 to -0.10; 4 studies; n = 405; very low-quality evidence) and at 3 to 4 and 5 to 7 months' follow-up. There was no evidence of an effect for level of drug/alcohol use post-treatment (SMD -0.13; 95% CI -0.41 to 0.15; 3 studies; n = 388; very low-quality evidence), but there was a small effect in favour of individual psychological therapy at 5 to 7 months (SMD -0.28; 95% CI -0.48 to -0.07; 3 studies; n = 388) when compared against TAU. Fewer participants completed trauma-focused therapy than TAU (risk ratio (RR) 0.78; 95% CI 0.64 to 0.96; 3 studies; n = 316; low-quality evidence).Individual-based psychological therapy with a trauma-focused component did not perform better than psychological therapy for SUD only for PTSD severity (mean difference (MD) -3.91; 95% CI -19.16 to 11.34; 1 study; n = 46; low-quality evidence) or drug/alcohol use (MD -1.27; 95% CI -5.76 to 3.22; 1 study; n = 46; low-quality evidence). Findings were based on one small study. No effects were observed for rates of therapy completion (RR 1.00; 95% CI 0.74 to 1.36; 1 study; n = 62; low-quality evidence).Non-trauma-focused psychological therapies did not perform better than TAU/minimal intervention for PTSD severity when delivered on an individual (SMD -0.22; 95% CI -0.83 to 0.39; 1 study; n = 44; low-quality evidence) or group basis (SMD -0.02; 95% CI -0.19 to 0.16; 4 studies; n = 513; low-quality evidence). There were no data on the effects on drug/alcohol use for individual therapy. There was no evidence of an effect on the level of drug/alcohol use for group-based therapy (SMD -0.03; 95% CI -0.37 to 0.31; 4 studies; n = 414; very low-quality evidence). A post-hoc analysis for full dose of a widely established group therapy called Seeking Safety showed reduced drug/alcohol use post-treatment (SMD -0.67; 95% CI -1.14 to -0.19; 2 studies; n = 111), but not at subsequent follow-ups. Data on the number of participants completing therapy were not for individual-based therapy. No effects were observed for rates of therapy completion for group-based therapy (RR 1.13; 95% CI 0.88 to 1.45; 2 studies; n = 217; low-quality evidence).Non-trauma-focused psychological therapy did not perform better than psychological therapy for SUD only for PTSD severity (SMD -0.26; 95% CI -1.29 to 0.77; 2 studies; n = 128; very low-quality evidence) or drug/alcohol use (SMD 0.22; 95% CI -0.13 to 0.57; 2 studies; n = 128; low-quality evidence). No effects were observed for rates of therapy completion (RR 0.91; 95% CI 0.68 to 1.20; 2 studies; n = 128; very low-quality evidence).Several studies reported on adverse events. There were no differences between rates of such events in any comparison. We rated several studies as being at 'high' or 'unclear' risk of bias in multiple domains, including for detection bias and attrition bias. AUTHORS' CONCLUSIONS We assessed the evidence in this review as mostly low to very low quality. Evidence showed that individual trauma-focused psychological therapy delivered alongside SUD therapy did better than TAU/minimal intervention in reducing PTSD severity post-treatment and at long-term follow-up, but only reduced SUD at long-term follow-up. All effects were small, and follow-up periods were generally quite short. There was evidence that fewer participants receiving trauma-focused therapy completed treatment. There was very little evidence to support use of non-trauma-focused individual- or group-based integrated therapies. Individuals with more severe and complex presentations (e.g. serious mental illness, individuals with cognitive impairment, and suicidal individuals) were excluded from most studies in this review, and so the findings from this review are not generalisable to such individuals. Some studies suffered from significant methodological problems and some were underpowered, limiting the conclusions that can be drawn. Further research is needed in this area.
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Affiliation(s)
- Neil P Roberts
- Cardiff University School of MedicineInstitute of Psychological Medicine and Clinical NeurosciencesHadyn Ellis BuildingMaindy RoadCardiffUKCF24 4HQ
- Cardiff and Vale University Health BoardPsychology and Counselling DirecorateCardiffUK
| | - Pamela A Roberts
- Cardiff and Vale University Health BoardPsychology and Counselling DirecorateCardiffUK
- Cardiff and Vale University Health BoardCommunity Addiction ServiceCardiffUK
| | - Neil Jones
- Cardiff and Vale University Health BoardCommunity Addiction ServiceCardiffUK
| | - Jonathan I Bisson
- Cardiff University School of MedicineInstitute of Psychological Medicine and Clinical NeurosciencesHadyn Ellis BuildingMaindy RoadCardiffUKCF24 4HQ
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Abstract
OBJECTIVE Individually-randomized psychotherapy trials are often partially nested. For instance, individuals assigned to a treatment arm may be clustered into therapy groups for purposes of treatment administration, whereas individuals assigned to a wait-list control are unclustered. The past several years have seen rapid expansion and investigation of methods for analyzing partially nested data. Yet partial nesting often remains ignored in psychotherapy trials. METHODS This review integrates and disseminates developments in the analysis of partially nested data that are particularly relevant for psychotherapy researchers. RESULTS First, we differentiate among alternative partially nested designs. Then, we present adaptations of multilevel model specifications that accommodate each design. Next, we address how moderation by treatment as well as mediation of the treatment effect can be investigated in partially nested designs. Model fitting results, annotated software syntax, and illustrative data sets are provided and key methodological issues are discussed. CONCLUSIONS We emphasize that cluster-level variability in the treatment arm need not be considered a nuisance; it can be modeled to yield insights about the treatment process.
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Affiliation(s)
- Sonya K Sterba
- a Department of Psychology and Human Development , Vanderbilt University , Nashville , TN , USA
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Bailey ZD, Okechukwu C, Kawachi I, Williams DR. Incarceration and Current Tobacco Smoking Among Black and Caribbean Black Americans in the National Survey of American Life. Am J Public Health 2015; 105:2275-82. [PMID: 26378842 DOI: 10.2105/ajph.2015.302772] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We examined the relationship between having a history of incarceration and being a current smoker using a national sample of noninstitutionalized Black adults living in the United States. METHODS With data from the National Survey of American Life collected between February 2001 and March 2003, we calculated individual propensity scores for having a history of incarceration. To examine the relationship between prior incarceration and current smoking status, we ran gender-specific propensity-matched fitted logistic regression models. RESULTS A history of incarceration was consistently and independently associated with a higher risk of current tobacco smoking in men and women. Formerly incarcerated Black men had 1.77 times the risk of being a current tobacco smoker than did their counterparts without a history of incarceration (95% confidence interval [CI] = 1.20, 2.61) in the propensity score-matched sample. The results were similar among Black women (prevalence ratio = 1.61; 95% CI = 1.00, 2.57). CONCLUSIONS Mass incarceration likely contributes to the prevalence of smoking among US Blacks. Future research should explore whether the exclusion of institutionalized populations in national statistics obscures Black-White disparities in tobacco smoking.
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Affiliation(s)
- Zinzi D Bailey
- Zinzi D. Bailey, Cassandra Okechukwu, Ichiro Kawachi, and David R. Williams are with the Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA. Zinzi D. Bailey is also with the Montreal Health Equity Research Consortium, Institute of Health and Social Policy, McGill University, Montreal, Canada
| | - Cassandra Okechukwu
- Zinzi D. Bailey, Cassandra Okechukwu, Ichiro Kawachi, and David R. Williams are with the Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA. Zinzi D. Bailey is also with the Montreal Health Equity Research Consortium, Institute of Health and Social Policy, McGill University, Montreal, Canada
| | - Ichiro Kawachi
- Zinzi D. Bailey, Cassandra Okechukwu, Ichiro Kawachi, and David R. Williams are with the Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA. Zinzi D. Bailey is also with the Montreal Health Equity Research Consortium, Institute of Health and Social Policy, McGill University, Montreal, Canada
| | - David R Williams
- Zinzi D. Bailey, Cassandra Okechukwu, Ichiro Kawachi, and David R. Williams are with the Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA. Zinzi D. Bailey is also with the Montreal Health Equity Research Consortium, Institute of Health and Social Policy, McGill University, Montreal, Canada
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Wolff N, Shi J. Screening for Substance Use Disorder Among Incarcerated Men with the Alcohol, Smoking, Substance Involvement Screening Test (ASSIST): A Comparative Analysis of Computer-Administered and Interviewer-Administered Modalities. J Subst Abuse Treat 2015; 53:22-32. [PMID: 25659203 PMCID: PMC4414742 DOI: 10.1016/j.jsat.2015.01.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Revised: 01/07/2015] [Accepted: 01/08/2015] [Indexed: 11/23/2022]
Abstract
Substance use disorders are overrepresented in incarcerated male populations. Cost- effective screening for alcohol and substance use problems among incarcerated populations is a necessary first step forward intervention. The Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) holds promise because it has strong psychometric properties, requires minimal training, is easy to score, is available in the public domain but, because of complicated skip patterns, cannot be self-administered. This study tests the feasibility, reliability, and validity of using computer-administered self-interviewing (CASI) versus interviewer-administered interviewing (IAI) to screen for substance use problems among incarcerated men using the ASSIST. A 2 X 2 factorial design was used to randomly assign 396 incarcerated men to screening modality. Findings indicate that computer screening was feasible. Compared to IAI, CASI produced equally reliable screening information on substance use and symptom severity, with test-retest intraclass correlations for ASSIST total and substance-specific scores ranging from 0.7 to 0.9, and ASSIST substance-specific scores and a substance abuse disorder diagnosis based on the Structured Clinical Interview (SCID) were significantly correlated for IAI and CASI. These findings indicate that data on substance use and symptom severity using the ASSIST can be reliably and validly obtained from CASI technology, increasing the efficiency by which incarcerated populations can be screened for substance use problems and, those at risk, identified for treatment.
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Affiliation(s)
- Nancy Wolff
- Center for Behavioral Health Services and Criminal Justice Research, Rutgers University, New Brunswick, NJ, 08901.
| | - Jing Shi
- Center for Behavioral Health Services and Criminal Justice Research, Rutgers University, New Brunswick, NJ, 08901
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