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Dasaro CR, Sabra A, Jeon Y, Williams TA, Sloan NL, Todd AC, Teitelbaum SL. A comparison of two user-friendly methods to identify and support correction of misspelled medications. Prev Med Rep 2024; 43:102765. [PMID: 38798907 PMCID: PMC11127154 DOI: 10.1016/j.pmedr.2024.102765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 04/29/2024] [Accepted: 05/14/2024] [Indexed: 05/29/2024] Open
Abstract
Objective To identify and support correction of misspelled medication names recorded as free text, we compared the relative effectiveness of two user-friendly methods, used without reliance on clinical knowledge. Methods Leveraging the SAS® COMPGED function, fuzzy string search programs examined 1.8 million medication records from 183,600 World Trade Center General Responder Cohort monitoring visits conducted in New York and New Jersey between 7/16/2002 and 3/31/2021, producing replicable generalized edit distance scores between the reported and correct spelling. Scores < 120 were selected as optimal and compared to Stedman's 2020 Plus Medical/Pharmaceutical Spell Checker first suggested word, used as the comparative standard because it employs both spelling and phonetic similarities to suggest matching words. We coded each methods' results as identifying or not identifying the medications within each visit. Results Most types of medications (94.4 % anxiety, 98.4 % asthma and 94.6 % ulcer/gastroesophageal reflux disease) were correctly spelled. Cross tabulations assessed the agreement (anxiety 99.9 %, asthma 99.6 % and 98.4 % ulcer/ gastroesophageal reflux disease), false positive (respectively 0.02 %, 0.03 % and 2.0 %) and false negative (respectively 1.9 %, 0.5 % and 1.0 %) values. Scores < 120 occasionally correctly identified medications missed by the spell checker. We observed no difference in medication misspellings across socio-economically and culturally diverse patient characteristics. Conclusions Both methods efficiently identified most misspelled medications, greatly minimizing the review and rectification needed. The fuzzy method is more universally applicable for condition-specific medications identification, but requires more programming skills. The spell checker is inexpensive, but benefits from modest programming skills and is only available in some languages.
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Affiliation(s)
- Christopher R. Dasaro
- World Trade Center Health Program General Responder Data Center, Department of Environmental Medicine and Climate Science, Icahn School of Medicine at Mount Sinai, 17 East 102 Street, 2 Floor, New York, NY 10029, United States of America
| | - Ahmad Sabra
- World Trade Center Health Program General Responder Data Center, Department of Environmental Medicine and Climate Science, Icahn School of Medicine at Mount Sinai, 17 East 102 Street, 2 Floor, New York, NY 10029, United States of America
| | - Yunho Jeon
- World Trade Center Health Program General Responder Data Center, Department of Environmental Medicine and Climate Science, Icahn School of Medicine at Mount Sinai, 17 East 102 Street, 2 Floor, New York, NY 10029, United States of America
| | - Tankeesha A. Williams
- World Trade Center Health Program General Responder Data Center, Department of Environmental Medicine and Climate Science, Icahn School of Medicine at Mount Sinai, 17 East 102 Street, 2 Floor, New York, NY 10029, United States of America
| | - Nancy L. Sloan
- World Trade Center Health Program General Responder Data Center, Department of Environmental Medicine and Climate Science, Icahn School of Medicine at Mount Sinai, 17 East 102 Street, 2 Floor, New York, NY 10029, United States of America
| | - Andrew C. Todd
- World Trade Center Health Program General Responder Data Center, Department of Environmental Medicine and Climate Science, Icahn School of Medicine at Mount Sinai, 17 East 102 Street, 2 Floor, New York, NY 10029, United States of America
| | - Susan L. Teitelbaum
- World Trade Center Health Program General Responder Data Center, Department of Environmental Medicine and Climate Science, Icahn School of Medicine at Mount Sinai, 17 East 102 Street, 2 Floor, New York, NY 10029, United States of America
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Pavlacic JM, Witcraft SM, Allan NP, Gros DF. Anxiety sensitivity and social support in veterans with emotional disorders. J Clin Psychol 2023; 79:2337-2350. [PMID: 37310172 PMCID: PMC10527913 DOI: 10.1002/jclp.23554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 05/11/2023] [Accepted: 05/28/2023] [Indexed: 06/14/2023]
Abstract
OBJECTIVE An understanding of the incremental value of social support in predicting psychopathology above transdiagnostic risk factors could speak to the benefit of leveraging social factors into existing, evidence-based interventions in veterans with emotional disorders. This cross-sectional study aimed to expand our understanding of associations between domains of anxiety sensitivity and facets of psychopathology in veterans with emotional disorders. We also determined whether social support predicted psychopathology above anxiety sensitivity domains and combat exposure and explored these relationships with a path model. METHODS One hundred and fifty-six treatment-seeking veterans with emotional disorders completed diagnostic interviews and assessments of demographics, social support, symptom measures (e.g., PTSD, depression, anxiety, and stress), and transdiagnostic risk factors (i.e., anxiety sensitivity). After data screening, 150 were included in regressions. RESULTS Using regression analyses with cross-sectional data, cognitive anxiety sensitivity concerns predicted PTSD and depression above combat exposure. Cognitive and physical concerns predicted anxiety, and cognitive and social concerns predicted stress. Above combat exposure and anxiety sensitivity, social support predicted PTSD and depression. CONCLUSION Focusing on social support in tandem with transdiagnostic mechanisms in clinical samples is critical. These findings inform transdiagnostic interventions and recommendations related to incorporation of assessment of transdiagnostic factors in clinical contexts.
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Affiliation(s)
- Jeffrey M. Pavlacic
- Mental Health Service, Ralph H. Johnson, VA Healthcare System, Charleston, South Carolina, USA
- Department of Psychology & Behavioral, Sciences, Medical University of South, Carolina, Charleston, South Carolina, USA
| | - Sara M. Witcraft
- College of Nursing, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Nicholas P. Allan
- Department of Psychiatry and Behavioral, Health, Ohio State University, Columbus, Ohio, USA
- VA Center of Excellence for Suicide, Prevention, VA Finger Lakes Healthcare, System, Canandaigua, New York, USA
| | - Daniel F. Gros
- Mental Health Service, Ralph H. Johnson, VA Healthcare System, Charleston, South Carolina, USA
- Department of Psychology & Behavioral, Sciences, Medical University of South, Carolina, Charleston, South Carolina, USA
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Kreminski MA, Courtney JA, Drummond SPA, Norton PJ. The Influence of Transdiagnostic Vulnerability Factors on PTSD Symptom Clusters in a Veteran Sample. Aust N Z J Psychiatry 2023; 57:442-455. [PMID: 35674388 DOI: 10.1177/00048674221103488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND There is continuing debate as to the latent structure underpinning posttraumatic stress disorder symptomatology. The transdiagnostic vulnerability factors of negative affect, anxiety sensitivity (and subcomponents) and intolerance of uncertainty have previously demonstrated the ability to explain symptom clusters in a range of anxiety and depressive disorders, and may give further understanding of PTSD symptomatology. METHOD Within an Australian Defence Force veteran population, structural equation modeling is utilized to assess whether a hierarchical Original Model containing negative affect as the general cognitive factor, anxiety sensitivity and intolerance of uncertainty as mid-level factors, can explain variability among posttraumatic stress disorder symptom clusters as defined by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. A further hierarchical Anxiety Sensitivity Extended model consisting of the general cognitive factor of negative affect and the three sub-factors of anxiety sensitivity as mid-level factors was also tested upon PTSD symptom clusters. RESULTS Both the hierarchical Original and Anxiety Sensitivity Extended models fit the data well. Within both models, negative affect consistently showed significant direct effects upon the posttraumatic stress disorder symptom clusters. In the Original Model, anxiety sensitivity served as a significant mediator of negative affect for several symptom clusters, while intolerance of uncertainty was non-significant both as a direct effect and as a mediator of negative affect. In the Anxiety Sensitivity Extended Model, the cognitive concerns sub-factor of anxiety sensitivity served as a significant mediator of negative affect for several symptom clusters, while the social and physical concerns sub-factors did not have significant direct or mediating effects. CONCLUSIONS This study demonstrates a transdiagnostic hierarchical model significantly explains the severity of Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition posttraumatic stress disorder symptom constructs within a subclinical population. Negative affect and anxiety sensitivity can each be targeted with specific interventions, suggesting new avenues to augment current gold standard psychotherapeutic interventions.
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Affiliation(s)
- Michael A Kreminski
- School of Psychological Sciences, Monash University, Clayton, VIC, Australia
| | - James A Courtney
- School of Psychological Sciences, Monash University, Clayton, VIC, Australia
| | - Sean P A Drummond
- School of Psychological Sciences, Monash University, Clayton, VIC, Australia
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Tsur N, Talmon A. Post-Traumatic Orientation to Bodily Signals: A Systematic Literature Review. TRAUMA, VIOLENCE & ABUSE 2023; 24:174-188. [PMID: 34159853 DOI: 10.1177/15248380211025237] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Theoretical literature suggests that trauma and (PTSD) may instigate changes in the interpretation of bodily signals. Some findings support these inquiries, revealing that exposure to traumatic events and PTSD are associated with pain catastrophizing, body vigilance, fear of pain, and other manifestations of bodily perceptions and interpretations. However, these findings are not integrated into an inclusive empirically based conceptualization, thus leading to a limited comprehension of this phenomenon. This systematic literature review was conducted to synthesize the existing literature referring to orientation to bodily signals. Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, the review included a final of 48 manuscripts that addressed orientation to bodily signals among participants (aged 18 and above) and its potential associations with PTSD. The review revealed that most studies assessed one orientation manifestation, which was tested for its link to PTSD. The majority of the manuscripts were cross-sectional and included participants who faced combat, vehicle accidents, or various types of traumas. Only five manuscripts focused on interpersonal trauma and abuse. Most manuscripts reported significant correlations, revealing that trauma and PTSD are associated with a negative, catastrophic and frightful interpretation of bodily signals. These findings emphasize the need to encapsulate the various manifestations of orientation to bodily signals under a unified construct, as proposed by the term post-traumatic orientation to bodily signals. Further research is needed to illuminate the circumstances and processes by which trauma is implicated in post-traumatic orientation to bodily signals.
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Affiliation(s)
- Noga Tsur
- Bob Shapell School of Social Work, Tel Aviv University, Israel
| | - Ada Talmon
- Bob Shapell School of Social Work, Tel Aviv University, Israel
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Rogers AH, Zvolensky MJ, Vujanovic AA, Ruggero CJ, Oltmanns J, Waszczuk MA, Luft BJ, Kotov R. Anxiety sensitivity and Pain Experience: a prospective investigation among World Trade Center Responders. J Behav Med 2022; 45:947-953. [PMID: 35715542 DOI: 10.1007/s10865-022-00336-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Accepted: 05/25/2022] [Indexed: 11/29/2022]
Abstract
Chronic pain is a significant public health problem and is exacerbated by stress. The World Trade Center (WTC) Disaster represents a unique stressor, and responders to the WTC disaster are at increased risk for pain and other health complaints. Therefore, there is a significant need to identify vulnerability factors for exacerbated pain experience among this high-risk population. Anxiety sensitivity (AS), defined as fear of anxiety-related sensations, is one such vulnerability factor associated with pain intensity and disability. Yet, no work has tested the predictive effects of AS on pain, limiting conclusions regarding the predictive utility and direction of associations. Therefore, the current study examined the prospective associations of AS, pain intensity, and pain interference among 452 (Mage = 55.22, SD = 8.73, 89.4% male) responders to the WTC disaster completing a 2-week daily diary study. Using multi-level modeling, AS total score was positively associated with both pain intensity and pain interference, and that AS cognitive concerns, but not social or physical concerns, were associated with increased pain. These results highlight the importance of AS as a predictor of pain complaints among WTC responders and provide initial empirical evidence to support AS as a clinical target for treating pain complaints among WTC responders.
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Affiliation(s)
- Andrew H Rogers
- Department of Psychology, University of Houston, 3695 Cullen Blvd., Room 126, 77204, Houston, TX, USA.
| | - Michael J Zvolensky
- Department of Psychology, University of Houston, 3695 Cullen Blvd., Room 126, 77204, Houston, TX, USA.,Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.,HEALTH Institute, University of Houston, Houston, TX, USA
| | - Anka A Vujanovic
- Department of Psychology, University of Houston, 3695 Cullen Blvd., Room 126, 77204, Houston, TX, USA
| | - Camilo J Ruggero
- Department of Psychology, University of North Texas, Denton, TX, USA
| | - Joshua Oltmanns
- Department of Psychiatry and Behavioral Sciences, Stony Brook University, Stony Brook, NY, United States
| | - Monika A Waszczuk
- Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, IL, United States
| | - Benjamin J Luft
- Department of Psychiatry and Behavioral Sciences, Stony Brook University, Stony Brook, NY, United States
| | - Roman Kotov
- Department of Psychiatry and Behavioral Sciences, Stony Brook University, Stony Brook, NY, United States
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Mazurkiewicz DW, Strzelecka J, Piechocka DI. Terrorism’s Impact on Mental Health Outcomes among Directly and Indirectly Exposed Victims and the Development of Psychopathology. J Clin Med 2022; 11:jcm11092630. [PMID: 35566764 PMCID: PMC9104983 DOI: 10.3390/jcm11092630] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 04/27/2022] [Accepted: 05/04/2022] [Indexed: 02/05/2023] Open
Abstract
After the events of 9/11, many police-responders developed post-traumatic stress disorder (PTSD) and were potentially vulnerable to developing depression and/or anxiety; in addition, nearly half of police with probable PTSD had comorbid depression and anxiety. Having in mind that victims who experience the effects of terrorism are exposed to high levels of psychological damage, we thus aimed to determine how sequelae of a terrorist act directly and indirectly affect victims. Quantitative synthesis findings were concluded on the basis of 200 records that met the inclusion criteria out of a total of 650. We grouped the patients according to their level of exposure to the WTC terrorist attack on 11 September 2001. The Level I group included individuals who had experienced the traumatic event and/or those who had observed the attack. The Level II group consisted of rescuers and/or persons who cleaned up debris in the area after the attack. The Level III group comprised the victims’ families. Our research enabled us to create a profile for those who were most vulnerable to mental disorders after the WTC terrorist attack. Patients who had survived the terrorist attack and/or those who had observed the incident exhibited fewer traumatic symptoms and a lower percentage of suicidal thoughts in comparison to individuals who had worked as rescuers or cleaning staff in the area after the attack. The number of symptoms rose along with increased contact time with the stressor. The dominant symptom was the triad of intrusion, avoidance, and hyperarousal. The findings may confirm the positive effect of protracted court cases in legal proceedings for compensation on the maintenance and development of psychopathology. Our research may contribute to a better understanding of the consequences of terrorism outcomes on the human psyche and be used in the development of standards for dealing with victims of terrorism’s impact.
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Affiliation(s)
| | - Jolanta Strzelecka
- Department of Pediatric Neurology, Medical University of Warsaw, Al. Żwirki and Wigury 63A Street, 02-091 Warsaw, Poland;
| | - Dorota Izabela Piechocka
- Department of Gynecology and Practical Obstetrics, Medical University of Bialystok, Szpitalna 37 Street, 15-295 Bialystok, Poland;
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Sex-Specific Link Between Emotional Vulnerability and Poor Weight Control in Cigarette Smokers. Int J Behav Med 2018; 26:69-75. [PMID: 30382509 DOI: 10.1007/s12529-018-9755-7] [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: 10/28/2022]
Abstract
BACKGROUND Cigarette smoking and poor weight control independently and synergistically increase risk for morbidity and mortality. However, few studies have examined the etiological role of emotion-regulatory dysfunction in the link between smoking and poor weight control, as well as the possible moderating role of sex. METHOD Participants (n = 577; Mage = 44.42; SD = 13.80; 52.7% female) were daily smokers who completed a single survey online through Qualtrics. Emotional vulnerability was indexed by a latent construct comprised of the subscales from the Distress Tolerance Scale (DTS) and the Anxiety Sensitivity Index-3 (ASI-3). A regression model was constructed to examine the relation between emotional vulnerability and poor weight control, measured via body mass index (BMI). RESULTS Emotional vulnerability was significantly and positively associated with BMI (b = .08, p = .020). The effect was moderated by sex, such that emotional vulnerability was significantly related to BMI in female smokers (b = .15, p = .002), but not in male smokers (b = .01, p = .806). CONCLUSIONS Emotional vulnerability appears to be a novel female-specific psychological mechanism related to poor weight control in smokers. Possible limitations are discussed.
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Pericot-Valverde I, Elliott RJ, Miller ME, Tidey JW, Gaalema DE. Posttraumatic stress disorder and tobacco use: A systematic review and meta-analysis. Addict Behav 2018; 84:238-247. [PMID: 29753221 PMCID: PMC7285418 DOI: 10.1016/j.addbeh.2018.04.024] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 03/18/2018] [Accepted: 04/30/2018] [Indexed: 12/26/2022]
Abstract
Posttraumatic stress disorder (PTSD) and tobacco use are prevalent conditions that co-occur at striking rates in the US. Previous reviews examined prevalence and factors associated with cigarette smoking among individuals with PTSD but have not been summarized since 2007. Moreover, none explored rates and factors associated with the use of other tobacco products. This study aimed to systematically review the most recent literature examining the comorbidity of PTSD and tobacco use to provide prevalence rates, as well as summarize the literature exploring other factors associated with tobacco use among individuals with PTSD. Studies were identified using a systematic search of keywords related to tobacco use and PTSD within the following databases: PubMed, PsycINFO, Web of Knowledge, CINAHL, PsycARTICLES, and Cochrane Clinical Trials Library. The studies included in this review (N = 66) showed that the prevalence of current use of tobacco products in individuals with PTSD was 24.0% and the rate of PTSD among users of tobacco products was 20.2%. Additionally, results demonstrated that individuals with PTSD present with high levels of nicotine dependence and heavy use of tobacco products, as well as underscore the importance of negative emotional states as a contributing factor to tobacco use among individuals with PTSD. It is imperative that future studies continue monitoring tobacco use among individuals with PTSD while also assessing factors identified as having a prominent role in tobacco use among individuals with PTSD. These findings also demonstrate the need for more innovative approaches to reduce the pervasive tobacco use among individuals with PTSD.
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Affiliation(s)
- Irene Pericot-Valverde
- Vermont Center on Behavior and Health, University of Vermont, Burlington, VT, United States; Department of Psychiatry, University of Vermont, Burlington, VT, United States; Department of Psychological Science, University of Vermont, Burlington, VT, United States.
| | - Rebecca J Elliott
- Vermont Center on Behavior and Health, University of Vermont, Burlington, VT, United States; Department of Psychiatry, University of Vermont, Burlington, VT, United States
| | - Mollie E Miller
- Center for Alcohol and Addiction Studies, Brown University, Providence, RI, United States
| | - Jennifer W Tidey
- Center for Alcohol and Addiction Studies, Brown University, Providence, RI, United States
| | - Diann E Gaalema
- Vermont Center on Behavior and Health, University of Vermont, Burlington, VT, United States; Department of Psychiatry, University of Vermont, Burlington, VT, United States; Department of Psychological Science, University of Vermont, Burlington, VT, United States
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Vujanovic AA, Farris SG, Bartlett BA, Lyons RC, Haller M, Colvonen PJ, Norman SB. Anxiety sensitivity in the association between posttraumatic stress and substance use disorders: A systematic review. Clin Psychol Rev 2018; 62:37-55. [PMID: 29778929 DOI: 10.1016/j.cpr.2018.05.003] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 05/08/2018] [Accepted: 05/09/2018] [Indexed: 11/19/2022]
Abstract
Posttraumatic stress disorder (PTSD) and substance use disorders (SUD) are complex psychiatric conditions that commonly co-occur. No evidence-based, "gold standard" treatments for PTSD/SUD comorbidity are currently available. Thus, it is imperative to better understand cognitive-affective mechanisms, targetable via cognitive-behavioral intervention (i.e., malleable), that may be related to both disorders in order to improve the theory and treatment of PTSD/SUD. Anxiety sensitivity is a malleable cognitive-affective factor with relevance to both PTSD and SUD. This systematic review focused on the published literature on anxiety sensitivity and trauma/PTSD and substance use/SUD from 1966 - May 1, 2018, and includes a total of 35 manuscripts. The state of the literature, limitations, and future research directions are discussed.
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Affiliation(s)
- Anka A Vujanovic
- University of Houston, Department of Psychology, Houston, TX, USA.
| | - Samantha G Farris
- The Warren Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior, Providence, RI, USA; The Miriam Hospital, Centers for Behavioral and Preventative Medicine, Providence, RI, USA; Butler Hospital, Behavioral Medicine and Addictions Research Unit, Providence, RI, USA; Rutgers, The State University of New Jersey, Department of Psychology, Piscataway, NJ, USA
| | | | - Robert C Lyons
- Veterans Affairs San Diego Healthcare System, San Diego, CA, USA; University of California, San Diego School of Medicine, Department of Psychiatry, San Diego, CA, USA
| | - Moira Haller
- Veterans Affairs San Diego Healthcare System, San Diego, CA, USA; University of California, San Diego School of Medicine, Department of Psychiatry, San Diego, CA, USA
| | - Peter J Colvonen
- Veterans Affairs San Diego Healthcare System, San Diego, CA, USA; University of California, San Diego School of Medicine, Department of Psychiatry, San Diego, CA, USA; Veterans Affairs Center of Excellence for Stress and Mental Health, San Diego, CA, USA
| | - Sonya B Norman
- Veterans Affairs San Diego Healthcare System, San Diego, CA, USA; University of California, San Diego School of Medicine, Department of Psychiatry, San Diego, CA, USA; Veterans Affairs Center of Excellence for Stress and Mental Health, San Diego, CA, USA; National Center for PTSD, White River Junction, VT, USA
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