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Zhang M, Ho E, Nowinski CJ, Fox RS, Ayturk E, Karpouzian-Rogers T, Novack M, Dodge HH, Weintraub S, Gershon R. The Paradox in Positive and Negative Aspects of Emotional Functioning Among Older Adults with Early Stages of Cognitive Impairment. J Aging Health 2024; 36:471-483. [PMID: 37800686 DOI: 10.1177/08982643231199806] [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] [Indexed: 10/07/2023]
Abstract
Introduction: Emotional functioning in older adults is influenced by normal aging and cognitive impairment, likely heterogeneous across positive versus negative aspects of emotional functioning. Little is known about positive emotional experiences at the early stages of cognitive impairment. Methods: We assessed different aspects of emotional functioning among 448 participants aged 65+ (Normal Control (NC) = 276, Mild Cognitive Impairment (MCI) = 103, and mild dementia of the Alzheimer type (mild DAT) = 69) and tested moderators. Results: Compared to NC, older adults with MCI and mild DAT have maintained many positive aspects of emotional functioning, despite higher levels of negative affect, sadness, and loneliness. Among the oldest-old, the mild DAT group experienced higher fear and lower self-efficacy. Discussion: Older adults at early stages of cognitive impairment can experience positive aspects of emotional functioning, such as positive affect, purpose, and life satisfaction, all of which are important buildable psychological resources for coping.
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Affiliation(s)
- Manrui Zhang
- Feinberg School of Medicine, Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA
| | - Emily Ho
- Feinberg School of Medicine, Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA
| | - Cindy J Nowinski
- Feinberg School of Medicine, Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA
- Department of Neurology, Northwestern University, Chicago, IL, USA
| | - Rina S Fox
- Feinberg School of Medicine, Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA
- College of Nursing, University of Arizona, Tuscon, AZ, USA
| | - Ezgi Ayturk
- College of Social Sciences and Humanities, KOC Universitesi, Istanbul, Turkey
| | - Tatiana Karpouzian-Rogers
- Department of Psychiatry and Behavioral Sciences, Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Miriam Novack
- Feinberg School of Medicine, Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA
| | - Hiroko H Dodge
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Sandra Weintraub
- Department of Psychiatry and Behavioral Sciences, Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Richard Gershon
- Feinberg School of Medicine, Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA
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2
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Penedo FJ, Moreno PI, Pons M, Pinheiro PS, Antoni MH, Lopes G, Calfa C, Chalela P, Garcini L, Wang CP, Chen Y, Diaz A, Cole S, Ramirez AG. Avanzando Caminos (Leading Pathways): design and procedures of the Hispanic/Latino Cancer Survivorship Study. Am J Epidemiol 2024; 193:940-950. [PMID: 38576195 DOI: 10.1093/aje/kwae033] [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: 12/20/2022] [Revised: 03/27/2024] [Accepted: 03/29/2024] [Indexed: 04/06/2024] Open
Abstract
Avanzando Caminos (Leading Pathways): The Hispanic/Latino Cancer Survivorship Cohort Study aims to examine the influence of sociocultural, medical, stress-related, psychosocial, lifestyle, behavioral, and biological factors on symptom burden, health-related quality of life, and clinical outcomes among Hispanics/Latinos who have been previously treated for cancer. Avanzando Caminos is a prospective, cohort-based study of 3000 Hispanics/Latinos who completed primary cancer treatment within the past 5 years that is representative of the general Hispanic/Latino population in the United States. Participants will complete self-report measures at baseline (time [T] 1), 6 months (T2), 1 year (T3), 2 years (T4), 3 years (T5), 4 years (T6), and 5 years (T7). Blood samples drawn for assessment of leukocyte gene expression, cardiometabolic markers, and genetic admixture will be collected at baseline (T1), 1 year (T3), 3 years (T5), and 5 years (T7). Medical and cancer characteristics and clinical outcomes will be extracted from the electronic medical record and/or state cancer registry at each time point. Data analysis will include general latent variable modeling and latent growth modeling. Avanzando Caminos will fill critical gaps in knowledge in order to guide future secondary and tertiary prevention efforts to mitigate cancer disparities and optimize health-related quality of life among Hispanic/Latino cancer survivors.
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Affiliation(s)
- Frank J Penedo
- Department of Psychology, College of Arts and Sciences, University of Miami, Coral Gables, FL 33124, United States
- Department of Medicine, Miller School of Medicine, University of Miami, Miami, FL 33136, United States
- Cancer Control Research Program, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL 33136, United States
| | - Patricia I Moreno
- Cancer Control Research Program, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL 33136, United States
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, FL 33136, United States
| | - Magela Pons
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, FL 33136, United States
| | - Paulo S Pinheiro
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, FL 33136, United States
| | - Michael H Antoni
- Department of Psychology, College of Arts and Sciences, University of Miami, Coral Gables, FL 33124, United States
- Cancer Control Research Program, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL 33136, United States
| | - Gilberto Lopes
- Department of Medicine, Miller School of Medicine, University of Miami, Miami, FL 33136, United States
| | - Carmen Calfa
- Department of Medicine, Miller School of Medicine, University of Miami, Miami, FL 33136, United States
| | - Patricia Chalela
- Institute for Health Promotion Research, UT Health San Antonio, San Antonio, TX 78229, United States
- Department of Population Health Sciences, Long School of Medicine, UT Health San Antonio, San Antonio, TX 78229, United States
| | - Luz Garcini
- Department of Psychological Sciences, School of Social Sciences, Rice University, Houston, TX 77005, United States
| | - Chen-Pin Wang
- Department of Population Health Sciences, Long School of Medicine, UT Health San Antonio, San Antonio, TX 78229, United States
| | - Yidong Chen
- Department of Population Health Sciences, Long School of Medicine, UT Health San Antonio, San Antonio, TX 78229, United States
| | - Adolfo Diaz
- Department of Medicine, Long School of Medicine, UT Health San Antonio, San Antonio, TX 78229, United States
| | - Steve Cole
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA 90095, United States
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA 90095, United States
| | - Amelie G Ramirez
- Institute for Health Promotion Research, UT Health San Antonio, San Antonio, TX 78229, United States
- Department of Population Health Sciences, Long School of Medicine, UT Health San Antonio, San Antonio, TX 78229, United States
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3
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Liebe RA, Holmes C, Misyak SA. Differing Within-Household Food Security Statuses Are Associated with Varied Maternal Mental Health Outcomes. Nutrients 2024; 16:1522. [PMID: 38794760 PMCID: PMC11123853 DOI: 10.3390/nu16101522] [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: 04/23/2024] [Revised: 05/13/2024] [Accepted: 05/16/2024] [Indexed: 05/26/2024] Open
Abstract
Household food insecurity is not necessarily equally experienced by all household members, with mothers often changing their intake first when food resources are limited. The purpose of this study was to understand the association between maternal mental health and intrahousehold differences in food security statuses. A cross-sectional survey was administered to Virginia mothers with low income (August-October 2021), assessing validated measures of food security, mental and physical health and related factors. Participants (n = 570) were grouped according to the food security status of adults and children within the household. Linear regression was used to assess the outcomes of interest by group and controlled for key demographic variables. Mothers in households with any food insecurity reported worse overall mental health and used 3-4 more food coping strategies than households experiencing food security (p < 0.05). Only mothers in households where adults experienced food insecurity reported significantly greater anxiety and depressive symptoms (61.5 and 58.1, respectively) compared to households experiencing food security (55.7 and 52.4, p < 0.001). While any experience of household food insecurity is associated with worse maternal mental health, there were differences by the within-household food security status. Future research should explore screening measures that capture specific household members' food security to connect households with available resources.
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Affiliation(s)
- Rachel A. Liebe
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK 74075, USA
| | - Chanit’a Holmes
- Department of Agricultural and Applied Economics, Virginia Tech, Blacksburg, VA 24061, USA;
| | - Sarah A. Misyak
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA 24061, USA;
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4
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Jelsma E, Zhang A, Goosby BJ, Cheadle JE. Sympathetic arousal among depressed college students: Examining the interplay between psychopathology and social activity. Psychophysiology 2024:e14597. [PMID: 38745361 DOI: 10.1111/psyp.14597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 02/07/2024] [Accepted: 04/10/2024] [Indexed: 05/16/2024]
Abstract
Depressed individuals exhibit altered sensitivity to both positive and negative social contact, and may not reap the same psychological and emotional benefits to socializing as non-depressed individuals. Although depressive symptoms and loneliness predict social withdrawal and decreased pleasure, little is currently understood about immediate affective arousal dynamics during real-time socializing. Using a novel ambulatory protocol that tracked both objective features of affective arousal (electrodermal activity) and subjective valence (self-reported) during college students' social interactions, we evaluated the moderating role of depression and loneliness symptoms on the associations between socializing with others (specifically, with a romantic partner, a close friend, or a group of friends) and the arousal and valence dimensions of affect. Among a racially and ethnically diverse sample of 118 college students (64% African American/Black/Continental African, 20% Latinx, 8% Asian, and 8% White) recruited from a large, predominantly White Midwestern university, those lower in depression and loneliness symptomatology evinced decreased average arousal (Β = -0.10, SE = 0.04, p < .01) when in relaxed and intimate socializing contexts (e.g., with a romantic partner and a close friend), consistent with the idea that these contexts facilitate important opportunities for psychological rest and recovery. Those lower in depression and loneliness symptoms also showed higher average arousal when socializing in the energizing context of being with a group of friends. Overall, the results suggest psychopathology is reflected in patterns of sympathetic arousal when socializing, with more depressed and lonely individuals generally feeling worse while receiving fewer psychophysiological rewards in multiple socializing contexts.
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Affiliation(s)
- Elizabeth Jelsma
- Psychological, Health, & Learning Sciences, University of Houston, Houston, Texas, USA
| | - Amy Zhang
- Department of Sociology & Population Research Center, University of Texas at Austin, Austin, Texas, USA
| | - Bridget J Goosby
- Department of Sociology & Population Research Center, University of Texas at Austin, Austin, Texas, USA
| | - Jacob E Cheadle
- Department of Sociology & Population Research Center, University of Texas at Austin, Austin, Texas, USA
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5
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Wynn J, Karlsen A, Huber B, Levine A, Salem A, White LC, Luby M, Bezborodko E, Xiao S, Chung WK, Klitzman RL, Appelbaum PS. Impact of a Genetic Diagnosis for a Child's Autism on Parental Perceptions. J Autism Dev Disord 2024:10.1007/s10803-024-06273-x. [PMID: 38578549 DOI: 10.1007/s10803-024-06273-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/28/2024] [Indexed: 04/06/2024]
Abstract
Genetic testing is recommended as part of an autism assessment, and most parents support genetic testing for their minor children. However, the impact on parents of receiving a monogenetic/ copy number variant diagnosis for autism in their child is not well understood. To explore this, we surveyed and interviewed parents of children in the SPARK study, a study of autism that includes genetic testing. Surveys were administered one month before and one and 12 months after parents received their child's genetic result. Interviews were conducted approximately one month after results disclosure. A genetic diagnosis (GD) for their child appeared to reduce parents' sense of self-blame and feelings of guilt, and this impact was relatively stable. The data also indicate a modest impact on parents' actions related to the condition, perceptions of themselves, and some aspects of life planning for their child, as measured by quantitative instruments at one month and 12 months after receipt of results. Other measures of parental identity and expectations for their child, in contrast, showed little change following receipt of genetic findings. Overall, parents who were told that no GD was identified showed minimal changes in their responses over time. These results suggest a discernable but relatively limited impact of genetic test results on parents of children with autism. These results should be reassuring to clinicians caring for children with autism and are consistent with studies in other areas of medicine that have suggested that genetic results tend to have fewer effects-negative or positive-than were anticipated.
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Affiliation(s)
- Julia Wynn
- Department of Pediatrics, Columbia University Irving Medical Center, New York, NY, USA.
| | - Anna Karlsen
- Columbia University Genetic Counseling Graduate Program, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Benjamin Huber
- Department of Epidemiology, Columbia University Irving Medical Center, New York, NY, USA
| | - Alina Levine
- Department of Epidemiology, Columbia University Irving Medical Center, New York, NY, USA
| | - Amanie Salem
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
| | | | | | - Ekaterina Bezborodko
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
| | | | - Wendy K Chung
- Department of Pediatrics, Columbia University Irving Medical Center, New York, NY, USA
- Simons Foundation, New York, NY, USA
- Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Robert L Klitzman
- Department of Psychiatry and Masters of Bioethics Program, and New York State Psychiatric Institute, Columbia University, New York, NY, USA
| | - Paul S Appelbaum
- Department of Psychiatry, and New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, NY, USA
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6
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Burgess DJ, Hagel Campbell EM, Branson M, Calvert C, Evans R, Allen KD, Bangerter A, Cross LJ, Driscoll MA, Hennessy S, Ferguson JE, Friedman JK, Matthias MS, Meis LA, Polusny MA, Taylor SL, Taylor BC. Exploring Gender Differences in Veterans in a Secondary Analysis of a Randomized Controlled Trial of Mindfulness for Chronic Pain. WOMEN'S HEALTH REPORTS (NEW ROCHELLE, N.Y.) 2024; 5:82-92. [PMID: 38404673 PMCID: PMC10890953 DOI: 10.1089/whr.2023.0086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 01/10/2024] [Indexed: 02/27/2024]
Abstract
Background Although studies have documented higher rates of chronic pain among women Veterans compared to men Veterans, there remains a lack of comprehensive information about potential contributors to these disparities. Materials and Methods This study examined gender differences in chronic pain and its contributors among 419 men and 392 women Veterans, enrolled in a mindfulness trial for chronic pain. We conducted descriptive analyses summarizing distributions of baseline measures, obtained by survey and through the electronic health record. Comparisons between genders were conducted using chi-square tests for categorical variables and t-tests for continuous measures. Results Compared to men, women Veterans were more likely to have chronic overlapping pain conditions and had higher levels of pain interference and intensity. Women had higher prevalence of psychiatric and sleep disorder diagnoses, greater levels of depression, anxiety, post-traumatic stress disorder, fatigue, sleep disturbance, stress and pain catastrophizing, and lower levels of pain self-efficacy and participation in social roles and activities. However, women were less likely to smoke or have a substance abuse disorder and used more nonpharmacological pain treatment modalities. Conclusion Among Veterans seeking treatment for chronic pain, women differed from men in their type of pain, had greater pain intensity and interference, and had greater prevalence and higher levels of many known biopsychosocial contributors to pain. Results point to the need for pain treatment that addresses the comprehensive needs of women Veterans. Clinical Trial Registration Number: NCT04526158. Patient enrollment began on December 4, 2020.
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Affiliation(s)
- Diana J. Burgess
- VA HSR&D Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, Minneapolis, Minnesota, USA
- Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Emily M. Hagel Campbell
- VA HSR&D Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, Minneapolis, Minnesota, USA
| | - Mariah Branson
- VA HSR&D Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, Minneapolis, Minnesota, USA
| | - Collin Calvert
- VA HSR&D Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, Minneapolis, Minnesota, USA
- Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Roni Evans
- Integrative Health and Wellbeing Research Program, Center for Spirituality and Healing, School of Nursing, University of Minnesota, Minneapolis, Minnesota, USA
| | - Kelli D. Allen
- VA HSR&D Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Health Care System, Durham, North Carolina, USA
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, North Carolina, USA
| | - Ann Bangerter
- VA HSR&D Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, Minneapolis, Minnesota, USA
| | - Lee J.S. Cross
- VA HSR&D Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, Minneapolis, Minnesota, USA
| | - Mary A. Driscoll
- Pain Research, Informatics, Multimorbidities, and Education (PRIME) Center, VA Connecticut Health Care System, West Haven, Connecticut, USA
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
| | - Sierra Hennessy
- VA HSR&D Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, Minneapolis, Minnesota, USA
| | - John E. Ferguson
- Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Jessica K. Friedman
- VA HSR&D Center for the Study of Health Care Innovation, Implementation and Policy, Greater Los Angeles VA Health Care System, Los Angeles, California, USA
| | - Marianne S. Matthias
- VA HSR&D Center for Health Information and Communication, Roudebush VA Medical Center, Indianapolis, Indiana, USA
- Regenstrief Institute, Indianapolis, Indiana, USA
- Department of Medicine, School of Medicine, Indiana University, Indianapolis, Indiana, USA
| | - Laura A. Meis
- VA HSR&D Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, Minneapolis, Minnesota, USA
- Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Melissa A. Polusny
- VA HSR&D Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, Minneapolis, Minnesota, USA
- Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Stephanie L. Taylor
- VA HSR&D Center for the Study of Health Care Innovation, Implementation and Policy, Greater Los Angeles VA Health Care System, Los Angeles, California, USA
- Department of Health Policy and Management, UCLA School of Public Health, Los Angeles, California, USA
- Department of Medicine, UCLA School of Medicine, Los Angeles, California, USA
| | - Brent C. Taylor
- VA HSR&D Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, Minneapolis, Minnesota, USA
- Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, USA
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7
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Berg KL, Mihaila I, Feinstein RT, Shiu CS, Gussin H, Acharya K, Gladstone TRG, Bernard L, Best M, Renz E, Abdallah G, Weldy S, Herrman D, Lynch E, Gerges M, Perez P, Buchholz KR, Msall M, Aaron S, Mutti M, Arnold C, Danguilan C, Argueta I, Hunter M, Pela E, Diviak K, Kuhn J, Berbaum ML, Van Voorhees BW. BEhavioral Health Stratified Treatment (B.E.S.T.) to optimize transition to adulthood for youth with intellectual and/or developmental disabilities. Contemp Clin Trials 2024; 136:107374. [PMID: 37898308 DOI: 10.1016/j.cct.2023.107374] [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: 06/16/2023] [Revised: 10/03/2023] [Accepted: 10/25/2023] [Indexed: 10/30/2023]
Abstract
Youth with intellectual and/or developmental disabilities (IDD) often struggle with depression and anxiety, which adversely impacts transition to adulthood. Integrated behavioral health care coordination, wherein care coordinators and behavioral health specialists collaborate to provide systematic, cost-effective, patient-centered care, is a promising strategy to improve access to behavioral health services and address factors that impact transition to adulthood, including depression/anxiety symptoms. Current care coordination models (e.g., Title V Maternal and Child Health Bureau [MCHB]) do not include behavioral health services. The CHECK (Coordinated HealthCarE for Complex Kids) mental health model, hereby refined and renamed BEhavioral Health Stratified Treatment (B.E.S.T.), is a behavioral health intervention delivery program designed for integration into care coordination programs. This study aims to determine whether an integrated behavioral health care coordination strategy (i.e., MCHB care coordination plus B.E.S.T.) would be more acceptable and lead to better youth health and transition outcomes, relative to standard care coordination (i.e., MCHB care coordination alone). Results would guide future investment in improving outcomes for youth with IDD. This study is a two-arm randomized clinical trial of 780 transition-aged youth with IDD (13-20 years) to evaluate the comparable efficacy of MCHB Care Coordination alone vs. MCHB Care Coordination plus B.E.S.T. on the following outcomes: 1) decreased symptoms and episodes of depression and anxiety over time; 2) improved health behaviors, adaptive functioning and health related quality of life; 3) increased health care transition (HCT) readiness; and 4) improved engagement and satisfaction with care coordination among stakeholders.
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Affiliation(s)
- Kristin L Berg
- Department of Disability and Human Development, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL 60612, USA; Department of Pediatrics, College of Medicine, University of Illinois at Chicago, Chicago, IL 60612, USA.
| | - Iulia Mihaila
- Department of Pediatrics, College of Medicine, University of Illinois at Chicago, Chicago, IL 60612, USA
| | - Rebecca T Feinstein
- Department of Pediatrics, College of Medicine, University of Illinois at Chicago, Chicago, IL 60612, USA
| | - Cheng-Shi Shiu
- University of California Los Angeles, Los Angeles, CA 90095, USA
| | - Helene Gussin
- Department of Pediatrics, College of Medicine, University of Illinois at Chicago, Chicago, IL 60612, USA
| | - Kruti Acharya
- Department of Disability and Human Development, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL 60612, USA; Department of Pediatrics, College of Medicine, University of Illinois at Chicago, Chicago, IL 60612, USA
| | - Tracy R G Gladstone
- Wellesley Centers for Women, Wellesley College, Wellesley, MA 02481, USA; Brown University, Providence, RI, 02912, USA
| | - Leah Bernard
- Department of Disability and Human Development, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL 60612, USA
| | - Megan Best
- University of Illinois, Urbana-Champaign, Champaign, IL 61820, United States of America
| | - Ellie Renz
- Department of Disability and Human Development, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL 60612, USA
| | - Ghada Abdallah
- University of Illinois, Urbana-Champaign, Champaign, IL 61820, United States of America
| | - Sarah Weldy
- Department of Disability and Human Development, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL 60612, USA
| | - Deana Herrman
- Northern Illinois University College of Allied Health and Communicative Disorders, USA
| | - Emma Lynch
- The University of Chicago, Chicago, IL 60637, USA
| | - Michael Gerges
- Department of Pediatrics, College of Medicine, University of Illinois at Chicago, Chicago, IL 60612, USA
| | - Patricia Perez
- The University of Illinois Division of Specialized Care for Children, Chicago, IL 60607, USA
| | | | | | | | | | - Catherine Arnold
- Department of Disability and Human Development, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL 60612, USA
| | - Chris Danguilan
- Department of Disability and Human Development, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL 60612, USA
| | - Isai Argueta
- Department of Pediatrics, College of Medicine, University of Illinois at Chicago, Chicago, IL 60612, USA
| | - Madeline Hunter
- Department of Pediatrics, College of Medicine, University of Illinois at Chicago, Chicago, IL 60612, USA
| | - Emily Pela
- Institute of Health Research and Policy, University of Illinois, Chicago, IL 60608, USA
| | - Kathleen Diviak
- Institute of Health Research and Policy, University of Illinois, Chicago, IL 60608, USA
| | - Jocelyn Kuhn
- Emory University School of Medicine, Department of Pediatrics, USA
| | - Michael L Berbaum
- Institute of Health Research and Policy, University of Illinois, Chicago, IL 60608, USA
| | - Benjamin W Van Voorhees
- Department of Pediatrics, College of Medicine, University of Illinois at Chicago, Chicago, IL 60612, USA
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8
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Kuzu D, Kallen MA, Kratz AL. Psychometric Properties of the Spinal Cord Injury-Quality of Life (SCI-QOL) Resilience Short Form in a Sample With Spinal Cord Injury. Arch Phys Med Rehabil 2024; 105:59-66. [PMID: 37865166 DOI: 10.1016/j.apmr.2023.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 10/02/2023] [Accepted: 10/03/2023] [Indexed: 10/23/2023]
Abstract
OBJECTIVE To explore the psychometric properties (eg, data distribution characteristics, convergent or discriminant validity, internal consistency reliability) of the Spinal Cord Injury-Quality of Life measurement system (SCI-QOL) Resilience 8-item short form (SF) in comparison to the criterion standard resilience measure, Connor Davidson Resilience Scale (CD-RISC) in a sample of individuals with spinal cord injury (SCI). DESIGN Descriptive statistics were calculated to examine variable data distribution characteristics. Correlation analyses were conducted for convergent and discriminant validity. Reliability statistics were calculated for resilience and other validity measures. SETTING General community. PARTICIPANTS Individuals with SCI (N=202; 51.5% male, 48% female). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Patient-Reported Outcomes Measurement Information System measures (depression, anxiety, ability to participate in social roles and activities, pain intensity, fatigue, sleep disturbance), SCI-QOL short forms (SF) (resilience, positive affect and well-being, mobility), CD-RISC, National Institutes of Health Toolbox for Assessment of Neurological and Behavioral Function - perceived stress (NIH Toolbox-perceived stress), and the Satisfaction with Life Scale were administered. RESULTS The mean and SD for the SCI-QOL Resilience SF (mean=48.60; SD=8.20) approximated the normative mean (mean=50, SD=10). The SCI-QOL Resilience SF scores were essentially normally distributed though somewhat kurtotic, with skew=-0.17 and excess kurtosis=1.4; internal consistency reliability was good (Cronbach's alpha=0.89). Convergent validity was supported by significant moderate correlations in expected directions between the SCI-QOL Resilience SF and measures of CD-RISC resilience, depressive symptoms, anxiety, social participation, positive affect and well-being, stress, and satisfaction with life. Discriminant validity was supported by small non-significant correlations between the SCI-QOL Resilience SF and age, sex, injury level, time since injury, pain intensity, mobility, sleep disturbance, and fatigue. CONCLUSION The SCI-QOL Resilience SF demonstrated good convergent and discriminant validity. Our study showed that the SCI-QOL Resilience SF is a psychometrically valid tool that can reliably estimate levels of resilience in the SCI population.
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Affiliation(s)
- Duygu Kuzu
- Department of Physical Medicine & Rehabilitation, University of Michigan, Ann Arbor, MI.
| | - Michael A Kallen
- Department of Physical Medicine & Rehabilitation, University of Michigan, Ann Arbor, MI
| | - Anna L Kratz
- Department of Physical Medicine & Rehabilitation, University of Michigan, Ann Arbor, MI
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9
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Blackwell CK, Sherlock P, Jackson KL, Hofheimer JA, Cella D, Algermissen MA, Alshawabkeh AN, Avalos LA, Bastain T, Blair C, Enlow MB, Brennan PA, Breton C, Bush NR, Chandran A, Collazo S, Conradt E, Crowell SE, Deoni S, Elliott AJ, Frazier JA, Ganiban JM, Gold DR, Herbstman JB, Joseph C, Karagas MR, Lester B, Lasky-Su JA, Leve LD, LeWinn KZ, Mason WA, McGowan EC, McKee KS, Miller RL, Neiderhiser JM, O’Connor TG, Oken E, O’Shea TM, Pagliaccio D, Schmidt RJ, Singh AM, Stanford JB, Trasande L, Wright RJ, Duarte CS, Margolis AE. Development and psychometric validation of the Pandemic-Related Traumatic Stress Scale for children and adults. Psychol Assess 2023; 35:1054-1067. [PMID: 37902671 PMCID: PMC10773574 DOI: 10.1037/pas0001211] [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] [Indexed: 10/31/2023]
Abstract
To assess the public health impact of the COVID-19 pandemic on mental health, investigators from the National Institutes of Health Environmental influences on Child Health Outcomes (ECHO) research program developed the Pandemic-Related Traumatic Stress Scale (PTSS). Based on the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) acute stress disorder symptom criteria, the PTSS is designed for adolescent (13-21 years) and adult self-report and caregiver-report on 3-12-year-olds. To evaluate psychometric properties, we used PTSS data collected between April 2020 and August 2021 from non-pregnant adult caregivers (n = 11,483), pregnant/postpartum individuals (n = 1,656), adolescents (n = 1,795), and caregivers reporting on 3-12-year-olds (n = 2,896). We used Mokken scale analysis to examine unidimensionality and reliability, Pearson correlations to evaluate relationships with other relevant variables, and analyses of variance to identify regional, age, and sex differences. Mokken analysis resulted in a moderately strong, unidimensional scale that retained nine of the original 10 items. We detected small to moderate positive associations with depression, anxiety, and general stress, and negative associations with life satisfaction. Adult caregivers had the highest PTSS scores, followed by adolescents, pregnant/postpartum individuals, and children. Caregivers of younger children, females, and older youth had higher PTSS scores compared to caregivers of older children, males, and younger youth, respectively. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Courtney K. Blackwell
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine
| | - Phillip Sherlock
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine
| | - Kathryn L. Jackson
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine
| | - Julie A. Hofheimer
- Department of Pediatrics, University of North Carolina School of Medicine
| | - David Cella
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine
| | | | - Akram N. Alshawabkeh
- Department of Civil and Environmental Engineering, College of Engineering, Northeastern University
| | - Lyndsay A. Avalos
- Kaiser Permanente North California, Division of Research, Oakland, California, United States
| | - Tracy Bastain
- Clinical Population and Public Health Sciences, Keck School of Medicine of the University of Southern California
| | - Clancy Blair
- New York University Grossman School of Medicine
- Department of Population Health, New York University Grossman School of Medicine
| | - Michelle Bosquet Enlow
- Boston Children’s Hospital, Boston, Massachusetts, United States
- Department of Psychiatry, Harvard Medical School
| | | | - Carrie Breton
- Clinical Population and Public Health Sciences, Keck School of Medicine of the University of Southern California
| | - Nicole R. Bush
- Department of Psychiatry, University of California, San Francisco
| | - Aruna Chandran
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health
| | - Shaina Collazo
- Icahn School of Medicine at Mount Sinai
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai
| | | | | | - Sean Deoni
- Bill and Melinda Gates Foundation, Seattle, Washington, United States
| | - Amy J. Elliott
- Avera Research Institute, Sioux Falls, South Dakota, United States
- Department of Pediatrics, University of South Dakota School of Medicine
| | - Jean A. Frazier
- Department of Psychiatry, University of Massachusetts Chan Medical School
| | - Jody M. Ganiban
- Department of Clinical/Developmental Psychology, George Washington University
| | - Diane R. Gold
- Department of Psychiatry, Harvard Medical School
- Department of Medicine, Harvard Medical School
- Harvard University T.H. Chan School of Public Health
- Department of Environmental Health, Harvard University T.H. Chan School of Public Health
- Brigham and Women’s Hospital, Boston, Massachusetts, United States
| | - Julie B. Herbstman
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health
| | | | | | - Barry Lester
- Women & Infants Hospital, Providence, Rhode Island, United States
- Department of Psychiatry and Human Behavior, Brown University
- Department of Pediatrics, Brown University
| | - Jessica A. Lasky-Su
- Department of Psychiatry, Harvard Medical School
- Department of Medicine, Harvard Medical School
- Brigham and Women’s Hospital, Boston, Massachusetts, United States
| | - Leslie D. Leve
- Department of Counseling Psychology and Human Services, University of Oregon College of Education
| | - Kaja Z. LeWinn
- Department of Psychiatry, University of California, San Francisco
| | - W. Alex Mason
- Department of Child, Youth, and Family Studies, College of Education and Human Sciences, University of Nebraska—Lincoln
| | - Elisabeth C. McGowan
- Women & Infants Hospital, Providence, Rhode Island, United States
- Department of Pediatrics, Brown University
| | - Kimberly S. McKee
- Department of Family Medicine, University of Michigan Medical School
| | - Rachel L. Miller
- Icahn School of Medicine at Mount Sinai
- Department of Medicine, Icahn School of Medicine at Mount Sinai
| | | | | | - Emily Oken
- Department of Psychiatry, Harvard Medical School
- Harvard University T.H. Chan School of Public Health
- Brigham and Women’s Hospital, Boston, Massachusetts, United States
- Department of Population Medicine, Harvard Medical School
- Department of Nutrition, Harvard University T.H. Chan School of Public Health
- Harvard Pilgrim Health Care Institute, Boston, Massachusetts, United States
| | - T. Michael O’Shea
- Department of Pediatrics, University of North Carolina School of Medicine
| | - David Pagliaccio
- Columbia University Irving Medical Center
- New York State Psychiatric Institute, New York, New York, United States
| | - Rebecca J. Schmidt
- Department of Public Health Services, University of California—Davis School of Medicine
| | - Anne Marie Singh
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health
| | - Joseph B. Stanford
- Department of Family and Preventative Medicine, University of Utah School of Medicine
| | - Leonardo Trasande
- New York University Grossman School of Medicine
- Department of Pediatrics, New York University Grossman School of Medicine
| | - Rosalind J. Wright
- Icahn School of Medicine at Mount Sinai
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai
| | - Cristiane S. Duarte
- Columbia University Irving Medical Center
- Department of Psychiatry, Columbia University
| | - Amy E. Margolis
- Columbia University Irving Medical Center
- Department of Psychiatry, Columbia University
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10
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Mansolf M, Blackwell CK, Lai JS, Cella D. Linking the Perceived Stress Scale to the PROMIS Psychological Stress Experiences-Pediatric in adolescents. Psychol Assess 2023; 35:888-894. [PMID: 37732965 PMCID: PMC10627295 DOI: 10.1037/pas0001256] [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] [Indexed: 09/22/2023]
Abstract
The Perceived Stress Scale (PSS) and PROMIS Psychological Stress Experiences-Pediatric (PPSE) are two self-report instruments that have been used with adolescents to measure subjective feelings of stress. Stress is a critical construct to evaluate, as chronic stress can result in negative long-term consequences for an individual's physical and mental health. While the PSS is more commonly used in research and clinical practice, use of the PPSE is becoming more widespread. This increased usage necessitates a way to compare the measures, for example, when changing which instrument is used in practice or when combining data from the two measures in pooled analysis. After assessing linking assumptions, we used equipercentile linking to score-link the two measures on the raw score and T-score metrics for both longer forms (10 PSS items; 8 PPSE items) and shorter forms (4 PSS or PPSE items), yielding crosswalk tables (Open Science Framework: https://osf.io/9pzyk/) to convert scores on each measure to the metric of the other. Raw scores between measures (.670 ≤ r ≤ .794) were not sufficiently correlated for score linking. Therefore, linked scores were treated as predictions, rather than counterfactual values on the alternative measure. Further, confirmatory factor analyses revealed that this low correlation was primarily due to the low reliability and multidimensionality of the PSS, and the derived linking functions were found to have minimal bias. Recommendations for the use of these conversion tables by researchers and practitioners are provided. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Maxwell Mansolf
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University
| | - Courtney K Blackwell
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University
| | - Jin-Shei Lai
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University
| | - David Cella
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University
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11
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Harris KM, Gaffey AE, Schwartz JE, Krantz DS, Burg MM. The Perceived Stress Scale as a Measure of Stress: Decomposing Score Variance in Longitudinal Behavioral Medicine Studies. Ann Behav Med 2023; 57:846-854. [PMID: 37084792 PMCID: PMC10498818 DOI: 10.1093/abm/kaad015] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/23/2023] Open
Abstract
BACKGROUND The Perceived Stress Scale (PSS) is a widely used measure designed to assess perceptions of recent stress. However, it is unclear to what extent the construct assessed by the PSS represents factors that are stable versus variable within individuals, and how these components might vary over time. PURPOSE Determine the degree to which variability in repeated PSS assessments is attributable to between-person versus within-person variance in two different studies and populations. METHODS Secondary analyses utilized data from two studies with up to 13 PSS assessments: An observational study of 127 patients with heart failure followed over 39 months (Study 1), and an experimental study of 73 younger, healthy adults followed over 12 months (Study 2). Multilevel linear mixed modeling was used to estimate sources of variance in the PSS total and subscale scores across assessments. RESULTS Between-person variance accounted for a large proportion of the total variance in PSS total scores in Study 1 (42.3%) and Study 2 (51.1%); within-person variance comprised the remainder. Between-person variance was higher for shorter assessment periods (e.g., 1 week), and was comparable when examining only the first 12 months of assessments in each study (52.9% vs. 51.1%). CONCLUSIONS Within two samples differing in age and health status, between-person variance accounted for approximately half of the total variation in PSS scores over time. While within-person variance was observed, the construct assessed by the PSS may substantially reflect a more stable characteristic of how an individual perceives stressful life circumstances than previously appreciated.
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Affiliation(s)
- Kristie M Harris
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
- VA Connecticut Healthcare System, West Haven, CT, USA
| | - Allison E Gaffey
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
- VA Connecticut Healthcare System, West Haven, CT, USA
| | - Joseph E Schwartz
- Department of Psychiatry, Stony Brook University, Stony Brook, NY, USA
- Department of Medicine, Columbia University, New York, NY, USA
| | - David S Krantz
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Matthew M Burg
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
- VA Connecticut Healthcare System, West Haven, CT, USA
- Department of Anesthesiology, Yale School of Medicine, New Haven, CT, USA
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12
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Burkhouse KL, Dao A, Argiros A, Granros M, Cárdenas E, Dickey L, Feurer C, Hill K, Pegg S, Venanzi L, Kujawa A. Targeting positive valence systems function in children of mothers with depressive symptoms: A pilot randomized trial of an RDoC-Informed preventive intervention. Behav Res Ther 2023; 168:104384. [PMID: 37591042 PMCID: PMC10542884 DOI: 10.1016/j.brat.2023.104384] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 07/27/2023] [Accepted: 08/03/2023] [Indexed: 08/19/2023]
Abstract
Reduced activation of the Research Domain Criteria (RDoC) positive valence systems (PVS) is observed in high-risk (HR) children of depressed mothers and predictive of future psychopathologies. We developed a dyadic, neuroscience-informed preventive intervention, Family Promoting Positive Emotions (FPPE), designed to prevent psychopathology in HR children by targeting PVS processes. We evaluated the initial efficacy of FPPE compared to written information (WI) psychoeducation in engaging PVS-related targets and reducing perceived stress and emotional distress symptoms in HR youth. Participants included 74 children ages 8-12 years and their biological mothers reporting elevated depressive symptoms. Following random assignment, 55 dyads completed FPPE (n = 29) or WI (n = 26) and pre-post assessments of child clinical symptoms. Youth completed a reinforcement learning task and 10 days of positive affect ratings to assess PVS-related targets. Results revealed a small within-subjects increase in child daily positive affect in FPPE, but not WI. Further, FPPE resulted in reductions in mother-reported child perceived stress and symptoms of anger, anxiety, and depression with medium-to-large within-subjects effects. Intervention effects on reinforcement learning and child-rated clinical symptoms were not observed. This study suggests FPPE shows promise in enhancing positive affect and reducing the emergence of clinical symptoms in HR children. CLINICALTRIALS.GOV IDENTIFIER: NCT05223842.
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Affiliation(s)
- Katie L Burkhouse
- The Research Institute, Nationwide Children's Hospital, USA; The Ohio State University, Department of Psychiatry and Behavioral Health, USA
| | - Anh Dao
- Vanderbilt University, Department of Psychology and Human Development, USA
| | - Alexandra Argiros
- Vanderbilt University, Department of Psychology and Human Development, USA
| | - Maria Granros
- University of Illinois at Chicago, Department of Psychiatry, USA
| | - Emilia Cárdenas
- Vanderbilt University, Department of Psychology and Human Development, USA
| | - Lindsay Dickey
- Vanderbilt University, Department of Psychology and Human Development, USA
| | - Cope Feurer
- University of Illinois at Chicago, Department of Psychiatry, USA
| | - Kaylin Hill
- Vanderbilt University, Department of Psychology and Human Development, USA
| | - Samantha Pegg
- Vanderbilt University, Department of Psychology and Human Development, USA
| | - Lisa Venanzi
- Vanderbilt University, Department of Psychology and Human Development, USA
| | - Autumn Kujawa
- Vanderbilt University, Department of Psychology and Human Development, USA.
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13
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Palatnik A, Saffian E, Flynn KE, Pan AY, Yee LM, Basir MA, Cruz M. GAP (gestational diabetes and pharmacotherapy) - study protocol for a randomized controlled, two-arm, single-site trial. Contemp Clin Trials 2023; 131:107237. [PMID: 37245726 PMCID: PMC10527045 DOI: 10.1016/j.cct.2023.107237] [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: 04/11/2023] [Revised: 05/18/2023] [Accepted: 05/19/2023] [Indexed: 05/30/2023]
Abstract
BACKGROUND Gestational diabetes (GDM) complicates 10% of pregnancies in the US. First-line treatment is medical nutrition therapy (MNT) and exercise. Second line is pharmacotherapy. The definition of what constitutes an unsuccessful trial of MNT and exercise has not been established. Tight glycemic control has been demonstrated to reduce GDM-related neonatal and maternal clinical complications. However, it could also increase rates of small-for-gestational age and carry negative effects on patient-reported outcomes such as anxiety and stress. We will study the effect of earlier and stricter pharmacotherapy in GDM on clinical and patient-reported outcomes. METHODS GDM and pharmacotherapy (GAP) study is a two-arm parallel, pragmatic randomized controlled trial, where 416 participants with GDM are randomized 1:1 to: 1) Intervention group - insulin initiation at 20% elevated glucose values on a weekly glucose log following MNT and exercise trial and insulin titration to keep elevated glucose values <20%; or 2) Active control group - insulin initiation at 40% elevated glucose values on a weekly log following MNT and exercise and insulin titration to keep elevated glucose values <40%. The primary outcome is a composite neonatal outcome of large-for-gestational-age, macrosomia, birth trauma, preterm birth, hypoglycemia, and hyperbilirubinemia. Secondary outcomes include preeclampsia, cesarean birth, small-for-gestational-age, maternal hypoglycemia, and patient-reported outcomes of anxiety, depression, perceived stress, and diabetes self-efficacy. CONCLUSIONS The GAP study will investigate the optimal glycemic threshold for pharmacotherapy addition to MNT and exercise in GDM. The GAP study will promote standardization in GDM management and will have direct relevance for clinical practice.
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Affiliation(s)
- Anna Palatnik
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Medical College of Wisconsin, Milwaukee, WI, United States of America; Cardiovascular Center, Medical College of Wisconsin, Milwaukee, WI, United States of America.
| | - Eleanor Saffian
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Medical College of Wisconsin, Milwaukee, WI, United States of America
| | - Kathryn E Flynn
- Department of Medicine, Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, WI, United States of America
| | - Amy Y Pan
- Department of Pediatrics, Division of Quantitative Health Services, Medical College of Wisconsin, Milwaukee, WI, United States of America
| | - Lynn M Yee
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Northwestern University, Chicago, IL, United States of America
| | - Mir Abdul Basir
- Department of Pediatrics, Division of Neonatology, Medical College of Wisconsin, Milwaukee, WI, United States of America
| | - Meredith Cruz
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Medical College of Wisconsin, Milwaukee, WI, United States of America
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14
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Yoo HJ, Nashiro K, Min J, Cho C, Mercer N, Bachman SL, Nasseri P, Dutt S, Porat S, Choi P, Zhang Y, Grigoryan V, Feng T, Thayer JF, Lehrer P, Chang C, Stanley JA, Head E, Rouanet J, Marmarelis VZ, Narayanan S, Wisnowski J, Nation DA, Mather M. Multimodal neuroimaging data from a 5-week heart rate variability biofeedback randomized clinical trial. Sci Data 2023; 10:503. [PMID: 37516756 PMCID: PMC10387077 DOI: 10.1038/s41597-023-02396-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 07/17/2023] [Indexed: 07/31/2023] Open
Abstract
We present data from the Heart Rate Variability and Emotion Regulation (HRV-ER) randomized clinical trial testing effects of HRV biofeedback. Younger (N = 121) and older (N = 72) participants completed baseline magnetic resonance imaging (MRI) including T1-weighted, resting and emotion regulation task functional MRI (fMRI), pulsed continuous arterial spin labeling (PCASL), and proton magnetic resonance spectroscopy (1H MRS). During fMRI scans, physiological measures (blood pressure, pulse, respiration, and end-tidal CO2) were continuously acquired. Participants were randomized to either increase heart rate oscillations or decrease heart rate oscillations during daily sessions. After 5 weeks of HRV biofeedback, they repeated the baseline measurements in addition to new measures (ultimatum game fMRI, training mimicking during blood oxygen level dependent (BOLD) and PCASL fMRI). Participants also wore a wristband sensor to estimate sleep time. Psychological assessment comprised three cognitive tests and ten questionnaires related to emotional well-being. A subset (N = 104) provided plasma samples pre- and post-intervention that were assayed for amyloid and tau. Data is publicly available via the OpenNeuro data sharing platform.
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Affiliation(s)
- Hyun Joo Yoo
- University of Southern California, Los Angeles, CA, 90007, USA
| | - Kaoru Nashiro
- University of Southern California, Los Angeles, CA, 90007, USA
| | - Jungwon Min
- University of Southern California, Los Angeles, CA, 90007, USA
| | - Christine Cho
- University of Southern California, Los Angeles, CA, 90007, USA
| | - Noah Mercer
- University of Southern California, Los Angeles, CA, 90007, USA
| | | | - Padideh Nasseri
- University of Southern California, Los Angeles, CA, 90007, USA
| | - Shubir Dutt
- University of Southern California, Los Angeles, CA, 90007, USA
| | - Shai Porat
- University of Southern California, Los Angeles, CA, 90007, USA
| | - Paul Choi
- University of Southern California, Los Angeles, CA, 90007, USA
| | - Yong Zhang
- University of Southern California, Los Angeles, CA, 90007, USA
| | | | - Tiantian Feng
- University of Southern California, Los Angeles, CA, 90007, USA
| | | | - Paul Lehrer
- Rutgers University, New Brunswick-Piscataway, USA
| | | | | | | | | | | | | | | | | | - Mara Mather
- University of Southern California, Los Angeles, CA, 90007, USA.
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15
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Son EH, Wallen GR, Flynn S, Yang L, Lee LJ. Patterns of health-promoting behaviors and associated factors in family caregivers of people receiving cancer treatment: A latent class profile analysis. Psychooncology 2023; 32:1038-1047. [PMID: 37157152 PMCID: PMC10590684 DOI: 10.1002/pon.6145] [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: 10/13/2022] [Revised: 04/02/2023] [Accepted: 04/10/2023] [Indexed: 05/10/2023]
Abstract
OBJECTIVE Family caregivers tend to neglect their health while prioritizing the needs of their care recipients. Identifying subgroups of caregivers based on the patterns of health-promoting behaviors (HPBs) may help develop tailored interventions for them, yet little is known. The purpose of this study was: (1) to identify latent classes with distinct patterns of HPBs in family caregivers of people with cancer; and (2) to investigate factors associated with the latent class membership. METHODS We performed a cross-sectional data analysis using the baseline dataset from a longitudinal survey study that assessed HPBs of family caregivers of individuals who received cancer treatment at a national research hospital (N = 124). Latent class profile analysis was conducted to identify latent classes based on the subdomains of the Health-Promoting Lifestyle Profile II, followed by multinomial logistic regression analysis to investigate factors associated with the latent class membership. RESULTS Three latent classes were identified: a high level of HPB (Class 1, 25.8%); a moderate level of HPB (Class 2, 53.2%); and a low level of HPB (Class 3, 21.0%) of HPBs. Controlling for caregiver age and sex, caregiver burden due to lack of family support, perceived stress, self-efficacy and body mass index were factors associated with the latent class membership. CONCLUSIONS HPBs of our caregiver sample appeared in relatively stable patterns at different levels. Higher caregiver burden and perceived stress and lower self-efficacy were associated with the lower practice of HPBs overall. Our findings may serve as a reference for screening caregivers who need support and developing person-centered interventions.
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Affiliation(s)
- Elisa H. Son
- Translational Biobehavioral and Health Disparities Branch, National Institutes of Health (NIH) Clinical Center, Bethesda, Maryland, USA
| | - Gwenyth R. Wallen
- Translational Biobehavioral and Health Disparities Branch, National Institutes of Health (NIH) Clinical Center, Bethesda, Maryland, USA
| | - Sharon Flynn
- National Heart, Lung, and Blood Institute, NIH, Bethesda, Maryland, USA
| | - Li Yang
- Translational Biobehavioral and Health Disparities Branch, National Institutes of Health (NIH) Clinical Center, Bethesda, Maryland, USA
| | - Lena J. Lee
- Translational Biobehavioral and Health Disparities Branch, National Institutes of Health (NIH) Clinical Center, Bethesda, Maryland, USA
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16
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Thornton CP, Perrin N, Kozachik S, Lukkahatai N, Ruble K. Biobehavioral Influences of Stress and Inflammation on Mucositis in Adolescents and Young Adults with Cancer: Results from a Pilot Study. J Adolesc Young Adult Oncol 2023; 12:340-348. [PMID: 36169621 PMCID: PMC10282803 DOI: 10.1089/jayao.2022.0067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023] Open
Abstract
Purpose: Chemotherapy-induced mucositis is a prevalent and burdensome toxicity among adolescent and young adults (AYAs) with cancer and impedes the delivery of optimal therapy. Its development is not well understood, but baseline stress and inflammation may be contributory factors. This pilot study evaluates stress and inflammation as risk factors for mucositis, identifies effect size estimates, and evaluates the feasibility of a prospective study to investigate mucositis development. Methods: Thirty AYAs receiving chemotherapy with substantial risk of mucositis completed baseline stress measures, and serum was collected for inflammatory biomarker analysis. Regression and mediation analyses determined the relationship between stress/inflammation and mucositis. Results: Stress appears to be a significant risk factor for incidence of mucositis (odds ratio 1.13, p = 0.125) and predicts total mucositis score (β = 0.281, p = 0.023) as well as peak incidence (β = 0.052, p = 0.018). Baseline levels of interleukin (IL)-1a and epidermal growth factor (EGF) predicted mucositis development, and EGF and IL-8 may mediate the relationship between stress and mucositis. Findings suggest that stress-induced inflammation exacerbates symptom development. Conclusion: Results from this pilot study inform mucositis symptom models, suggesting that psychosocial and physiologic factors are involved in development. Importantly, this pilot study provides initial effect size estimates, including magnitude and direction of relationships, that are essential to informing larger, more robustly powered studies. High enrollment, low attrition, and minimal missing data in this study suggest this model is feasible for research in this population. Importantly, this work is a first step in identifying new risk factors for mucositis and targets for nurse-led interventions to prevent toxicity development.
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Affiliation(s)
- Clifton P. Thornton
- Division of Pediatric Hematology/Oncology, Herman and Walter Samuelson Children's Hospital at Sinai, Johns Hopkins School of Nursing, Baltimore, Maryland, USA
| | - Nancy Perrin
- Johns Hopkins School of Nursing, Baltimore, Maryland, USA
| | - Sharon Kozachik
- Medical University of South Carolina College of Nursing, Charleston, South Carolina, USA
| | - Nada Lukkahatai
- Division of Pediatric Hematology/Oncology, Herman and Walter Samuelson Children's Hospital at Sinai, Johns Hopkins School of Nursing, Baltimore, Maryland, USA
| | - Kathy Ruble
- Division of Pediatric Oncology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
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17
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Mansolf M. A true score imputation method to account for psychometric measurement error. Psychol Methods 2023:2023-75982-001. [PMID: 37227895 PMCID: PMC10674037 DOI: 10.1037/met0000578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Scores on self-report questionnaires are often used in statistical models without accounting for measurement error, leading to bias in estimates related to those variables. While measurement error corrections exist, their broad application is limited by their simplicity (e.g., Spearman's correction for attenuation), which complicates their inclusion in specialized analyses, or complexity (e.g., latent variable modeling), which necessitates large sample sizes and can limit the analytic options available. To address these limitations, a flexible multiple imputation-based approach, called true score imputation, is described, which can accommodate a broad class of statistical models. By augmenting copies of the original dataset with sets of plausible true scores, the resulting set of datasets can be analyzed using widely available multiple imputation methodology, yielding point estimates and confidence intervals calculated with respect to the estimated true score. A simulation study demonstrates that the method yields a large reduction in bias compared to treating scores as measured without error, and a real-world data example is further used to illustrate the benefit of the method. An R package implements the proposed method via a custom imputation function for an existing, commonly used multiple imputation library (mice), allowing true score imputation to be used alongside multiple imputation for missing data, yielding a unified framework for accounting for both missing data and measurement error. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Maxwell Mansolf
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University
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18
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Liebe RA, Adams LM, Hedrick VE, Serrano EL, Porter KJ, Cook NE, Misyak SA. Developing a conceptual framework for the relationship between food security status and mental health among low-income mothers. FRONTIERS IN SUSTAINABLE FOOD SYSTEMS 2023. [DOI: 10.3389/fsufs.2022.1078811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
IntroductionBuilding household resiliency is one strategy that may help insulate households from the effects of food system volatility that contributes to in food insecurity. A stronger understanding of the relationship between food security and mental health is needed to identify potential factors for intervention to improve household resiliency to food system stressors. Because mothers often make household food decisions, they are an important population for building household resiliency. The purpose of this study was to develop and test a conceptual framework for the relationship between food security and mental health for low-income mothers and to identify potential targets for intervention.MethodsA conceptual framework was developed based on the existing literature on mental health and food security, as well as factors that impact both constructs. This framework was tested by a path analysis using data from a 2021 cross-sectional survey of low-income Virginia mothers that used validated scales to assess food security status, indicators of mental and physical health, food coping strategies, and social support.Results and discussionThe initial model was systematically adapted to develop the final retained model. The retained model did not include a direct effect of food security on mental health, but highlighted two significant mediators of the relationship, food coping strategies and social support. While the effect of social support was not practically significant, the effects of food coping strategies as a mediator from food security to perceived stress and life satisfaction were small (β = 0.21, 0.14, respectively; p < 0.001). The retained model provides a framework for understanding the relationship between food security and mental health and highlights potential targets for intervention. Notably, reducing the need for mothers to utilize food coping strategies should be targeted on multiple levels to reduce the impact on mental health and ultimately improve resiliency to future food system shocks.
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Bellone KM, Elliott SC, Hynan LS, Warren B, Jarrett RB. Mindful Self-Care for Caregivers: A Proof of Concept Study Investigating a Model for Embedded Caregiver Support in a Pediatric Setting. J Autism Dev Disord 2023; 53:539-552. [PMID: 34109461 PMCID: PMC8189552 DOI: 10.1007/s10803-021-05113-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2021] [Indexed: 11/30/2022]
Abstract
We conducted an open-trial proof of concept study to determine the safety, acceptability, and feasibility of Mindful Self-Care for Caregivers (MSCC) for parents of children with Autism Spectrum Disorders (ASD) (N = 13). The intervention was offered as a co-located care model in a pediatric specialty center where the participants' children received care. Results demonstrated that the intervention was: highly acceptable to all stakeholders (i.e., participants, the group facilitator, and center administration) and could be conducted safely by a masters-level practitioner with minimal resources. Further, secondary measures support a hypothesized interventional model of MSCC, demonstrating gains in mindfulness skills and sense of competency in the parenting role reduced perceived stress and depression in parents of children with ASD.
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Affiliation(s)
- Katherine M Bellone
- Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Mail Code 9086, Dallas, TX, 75390, USA.
- Children's Health System of Texas, Dallas, TX, USA.
| | - Stephen C Elliott
- Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Mail Code 9086, Dallas, TX, 75390, USA
- Children's Health System of Texas, Dallas, TX, USA
| | - Linda S Hynan
- Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Mail Code 9086, Dallas, TX, 75390, USA
- Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Beth Warren
- Children's Health System of Texas, Dallas, TX, USA
| | - Robin B Jarrett
- Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Mail Code 9086, Dallas, TX, 75390, USA
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20
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Subjective, neuropsychological, and neural markers of memory in older adults. Int Psychogeriatr 2022; 34:1035-1043. [PMID: 34763748 DOI: 10.1017/s1041610221002623] [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: 12/25/2022]
Abstract
OBJECTIVES To investigate the relationship between the P300 event-related potential, neuropsychological measures of memory, subjective memory complaints (SMCs), and indicators of psychosocial functioning. DESIGN, SETTING, AND PARTICIPANTS In this cross-sectional study of 79 community-based older adults, aged 60-75 years, participants completed online surveys and in-person neuropsychological and electroencephalogram (EEG) assessments. MEASUREMENTS Measures included: the Change subscale of the Metamemory in Adulthood Questionnaire, NIH Toolbox Emotions battery (Perceived Stress and Psychological Well-Being), Geriatric Depression Scale, Geriatric Anxiety Scale, electrocortical measures (EEG), California Verbal Learning Test, 3rd Edition, and diagnostic ratings for mild and major neurocognitive disorders based on full neuropsychological battery, clinical interview, and two-clinician consensus. RESULTS P300 amplitude was associated with long-delay verbal memory recall and diagnostic rating. SMCs were not associated with objective memory or diagnostic rating. SMCs were associated with higher perceived stress, anxiety, and depression symptoms and lower psychological well-being. CONCLUSIONS Neural indicators such as the P300 may be useful for early detection of cognitive impairment. SMCs were not a reliable indicator of early memory impairment in relation to neuropsychological or neural indicators, but may be a useful indicator of unreported stress and mood symptoms in clinical settings.
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21
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Hammond TC, Powell E, Green SJ, Chlipala G, Frank J, Yackzan AT, Yanckello LM, Chang YH, Xing X, Heil S, Springer JE, Pennypacker K, Stromberg A, Sawaki L, Lin AL. Functional recovery outcomes following acute stroke is associated with abundance of gut microbiota related to inflammation, butyrate and secondary bile acid. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:1017180. [PMID: 36386777 PMCID: PMC9644110 DOI: 10.3389/fresc.2022.1017180] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 10/04/2022] [Indexed: 11/23/2022]
Abstract
Accumulating evidence suggests that gut microbes modulate brain plasticity via the bidirectional gut-brain axis and play a role in stroke rehabilitation. However, the microbial species alterations associated with stroke and their correlation with functional outcome measures following acute stroke remain unknown. Here we measure post-stroke gut dysbiosis and how it correlates with gut permeability and cognitive functions in 12 stroke participants, 18 controls with risk factors for stroke, and 12 controls without risk factors. Stool samples were used to measure the microbiome with whole genome shotgun sequencing and leaky gut markers. We genotyped APOE status and measured diet composition and motor, cognitive, and emotional status using NIH Toolbox. We used linear regression methods to identify gut microbial associations with cognitive and emotional assessments. We did not find significance differences between the two control groups. In contrast, the bacteria populations of the Stroke group were statistically dissimilar from the control groups. Relative abundance analysis revealed notable decreases in butyrate-producing microbial taxa, secondary bile acid-producing taxa, and equol-producing taxa. The Stroke group had higher levels of the leaky gut marker alpha-1-antitrypsin in the stool than either of the groups and several taxa including Roseburia species (a butyrate producer) were negatively correlated with alpha-1-antitrypsin. Stroke participants scored lower on memory testing than those in the two control groups. Stroke participants with more Roseburia performed better on the picture vocabulary task; more Bacteroides uniformis (a butyrate producer) and less Escherichia coli (a pro-inflammatory species) reported higher levels of self-efficacy. Intakes of fiber, fruit and vegetable were lower, but sweetened beverages were higher, in the Stroke group compared with controls. Vegetable consumption was correlated with many bacterial changes among the participants, but only the species Clostridium bolteae, a pro-inflammatory species, was significantly associated with stroke. Our findings indicate that stroke is associated with a higher abundance of proinflammatory species and a lower abundance of butyrate producers and secondary bile acid producers. These altered microbial communities are associated with poorer functional performances. Future studies targeting the gut microbiome should be developed to elucidate whether its manipulation could optimize rehabilitation and boost recovery.
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Affiliation(s)
- Tyler C. Hammond
- Sanders-Brown Center on Aging, University of Kentucky, Lexington, KY, United States
- Department of Neuroscience, University of Kentucky, Lexington, KY, United States
| | - Elizabeth Powell
- Department of Physical Medicine and Rehabilitation, University of Kentucky, Lexington, KY, United States
| | - Stefan J. Green
- Genomics and Microbiome Core Facility, Rush University, Chicago, IL, United States
| | - George Chlipala
- Research Informatics Core, University of Illinois Chicago, Chicago, IL, United States
| | - Jacqueline Frank
- Department of Neuroscience, University of Kentucky, Lexington, KY, United States
- Center for Advanced Stroke Science, Department of Neurology, University of Kentucky, Lexington, KY, United States
| | - Andrew T. Yackzan
- Sanders-Brown Center on Aging, University of Kentucky, Lexington, KY, United States
| | - Lucille M. Yanckello
- Sanders-Brown Center on Aging, University of Kentucky, Lexington, KY, United States
- Department of Pharmacology and Nutritional Sciences, University of Kentucky, Lexington, KY, United States
| | - Ya-Hsuan Chang
- Sanders-Brown Center on Aging, University of Kentucky, Lexington, KY, United States
- Department of Pharmacology and Nutritional Sciences, University of Kentucky, Lexington, KY, United States
| | - Xin Xing
- Sanders-Brown Center on Aging, University of Kentucky, Lexington, KY, United States
- Department of Computer Science, University of Kentucky, Lexington, KY, United States
| | - Sally Heil
- School of Medicine, University of Missouri, Columbia, MO, United States
| | - Joe E. Springer
- Department of Neuroscience, University of Kentucky, Lexington, KY, United States
- Spinal Cord and Brain Injury Research Center, University of Kentucky, Lexington, KY, United States
| | - Keith Pennypacker
- Department of Neuroscience, University of Kentucky, Lexington, KY, United States
- Center for Advanced Stroke Science, Department of Neurology, University of Kentucky, Lexington, KY, United States
| | - Arnold Stromberg
- Department of Statistics, University of Kentucky, Lexington, KY, United States
| | - Lumy Sawaki
- Department of Physical Medicine and Rehabilitation, University of Kentucky, Lexington, KY, United States
| | - Ai-Ling Lin
- Department of Radiology, University of Missouri, Columbia, MO, United States
- Institute for Data Science & Informatics, University of Missouri, Columbia, MOUnited States
- Department of Biological Sciences, University of Missouri, Columbia, MO, United States
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22
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Tan KR, Fredrickson B, Santos H, Wood W, Schwartz TA, Mayer DK. A Visual Case-Oriented Analysis of Stress-Related Symptoms in Caregivers of Allogeneic Bone Marrow Transplantation Recipients. Oncol Nurs Forum 2022; 49:541-551. [PMID: 36413733 PMCID: PMC10431954 DOI: 10.1188/22.onf.541-551] [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] [Indexed: 12/13/2022]
Abstract
OBJECTIVES To describe trends in caregiver stress and stress-related symptoms (anxiety, depression, fatigue, and sleep disturbance) across 12 weeks post-transplantation. SAMPLE & SETTING 11 caregivers were recruited from a National Cancer Institute-designated comprehensive cancer center's bone marrow transplantation (BMT) outpatient clinic in the southeastern United States. METHODS & VARIABLES A visual case-oriented analysis was conducted on data from 11 caregivers' weekly self-reported data to identify trends after allogeneic BMT. RESULTS The authors identified three primary trends as follows: U-shaped (highest symptoms at start of transplantation and end of study; n = 3), negatively sloped (highest symptoms at beginning of transplantation and decreasing over time; n = 2), and V-shaped predischarge (highest symptoms at start of transplantation and right before discharge home; n = 4). Two caregivers did not have postdischarge data because of patient death prior to study completion. IMPLICATIONS FOR NURSING Caregivers may benefit from additional support to manage their stress-related symptoms at the start of transplantation and just before discharge.
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Affiliation(s)
- Kelly R. Tan
- Lineberger Comprehensive Cancer Center, University of North Carolina At Chapel Hill, Chapel Hill, NC, USA
| | - Barbara Fredrickson
- Department of Psychology & Neuroscience, University of North Carolina At Chapel Hill, Chapel Hill, NC, USA
| | - Hudson Santos
- School of Nursing, University of North Carolina At Chapel Hill, Chapel Hill, NC, USA
| | - William Wood
- Lineberger Comprehensive Cancer Center, University of North Carolina At Chapel Hill, Chapel Hill, NC, USA
- School of Medicine, University of North Carolina At Chapel Hill, Chapel Hill, NC, USA
| | - Todd A. Schwartz
- School of Public Health, Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Deborah K. Mayer
- Lineberger Comprehensive Cancer Center, University of North Carolina At Chapel Hill, Chapel Hill, NC, USA
- School of Nursing, University of North Carolina At Chapel Hill, Chapel Hill, NC, USA
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23
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Krok D, Telka E, Zarzycka B. Total Pain and Illness Acceptance in Pelvic Cancer Patients: Exploring Self-Efficacy and Stress in a Moderated Mediation Model. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159631. [PMID: 35954987 PMCID: PMC9368026 DOI: 10.3390/ijerph19159631] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 08/02/2022] [Accepted: 08/03/2022] [Indexed: 06/13/2023]
Abstract
Cancer patients experience pain not only in its physical dimension, but also in a broader context that includes psychological, social, and spiritual aspects due to a higher level of anxiety and stress. The present prospective, longitudinal study examined the relationship between total pain and illness acceptance among pelvic cancer patients, taking into consideration the moderated mediation effects of self-efficacy and stress. The study involved a sample of pelvic cancer patients receiving radiotherapy treatment. Assessments were completed at T1 (before radiotherapy), T2 (after 3-4 weeks), and T3 (after radiotherapy) to assess the psychosocial dynamics of illness acceptance (N = 267). The more physical, psychological, social, and spiritual pain symptoms the patients experienced, the less they accepted negative health conditions and the effects of their illness. Stress moderated the indirect effect between total pain dimensions and illness acceptance through self-efficacy, but it did not moderate the relationship between total pain and illness acceptance. The relationships between total pain dimensions and illness acceptance thus depend on both the mediating effect of self-efficacy and the moderating effect of stress. This highlights the need to control one's motivation and behavior and manage emotional strain or tension.
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Affiliation(s)
- Dariusz Krok
- Institute of Psychology, University of Opole, 45-040 Opole, Poland
| | - Ewa Telka
- Department of Radiotherapy, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, 44-101 Gliwice, Poland
| | - Beata Zarzycka
- Institute of Psychology, John Paul II Catholic University of Lublin, 20-950 Lublin, Poland
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Mulligan J, Olivieri H, Young K, Lin J, Anthony SJ. Single session therapy in pediatric healthcare: the value of adopting a strengths-based approach for families living with neurological disorders. Child Adolesc Psychiatry Ment Health 2022; 16:59. [PMID: 35869483 PMCID: PMC9308282 DOI: 10.1186/s13034-022-00495-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 04/14/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Pediatric patients with neurological disorders often require lifelong management of symptoms and behaviours that can result in enduring emotional burden, stress and impacted health-related quality of life. Single session therapy (SST) draws upon patients' existing skills and knowledge and has emerged as a therapeutic approach to address pediatric patient and family needs in a timely manner. This study aimed to assess the clinical effectiveness of SST for pediatric patients with neurological disorders and their families, considering self-efficacy, distress, anxiety, therapeutic alliance and client satisfaction, as well as perceptions of whether SST met their pressing needs. METHODS A convergent parallel mixed-methods design included quantitative data collection via five standardized questionnaires across three time points and qualitative data collection through semi-structured interviews. Quantitative and qualitative data were analyzed independently and then integrated. RESULTS The study comprised of 135 participants, including patients, parents and siblings across diverse neurological conditions. Scores of self-efficacy and anxiety in children, and distress and anxiety in adults, improved significantly after the SST. Notably, changes in anxiety in adults remained significant five to seven weeks after the SST. Seventeen participants participated in 12 semi-structured interviews. Participants described that SST (1) was a missing piece in ongoing clinical care, (2) illuminated existing strengths and resilience, and (3) effected a lasting impact beyond the single session. CONCLUSIONS SST may be a promising initial, strengths-based treatment to support the short-term and potentially long-term needs of pediatric patients with neurological disorders and their families by emphasizing existing strengths, supporting therapeutic alliance and cultivating hope.
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Affiliation(s)
- Janice Mulligan
- Division of Neurology, Gary Hurvitz Centre for Brain and Mental Health, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada. .,Department of Social Work, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada. .,Child Health Evaluative Sciences, Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, 686 Bay Street, Toronto, ON, M5G 0A4, Canada.
| | - Heather Olivieri
- grid.42327.300000 0004 0473 9646Division of Neurology, Gary Hurvitz Centre for Brain and Mental Health, The Hospital for Sick Children, 555 University Avenue, Toronto, ON M5G 1X8 Canada ,grid.42327.300000 0004 0473 9646Department of Social Work, The Hospital for Sick Children, 555 University Avenue, Toronto, ON M5G 1X8 Canada
| | - Katarina Young
- grid.42327.300000 0004 0473 9646Child Health Evaluative Sciences, Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, 686 Bay Street, Toronto, ON M5G 0A4 Canada
| | - Jia Lin
- grid.42327.300000 0004 0473 9646Child Health Evaluative Sciences, Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, 686 Bay Street, Toronto, ON M5G 0A4 Canada
| | - Samantha J. Anthony
- grid.42327.300000 0004 0473 9646Department of Social Work, The Hospital for Sick Children, 555 University Avenue, Toronto, ON M5G 1X8 Canada ,grid.42327.300000 0004 0473 9646Child Health Evaluative Sciences, Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, 686 Bay Street, Toronto, ON M5G 0A4 Canada ,grid.17063.330000 0001 2157 2938Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, ON M5S 1V4 Canada
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25
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Fialk A, Connors A, Cerrito B, Jones K, Buono F. The Impact of SARS-CoV-2 (COVID-19) on the Acuity of Mental Health-Related Diagnosis at Admission for Young Adults in New York City and Washington, DC: Observational Study. JMIR Form Res 2022; 6:e39217. [PMID: 35767688 PMCID: PMC9285669 DOI: 10.2196/39217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 06/21/2022] [Accepted: 06/27/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has required restrictive measures to mitigate transmission of the virus. Evidence has demonstrated increased generalized anxiety and depression among young adults due to the COVID-19 pandemic. However, minimal research has examined the longitudinal effect of COVID-19 over the course of time and its impact on anxiety and depression. Additionally, age and gender have been found to play a significant role on individuals' mental health, with young adults and women particularly at risk. OBJECTIVE The aim of this study was to examine the impact of the COVID-19 pandemic on anxiety and depression upon admissions to treatment. METHODS This was an observational study that was completed longitudinally in which the grouping variable split the time interval into five equal groups for assessments over each period of time. A total of 112 young adults (aged 18-25 years) were recruited for the study. Participants completed assessments online through a Qualtrics link. RESULTS Psychometric properties of the admission assessments were uniformly highly statistically significant. There was a significant difference in generalized anxiety between the group-1 and group-3 time intervals. No significant difference was found across the time intervals for depression. Differences in predicting the impact of the psychometrics scores were found with respect to gender. Only the ability to participate and the quality-of-life subfactor of the Functional Assessment of Chronic Illness Therapy (FACIT) assessment were significant. CONCLUSIONS This study sought to understand the impact that COVID-19 has had on young adults seeking mental health services during the pandemic. Gender emerged as a clear significant factor contributing to increased anxiety in young adults seeking mental health services during the pandemic. These findings have critical importance to ensuring the potential treatment success rate of clients, while providing an overarching understanding of the impact of the pandemic and establishing clinical recommendations for the treatment of individuals who are seeking out treatment.
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Affiliation(s)
| | | | | | | | - Frank Buono
- Department of Psychiatry, Yale School of Medicine, Yale University, New Haven, CT, United States
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26
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Eick SM, Enright EA, Padula AM, Aung M, Geiger SD, Cushing L, Trowbridge J, Keil AP, Gee Baek H, Smith S, Park JS, DeMicco E, Schantz SL, Woodruff TJ, Morello-Frosch R. Prenatal PFAS and psychosocial stress exposures in relation to fetal growth in two pregnancy cohorts: Applying environmental mixture methods to chemical and non-chemical stressors. ENVIRONMENT INTERNATIONAL 2022; 163:107238. [PMID: 35436721 PMCID: PMC9202828 DOI: 10.1016/j.envint.2022.107238] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 04/01/2022] [Accepted: 04/07/2022] [Indexed: 05/19/2023]
Abstract
BACKGROUND Prenatal exposure to individual per‑ and poly‑fluoroalkyl substances (PFAS) and psychosocial stressors have been associated with reductions in fetal growth. Studies suggest cumulative or joint effects of chemical and non-chemical stressors on fetal growth. However, few studies have examined PFAS and non-chemical stressors together as a mixture, which better reflects real life exposure patterns. We examined joint associations between PFAS, perceived stress, and depression, and fetal growth using two approaches developed for exposure mixtures. METHODS Pregnant participants were enrolled in the Chemicals in Our Bodies cohort and Illinois Kids Development Study, which together make up the ECHO.CA.IL cohort. Seven PFAS were previously measured in 2nd trimester maternal serum samples and were natural log transformed for analyses. Perceived stress and depression were assessed using self-reported validated questionnaires, which were converted to t-scores using validated methods. Quantile g-computation and Bayesian kernel machine regression (BKMR) were used to assess joint associations between PFAS, perceived stress and depression t-scores and birthweight z-scores (N = 876). RESULTS Individual PFAS, depression and perceived stress t-scores were negatively correlated with birthweight z-scores. Using quantile g-computation, a simultaneous one quartile increase in all PFAS, perceived stress and depression t-scores was associated with a slight reduction in birthweight z-scores (mean change per quartile increase = -0.09, 95% confidence interval = -0.21,0.03). BKMR similarly indicated that cumulative PFAS and stress t-scores were modestly associated with lower birthweight z-scores. Across both methods, the joint association appeared to be distributed across multiple exposures rather than due to a single exposure. CONCLUSIONS Our study is one of the first to examine the joint effects of chemical and non-chemical stressors on fetal growth using mixture methods. We found that PFAS, perceived stress, and depression in combination were modestly associated were lower birthweight z-scores, which supports prior studies indicating that chemical and non-chemical stressors are jointly associated with adverse health outcomes.
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Affiliation(s)
- Stephanie M Eick
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
| | - Elizabeth A Enright
- Department of Psychology, St. Mary's College of Maryland, St. Mary's City, MD, USA
| | - Amy M Padula
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Max Aung
- Division of Environmental Health, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California
| | - Sarah D Geiger
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Lara Cushing
- Department of Environmental Health Sciences, Fielding School of Public Health, University of California, Los Angeles, CA, USA
| | - Jessica Trowbridge
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Alexander P Keil
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Hyoung Gee Baek
- Environmental Chemistry Laboratory, Department of Toxic Substances Control, California Environmental Protection Agency, Berkeley, CA, USA
| | - Sabrina Smith
- Environmental Chemistry Laboratory, Department of Toxic Substances Control, California Environmental Protection Agency, Berkeley, CA, USA
| | - June-Soo Park
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA; Environmental Chemistry Laboratory, Department of Toxic Substances Control, California Environmental Protection Agency, Berkeley, CA, USA
| | - Erin DeMicco
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Susan L Schantz
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Champaign, IL USA; Department of Comparative Biosciences, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Tracey J Woodruff
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Rachel Morello-Frosch
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA; Department of Environmental Science, Policy and Management and School of Public Health, University of California, Berkeley, CA, USA.
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Demers M, Pagnini F, Phillips D, Chang B, Winstein C, Langer E. Feasibility of an Online Langerian Mindfulness Program for Stroke Survivors and Caregivers. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2022; 42:228-237. [PMID: 35485301 DOI: 10.1177/15394492221091266] [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: 11/17/2022]
Abstract
Mindfulness is promising for individuals with neurological disorders and their caregivers to improve psychological well-being. The potential application of a Langerian mindfulness intervention, focused on attention to variability, however, is still unknown. The objective of the study was to determine the feasibility (usability, satisfaction, and potential effectiveness on psychological well-being) of an online mindfulness intervention for stroke survivors and caregivers. Using mixed methods, 11 stroke survivors and three caregivers participated in a 3-week, online, Langerian mindfulness intervention. A semi-structured interview assessed the intervention's usability and gathered feedback. Self-reported measures about psychological well-being were documented remotely 3 times (preintervention, postintervention, and 1-month follow-up). Qualitatively, participants were highly satisfied with the intervention and reported subjective benefits, but the usability of the online platform was poor. None of the self-reported measures changed over time. This study provided evidence of feasibility of an online Langerian mindfulness intervention in a new population: stroke survivors and caregivers.
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Affiliation(s)
| | - Francesco Pagnini
- Università Cattolica del Sacro Cuore, Milano, Italy.,Harvard University, Cambridge, MA, USA
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28
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Study Protocol to Evaluate Influences of Stress and Inflammation on Mucositis in Adolescents and Young Adults With Cancer. Nurs Res 2022; 71:404-410. [PMID: 35446269 PMCID: PMC9420760 DOI: 10.1097/nnr.0000000000000599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Adolescent and young adult (AYA) cancer diagnoses are rising, and gains in survivorship are falling behind for this age group. Dose-limiting toxicities of therapy, including mucositis, are more frequent in this age group and may be contributing to poorer survivorship. Animal models and observational studies suggest that stress and inflammation may be contributing to the high prevalence of dose-limiting mucositis in this age demographic. The AYA oncology population has been an overlooked and under-researched oncology demographic, leading to poor understanding of why this age group has high side-effect burdens and poorer cancer survival. OBJECTIVES This paper describes a novel, prospective clinical study in AYAs receiving chemotherapy designed to evaluate if stress at the time of chemotherapy administration predicts the development of dose-limiting mucositis and determines if stress-induced inflammatory profiles mediate this relationship. This is the first study to translate these stress and inflammation findings from animal models to a nurse-centered research design in humans. METHODS Persons aged 15-39 years who are receiving chemotherapy with a significant (> 20%) risk of developing mucositis will be recruited for a prospective study. Baseline stress is measured through participant questionnaires, and blood is collected to analyze for inflammatory markers. Participants receive chemotherapy as clinically planned and complete a daily survey of mucositis symptoms for 14 days after chemotherapy. Regression and mediation analysis will determine if stress and inflammatory profiles predict the development of dose-limiting mucositis. RESULTS This model of inquiry through a nursing framework uses a biobehavioral model that considers physiologic and psychologic risk factors for chemotherapy toxicities. This study is also an important translational science study essential in bringing data from laboratory studies to the clinical arena. The study may also be important to implementation science since assessing the ability of critically ill individuals to participate in low-burden clinical studies that may yield essential findings to improve care delivery. DISCUSSION Findings from this work will identify potentially modifiable factors that may be manipulated to minimize chemotherapy toxicities and lead to improved survival. Data from this study will inform larger research endeavors to better understand symptom development in this high-risk oncologic population.
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Understanding the Relationship between Food Security and Mental Health for Food-Insecure Mothers in Virginia. Nutrients 2022; 14:nu14071491. [PMID: 35406104 PMCID: PMC9003049 DOI: 10.3390/nu14071491] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 03/25/2022] [Accepted: 03/30/2022] [Indexed: 12/04/2022] Open
Abstract
Food insecurity, which disproportionately impacts mothers, can have chronic consequences on physical and mental health. There is a relationship between food insecurity and mental health, but the relationship’s mechanisms are unclear. This study aimed to understand how mental health outcomes differ by food insecurity severity and race among Virginia mothers. A cross-sectional survey employed previously validated food security status measures, physical and mental health, social support, and food coping strategies. Results were analyzed using descriptive statistics, Spearman’s rank-order correlations, linear regression, and chi-squared with effect sizes. Overall, respondents (n = 1029) reported worse mental health than the U.S. average (44.3 ± 10.1 and 50, respectively). There was a large effect of food security on mental health (d = 0.6), with worse mental health outcomes for mothers experiencing very low food security (VLFS) than low food security (LFS; p < 0.001). There was a small effect of race on mental health (φc = 0.02), with Black mothers having better mental health than White mothers (p < 0.001). Compared to mothers experiencing LFS, mothers experiencing VLFS had less social support (d = 0.5) and used more food coping strategies, especially financial strategies (d = −1.5; p < 0.001). This study suggests that food-insecure mothers experience stressors and lack adequate social support, which is even more distinct for mothers experiencing VLFS.
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Wulsin LR, Sagui-Henson SJ, Roos LG, Wang D, Jenkins B, Cohen BE, Shah AJ, Slavich GM. Stress Measurement in Primary Care: Conceptual Issues, Barriers, Resources, and Recommendations for Study. Psychosom Med 2022; 84:267-275. [PMID: 35067657 PMCID: PMC8976751 DOI: 10.1097/psy.0000000000001051] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Exposure to stressors in daily life and dysregulated stress responses are associated with increased risk for a variety of chronic mental and physical health problems, including anxiety disorders, depression, asthma, heart disease, certain cancers, and autoimmune and neurodegenerative disorders. Despite this fact, stress exposure and responses are rarely assessed in the primary care setting and infrequently targeted for disease prevention or treatment. METHOD In this narrative review, we describe the primary reasons for this striking disjoint between the centrality of stress for promoting disease and how rarely it is assessed by summarizing the main conceptual, measurement, practical, and reimbursement issues that have made stress difficult to routinely measure in primary care. The following issues will be reviewed: a) assessment of stress in primary care, b) biobehavioral pathways linking stress and illness, c) the value of stress measurements for improving outcomes in primary care, d) barriers to measuring and managing stress, and e) key research questions relevant to stress assessment and intervention in primary care. RESULTS On the basis of our synthesis, we suggest several approaches that can be pursued to advance this work, including feasibility and acceptability studies, cost-benefit studies, and clinical improvement studies. CONCLUSIONS Although stress is recognized as a key contributor to chronic disease risk and mortality, additional research is needed to determine how and when instruments for assessing life stress might be useful in the primary care setting, and how stress-related data could be integrated into disease prevention and treatment strategies to reduce chronic disease burden and improve human health and well-being.
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Affiliation(s)
- Lawson R Wulsin
- From the Departments of Psychiatry and Family Medicine, University of Cincinnati, and Cincinnati Veterans Administration Medical Center (Wulsin), Cincinnati, Ohio; Osher Center for Integrative Medicine (Sagui-Henson), University of California, San Francisco, San Francisco, California; Health Psychology PhD Program (Roos), University of North Carolina at Charlotte, Charlotte, North Carolina; Center for Economic and Social Research (Wang), University of Southern California, Los Angeles; Department of Psychology, Chapman University, Center on Stress & Health, and Department of Anesthesiology and Perioperative Care (Jenkins), University of California, Irvine; Department of Medicine, University of California, San Francisco, and San Francisco Veterans Affairs Healthcare System (Cohen), San Francisco, California; Department of Epidemiology (Shah), Rollins School of Public Health, Emory University; Department of Medicine, Division of Cardiology (Shah), Emory University School of Medicine, Atlanta; and Atlanta Veterans Affairs Healthcare System (Shah), Decatur, Georgia; and Cousins Center for Psychoneuroimmunology and Department of Psychiatry and Biobehavioral Sciences (Slavich), University of California, Los Angeles, Los Angeles, California
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Rubin MR, Tabacco G, Omeragic B, Majeed R, Hale C, Brickman AM. A Pilot Study of Cognition Among Hypoparathyroid Adults. J Endocr Soc 2022; 6:bvac002. [PMID: 35155969 PMCID: PMC8824458 DOI: 10.1210/jendso/bvac002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Indexed: 11/19/2022] Open
Abstract
Abstract
Purpose
Hypoparathyroid patients describe cognitive deficits, yet data regarding objective assessment of cognitive function are limited. We assessed cognition in a pilot study of hypoparathyroid patients using the NIH Toolbox® Adult Cognitive Battery (NIHTB-CB). We also sought to determine whether cognition relates to emotion, quality of life (QoL) and hypoparathyroidism-related biochemistries.
Methods
Nineteen hypoparathyroid patients were studied. Objective cognition was assessed with NIHTB-CB. Impairment was defined as fully demographically adjusted T-score < 1.5 SD in at least 1 cognitive domain or < 1 SD in 2 or more domains.
Results
Of the 19 participants (17 women; median age 49; 18 postsurgical), impaired demographically adjusted NIHTB-CB cognition scores were observed in 13 subjects (68%). Cognition scores correlated with self-reported perception of general health. Processing speed was the most commonly impaired cognitive domain, with T-scores that were ≤ 2 SD in 6 subjects (32%). Processing speed correlated with serum calcium (r=0.53, p=0.023) and inversely with serum phosphate (r=-0.48, p=0.042) levels.
Conclusions
Impaired cognition using the NIHTB-CB was common in this small pilot cohort of hypoparathyroid patients. Slower processing speed was present and associated with lower serum calcium and higher serum phosphate levels. Larger controlled studies with additional neuropsychological testing are needed to investigate cognitive function in hypoparathyroidism.
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Affiliation(s)
- Mishaela R Rubin
- Department of Medicine, Metabolic Bone Diseases Unit, Division of Endocrinology, Vagelos College of Physicians & Surgeons, Columbia University, New York, NY
| | - Gaia Tabacco
- Department of Medicine, Metabolic Bone Diseases Unit, Division of Endocrinology, Vagelos College of Physicians & Surgeons, Columbia University, New York, NY
- Unit of Endocrinology and Diabetes, Campus Bio-Medico, University of Rome, Rome, Italy
| | - Beatriz Omeragic
- Department of Medicine, Metabolic Bone Diseases Unit, Division of Endocrinology, Vagelos College of Physicians & Surgeons, Columbia University, New York, NY
| | - Rukshana Majeed
- Department of Medicine, Metabolic Bone Diseases Unit, Division of Endocrinology, Vagelos College of Physicians & Surgeons, Columbia University, New York, NY
| | - Christiane Hale
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain and Department of Neurology, Vagelos College of Physicians & Surgeons, Columbia University, New York, NY
| | - Adam M Brickman
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain and Department of Neurology, Vagelos College of Physicians & Surgeons, Columbia University, New York, NY
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Bernstein R, Sanchez N, Clark ELM, Conte I, Gulley LD, Legget KT, Cornier MA, Melby C, Johnson SA, Lucas-Thompson R, Shomaker LB. Mindfulness-based intervention in adolescents at risk for excess weight gain: 1.5-year follow-up of pilot randomized controlled trial. Eat Behav 2021; 43:101580. [PMID: 34775283 PMCID: PMC8691759 DOI: 10.1016/j.eatbeh.2021.101580] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 10/07/2021] [Accepted: 11/03/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Mindfulness-based intervention (MBI) may offer a novel means of preventing excess weight gain in adolescents, theoretically by decreasing stress-eating through altering executive functioning (EF) and food-reward sensitivity. METHODS N = 54 12-17y girls and boys at-risk for excess weight gain (i.e., BMI ≥70th percentile or two biological parents with reported obesity [BMI ≥30 kg/m2]) participated in a 1.5-year follow-up of a pilot randomized controlled trial comparing 6-week/6-session MBI (n = 29) and a health education (HE) control (n = 25). Laboratory stress-eating, food-reward sensitivity, EF, perceived stress, and BMI/adiposity were re-assessed at 1.5-years with validated measures. Changes from baseline to 1.5-year follow-up were explored with ANCOVA, accounting for the respective baseline outcome, age, and sex. RESULTS Compared to MBI (M = -21, SE = 59), HE had greater increases in stress-eating from baseline to 1.5-years (M = 194, SE = 63, Cohen's d = 0.59, p = .01). There were no other between-condition differences. DISCUSSION MBI may prevent worsening stress-eating for adolescents at-risk for excess weight gain. The potential for MBI as an intervention for stress-eating and ultimately, weight stabilization warrants testing in an adequately-powered trial.
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Affiliation(s)
- Ruth Bernstein
- Human Development & Family Studies, Colorado State University, 1570 Campus Delivery, Fort Collins, CO 80523, United States
| | - Natalia Sanchez
- Human Development & Family Studies, Colorado State University, 1570 Campus Delivery, Fort Collins, CO 80523, United States
| | - Emma L M Clark
- Human Development & Family Studies, Colorado State University, 1570 Campus Delivery, Fort Collins, CO 80523, United States
| | - Isabella Conte
- Human Development & Family Studies, Colorado State University, 1570 Campus Delivery, Fort Collins, CO 80523, United States
| | - Lauren D Gulley
- Human Development & Family Studies, Colorado State University, 1570 Campus Delivery, Fort Collins, CO 80523, United States
| | - Kristina T Legget
- Department of Psychiatry, School of Medicine, Anschutz Medical Campus, University of Colorado, 13001 E. 17(th) Pl, Aurora, CO 80045, United States; Research Service, Rocky Mountain Regional VA Medical Center, 1700 N. Wheeling St., Aurora, CO 80045, United States
| | - Marc-Andre Cornier
- Division of Endocrinology, Metabolism & Diabetes, Department of Medicine, School of Medicine, Anschutz Medical Campus, University of Colorado, 13001 E. 17(th) Pl, 80045 Aurora, CO, United States
| | - Christopher Melby
- Food Science & Human Nutrition, Colorado State University, 1571 Campus Delivery, Fort Collins, CO 80523, United States
| | - Sarah A Johnson
- Food Science & Human Nutrition, Colorado State University, 1571 Campus Delivery, Fort Collins, CO 80523, United States
| | - Rachel Lucas-Thompson
- Human Development & Family Studies, Colorado State University, 1570 Campus Delivery, Fort Collins, CO 80523, United States; Community & Behavioral Health, Colorado School of Public Health, 13001 E. 17(th) Pl, Aurora, CO 80045, United States
| | - Lauren B Shomaker
- Human Development & Family Studies, Colorado State University, 1570 Campus Delivery, Fort Collins, CO 80523, United States; Community & Behavioral Health, Colorado School of Public Health, 13001 E. 17(th) Pl, Aurora, CO 80045, United States.
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Mediators and Moderators of the Association Between Perceived Stress and Episodic Memory in Diverse Older Adults. J Int Neuropsychol Soc 2021; 27:883-895. [PMID: 33292897 PMCID: PMC8187476 DOI: 10.1017/s1355617720001253] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Stress is a risk factor for numerous negative health outcomes, including cognitive impairment in late-life. The negative association between stress and cognition may be mediated by depressive symptoms, which separate studies have identified as both a consequence of perceived stress and a risk factor for cognitive decline. Pathways linking perceived stress, depressive symptoms, and cognition may be moderated by sociodemographics and psychosocial resources. The goal of this cross-sectional study was to identify modifying factors and enhance understanding of the mechanisms underlying the stress-cognition association in a racially and ethnically diverse sample of older adults. METHOD A linear regression estimated the association between perceived stress and episodic memory in 578 older adults (Mage = 74.58) in the Washington Heights-Inwood Columbia Aging Project. Subsequent models tested whether depressive symptoms mediated the stress-memory relationship and whether sociodemographics (gender, race, and ethnicity) or perceived control moderated these pathways. RESULTS Independent of sociodemographics and chronic diseases, greater perceived stress was associated with worse episodic memory. This relationship was mediated by more depressive symptoms. Higher perceived control buffered the association between stress and depressive symptoms. There was no significant moderation by gender, race, or ethnicity. CONCLUSION Depressive symptoms may play a role in the negative association between perceived stress and cognition among older adults; however, longitudinal analyses and studies using experimental designs are needed. Perceived control is a modifiable psychological resource that may offset the negative impact of stress.
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Peterson BS, West AE, Weisz JR, Mack WJ, Kipke MD, Findling RL, Mittman BS, Bansal R, Piantadosi S, Takata G, Koebnick C, Ashen C, Snowdy C, Poulsen M, Arora BK, Allem CM, Perez M, Marcy SN, Hudson BO, Chan SH, Weersing R. A Sequential Multiple Assignment Randomized Trial (SMART) study of medication and CBT sequencing in the treatment of pediatric anxiety disorders. BMC Psychiatry 2021; 21:323. [PMID: 34193105 PMCID: PMC8243307 DOI: 10.1186/s12888-021-03314-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 06/04/2021] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Treatment of a child who has an anxiety disorder usually begins with the question of which treatment to start first, medication or psychotherapy. Both have strong empirical support, but few studies have compared their effectiveness head-to-head, and none has investigated what to do if the treatment tried first isn't working well-whether to optimize the treatment already begun or to add the other treatment. METHODS This is a single-blind Sequential Multiple Assignment Randomized Trial (SMART) of 24 weeks duration with two levels of randomization, one in each of two 12-week stages. In Stage 1, children will be randomized to fluoxetine or Coping Cat Cognitive Behavioral Therapy (CBT). In Stage 2, remitters will continue maintenance-level therapy with the single-modality treatment received in Stage 1. Non-remitters during the first 12 weeks of treatment will be randomized to either [1] optimization of their Stage 1 treatment, or [2] optimization of Stage 1 treatment and addition of the other intervention. After the 24-week trial, we will follow participants during open, naturalistic treatment to assess the durability of study treatment effects. Patients, 8-17 years of age who are diagnosed with an anxiety disorder, will be recruited and treated within 9 large clinical sites throughout greater Los Angeles. They will be predominantly underserved, ethnic minorities. The primary outcome measure will be the self-report score on the 41-item youth SCARED (Screen for Child Anxiety Related Disorders). An intent-to-treat analysis will compare youth randomized to fluoxetine first versus those randomized to CBT first ("Main Effect 1"). Then, among Stage 1 non-remitters, we will compare non-remitters randomized to optimization of their Stage 1 monotherapy versus non-remitters randomized to combination treatment ("Main Effect 2"). The interaction of these main effects will assess whether one of the 4 treatment sequences (CBT➔CBT; CBT➔med; med➔med; med➔CBT) in non-remitters is significantly better or worse than predicted from main effects alone. DISCUSSION Findings from this SMART study will identify treatment sequences that optimize outcomes in ethnically diverse pediatric patients from underserved low- and middle-income households who have anxiety disorders. TRIAL REGISTRATION This protocol, version 1.0, was registered in ClinicalTrials.gov on February 17, 2021 with Identifier: NCT04760275 .
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Affiliation(s)
- Bradley S. Peterson
- grid.239546.f0000 0001 2153 6013Children’s Hospital Los Angeles, Los Angeles, CA USA ,grid.42505.360000 0001 2156 6853Department of Psychiatry, Keck School of Medicine at The University of Southern California, Los Angeles, USA
| | - Amy E. West
- grid.239546.f0000 0001 2153 6013Children’s Hospital Los Angeles, Los Angeles, CA USA ,grid.42505.360000 0001 2156 6853Department of Pediatrics, Keck School of Medicine at the University of Southern California, Los Angeles, USA
| | - John R. Weisz
- grid.38142.3c000000041936754XDepartment of Psychology, Harvard University, Cambridge, USA
| | - Wendy J. Mack
- grid.42505.360000 0001 2156 6853Department of Preventive Medicine, Keck School of Medicine at The University of Southern California, Los Angeles, USA
| | - Michele D. Kipke
- grid.239546.f0000 0001 2153 6013Children’s Hospital Los Angeles, Los Angeles, CA USA ,grid.42505.360000 0001 2156 6853Department of Pediatrics, Keck School of Medicine at the University of Southern California, Los Angeles, USA ,grid.42505.360000 0001 2156 6853Department of Preventive Medicine, Keck School of Medicine at The University of Southern California, Los Angeles, USA
| | - Robert L. Findling
- grid.224260.00000 0004 0458 8737Virginia Commonwealth University, Richmond, USA
| | - Brian S. Mittman
- grid.414895.50000 0004 0445 1191Department of Research & Evaluation, Kaiser Permanente, Los Angeles, USA
| | - Ravi Bansal
- grid.239546.f0000 0001 2153 6013Children’s Hospital Los Angeles, Los Angeles, CA USA ,grid.42505.360000 0001 2156 6853Department of Pediatrics, Keck School of Medicine at the University of Southern California, Los Angeles, USA
| | - Steven Piantadosi
- grid.38142.3c000000041936754XBrigham And Women’s Hospital, Harvard Medical School, Boston, USA
| | - Glenn Takata
- grid.239546.f0000 0001 2153 6013Children’s Hospital Los Angeles, Los Angeles, CA USA ,grid.42505.360000 0001 2156 6853Department of Pediatrics, Keck School of Medicine at the University of Southern California, Los Angeles, USA
| | - Corinna Koebnick
- grid.414895.50000 0004 0445 1191Department of Research & Evaluation, Kaiser Permanente, Los Angeles, USA
| | - Ceth Ashen
- Children’s Bureau of Southern California, Los Angeles, USA
| | - Christopher Snowdy
- grid.42505.360000 0001 2156 6853Department of Psychiatry, Keck School of Medicine at The University of Southern California, Los Angeles, USA
| | - Marie Poulsen
- grid.239546.f0000 0001 2153 6013Children’s Hospital Los Angeles, Los Angeles, CA USA ,grid.42505.360000 0001 2156 6853Department of Pediatrics, Keck School of Medicine at the University of Southern California, Los Angeles, USA
| | - Bhavana Kumar Arora
- grid.239546.f0000 0001 2153 6013Children’s Hospital Los Angeles, Los Angeles, CA USA ,grid.42505.360000 0001 2156 6853Department of Pediatrics, Keck School of Medicine at the University of Southern California, Los Angeles, USA
| | - Courtney M. Allem
- grid.239546.f0000 0001 2153 6013Children’s Hospital Los Angeles, Los Angeles, CA USA
| | - Marisa Perez
- Hathaway-Sycamores Child and Family Services, Altadena, USA
| | - Stephanie N. Marcy
- grid.239546.f0000 0001 2153 6013Children’s Hospital Los Angeles, Los Angeles, CA USA ,grid.42505.360000 0001 2156 6853Department of Pediatrics, Keck School of Medicine at the University of Southern California, Los Angeles, USA
| | - Bradley O. Hudson
- grid.239546.f0000 0001 2153 6013Children’s Hospital Los Angeles, Los Angeles, CA USA ,grid.42505.360000 0001 2156 6853Department of Pediatrics, Keck School of Medicine at the University of Southern California, Los Angeles, USA
| | | | - Robin Weersing
- grid.263081.e0000 0001 0790 1491SDSU-UC San Diego Joint Doctoral Program in Clinical Psychology, San Diego State University, San Diego, USA
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Akard TF, Davis K, Hills T, Lense M, Kim D, Webber R, Dietrich MS, Gilmer MJ. Songwriting intervention for cognitively-impaired children with life-limiting conditions: Study protocol. Contemp Clin Trials Commun 2021; 22:100765. [PMID: 33981908 PMCID: PMC8085894 DOI: 10.1016/j.conctc.2021.100765] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 03/11/2021] [Accepted: 03/29/2021] [Indexed: 11/15/2022] Open
Abstract
Investigations evaluating the effectiveness of music-based interventions as a complementary approach to symptom management and health promotion for cognitively-impaired children with life-limiting conditions and their families are needed to minimize the physical and psychological burdens on individuals and their caregivers. Songwriting is one music-based strategy for a remote family-centered complementary approach to improve outcomes for cognitively-impaired children with life-limiting conditions, their parents, and families. The overall purpose of this study is to test the feasibility and preliminary efficacy of a songwriting intervention for cognitively-impaired children (ages 5-17 years) who are receiving palliative or complex care and their parents. Specific aims are to: (1) determine the feasibility of songwriting for cognitively-impaired children with life-limiting conditions and their parents, and (2) examine preliminary efficacy of songwriting for child psychological distress and physical symptoms, parent psychological distress, and family environment. The protocol for this 1-group pre-and post-intervention clinical trial (N = 25) is described.
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Affiliation(s)
| | - Kelly Davis
- Vanderbilt University, Nashville, TN, USA
- Monroe Carrell Jr. Children's Hospital at Vanderbilt, Nashville, TN, USA
| | - Tracy Hills
- Monroe Carrell Jr. Children's Hospital at Vanderbilt, Nashville, TN, USA
| | - Miriam Lense
- Vanderbilt University, Nashville, TN, USA
- Vanderbilt University Medical Center, Nashville, TN, USA
| | - Dana Kim
- Monroe Carrell Jr. Children's Hospital at Vanderbilt, Nashville, TN, USA
| | - Rylie Webber
- Monroe Carrell Jr. Children's Hospital at Vanderbilt, Nashville, TN, USA
| | | | - Mary Jo Gilmer
- Vanderbilt University, Nashville, TN, USA
- Monroe Carrell Jr. Children's Hospital at Vanderbilt, Nashville, TN, USA
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Abstract
BACKGROUND Understanding the impact of the COVID-19 pandemic on paediatric non-COVID-19-related care, as well as patient and caregiver concerns and stressors, is critical for informing healthcare delivery. It was hypothesised that high care disruptions and psychological stress would be observed among paediatric and adult CHD patients in the early phase of the pandemic. METHODS A cross-sectional, international, electronic survey study was completed. Eligible participants included parents of children with acquired or CHD, adults with CHD, or caregivers of adults with CHD. RESULTS A total of 1220 participants from 25 countries completed the survey from 16 April to 4 May, 2020. Cardiac care disruption was significant with 38% reporting delays in pre-pandemic scheduled cardiac surgeries and 46% experiencing postponed cardiac clinic visits. The majority of respondents (75%) endorsed moderate to high concern about the patient with heart disease becoming ill from COVID-19. Worry about returning for in-person care was significantly greater than worry of harm to patient due to postponed care. Clinically significant psychological stress was high across the sample including children (50%), adults with CHD (42%), and caregivers (42%). CONCLUSIONS The early phase of the COVID-19 pandemic contributed to considerable disruptions in cardiac care for patients with paediatric and adult CHD. COVID-19-related fears are notable with potential to impact willingness to return to in-person care. Psychological stress is also very high necessitating intervention. Further study of the impact of delays in care on clinical outcomes is warranted.
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Lo SL, Gearhardt AN, Fredericks EM, Katz B, Sturza J, Kaciroti N, Gonzalez R, Hunter CM, Sonneville K, Chaudhry K, Lumeng JC, Miller AL. Targeted self-regulation interventions in low-income children: Clinical trial results and implications for health behavior change. J Exp Child Psychol 2021; 208:105157. [PMID: 33910138 DOI: 10.1016/j.jecp.2021.105157] [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: 11/13/2019] [Revised: 02/02/2021] [Accepted: 03/16/2021] [Indexed: 10/21/2022]
Abstract
Self-regulation, known as the ability to harness cognitive, emotional, and motivational resources to achieve goals, is hypothesized to contribute to health behaviors across the lifespan. Enhancing self-regulation early in life may increase positive health outcomes. During pre-adolescence, children assume increased autonomy in health behaviors (e.g., eating; physical activity), many of which involve self-regulation. This article presents results from a clinical trial (NCT03060863) that used a factorial design to test behavioral interventions designed to enhance self-regulation, specifically targeting executive functioning, emotion regulation, future-oriented thinking, and approach biases. Participants were 118 children (9-12 years of age, M = 10.2 years) who had a history of living in poverty. They were randomized to receive up to four interventions that were delivered via home visits. Self-regulation was assayed using behavioral tasks, observations, interviews, and parent- and child-report surveys. Results were that self-regulation targets were reliably assessed and that interventions were delivered with high fidelity. Intervention effect sizes were very small to moderate (d range = .02-.65, median = .14), and most were not statistically significant. Intercorrelation analyses indicated that associations between measures within each target varied based on the self-regulation target evaluated. Results are discussed with regard to the role of self-regulation-focused interventions in child health promotion. Implications of findings are reviewed for informing next steps in behavioral self-regulation interventions among children from low-income backgrounds.
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Affiliation(s)
- Sharon L Lo
- School of Graduate Psychology, Pacific University, Hillsboro, OR 97123, USA; School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA.
| | - Ashley N Gearhardt
- Department of Psychology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Emily M Fredericks
- Department of Pediatrics, University of Michigan, Ann Arbor, MI 48109, USA
| | - Benjamin Katz
- Department of Human Development and Family Science, Virginia Tech, Blacksburg, VA 24061, USA
| | - Julie Sturza
- School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA
| | - Niko Kaciroti
- School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA
| | - Richard Gonzalez
- Department of Psychology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Christine M Hunter
- Office of Behavioral and Social Sciences Research, National Institutes of Health, Bethesda, MD 20892, USA
| | - Kendrin Sonneville
- School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA
| | - Kiren Chaudhry
- School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA
| | - Julie C Lumeng
- School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA; Department of Pediatrics, University of Michigan, Ann Arbor, MI 48109, USA
| | - Alison L Miller
- School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA
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Jelsma EB, Goosby BJ, Cheadle JE. Do trait psychological characteristics moderate sympathetic arousal to racial discrimination exposure in a natural setting? Psychophysiology 2021; 58:e13763. [PMID: 33462861 PMCID: PMC10624514 DOI: 10.1111/psyp.13763] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 12/12/2020] [Accepted: 12/14/2020] [Indexed: 11/28/2022]
Abstract
Personality and psychological traits are known to influence how individuals react to and cope with stress, and thus, have downstream health and aging consequences. However, research considering psychological health traits as individual-level difference factors moderating the links been racism-related stress and health for racial and ethnic minorities in the United States is rare. Using intensive daily diaries and a wearable sensor that continuously recorded sympathetic nervous system arousal in a sample of racial and ethnic minority college students (80% African American, first-generation Black, or African; 20% Latinx), we linked arousal to racism-related experiences dynamically throughout the day as participants naturally went about their lives. Findings suggest that multiple traits are associated with increased arousal in real time when interpersonal discrimination is perceived, but that only anger and anxiety also predicted increased arousal during moments of rumination and reflection on race-related inequities. Vicarious discrimination exposure moments were also linked to suppressed arousal in general, but particularly for more anxious individuals. We use a stress appraisal and coping framework to elucidate the ways in which individual psychological differences may inform physiological responses to race-related stress. The biopsychosocial pathways by which cognitive appraisal and interpersonal race-related stress contribute to racial health disparities are also discussed.
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Affiliation(s)
- Elizabeth B Jelsma
- Department of Human Development and Family Sciences, The University of Texas at Austin, Austin, TX, USA
- Population Research Center, University of Texas at Austin, Austin, TX, USA
| | - Bridget J Goosby
- Population Research Center, University of Texas at Austin, Austin, TX, USA
- Department of Sociology, University of Texas at Austin, Austin, TX, USA
| | - Jacob E Cheadle
- Population Research Center, University of Texas at Austin, Austin, TX, USA
- Department of Sociology, University of Texas at Austin, Austin, TX, USA
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Tan KR, Santacroce SJ, Wood WA, Mayer DK, Santos H, Mucha PJ, Schwartz TA, Fredrickson BL. Positive psychological states and stress responses in caregivers of adults receiving an allogeneic bone marrow transplant: A study protocol. J Adv Nurs 2021; 77:2073-2084. [PMID: 33460207 DOI: 10.1111/jan.14742] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 12/10/2020] [Indexed: 12/24/2022]
Abstract
AIMS This protocol directs a study that aims to: (a) describe the caregiver's experience over 8-12 weeks after an index adult patient's allogeneic bone marrow transplant (BMT) for advanced cancer using a case-oriented approach and mixed methods, with qualitative methods in the foreground; and (b) explore networks of relationships among psycho-neurological symptoms, positive psychological states and caregiver health. DESIGN Case-oriented longitudinal design using multiple data types and analytic approaches. METHODS Data will be collected from 10-12 caregivers. The sample will be recruited from a large public hospital in the southeastern United States using maximum variation sampling (e.g., caregiver race/ethnicity, relationship to patient, age, education, and number of caregiving roles). Participants will be asked to complete weekly surveys, have their blood drawn bi-weekly and participate in an interview each month during the study period (~100 days). Aim 1 analysis will include directed content analysis and case-oriented visual analysis. Aim 2 analysis will include symptom network estimation of psycho-neurological symptoms, positive psychological states, and caregiver health. Institutional review board approval was obtained August 2018. DISCUSSION Results will provide an in-depth description of caregivers' experiences in the 100 days after BMT. Findings will inform generation of hypotheses and identification of targets for interventions to improve caregiver's experiences after BMT. IMPACT This in-depth multi-method longitudinal study to describe caregivers of adult patients receiving an allogeneic BMT is an essential step in understanding caregivers' complex responses to chronic stress and the role of positive psychological states. The results from this study will inform future research on chronic stress processes, intense caregiving, and intervention development.
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Affiliation(s)
- Kelly R Tan
- School of Nursing, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Sheila J Santacroce
- School of Nursing, University of North Carolina, Chapel Hill, North Carolina, USA.,Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA
| | - William A Wood
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA.,Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Deborah K Mayer
- School of Nursing, University of North Carolina, Chapel Hill, North Carolina, USA.,Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Hudson Santos
- School of Nursing, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Peter J Mucha
- Department of Mathematics and Applied Physical Sciences, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Todd A Schwartz
- School of Nursing, University of North Carolina, Chapel Hill, North Carolina, USA.,Department of Biostatistics, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Barbara L Fredrickson
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA.,Department Of Psychology and Neuroscience, University of North Carolina, Chapel Hill, North Carolina, USA
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Eick SM, Enright EA, Geiger SD, Dzwilewski KLC, DeMicco E, Smith S, Park JS, Aguiar A, Woodruff TJ, Morello-Frosch R, Schantz SL. Associations of Maternal Stress, Prenatal Exposure to Per- and Polyfluoroalkyl Substances (PFAS), and Demographic Risk Factors with Birth Outcomes and Offspring Neurodevelopment: An Overview of the ECHO.CA.IL Prospective Birth Cohorts. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:E742. [PMID: 33467168 PMCID: PMC7830765 DOI: 10.3390/ijerph18020742] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 01/11/2021] [Accepted: 01/13/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Infants whose mothers experience greater psychosocial stress and environmental chemical exposures during pregnancy may face greater rates of preterm birth, lower birth weight, and impaired neurodevelopment. METHODS ECHO.CA.IL is composed of two cohorts, Chemicals in Our Bodies (CIOB; n = 822 pregnant women and n = 286 infants) and Illinois Kids Development Study (IKIDS; n = 565 mother-infant pairs), which recruit pregnant women from San Francisco, CA and Urbana-Champaign, IL, respectively. We examined associations between demographic characteristics and gestational age, birth weight z-scores, and cognition at 7.5 months across these two cohorts using linear models. We also examined differences in biomarkers of exposure to per- and polyfluoroalkyl substances (PFAS), measured in second-trimester serum, and psychosocial stressors by cohort and participant demographics. RESULTS To date, these cohorts have recruited over 1300 pregnant women combined. IKIDS has mothers who are majority white (80%), whereas CIOB mothers are racially and ethnically diverse (38% white, 34% Hispanic, 17% Asian/Pacific Islander). Compared to CIOB, median levels of PFOS, a specific PFAS congener, are higher in IKIDS (2.45 ng/mL versus 1.94 ng/mL), while psychosocial stressors are higher among CIOB. Across both cohorts, women who were non-white and single had lower birth weight z-scores relative to white women and married women, respectively. Demographic characteristics are not associated with cognitive outcomes at 7.5 months. CONCLUSIONS This profile of the ECHO.CA.IL cohort found that mothers and their infants who vary in terms of socioeconomic status, race/ethnicity, and geographic location are similar in many of our measures of exposures and cognitive outcomes. Similar to past work, we found that non-white and single women had lower birth weight infants than white and married women. We also found differences in levels of PFOS and psychosocial stressors based on geographic location.
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Affiliation(s)
- Stephanie M. Eick
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, CA 94143, USA; (E.D.); (T.J.W.); (R.M.-F.)
| | - Elizabeth A. Enright
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Champaign, IL 61801, USA; (S.D.G.); (K.L.C.D.); (A.A.); (S.L.S.)
- Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, IL 61820, USA
| | - Sarah D. Geiger
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Champaign, IL 61801, USA; (S.D.G.); (K.L.C.D.); (A.A.); (S.L.S.)
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL 61820, USA
| | - Kelsey L. C. Dzwilewski
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Champaign, IL 61801, USA; (S.D.G.); (K.L.C.D.); (A.A.); (S.L.S.)
| | - Erin DeMicco
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, CA 94143, USA; (E.D.); (T.J.W.); (R.M.-F.)
| | - Sabrina Smith
- Environmental Chemistry Laboratory, Department of Toxic Substances Control, California Environmental Protection Agency, Berkeley, CA 94710, USA; (S.S.); (J.-S.P.)
| | - June-Soo Park
- Environmental Chemistry Laboratory, Department of Toxic Substances Control, California Environmental Protection Agency, Berkeley, CA 94710, USA; (S.S.); (J.-S.P.)
| | - Andrea Aguiar
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Champaign, IL 61801, USA; (S.D.G.); (K.L.C.D.); (A.A.); (S.L.S.)
- Department of Comparative Biosciences, University of Illinois at Urbana-Champaign, Champaign, IL 61802, USA
| | - Tracey J. Woodruff
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, CA 94143, USA; (E.D.); (T.J.W.); (R.M.-F.)
| | - Rachel Morello-Frosch
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, CA 94143, USA; (E.D.); (T.J.W.); (R.M.-F.)
- Department of Environmental Science, Policy and Management and School of Public Health, University of California, Berkeley, CA 94720, USA
| | - Susan L. Schantz
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Champaign, IL 61801, USA; (S.D.G.); (K.L.C.D.); (A.A.); (S.L.S.)
- Department of Comparative Biosciences, University of Illinois at Urbana-Champaign, Champaign, IL 61802, USA
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Hamilton CB, Li LC. Measures of Patient Activation and Self-Efficacy. Arthritis Care Res (Hoboken) 2020; 72 Suppl 10:645-659. [PMID: 33091240 DOI: 10.1002/acr.24350] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 06/05/2020] [Indexed: 12/17/2022]
Affiliation(s)
- Clayon B Hamilton
- The University of British Columbia, Vancouver, British Columbia, Canada, and Arthritis Research Canada, Richmond, British Columbia, Canada
| | - Linda C Li
- The University of British Columbia, Vancouver, British Columbia, Canada, and Arthritis Research Canada, Richmond, British Columbia, Canada
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42
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Foy JG, Foy MR. Dynamic Changes in EEG Power Spectral Densities During NIH-Toolbox Flanker, Dimensional Change Card Sort Test and Episodic Memory Tests in Young Adults. Front Hum Neurosci 2020; 14:158. [PMID: 32508607 PMCID: PMC7248326 DOI: 10.3389/fnhum.2020.00158] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 04/14/2020] [Indexed: 11/13/2022] Open
Abstract
Much is known about electroencephalograph (EEG) patterns during sleep, but until recently, it was difficult to study EEG patterns during conscious, awake behavior. Technological advances such as powerful wireless EEG systems have led to a renewed interest in EEG as a clinical and research tool for studying real-time changes in the brain. We report here the first normative study of EEG activity while healthy young adults completed a series of cognitive tests recently published by the National Institutes of Health Toolbox Cognitive Battery (NIH-TCB), a commonly-used standardized measure of cognition primarily used in clinical populations. In this preliminary study using a wireless EEG system, we examined power spectral density (PSD) in four EEG frequency bands. During baseline and cognitive testing, PSD activity for the lower frequency bands (theta and alpha) was greater, relative to the higher frequency bands (beta and gamma), suggesting participants were relaxed and mentally alert. Alpha, beta and gamma activity was increased during a memory test compared to two other, less demanding executive function tests. Gamma activity was also inversely correlated with performance on the memory test, consistent with the neural efficiency hypothesis which proposes that better cognitive performance may link with lower cortical energy consumption. In summary, our study suggests that cognitive performance is related to the dynamics of EEG activity in a normative young adult population.
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Affiliation(s)
- Judith G. Foy
- Department of Psychology, Loyola Marymount University, Los Angeles, CA, United States
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Williams JR, Cole V, Girdler S, Cromeens MG. Exploring stress, cognitive, and affective mechanisms of the relationship between interpersonal trauma and opioid misuse. PLoS One 2020; 15:e0233185. [PMID: 32413081 PMCID: PMC7228080 DOI: 10.1371/journal.pone.0233185] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 04/29/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND People with a history of interpersonal trauma, including intimate partner violence, sexual assault, and adverse childhood experiences, are disproportionately affected by the current opioid epidemic. Interpersonal trauma has been shown to increase risk for chronic pain conditions, prescription opioid use, and opioid misuse. Stress, cognition, and affective function have been examined as potential mechanisms that may influence opioid misuse among individuals with a history of interpersonal trauma. However, no studies have examined these factors simultaneously, despite their interrelatedness. OBJECTIVE The purpose of this study was to 1) examine perceived stress, perceived cognitive function, depressive symptoms, and PTSD symptoms as potential mechanisms of opioid misuse among individuals with a history of interpersonal trauma, 2) examine the types of interpersonal trauma that are associated with opioid misuse, and 3) assess the mediating role of pain and opioid prescription. METHODS A cross-sectional, observational study design was conducted. Data were collected through a confidential self-report online survey using validated instruments (n = 230). A series of regression analyses were conducted to identify mechanistic factors and interpersonal trauma types associated with opioid misuse, opioid prescription, and pain intensity. Structural equation modeling was used to examine mediating effects of pain intensity and opioid prescription. RESULTS Opioid prescription, depressive symptoms, and intimate partner violence increased the odds of reporting opioid misuse. Pain intensity and adverse childhood experiences increased the odds of opioid prescription. Higher levels of perceived stress and depressive symptoms were associated with increased pain intensity. Pain intensity emerged as a mediator of the relationship between depressive symptoms and opioid misuse. CONCLUSIONS Our work shows that there are likely several pathways through which interpersonal trauma can lead to opioid misuse. Interventions aimed at improving depressive symptoms and coping with traumatizing events should be included as part of comprehensive trauma-informed pain management practices.
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Affiliation(s)
- Jessica Roberts Williams
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- * E-mail:
| | - Veronica Cole
- Department of Psychology, Wake Forest University, Wake Forest, North Carolina, United States of America
| | - Susan Girdler
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Martha Grace Cromeens
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
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44
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Smith AD, Sanchez N, Reynolds C, Casamassima M, Verros M, Annameier SK, Melby C, Johnson SA, Lucas-Thompson RG, Shomaker LB. Associations of parental feeding practices and food reward responsiveness with adolescent stress-eating. Appetite 2020; 152:104715. [PMID: 32315656 DOI: 10.1016/j.appet.2020.104715] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 04/13/2020] [Accepted: 04/13/2020] [Indexed: 01/23/2023]
Abstract
Rates of adolescent obesity have continued to rise over the past decade. As adolescence is an important time for developing eating habits that endure into adulthood, more information is needed about the potentially modifiable family- and individual-level factors that influence the development of common overeating behaviors such as stress-eating during adolescence. In this study, we conducted secondary data analyses to evaluate how parental feeding practices and adolescents' food reward responsiveness related to adolescents' stress-eating during a laboratory test meal. Participants were 90 healthy adolescents (50% female), 12-17 years of age (M = 14.3, SD = 1.7 years), at risk for excess weight gain (BMI percentile M = 92.7, SD = 7.5). Parental feeding behaviors were assessed with parent-report on the Child Feeding Questionnaire-Adolescent Version. Adolescents' relative reward value of food was measured with a behavioral task. Stress-eating was assessed as total energy intake from a buffet lunch meal after adolescents participated in the Trier Social Stress Test adapted for adolescents. Results revealed that parental concern about their child's weight (t = 2.27, p = .02) and adolescents' relative reward value of food (t = 2.24, p = .03) were related to greater stress-eating, controlling for BMI standard score, age, sex, and general perceived stress. Parental restriction was not related to stress-eating in this sample (p = .21). These findings suggest that parental attitudes about their adolescent's weight and adolescents' own internalized responsiveness to food as a reward may play a role in propensity to engage in overeating in response to stress.
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Affiliation(s)
- Amy D Smith
- Human Development & Family Studies, Colorado State University, 1570 Campus Delivery, Fort Collins, CO, 80523, United States
| | - Natalia Sanchez
- Colorado School of Public Health, 1612 Campus Delivery, Fort Collins, CO, 80523, United States
| | - Chelsea Reynolds
- Human Development & Family Studies, Colorado State University, 1570 Campus Delivery, Fort Collins, CO, 80523, United States
| | - Milena Casamassima
- Colorado School of Public Health, 1612 Campus Delivery, Fort Collins, CO, 80523, United States
| | - Megan Verros
- Colorado School of Public Health, 1612 Campus Delivery, Fort Collins, CO, 80523, United States
| | - Shelly K Annameier
- Human Development & Family Studies, Colorado State University, 1570 Campus Delivery, Fort Collins, CO, 80523, United States
| | - Christopher Melby
- Colorado School of Public Health, 1612 Campus Delivery, Fort Collins, CO, 80523, United States; Food Science & Human Nutrition, Colorado State University, 1501 Campus Delivery, Fort Collins, CO, 80523, United States
| | - Sarah A Johnson
- Food Science & Human Nutrition, Colorado State University, 1501 Campus Delivery, Fort Collins, CO, 80523, United States
| | - Rachel G Lucas-Thompson
- Human Development & Family Studies, Colorado State University, 1570 Campus Delivery, Fort Collins, CO, 80523, United States
| | - Lauren B Shomaker
- Human Development & Family Studies, Colorado State University, 1570 Campus Delivery, Fort Collins, CO, 80523, United States; Colorado School of Public Health, 1612 Campus Delivery, Fort Collins, CO, 80523, United States.
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Graham Holmes L, Zampella CJ, Clements C, McCleery JP, Maddox BB, Parish-Morris J, Udhnani MD, Schultz RT, Miller JS. A Lifespan Approach to Patient-Reported Outcomes and Quality of Life for People on the Autism Spectrum. Autism Res 2020; 13:970-987. [PMID: 32154664 DOI: 10.1002/aur.2275] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 01/11/2020] [Accepted: 01/23/2020] [Indexed: 12/16/2022]
Abstract
Autistic self-advocates, family members, and community organizations have called for greater emphasis on enhancing quality of life (QoL) for people with autism. Doing this is critical to understand how QoL unfolds across the life course and to clarify whether gender affects QoL, health, and functioning for people with autism. The purpose of this study was to curate and test a lifespan QoL measurement tool using freely available and well-constructed National Institutes of Health Parent-Reported Outcomes Measurement Information System (PROMIS). To develop the PROMIS Autism Battery-Lifespan (PAB-L), we identified PROMIS scales relevant for autism, reviewed each item, consulted with a panel of autism experts, and elicited feedback from autistic people and family members. This battery provides a comprehensive portrait of QoL for children ages 5-13 (through parent proxy), teens 14-17 (parent proxy and self-report), and adults 18-65 (self-report) with autism compared to the general population. Participants and parent informants (N = 912) recruited through a children's hospital and nationwide U.S. autism research registry completed the PAB-L online. Results indicate that compared to general population norms, people with autism of all ages (or their proxies) reported less desirable outcomes and lower QoL across all domains. Women and girls experienced greater challenges in some areas compared to men and boys with autism. The PAB-L appears to be a feasible and acceptable method for assessing patient-reported outcomes and QoL for autistic people across the life course. Autism Res 2020, 13: 970-987. © 2020 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: We developed a survey to measure the quality of life of children, teens, and adults with autism using free National Institutes of Health PROMIS questionnaires. People with autism and family members rated the PROMIS Autism Battery-Lifespan as useful and important. Some reported a good quality of life, while many reported that their lives were not going as well as they wanted. Women and girls reported more challenges in some areas of life than men and boys.
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Affiliation(s)
- Laura Graham Holmes
- Children's Hospital of Philadelphia Center for Autism Research, Philadelphia, Pennsylvania.,A. J. Drexel Autism Institute, Drexel University, Philadelphia, Pennsylvania
| | - Casey J Zampella
- Children's Hospital of Philadelphia Center for Autism Research, Philadelphia, Pennsylvania
| | - Caitlin Clements
- Children's Hospital of Philadelphia Center for Autism Research, Philadelphia, Pennsylvania.,Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Joseph P McCleery
- Children's Hospital of Philadelphia Center for Autism Research, Philadelphia, Pennsylvania.,Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania.,Department of Psychology and Kinney Center for Autism Education and Support, Saint Joseph's University, Philadelphia, Pennsylvania
| | - Brenna B Maddox
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Julia Parish-Morris
- Children's Hospital of Philadelphia Center for Autism Research, Philadelphia, Pennsylvania.,Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Manisha D Udhnani
- Children's Hospital of Philadelphia Center for Autism Research, Philadelphia, Pennsylvania
| | - Robert T Schultz
- Children's Hospital of Philadelphia Center for Autism Research, Philadelphia, Pennsylvania.,Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Judith S Miller
- Children's Hospital of Philadelphia Center for Autism Research, Philadelphia, Pennsylvania.,Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania
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Mendelson T, Clary LK, Sibinga E, Tandon D, Musci R, Mmari K, Salkever D, Stuart EA, Ialongo N. A randomized controlled trial of a trauma-informed school prevention program for urban youth: Rationale, design, and methods. Contemp Clin Trials 2020; 90:105895. [PMID: 31786150 PMCID: PMC8100974 DOI: 10.1016/j.cct.2019.105895] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 11/12/2019] [Accepted: 11/14/2019] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Youth in disadvantaged urban areas are frequently exposed to chronic stress and trauma, including housing instability, neighborhood violence, and other poverty-related adversities. These exposures increase risk for emotional, behavioral, and academic problems and ultimately, school dropout. Schools are a promising setting in which to address these issues; however, there are few universal, trauma-informed school-based interventions for urban youth. METHODS/DESIGN Project POWER (Promoting Options for Wellness and Emotion Regulation) is a randomized controlled trial testing the impact of RAP Club, a trauma-informed intervention for eighth graders that includes mindfulness as a core component. Students in 32 urban public schools (n = 800) are randomly assigned to either RAP Club or a health education active control group. We assess student emotional, behavioral, and academic outcomes using self-report surveys and teacher ratings at baseline, post-intervention, and 4-month follow up. Focus groups and interviews with students, teachers, and principals address program feasibility, acceptability, and fidelity, as well as perceived program impacts. Students complete an additional self-report survey in ninth grade. Schools provide students' academic and disciplinary data for their seventh, eighth, and ninth grade years. In addition, data on program costs are collected to conduct an economic analysis of the intervention and active control programs. DISCUSSION Notable study features include program co-leadership by young adults from the community and building capacity of school personnel for continued program delivery. In addition to testing program impact, we will identify factors related to successful program implementation to inform future program use and dissemination.
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Affiliation(s)
- Tamar Mendelson
- Johns Hopkins Bloomberg School of Public Health, United States.
| | - Laura K Clary
- Johns Hopkins Bloomberg School of Public Health, United States
| | - Erica Sibinga
- Johns Hopkins Bloomberg School of Public Health, United States
| | | | - Rashelle Musci
- Johns Hopkins Bloomberg School of Public Health, United States
| | - Kristin Mmari
- Johns Hopkins Bloomberg School of Public Health, United States
| | - David Salkever
- Johns Hopkins Bloomberg School of Public Health, United States
| | | | - Nick Ialongo
- Johns Hopkins Bloomberg School of Public Health, United States
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Ma L, Steinberg JL, Bjork JM, Wang Q, Hettema JM, Abbate A, Moeller FG. Altered Effective Connectivity of Central Autonomic Network in Response to Negative Facial Expression in Adults With Cannabis Use Disorder. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2020; 5:84-96. [PMID: 31345781 PMCID: PMC8598077 DOI: 10.1016/j.bpsc.2019.05.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 05/06/2019] [Accepted: 05/28/2019] [Indexed: 12/31/2022]
Abstract
BACKGROUND Cannabis use is associated with an increased risk of stress-related adverse cardiovascular events. Because brain regions of the central autonomic network largely overlap with brain regions related to the neural response to emotion and stress, the central autonomic network may mediate the autonomic response to negative emotional stimuli. We aimed to obtain evidence to determine whether neural connectivity of the central autonomic network is altered in individuals with cannabis use disorder (CUD) when they are exposed to negative emotional stimuli. METHODS Effective (directional) connectivity (EC) analysis using dynamic causal modeling was applied to functional magnetic resonance imaging data acquired from 23 subjects with CUD and 23 control subjects of the Human Connectome Project while they performed an emotional face-matching task with interleaving periods of negative-face (fearful/angry) and neutral-shape stimuli. The EC difference (modulatory change) was measured during the negative-face trials relative to the neutral-shape trials. RESULTS The CUD group was similar to the control group in nonimaging measures and brain activations but showed greater modulatory changes in left amygdala to hypothalamus EC (positively associated with Perceived Stress Scale score), right amygdala to bilateral fusiform gyri ECs (positively associated with Perceived Stress Scale score), and left ventrolateral prefrontal cortex to bilateral fusiform gyri ECs (negatively associated with Perceived Stress Scale score). CONCLUSIONS Left amygdala to hypothalamus EC and right amygdala to bilateral fusiform gyri ECs are possibly part of circuits underlying the risk of individuals with CUD to stress-related disorders. Correspondingly, left ventrolateral prefrontal cortex to bilateral fusiform gyri ECs are possibly part of circuits reflecting a protective mechanism.
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Affiliation(s)
- Liangsuo Ma
- Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, Virginia; Department of Radiology, Virginia Commonwealth University, Richmond, Virginia.
| | - Joel L Steinberg
- Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, Virginia; Department of Psychiatry, Virginia Commonwealth University, Richmond, Virginia
| | - James M Bjork
- Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, Virginia; Department of Psychiatry, Virginia Commonwealth University, Richmond, Virginia
| | - Qin Wang
- Information Systems, Statistics, and Management Science, University of Alabama, Tuscaloosa, Alabama
| | - John M Hettema
- Department of Psychiatry, Virginia Commonwealth University, Richmond, Virginia
| | - Antonio Abbate
- Department of Internal Medicine, Virginia Commonwealth University, Richmond, Virginia
| | - F Gerard Moeller
- Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, Virginia; Department of Psychiatry, Virginia Commonwealth University, Richmond, Virginia; Department of Pharmacology and Toxicology, Virginia Commonwealth University, Richmond, Virginia; Department of Neurology, Virginia Commonwealth University, Richmond, Virginia
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Shomaker LB, Berman Z, Burke M, Annameier SK, Pivarunas B, Sanchez N, Smith AD, Hendrich S, Riggs NR, Legget KT, Cornier MA, Melby C, Johnson SA, Lucas-Thompson R. Mindfulness-based group intervention in adolescents at-risk for excess weight gain: A randomized controlled pilot study. Appetite 2019; 140:213-222. [PMID: 31112737 PMCID: PMC6585452 DOI: 10.1016/j.appet.2019.05.022] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 05/15/2019] [Accepted: 05/17/2019] [Indexed: 12/18/2022]
Abstract
OBJECTIVES To assess feasibility/acceptability of a mindfulness-based approach to excess weight prevention in adolescents at-risk for excess weight gain. To pilot test efficacy of a mindfulness-based intervention for improving food reward sensitivity, stress-eating, executive function (EF), and BMI/adiposity. METHODS A pilot randomized controlled trial was conducted with 12-17y adolescents at-risk for excess weight gain based on above-average weight (body mass index [BMI]≥70%ile) or parental history of obesity (BMI≥30 kg/m2). Adolescents were randomized to a mindfulness-based (n = 29) or health education control group (n = 25) that met for six weekly one-hour sessions. Feasibility/acceptability were determined from attendance and acceptability survey ratings. At baseline, six-week and six-month follow-up, adolescents' perceived stress was measured with the Perceived Stress Scale, food reward sensitivity with a behavioral task, stress-eating during a laboratory test meal, and EF with the parent-reported Behavior Rating Inventory of Executive Function and NIH Toolbox. At the same intervals, BMI indices and body fat by air displacement plethysmography were assessed in a fasted state. RESULTS Median session attendance was 6:6 sessions in both conditions; program acceptability ratings were above-average. Compared to health education, adolescents in mindfulness had lower food reward sensitivity at six-months (Cohen's d = 0.64, p = .01). There were no between-condition differences in BMI (mindfulness vs. health educationΔsix-months 95%CI 0.20, 1.52 kg/m2 vs. 0.21, 1.62 kg/m2) or adiposity (-3.64, -0.61% vs. -4.31, -1.04%) changes. CONCLUSIONS A mindfulness-based group intervention is feasible/acceptable among adolescents at-risk for excess weight. In this pilot sample, mindfulness and health education were equivocal for BMI/adiposity outcomes. Future trials with a larger, adequately-powered sample and longer-term follow-up are necessary to test efficacy of a mindfulness-based intervention for food reward sensitivity, stress-eating, EF, and stabilizing growth trajectories in youth at-risk for adult obesity.
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Affiliation(s)
- Lauren B Shomaker
- Human Development & Family Studies, Colorado State University, 1570 Campus Delivery, Fort Collins, CO, 80523, United States; Community & Behavioral Health, Colorado School of Public Health, 13001 E. 17th Pl, Aurora, CO, 80045, United States.
| | - Zoe Berman
- Human Development & Family Studies, Colorado State University, 1570 Campus Delivery, Fort Collins, CO, 80523, United States
| | - Morgan Burke
- Human Development & Family Studies, Colorado State University, 1570 Campus Delivery, Fort Collins, CO, 80523, United States
| | - Shelly K Annameier
- Human Development & Family Studies, Colorado State University, 1570 Campus Delivery, Fort Collins, CO, 80523, United States
| | - Bernadette Pivarunas
- Human Development & Family Studies, Colorado State University, 1570 Campus Delivery, Fort Collins, CO, 80523, United States
| | - Natalia Sanchez
- Community & Behavioral Health, Colorado School of Public Health, 13001 E. 17th Pl, Aurora, CO, 80045, United States
| | - Amy D Smith
- Human Development & Family Studies, Colorado State University, 1570 Campus Delivery, Fort Collins, CO, 80523, United States
| | - Silas Hendrich
- Human Development & Family Studies, Colorado State University, 1570 Campus Delivery, Fort Collins, CO, 80523, United States
| | - Nathaniel R Riggs
- Human Development & Family Studies, Colorado State University, 1570 Campus Delivery, Fort Collins, CO, 80523, United States
| | - Kristina T Legget
- Psychiatry, School of Medicine, Anschutz Medical Campus, University of Colorado, 13001 E. 17th Pl, Aurora, CO, 80045, United States
| | - Marc-Andre Cornier
- Division of Endocrinology, Metabolism & Diabetes, Department of Medicine, School of Medicine, Anschutz Medical Campus, University of Colorado, 13001 E. 17th Pl, Aurora, CO, 80045, Aurora, CO, United States
| | - Christopher Melby
- Food Science & Human Nutrition, Colorado State University, 1571 Campus Delivery, Fort Collins, CO, 80523, United States
| | - Sarah A Johnson
- Food Science & Human Nutrition, Colorado State University, 1571 Campus Delivery, Fort Collins, CO, 80523, United States
| | - Rachel Lucas-Thompson
- Human Development & Family Studies, Colorado State University, 1570 Campus Delivery, Fort Collins, CO, 80523, United States
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Babakhanyan I, Carlozzi NE, McKenna BS, Casaletto KB, Heinemann AW, Heaton RK. National Institutes of Health Toolbox Emotion Battery: Application of Summary Scores to Adults With Spinal Cord Injury, Traumatic Brain Injury, and Stroke. Arch Phys Med Rehabil 2019; 100:1863-1871. [PMID: 31153854 DOI: 10.1016/j.apmr.2019.05.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 03/23/2019] [Accepted: 05/04/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To examine the validity of factor analytically based summary scores that were developed using the National Institutes of Health Toolbox Emotion Battery (NIHTB-EB); (ie, psychological well-being, social satisfaction, negative affect) normative sample in individuals with neurologic conditions. DESIGN Cross-sectional, observational cohort. SETTING Community. PARTICIPANTS A total of 1036 English-speaking adults from the National Institutes of Health Toolbox (NIHTB) normative project and 604 community-dwelling adults with neurologic conditions including spinal cord injury (SCI n=209), traumatic brain injury (TBI n=184), and stroke (cerebrovascular accident [CVA] n=211) (N=1640). INTERVENTION Not applicable. MAIN OUTCOME MEASURES The NIHTB-EB. RESULTS A series of univariate analyses comparing summary scores across the 4 groups (SCI, TBI, CVA, normative group) were conducted to identify group differences. Base rates (defined as >1 SD toward the problematic direction) were also identified. The normative group demonstrated better emotional functioning characterized by greater social satisfaction and psychological well-being (normative group > SCI, TBI, CVA; P's <.0001), and less negative affect (normative group < SCI, P=.016; normative group < TBI, P<.001; normative group < CVA; P=.034) compared with each neurologic group. Using base rates to identify problematic emotions for the 3 summary scores, there were higher rates of problematic emotions on all 3 summary scores for the neurologic groups compared with the normative group. CONCLUSIONS The NIHTB-EB summary scores demonstrate an increased prevalence of problematic emotions among individuals with 3 neurologic conditions, and might be useful for identifying individuals with similar conditions and potentially in need of psychological support.
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Affiliation(s)
- Ida Babakhanyan
- Department of Psychiatry, University of California San Diego, San Diego, CA.
| | - Noelle E Carlozzi
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI
| | - Benjamin S McKenna
- Department of Psychiatry, University of California San Diego, San Diego, CA
| | - Kaitlin B Casaletto
- Memory and Aging Center, University of California San Francisco, Department of Neurology, San Francisco, CA
| | - Allen W Heinemann
- Shirley Ryan AbilityLab and Department of Physical Medicine and Rehabilitation, Northwestern University, Chicago, IL
| | - Robert K Heaton
- Department of Psychiatry, University of California San Diego, San Diego, CA
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Salsman JM, Schalet BD, Merluzzi TV, Park CL, Hahn EA, Snyder MA, Cella D. Calibration and initial validation of a general self-efficacy item bank and short form for the NIH PROMIS ®. Qual Life Res 2019; 28:2513-2523. [PMID: 31140041 DOI: 10.1007/s11136-019-02198-6] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/02/2019] [Indexed: 11/26/2022]
Abstract
AIMS General self-efficacy is associated with adaptive coping and positive health outcomes. The Patient-Reported Outcomes Measurement Information System (PROMIS®) has developed self-efficacy item banks for managing chronic conditions, but lacks a general self-efficacy measure. We sought to refine and validate an item-response theory (IRT)-based measure of general self-efficacy for PROMIS®. METHODS Ten items were modified from the NIH Toolbox® Self-Efficacy Item Bank by creating "confidence" response options, and administered to a general population sample (n = 1000) with the Toolbox® Self-Efficacy Item Bank, Life Orientation Test-Revised (LOT-R), and Generalized Expectancy for Success Scale (GESS). We split the sample in half for exploratory factor analysis (EFA) followed by confirmatory factor analysis (CFA). IRT analyses included evaluation of differential item functioning (DIF). RESULTS Participants had a mean age of 47.8 years and 50.3% were male. EFA showed all items loaded onto one dominant factor and CFA yielded a good fitting model for a general self-efficacy bank with confidence response options (CFI = 0.987, TLI = 0.984, RMSEA = 0.090). Items showed no evidence of DIF by gender, age, education, or race. Internal consistency reliability was α = .94 and .88 for a new 10-item general self-efficacy bank and 4-item short form, respectively. The new bank was correlated with the LOT-R (r = .58), the GESS (r = .55), and the Toolbox® Self-Efficacy Item Bank (r = .87). CONCLUSIONS The PROMIS® General Self-Efficacy measure demonstrated sufficient unidimensionality and displayed good internal consistency reliability, model fit, and convergent validity. Further psychometric testing of the PROMIS® General Self-Efficacy Item Bank and Short Form can evaluate its utility in people with chronic health conditions.
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Affiliation(s)
- John M Salsman
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157, USA.
- Wake Forest Baptist Comprehensive Cancer Center, Medical Center Boulevard, Winston-Salem, NC, 27157, USA.
| | - Benjamin D Schalet
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Thomas V Merluzzi
- Department of Psychology, University of Notre Dame, Notre Dame, IN, USA
| | - Crystal L Park
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA
| | - Elizabeth A Hahn
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- The Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL, USA
| | - Mallory A Snyder
- University Research Administration, The University of Chicago, Chicago, IL, USA
| | - David Cella
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- The Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL, USA
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