1
|
Ashrafioun L, Allan NP, Stecker TA. A randomized clinical trial to assess feasibility, acceptability and preliminary effects of telehealth-delivered cognitive-behavioral therapy for perceived social isolation among individuals with opioid use disorders. Drug Alcohol Depend 2024; 258:111268. [PMID: 38520791 PMCID: PMC11088495 DOI: 10.1016/j.drugalcdep.2024.111268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 03/04/2024] [Accepted: 03/05/2024] [Indexed: 03/25/2024]
Abstract
BACKGROUND The purpose of this study was to report on feasibility, acceptability, and initial efficacy data cognitive-behavioral therapy for perceived isolation (CBT-PSI) compared to health education among individuals with opioid use disorders (OUD) reporting elevated loneliness. METHODS Participants (n = 125) with OUD reporting elevated loneliness were recruited using online advertising to participate in a telehealth-delivered randomized clinical trial. Participants received either a 6-session CBT-PSI (n = 63) or health education (n = 62). Measures assessing loneliness, quantity of social interactions, perceived social support, substance use, substance use consequences, and treatment engagement among others, were completed at baseline, post-intervention, and 1- and 2-months post-intervention. Participants also reported on treatment acceptability for both conditions. RESULTS Target enrollment was met with loneliness, social disconnectedness measures, and substance use reflecting a clinically severe sample. Retention was high (> 80%) for both conditions. Participants rated both Health Education and CBT-PSI as acceptable, helpful, and useful interventions to address loneliness and opioid use. Loneliness was reduced and quantity of social interactions and perceived social support were increased to the same extent for both conditions and across the follow-up assessments. Opioid use and overall substance use were reduced in both conditions; however, the reductions among participants received CBT-PSI were significantly greater compared to Health Education. CONCLUSIONS This study supports the feasibility and acceptability of CBT-PSI. CBT-PSI findings related to loneliness, substance use, and other social connectedness outcomes are encouraging. Additional testing of CBT-PSI in a fully-powered trial is warranted.
Collapse
Affiliation(s)
- Lisham Ashrafioun
- Department of Psychiatry, University of Rochester School of Medicine & Dentistry, 300 Crittenden Boulevard, Rochester, NY 14642, USA; VA Center of Excellence for Suicide Prevention, VA Finger Lakes Healthcare System, 400 Fort Hill Avenue, Canandaigua, NY 14424, USA.
| | - Nicholas P Allan
- VA Center of Excellence for Suicide Prevention, VA Finger Lakes Healthcare System, 400 Fort Hill Avenue, Canandaigua, NY 14424, USA; Department of Psychiatry & Behavioral Health, Ohio State University, 370 W 9th Avenue, Columbus, OH 43210, USA
| | - Tracy A Stecker
- VA Center of Excellence for Suicide Prevention, VA Finger Lakes Healthcare System, 400 Fort Hill Avenue, Canandaigua, NY 14424, USA; School of Nursing, Medical University of South Carolina, 99 Jonathan Lucas Street, Charleston, SC 29425, USA
| |
Collapse
|
2
|
Luk JW, Leiter N, Stangl BL, Gunawan T, Schwandt ML, Goldman D, Diazgranados N, Ramchandani VA. Associations of history of alcohol use disorder with loneliness, social support, and mental health during the COVID-19 pandemic. Psychiatry Res 2024; 335:115826. [PMID: 38479194 PMCID: PMC11229409 DOI: 10.1016/j.psychres.2024.115826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 02/23/2024] [Accepted: 02/24/2024] [Indexed: 04/14/2024]
Abstract
This study examined the effects of alcohol use disorder (AUD) and treatment history on changes in loneliness, social support, and mental health symptoms from before to during the pandemic, and tested loneliness and social support as mediators of the AUD-mental health associations. Participants (n = 427) enrolled in the NIAAA COVID-19 Pandemic Impact on Alcohol Study were categorized into three groups: healthy control (62.3%), nontreatment AUD (14.1%), and treatment AUD (23.7%). Multilevel generalized linear models were conducted to examine changes in loneliness, social support, and mental health symptoms by group. Path analyses tested the mediating roles of loneliness and social support. Loneliness increased during the pandemic, especially in the nontreatment AUD group. Social support decreased in the healthy control and AUD treatment group. Anxiety and depressive symptoms increased in the nontreatment AUD group. Individuals with a history of AUD regardless of treatment history reported greater loneliness, which was linked to higher anxiety and depressive symptoms. Loneliness, but not social support, mediated the AUD-mental health associations. Psychosocial interventions aimed at increasing positive social engagement among individuals with AUD may help alleviate feelings of loneliness and mitigate mental health symptoms. Study findings can also help improve preparedness for future public health crises.
Collapse
Affiliation(s)
- Jeremy W Luk
- Office of the Clinical Director, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, United States.
| | - Noa Leiter
- Human Psychopharmacology Laboratory, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, United States
| | - Bethany L Stangl
- Human Psychopharmacology Laboratory, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, United States
| | - Tommy Gunawan
- Office of the Clinical Director, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, United States; Human Psychopharmacology Laboratory, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, United States
| | - Melanie L Schwandt
- Office of the Clinical Director, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, United States
| | - David Goldman
- Office of the Clinical Director, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, United States; Laboratory of Neurogenetics, National Institute on Alcohol Abuse and Alcoholism, Rockville, MD, United States
| | - Nancy Diazgranados
- Office of the Clinical Director, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, United States
| | - Vijay A Ramchandani
- Human Psychopharmacology Laboratory, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, United States
| |
Collapse
|
3
|
Ysseldyk R, Morton TA, Haslam C, Haslam SA, Boger J, Giau E, Macdonald EP, Matharu A, McCoy M. You've Got E-Mail: A Pilot Study Examining the Feasibility and Impact of a Group-Based Technology-Training Intervention Among Older Adults Living in Residential Care. Can J Aging 2024; 43:45-56. [PMID: 37501571 DOI: 10.1017/s0714980823000375] [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: 07/29/2023] Open
Abstract
Older adults living in residential care often experience challenges in sustaining meaningful social relationships, which can result in compromised health and well-being. Online social networking has the potential to mitigate this problem, but few studies have investigated its implementation and its effectiveness in maintaining or enhancing well-being. This pilot study used a cluster-randomized pre-post design to examine the feasibility of implementing a 12-week group-based technology-training intervention for older adults (n = 48) living in residential care by exploring how cognitive health, mental health, and confidence in technology were impacted. Analysis of variance revealed significant increases in life satisfaction, positive attitudes toward computer use, and self-perceived competence among participants who received the intervention, but increased depressive symptoms for the control group. These findings suggest that, despite challenges in implementing the intervention in residential care, group-based technology training may enhance confidence among older adults while maintaining or enhancing mental health.
Collapse
Affiliation(s)
- Renate Ysseldyk
- Department of Health Sciences, Carleton University, Ottawa, ON, Canada
| | | | - Catherine Haslam
- School of Psychology, The University of Queensland, Brisbane, QL, Australia
| | - S Alexander Haslam
- School of Psychology, The University of Queensland, Brisbane, QL, Australia
| | - Jennifer Boger
- Systems Design Engineering, University of Waterloo, ON, Canada
- Research Institute for Aging, Waterloo, ON, Canada
| | - Emily Giau
- Systems Design Engineering, University of Waterloo, ON, Canada
| | - Erin P Macdonald
- Department of Health Sciences, Carleton University, Ottawa, ON, Canada
| | - Amy Matharu
- Research Institute for Aging, Waterloo, ON, Canada
| | - Madeline McCoy
- Department of Health Sciences, Carleton University, Ottawa, ON, Canada
| |
Collapse
|
4
|
Charles SJ, Stevenson C, Wakefield JRH, Fino E. Diversity of Group Memberships Predicts Well-Being: Cross-Sectional and Longitudinal Evidence. PERSONALITY AND SOCIAL PSYCHOLOGY BULLETIN 2023:1461672231202278. [PMID: 37776314 DOI: 10.1177/01461672231202278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/02/2023]
Abstract
Groups have their health and well-being impacted by satisfying their members' needs and providing resources to help cope with threats. Multiple group memberships serve to accumulate these benefits and also provide resilience to the effects of group loss. However, the additional well-being benefits of belonging to multiple different types of group remain to be determined. In a preregistered cross-sectional survey in Nottingham, England (Study 1, N = 328), we found that group-type diversity predicted well-being and that this effect was fully serially mediated by increased creative self-efficacy, then reduced loneliness. To confirm our hypothesis in a more robust sample we conducted longitudinal analyses on the English Longitudinal Study of Aging (ELSA) dataset (Study 2, N = 5,838) finding that group-type diversity at time one (T1) predicted well-being at T2 (4 years later), even when accounting for wellbeing and loneliness at T1. We discuss the implications for enhancing group-based health interventions.
Collapse
|
5
|
Kerr-Little A, Bramness JG, Newberry RC, Biong S. Exploring dog ownership in the lives of people with substance use disorder: a qualitative study. Addict Sci Clin Pract 2023; 18:57. [PMID: 37759274 PMCID: PMC10523709 DOI: 10.1186/s13722-023-00411-z] [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: 08/06/2022] [Accepted: 09/13/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Recovery from substance use is commonly seen as a process of integrating social relationships and creating a sense of meaning in one's life. Dog owners describe a close relationship with their dog that impacts many aspects of their everyday life. Yet for individuals with substance use disorder (SUD), little is known about how dog ownership could affect their lives. The aim of this study was to explore how people living with SUD experience and describe their everyday life when owning a dog. METHOD Eight semi-structured in-depth individual interviews were conducted with people having personal experience of living with SUD and owning a dog. Data were gathered and analysed using qualitative content analysis. RESULTS The analysis yielded four categories, reflecting different aspects of dog ownership. Living with SUD and owning a dog was primarily something positive in their life. People increased their social connections personally and within society. They felt a belonging which gave a sense of agency and purpose, and they developed structure in their day and boundaries to their environment. Dog ownership, however, could hinder access to services which was found to be challenging for some participants. CONCLUSIONS The owning of a dog can lead to changes that parallel those of a recovery process. This finding adds to the research on the connection that dogs can provide and shows how pertinent this can be particularly for vulnerable persons such as those with SUD.
Collapse
Affiliation(s)
- Andi Kerr-Little
- Norwegian National Advisory Unit On Concurrent Substance Abuse & Mental Health Disorders, Hamar, Norway.
- Institute of Clinical Medicine, UIT The Arctic University of Norway, Tromsø, Norway.
| | - Jørgen G Bramness
- Norwegian National Advisory Unit On Concurrent Substance Abuse & Mental Health Disorders, Hamar, Norway
- Institute of Clinical Medicine, UIT The Arctic University of Norway, Tromsø, Norway
- Dept of Alcohol Drug and Tobacco Research, Norwegian Institute of Public Health, Oslo, Norway
| | - Ruth C Newberry
- Department of Animal & Aquacultural Sciences, Faculty of Biosciences, Norwegian University of Life Sciences, Ås, Norway
| | - Stian Biong
- Lovisenberg Diaconal University College, Lovisenberggata 15B, 0456, Oslo, Norway
| |
Collapse
|
6
|
Martin E, Schoeler T, Pingault JB, Barkhuizen W. Understanding the relationship between loneliness, substance use traits and psychiatric disorders: A genetically informed approach. Psychiatry Res 2023; 325:115218. [PMID: 37146462 PMCID: PMC10636586 DOI: 10.1016/j.psychres.2023.115218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 04/05/2023] [Accepted: 04/21/2023] [Indexed: 05/07/2023]
Abstract
Loneliness is a common, yet distressing experience associated with adverse outcomes including substance use problems and psychiatric disorders. To what extent these associations reflect genetic correlations and causal relationships is currently unclear. We applied Genomic Structural Equation Modelling (GSEM) to dissect the genetic architecture between loneliness and psychiatric-behavioural traits. Included were summary statistics from 12 genome-wide association analyses, including loneliness and 11 psychiatric phenotypes (range N: 9,537 - 807,553). We first modelled latent genetic factors amongst the psychiatric traits to then investigate potential causal effects between loneliness and the identified latent factors, using multivariate genome-wide association analyses and bidirectional Mendelian randomization. We identified three latent genetic factors, encompassing neurodevelopmental/mood conditions, substance use traits and disorders with psychotic features. GSEM provided evidence of a unique association between loneliness and the neurodevelopmental/mood conditions latent factor. Mendelian randomization results were suggestive of bidirectional causal effects between loneliness and the neurodevelopmental/mood conditions factor. These results imply that a genetic predisposition to loneliness may elevate the risk of neurodevelopmental/mood conditions, and vice versa. However, results may reflect the difficulty of distiguishing between loneliness and neurodevelopmental/mood conditions, which present in similar ways. We suggest, overall, the importance of addressing loneliness in mental health prevention and policy.
Collapse
Affiliation(s)
- Ellen Martin
- Division of Psychology and Language Sciences, University College London, London, United Kingdom
| | - Tabea Schoeler
- Division of Psychology and Language Sciences, University College London, London, United Kingdom; Department of Computational Biology, University of Lausanne, Lausanne, Switzerland
| | - Jean-Baptiste Pingault
- Division of Psychology and Language Sciences, University College London, London, United Kingdom; Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College, London, United Kingdom
| | - Wikus Barkhuizen
- Division of Psychology and Language Sciences, University College London, London, United Kingdom.
| |
Collapse
|
7
|
Mavragani A, Yan RJ, Harkin LJ, Katz D, Stevenson C, Mehta V, Giles E, Talbot C, Gooch D, Bennasar M, Self T, Nuseibeh B, Price B. Digital Intervention in Loneliness in Older Adults: Qualitative Analysis of User Studies. JMIR Form Res 2023; 7:e42172. [PMID: 36705962 PMCID: PMC9919429 DOI: 10.2196/42172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 11/18/2022] [Accepted: 12/01/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Loneliness is a significant well-being issue that affects older adults. Existing, commonly used social connection platforms do not contain facilities to break the cognitive cycle of loneliness, and loneliness interventions implemented without due processes could have detrimental effects on well-being. There is also a lack of digital technology designed with older adults. OBJECTIVE We aimed to iteratively design a user-centered smartphone app that can address loneliness in older adults. The aim of this study was to investigate the loneliness-related psychological processes that our conceptual smartphone app promotes. We also identified the emergent needs and concerns that older adults raised regarding the potential benefits and detriments of the app. METHODS We used technology probes to elicit older adults' reflections on the concept of using the app in 2 studies as follows: concept focus groups (n=33) and concept interviews (n=10). We then conducted a prototype trial with 1 week of use and follow-up interviews (n=12). RESULTS Thematic analysis explored the experiences and emergent challenges of our app through the design process. This led to the development of 4 themes as follows occurring in all 3 qualitative data sets: reflection on a digital social map is reassuring; app features encourage socializing; the risk of compounding loneliness; and individuals feel more control with mutual, socially beneficial activities. CONCLUSIONS Smartphone apps have the potential to increase older adults' awareness of the richness of their social connections, which may support loneliness reduction. Our qualitative approach to app design enabled the inclusion of older adults' experiences in technology design. Thus, we conclude that the older adults in our study most desired functionalities that can support mutual activities and maintain or find new connections rather than enable them to share an emotional state. They were wary of the app replacing their preferred in-person social interaction. Participants also raised concerns about making the user aware of the lack of support in their social network and wanted specific means of addressing their needs. Further user-centered design work could identify how the app can support mutual activities and socializing.
Collapse
Affiliation(s)
| | - Ronnie Jieru Yan
- Department of Psychology, Nottingham Trent University, Nottingham, United Kingdom
| | - Lydia Jo Harkin
- Department of Psychology, Nottingham Trent University, Nottingham, United Kingdom
| | - Dmitri Katz
- Computing and Communications, The Open University, Milton Keynes, United Kingdom
| | - Clifford Stevenson
- Department of Psychology, Nottingham Trent University, Nottingham, United Kingdom
| | - Vikram Mehta
- Computing and Communications, The Open University, Milton Keynes, United Kingdom
| | - Emilie Giles
- Graphic Design, School of Arts and Communication, Arts University Bournemouth, Bournemouth, United Kingdom
| | - Catherine Talbot
- Department of Psychology, Bournemouth University, Bournemouth, United Kingdom
| | - Daniel Gooch
- Computing and Communications, The Open University, Milton Keynes, United Kingdom
| | - Mohamed Bennasar
- Computing and Communications, The Open University, Milton Keynes, United Kingdom
| | - Tara Self
- Department of Psychology, Nottingham Trent University, Nottingham, United Kingdom
| | - Bashar Nuseibeh
- Computing and Communications, The Open University, Milton Keynes, United Kingdom.,Lero - The Irish Software Research Centre, University of Limerick, Limerick, Ireland
| | - Blaine Price
- Computing and Communications, The Open University, Milton Keynes, United Kingdom
| |
Collapse
|
8
|
Ingram I, Kelly PJ, Deane FP, Baker AL, Dingle GA. Perceptions of loneliness among people accessing treatment for substance use disorders. Drug Alcohol Rev 2020; 39:484-494. [PMID: 32657495 DOI: 10.1111/dar.13120] [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: 02/03/2020] [Revised: 04/22/2020] [Accepted: 05/31/2020] [Indexed: 12/13/2022]
Abstract
INTRODUCTION AND AIMS Guided by cognitive theory of loneliness, this study sought to explore the experience of loneliness among people accessing treatment for substance use disorders. Specifically, contributors to, consequences and alleviators of loneliness were explored. DESIGN AND METHODS Individual semi-structured interviews were conducted with 20 participants. Interviews were conducted onsite at two residential treatment facilities in New South Wales, Australia. Interviews were audio recorded and transcribed and an iterative categorisation approach was used to guide data analysis and reporting. RESULTS Four key themes emerged as contributors to and consequences of loneliness: cognitions (mistrust, perceived support from others, low self-worth and fear of negative evaluation), quality and authenticity of relationships, unhelpful interpersonal behaviours and the role of substance use. Participants indicated that overcoming the cognitive and behavioural perpetuators helped to alleviate loneliness and also described the utility of support groups, pursuit of authentic relationships and activities that provide a sense of purpose as helpful. DISCUSSION AND CONCLUSIONS Cognitions related to mistrust, lack of perceived support, low self-worth, fear of negative evaluation and identification and pursuit of meaningful relationships supportive of recovery should be key treatment targets for this population.
Collapse
Affiliation(s)
- Isabella Ingram
- School of Psychology, University of Wollongong, Wollongong, Australia.,Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
| | - Peter J Kelly
- School of Psychology, University of Wollongong, Wollongong, Australia.,Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
| | - Frank P Deane
- School of Psychology, University of Wollongong, Wollongong, Australia.,Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
| | - Amanda L Baker
- School of Medicine and Public Health, University of Newcastle, Newcastle, Australia
| | | |
Collapse
|