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Pluck G. Executive function and adult homelessness, true impairment or frontal lobology? Front Hum Neurosci 2024; 18:1359027. [PMID: 38322781 PMCID: PMC10844389 DOI: 10.3389/fnhum.2024.1359027] [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: 12/20/2023] [Accepted: 01/08/2024] [Indexed: 02/08/2024] Open
Abstract
Homelessness is associated with multiple risk factors for neurocognitive impairment. Past research with people experiencing homelessness has described "frontal lobe" dysfunction including behavioral disorders and executive cognitive impairments. In the current study, 72 adults experiencing homelessness were assessed with a standardized assessment of executive function, and interviewed regarding neurological and psychiatric history. When compared to a control sample of 25 never-homeless participants, and controlling for level of education, there was little evidence for executive dysfunction in the sample of people experiencing homelessness. Levels of substance abuse, past head injury, and post-traumatic stress disorder were notably high. However, there were no statistically significant associations between cognitive task performance and clinical or substance abuse variables. Gambling was surprisingly infrequent, but risk-taking behavior among intravenous drug users was common. Though in neither case was it linked to executive function. Overall, there was little evidence for executive impairment in this sample of people experiencing homelessness. I suggest that past research has often used inappropriate criteria for "normal" performance, particularly comparing people experiencing homelessness to control data of relatively high education level. This has led to elements of "frontal lobology," that is, clinical neuroscience research that tends to overly link non-typical or pathological behavior to frontal lobe impairment. When appropriate comparisons are made, controlling for education level, as in this study, associations between executive function impairments and adult homelessness may be weaker than previously reported.
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Affiliation(s)
- Graham Pluck
- Clinical Cognitive Sciences Laboratory, Faculty of Psychology, Chulalongkorn University, Bangkok, Thailand
- Academic Clinical Psychiatry, Division of Neuroscience, University of Sheffield, Sheffield, United Kingdom
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Hadadgar S, Peimani J, Hassani-Abharian P, Mashayekh M, Peivandi P, Fekrazad R. Comparative Effects of Cognitive Rehabilitation and Photobiomodulation on Drug Craving in Treatment-Seeking Opioid Addicts. Photobiomodul Photomed Laser Surg 2024; 42:54-65. [PMID: 38252491 DOI: 10.1089/photob.2023.0064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2024] Open
Abstract
Background: Drug addiction refers to a maladaptive pattern of drug use that frequently leads to substance abuse problems and accompanying cognitive and behavioral symptoms. Among the crucial criteria of drug addiction, craving stands out as a potent factor contributing to ongoing drug abuse and relapse following period of abstinence. To date, there is no definitive method for eradicating opioid cravings. The introduction of novel neurocognitive interventions, such as cognitive rehabilitation and photobiomodulation (PBM), into the realm of psychiatric treatments holds promise due to the parallels between drug addiction and other psychiatric disorders. These innovative techniques offer potential value in addressing drug addiction. Objective: This study aimed to assess and compare the efficacy of cognitive rehabilitation and PBM in alleviating drug cravings among individuals undergoing addiction treatment in clinical settings. Methods: The research used randomized clinical trial as the chosen research method. The statistical population encompassed all clients receiving treatment for addiction at clinics, selected through the convenience sampling method, with α = 0.05 significance level and an effect size of 85%. Gpower software was utilized to determine three equal groups. Sixty-three participants, each having a mean total score higher than 3 out of 5 on the Desire for Drug Questionnaire (DDQ), were randomly assigned to two experimental groups (n = 21 each) and a control group (n = 21). For the assessment of immediate and periodic opioid craving, the DDQ and the Obsessive Compulsive Drug Use Scale were used. In the low-level laser group, an 810 nm wavelength with continuous irradiation was applied twice a week at a distance of 1 cm by 1 cm to the prefrontal part of the brain for duration of 6 weeks (12 sessions). In the brain rehabilitation group, the stop signal and n-back tasks software were used twice a week for period of 6 weeks (comprising 12 sessions, each lasting 30 min). Results: The results demonstrated that each intervention significantly reduced drug craving in both the post-test and follow-up phases compared to the control group. The Bonferroni post hoc test indicated that PBM was more effective than cognitive rehabilitation in terms of working memory (WM) and inhibitory control for reducing drug craving (p < 0.05). Conclusions: While both PBM and cognitive rehabilitation targeting WM and inhibitory control effectively reduced opioid drug craving, low-level laser therapy proved to be more effective than cognitive rehabilitation in this regard.
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Affiliation(s)
- Sayena Hadadgar
- Department of Psychology, Karaj Branch of Islamic Azad University, Karaj, Iran
| | - Javid Peimani
- Department of Psychology, Karaj Branch of Islamic Azad University, Karaj, Iran
| | - Peyman Hassani-Abharian
- Cognitive Psychology and Rehabilitation Department, Institute for Cognitive Science Studies (IRICSS), Tehran, Iran
| | - Maryam Mashayekh
- Department of Psychology, Karaj Branch of Islamic Azad University, Karaj, Iran
| | - Parisa Peivandi
- Department of Psychology, Karaj Branch of Islamic Azad University, Karaj, Iran
| | - Reza Fekrazad
- Radiation Sciences Research Center, AJA University of Medical Sciences, Tehran, Iran
- International Network for Photo Medicine and Photo Dynamic Therapy (INPMPDT), Universal Scientific Education and Research, Network (USERN), Tehran, Iran
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Cooke JT, Schmidt AT, Garos S, Littlefield AK. The Relations Between an Inventory-Based Measure of Executive Function and Impulsivity Factors in Alcohol- and Cannabis-Relevant Outcomes. Arch Clin Neuropsychol 2023; 38:1068-1081. [PMID: 37001549 DOI: 10.1093/arclin/acad026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2023] [Indexed: 10/27/2023] Open
Abstract
OBJECTIVE While the lack of relation between performance- and inventory-based executive function (EF) measures is well documented, there remains ambiguity between self-report EFs and closely related constructs (e.g., impulsivity) assessed via the same method. The degree of convergence between purported EF measures with similar yet distinct constructs contain important theoretical implications for available EF assessment strategies and their construct validity. A newer measure of EF, the Behavior Regulation Inventory of Executive Functions-Adult (BRIEF-A), allows for more direct comparisons to self-reported measures of impulsivity, such as the commonly used Urgency, Planning, Perseverance, Sensation Seeking-Positive Urgency (UPPS-P) assessment. METHOD The present study used factor analysis and hierarchical regression to explore the associations between the BRIEF-A and UPPS-P, using alcohol and cannabis consumption across various outcomes (i.e., quantity-frequency and consequences) as an external criterion. Participants were 339 undergraduate students (Mage = 19.35; Female = 63%) from a large southwestern university. RESULTS The BRIEF-A and UPPS-P demonstrated strong correlations at both higher- and lower order facets. While the BRIEF-A was a significant correlate to many substance use outcomes, these relations were generally weaker than those seen with the UPPS-P. Hierarchical regression suggested limited contributions of the BRIEF-A over and above the UPPS-P. CONCLUSIONS Overall, this study suggested substantial overlap between impulsigenic factors and EFs when measured by self-report, and limited utility of EF measures to account for unique variance with substance use outcomes in this sample.
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Affiliation(s)
- Jeffrey T Cooke
- Department of Psychological Sciences, Texas Tech University, Box 42051, Lubbock, Texas 79409, USA
| | - Adam T Schmidt
- Department of Psychological Sciences, Texas Tech University, Box 42051, Lubbock, Texas 79409, USA
| | - Sheila Garos
- Department of Psychological Sciences, Texas Tech University, Box 42051, Lubbock, Texas 79409, USA
| | - Andrew K Littlefield
- Department of Psychological Sciences, Texas Tech University, Box 42051, Lubbock, Texas 79409, USA
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Bounds D, Woo MA, Nyamathi A, Kehoe P, Roy B, Yadav K, Cabrera-Mino C, Kumar R. Brain Changes Linked to Cognitive Symptomatology in Homeless Youth. Clin Nurs Res 2023:10547738231168465. [PMID: 37157815 DOI: 10.1177/10547738231168465] [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: 05/10/2023]
Abstract
Youth impacted by homelessness experience diminished cognition due to a variety of reasons including mental health symptoms, alcohol and substance use, and adverse childhood experiences. However, the status of specific brain regions which could impact important cognitive functions in homeless youth remains unclear. In this pilot comparative and correlational study, a series of demographic, psychological, cognitive assessments, and brain magnetic resonance imaging were performed in 10 male youth experiencing homelessness and 9 age-matched healthy male controls (age range: 18-25 years). Participants experiencing homelessness had significantly decreased regional brain gray matter tissue in comparison to the controls. Moreover, there were strong inverse correlations between the brain regions classically associated with executive decision-making (prefrontal cortices), depression (insular lobes), and conflict resolution (anterior cingulate), and the level of the symptoms detected by their questionnaires.
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Affiliation(s)
| | - Mary A Woo
- University of California Los Angeles, USA
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Truckenbrod LM, Cooper EM, Orsini CA. Cognitive mechanisms underlying decision making involving risk of explicit punishment in male and female rats. COGNITIVE, AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2023; 23:248-275. [PMID: 36539558 PMCID: PMC10065932 DOI: 10.3758/s13415-022-01052-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/29/2022] [Indexed: 12/24/2022]
Abstract
Individuals engage in the process of risk-based decision making on a daily basis to navigate various aspects of life. There are, however, individual differences in this form of decision making, with some individuals exhibiting preference for riskier choices (risk taking) and others exhibiting preference for safer choices (risk aversion). Recent work has shown that extremes in risk taking (e.g., excessive risk taking or risk aversion) are not only cognitive features of neuropsychiatric diseases, but may in fact predispose individuals to the development of such diseases. To better understand individual differences in risk taking, and thus the mechanisms by which they confer disease vulnerability, the current study investigated the cognitive contributions to risk taking in both males and females. Rats were first behaviorally characterized in a decision-making task involving risk of footshock punishment and then tested on a battery of cognitive behavioral assays. Individual variability in risk taking was compared with performance on these tasks. Consistent with prior work, females were more risk averse than males. With the exception of the Set-shifting Task, there were no sex differences in performance on other cognitive assays. There were, however, sex-dependent associations between risk taking and specific cognitive measures. Greater risk taking was associated with better cognitive flexibility in males whereas greater risk aversion was associated with better working memory in females. Collectively, these findings reveal that distinct cognitive mechanisms are associated with risk taking in males and females, which may account for sex differences in this form of decision making.
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Affiliation(s)
- Leah M Truckenbrod
- Institute for Neuroscience, The University of Texas at Austin, Austin, TX, USA
| | - Emily M Cooper
- Department of Psychology, The University of Texas at Austin, Austin, TX, USA
| | - Caitlin A Orsini
- Department of Psychology, The University of Texas at Austin, Austin, TX, USA.
- Department of Neurology, The University of Texas at Austin, Austin, TX, USA.
- Waggoner Center for Alcohol and Addiction Research, The University of Texas at Austin, 1601B Trinity Street, Austin, TX, 78712, USA.
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Burke CW, Firmin ES, Wilens TE. Systematic review: Rates of psychopathology, substance misuse, and neuropsychological dysfunction among transitional age youth experiencing homelessness. Am J Addict 2022; 31:523-534. [PMID: 36036233 DOI: 10.1111/ajad.13340] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 08/10/2022] [Accepted: 08/11/2022] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Transitional age youth experiencing homelessness (TAY-EH) bear a disproportionate burden of morbidity and mortality related to psychopathology, substance use disorders (SUD), and neuropsychological dysfunction. Prior reviews examining these conditions are now nearly a decade old, have focused on younger adolescent populations, or have utilized nonsystematic approaches. To our knowledge, no prior reviews have reported on all three of these domains in an integrated fashion. Here, we provide a contemporary, critical synthesis of the literature on the functioning of TAY-EH in North America within these three domains. METHODS Based upon PRISMA guidelines, a search of PubMed, Medline, and PsycInfo databases was conducted, including literature published between January 2015 and June 2021. RESULTS The initial search yielded 2024 citations; 104 underwent full text review and 32 met inclusion criteria, with a final aggregate sample size of 13,516. Studies revealed elevated rates of mood disorders, PTSD, anxiety disorders, and alcohol misuse. There is insufficient data to draw generalizable conclusions regarding neuropsychological functioning, other SUD, or other psychiatric diagnoses. No studies reported on co-occurrence of disorders among or between the domains of psychopathology, SUD, and neuropsychological dysfunction. Four studies used structured interviews for diagnoses, with the remainder relying upon brief screeners or self-report measures. CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE To our knowledge, this is the first systematic review to provide integrated findings on psychopathology, SUD, and neuropsychological dysfunction among TAY-EH. Further research using structured, DSM-based tools is needed to characterize rates of single and co-occurring conditions to inform tailored treatment interventions.
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Affiliation(s)
- Colin W Burke
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Elizabeth S Firmin
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Timothy E Wilens
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
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Haugen I, Stubberud J, Haug E, McGurk SR, Hovik KT, Ueland T, Øie MG. A randomized controlled trial of Goal Management Training for executive functioning in schizophrenia spectrum disorders or psychosis risk syndromes. BMC Psychiatry 2022; 22:575. [PMID: 36031616 PMCID: PMC9420179 DOI: 10.1186/s12888-022-04197-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 08/09/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Executive functioning is essential to daily life and severely impaired in schizophrenia and psychosis risk syndromes. Goal Management Training (GMT) is a theoretically founded, empirically supported, metacognitive strategy training program designed to improve executive functioning. METHODS A randomized controlled parallel group trial compared GMT with treatment as usual among 81 participants (GMT, n = 39 versus Wait List Controls, n = 42) recruited from an early intervention for psychosis setting. Computer generated random allocation was performed by someone independent from the study team and raters post-intervention were unaware of allocation. The primary objective was to assess the impact of GMT administered in small groups for 5 weeks on executive functioning. The secondary objective was to explore the potential of the intervention in influencing daily life functioning and clinical symptoms. RESULTS GMT improved self-reported executive functioning, measured with the Behavior Rating Inventory of Executive Function - Adult version (BRIEF-A), significantly more than treatment as usual. A linear mixed model for repeated measures, including all partial data according to the principle of intention to treat, showed a significant group x time interaction effect assessed immediately after intervention (post-test) and 6 months after intervention (follow-up), F = 8.40, p .005, r .37. Improvement occurred in both groups in objective executive functioning as measured by neuropsychological tests, functional capacity, daily life functioning and symptoms of psychosis rated by clinicians. Self-reported clinical symptoms measured with the Symptoms Check List (SCL-10) improved significantly more after GMT than after treatment as usual, F = 5.78, p .019, r .29. Two participants withdrew due to strenuous testing and one due to adverse effects. CONCLUSIONS GMT had clinically reliable and lasting effects on subjective executive function. The intervention is a valuable addition to available treatment with considerable gains at low cost. TRIAL REGISTRATION Registered at clinicaltrials.gov NCT03048695 09/02/2017.
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Affiliation(s)
- Ingvild Haugen
- Division of Mental Health Care, Innlandet Hospital Trust, P. O. Box 104, 2381, Brumunddal, Norway. .,Department of Psychology, University of Oslo, P.O. Box 1094, 0317, Oslo, Norway.
| | - Jan Stubberud
- grid.5510.10000 0004 1936 8921Department of Psychology, University of Oslo, P.O. Box 1094, 0317 Oslo, Norway ,grid.416137.60000 0004 0627 3157Department of Research, Lovisenberg Diaconal Hospital, P.O. Box 4970, Nydalen, 0440 Oslo, Norway
| | - Elisabeth Haug
- grid.412929.50000 0004 0627 386XDivision of Mental Health Care, Innlandet Hospital Trust, P. O. Box 104, 2381 Brumunddal, Norway
| | - Susan R. McGurk
- grid.189504.10000 0004 1936 7558Departments of Occupational Therapy and Psychological and Brain Sciences, Boston University, 930 Commonwealth Avenue, Boston, MA 02215 USA
| | - Kjell Tore Hovik
- grid.412929.50000 0004 0627 386XDivision of Mental Health Care, Innlandet Hospital Trust, P. O. Box 104, 2381 Brumunddal, Norway ,grid.477237.2Department of Psychology, Inland Norway University of Applied Sciences, P.O.Box 400, Elverum, Norway
| | - Torill Ueland
- grid.5510.10000 0004 1936 8921Department of Psychology, University of Oslo, P.O. Box 1094, 0317 Oslo, Norway ,grid.55325.340000 0004 0389 8485Norwegian Centre for Mental Disorders Research, Oslo University Hospital, Postboks 4956, Nydalen, 0424 Oslo, Norway
| | - Merete Glenne Øie
- grid.5510.10000 0004 1936 8921Department of Psychology, University of Oslo, P.O. Box 1094, 0317 Oslo, Norway ,grid.412929.50000 0004 0627 386XResearch Division, Innlandet Hospital Trust, P.O. Box 104, 2381 Brumunddal, Norway
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Fraser B, Chun S, Pehi T, Jiang T, Johnson E, Ombler J, McMinn C, Pierse N. Post-housing first outcomes amongst a cohort of formerly homeless youth in Aotearoa New Zealand. J R Soc N Z 2022. [DOI: 10.1080/03036758.2022.2088572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Brodie Fraser
- Department of Public Health, Te Whare Wānanga o Otāgo ki Pōneke – University of Otago, Wellington, New Zealand
| | - Saera Chun
- Department of Public Health, Te Whare Wānanga o Otāgo ki Pōneke – University of Otago, Wellington, New Zealand
| | - Tiria Pehi
- Department of Public Health, Te Whare Wānanga o Otāgo ki Pōneke – University of Otago, Wellington, New Zealand
| | - Terence Jiang
- Department of Public Health, Te Whare Wānanga o Otāgo ki Pōneke – University of Otago, Wellington, New Zealand
| | - Ellie Johnson
- Department of Public Health, Te Whare Wānanga o Otāgo ki Pōneke – University of Otago, Wellington, New Zealand
| | - Jenny Ombler
- Department of Public Health, Te Whare Wānanga o Otāgo ki Pōneke – University of Otago, Wellington, New Zealand
| | | | - Nevil Pierse
- Department of Public Health, Te Whare Wānanga o Otāgo ki Pōneke – University of Otago, Wellington, New Zealand
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Ssewanyana D, Newton CR, van Baar A, Hassan AS, Stein A, Taylor HG, Van De Vijver F, Scerif G, Abubakar A. Beyond Their HIV Status: the Occurrence of Multiple Health Risk Behavior Among Adolescents from a Rural Setting of Sub-Saharan Africa. Int J Behav Med 2020; 27:426-443. [PMID: 32215858 PMCID: PMC7359141 DOI: 10.1007/s12529-020-09877-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Background Health risk behaviors during adolescence may cluster into patterns that might be predicted by specific factors, among which HIV may have an important role. Method In a cross-sectional study conducted between 2017 and 2018, clustering of HRB and its associated factors was investigated in rural Kenya among 588 adolescents (36% perinatally HIV infected; 28% perinatally HIV exposed but uninfected; and 36% HIV unexposed/uninfected). Latent class analysis of 22 behaviors followed by multinomial logistic regression were conducted. Four risk behavior classes were identified. Results No significant differences were found in behavioral class membership across the three HIV groups (p = 0.366). The risk of membership to the higher risk behavioral classes relative to class 1 (the substance and drug abstinent low risk takers) increased with older adolescent age (p = 0.047), increased among adolescent who experienced mental distress (p < 0.001), and those who felt unsafe in their neighborhood (p < 0.002). Better working memory (p = 0.0037) was found to be protective. Conclusion The results highlight a need to include screening and interventions for internalizing mental health problems and deficits in executive functioning, as well as steps to involve family members and communities to address psychosocial risk factors in adolescents in Kenya.
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Affiliation(s)
- Derrick Ssewanyana
- Centre for Geographic Medicine Research Coast, Kenya Medical Research Institute (KEMRI), P. O Box 230, Kilifi, 80108, Kenya.
- Utrecht Centre for Child and Adolescent Studies, Utrecht University, Utrecht, The Netherlands.
| | - Charles R Newton
- Centre for Geographic Medicine Research Coast, Kenya Medical Research Institute (KEMRI), P. O Box 230, Kilifi, 80108, Kenya
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Anneloes van Baar
- Utrecht Centre for Child and Adolescent Studies, Utrecht University, Utrecht, The Netherlands
| | - Amin S Hassan
- Centre for Geographic Medicine Research Coast, Kenya Medical Research Institute (KEMRI), P. O Box 230, Kilifi, 80108, Kenya
| | - Alan Stein
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - H Gerry Taylor
- Department of Pediatrics, Center for Biobehavioral Health, Nationwide Children's Hospital Research Institute, The Ohio State University, Columbus, OH, USA
| | - Fons Van De Vijver
- Department of Culture Studies, Tilburg University, Tilburg, The Netherlands
| | - Gaia Scerif
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Amina Abubakar
- Centre for Geographic Medicine Research Coast, Kenya Medical Research Institute (KEMRI), P. O Box 230, Kilifi, 80108, Kenya
- Utrecht Centre for Child and Adolescent Studies, Utrecht University, Utrecht, The Netherlands
- Department of Psychiatry, University of Oxford, Oxford, UK
- Department of Public Health, Pwani University, Kilifi, Kenya
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
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Taggart T, Milburn NG, Nyhan K, Ritchwood TD. Utilizing a Life Course Approach to Examine HIV Risk for Black Adolescent Girls and Young Adult Women in the United States: A Systematic Review of Recent Literature. Ethn Dis 2020; 30:277-286. [PMID: 32346273 DOI: 10.18865/ed.30.2.277] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Objective Black female youth have been disproportionately burdened by the HIV epidemic. Emerging literature suggests that individual and social-structural factors may uniquely increase HIV risk within this population during key developmental periods, namely adolescence (ages 10-17 years) and emerging adulthood (ages 18-25 years). Few studies, however, have compared drivers of risk within and between these key developmental periods. Therefore, we conducted a systematic review of recent literature to characterize and identify important gaps in our understanding of the individual, psychosocial, and social-structural determinants of HIV risk among Black adolescent girls and emerging adult women. Design Using a replicable strategy, we searched electronic databases for articles and abstracts published between October 1, 2017 and September 30, 2019 in which the primary focus was on HIV prevention among Black adolescent girls and emerging adults in the United States. Results In total, 21 studies met the inclusion criteria. Most of the studies on Black adolescent girls assessed family functioning, parental monitoring, and parent-adolescent communication as determinants of HIV-related behaviors. However, equivalent studies were lacking for Black emerging adult women. Moreover, few studies assessed neighborhood characteristics, social networks, or other community-level factors as determinants of HIV-related behaviors, which are known drivers of HIV disparities. Conclusions Our findings highlighted several gaps in the literature, including failure to recognize the ethnic and cultural differences among Black women that may contribute to behavioral differences within this population and insufficient acknowledgment of the role of HIV protective factors (eg, resilience and community assets). Implications and future directions are discussed.
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Affiliation(s)
- Tamara Taggart
- Department of Prevention and Community Health, George Washington University, Washington, DC; Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT
| | - Norweeta G Milburn
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA
| | - Kate Nyhan
- Yale School of Public Health; Harvey Cushing/John Hay Whitney Medical Library, Department of Environmental Health Sciences, Yale University, New Haven, CT
| | - Tiarney D Ritchwood
- Department of Family Medicine and Community Health, Duke University School of Medicine, Durham, NC
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Simpson EK, McDermott CP, Hild LE. Needs of Transitionally Housed Young People to Promote Occupational Participation. Occup Ther Health Care 2020; 34:62-80. [PMID: 32153251 DOI: 10.1080/07380577.2020.1737895] [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: 10/24/2022]
Abstract
This qualitative descriptive study explored what young people who are transitionally housed need to promote occupational participation. Nine young people and four staff members from a transitional living facility participated in interviews and focus groups. Results suggested that the young people need opportunities to practice independent living skills, develop routines to support employment, housing, and education, and receive more individualized support from service providers. Findings also reveal that service providers experience a range of barriers to meeting young people's needs. This study underscores the importance of occupational therapy practitioners being informed of national and regional policies as well as emerging evidence of innovative approaches with populations, communities, and individuals so as to ultimately develop novel, collaborative, occupation-based programs to help young people set goals and transition out of homelessness.
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Affiliation(s)
- Emily K Simpson
- Occupational Therapy Program, Midwestern University, Downers Grove, IL, USA
| | - Callan P McDermott
- Occupational Therapy Program, Midwestern University, Downers Grove, IL, USA
| | - Lauren E Hild
- Occupational Therapy Program, Midwestern University, Downers Grove, IL, USA
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