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Merians AN, Mischel E, Frazier P, Lust K. Relationships between childhood adversity and life functioning in US college students: Risk and resilience. J Am Coll Health 2024; 72:71-81. [PMID: 35108156 DOI: 10.1080/07448481.2021.2024205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 03/16/2021] [Accepted: 12/26/2021] [Indexed: 06/14/2023]
Abstract
Objective: We examined the relationships between adverse childhood experiences (ACEs) and measures of mental health, academic achievement, and consequences of alcohol use, and moderators of these associations. We hypothesized that most students with high (3+) ACEs scores would be resilient on at least one measure but that few would be resilient on all measures. Additionally, we expected that greater social support and coping self-efficacy would buffer the association between ACEs and outcomes.Participants and methods: Secondary analysis of survey data from undergraduate students collected in 2015 (N = 8,997) and 2018 (N = 7,924).Results: The majority of students with high ACEs scores were resilient on each measure; 34% were resilient across all three. More students without ACEs were resilient on each measure and across all measures. Higher coping self-efficacy buffered the association between ACEs and poorer mental health.Conclusions: Research on ACEs in students should acknowledge resilience and risk.
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Affiliation(s)
- Addie N Merians
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Emily Mischel
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Patricia Frazier
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Katherine Lust
- Boynton Health Service, University of Minnesota, Minneapolis, Minnesota, USA
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Spiller TR, Na PJ, Merians AN, Duek O, Ben-Zion Z, Tsai J, von Känel R, Harpaz-Rotem I, Pietrzak RH. Changes in mental health among U.S. military veterans during the COVID-19 pandemic: A network analysis. J Psychiatr Res 2023; 165:352-359. [PMID: 37595331 DOI: 10.1016/j.jpsychires.2023.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 07/17/2023] [Accepted: 08/08/2023] [Indexed: 08/20/2023]
Abstract
Increases of symptoms of posttraumatic stress disorder (PTSD), anxiety and depression have been observed among individuals exposed to potentially traumatic events in the first months of the COVID-19 pandemic. Similarly, associations among different aspects of mental health, such as symptoms of PTSD and suicidal ideation, have also been documented. However, studies including an assessment prior to the onset and during the height of the pandemic are lacking. We investigated changes in symptoms of PTSD, depression, anxiety, suicidal ideation, and posttraumatic growth in a population-based sample of 1232 U.S. military veterans who experienced a potentially traumatic event during the first year of the pandemic. Symptoms were assessed prior to (fall/winter 2019) and one year into the pandemic (fall/winter 2020). We compared changes in symptom interrelations using network analysis, and assessed their associations with pandemic-related PTSD and posttraumatic growth symptoms. A subtle increase in psychopathological symptoms and a decrease in posttraumatic growth was observed one year into the pandemic. The peripandemic network was more densely connected, and pandemic-related PTSD symptoms were positively associated with age, anxiety, worst-event PTSD symptoms, and pandemic-related posttraumatic growth. Our findings highlight the resilience of veterans exposed to a potentially traumatic event during the first year of a pandemic. Similarly, the networks did not fundamentally change from prepandemic to one year into the pandemic. Despite this relative stability on a group level, individual reactions to potentially traumatic events could have varied substantially. Clinicians should individualize their assessments but be aware of the general resilience of most veterans.
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Affiliation(s)
- Tobias R Spiller
- US Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, 06516, USA; Department of Psychiatry, Yale School of Medicine, New Haven, CT, 06510, USA; Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
| | - Peter J Na
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, 06510, USA; VA Connecticut Healthcare System, West Haven, CT, 06516, USA
| | - Addie N Merians
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, 06510, USA; Psychology Service, VA Connecticut Healthcare System, West Haven, CT, USA
| | - Or Duek
- US Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, 06516, USA; Department of Psychiatry, Yale School of Medicine, New Haven, CT, 06510, USA; Department of Epidemiology, Biostatistics and Community Health Sciences, School of Public Health, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Ziv Ben-Zion
- US Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, 06516, USA; Department of Psychiatry, Yale School of Medicine, New Haven, CT, 06510, USA
| | - Jack Tsai
- U.S. Department of Veterans Affairs National Center on Homelessness Among Veterans, Tampa, FL, USA; School of Public Health, University of Texas Health Science Center at Houston, TX, USA
| | - Roland von Känel
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Ilan Harpaz-Rotem
- US Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, 06516, USA; Department of Psychiatry, Yale School of Medicine, New Haven, CT, 06510, USA; Department of Psychology, Yale University, New Haven, CT, 06510, USA
| | - Robert H Pietrzak
- US Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, 06516, USA; Department of Psychiatry, Yale School of Medicine, New Haven, CT, 06510, USA; Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, 06510, USA
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Webermann AR, Merians AN, Gross GM, Portnoy GA, Rosen MI, Pietrzak RH. Military Sexual Trauma and its Association with Mental Health Among Sexual Minority and Heterosexual Veterans in the United States. LGBT Health 2023; 10:S61-S69. [PMID: 37754922 DOI: 10.1089/lgbt.2023.0074] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/28/2023] Open
Abstract
Purpose: The purpose of this study was to examine the prevalence of military sexual trauma (MST) by sexual orientation, characteristics of sexual minority (SM) and heterosexual veterans who have experienced MST, and associations between sexual orientation and mental health symptoms among veterans who have experienced MST. Methods: Data were analyzed from a nationally representative web-based survey of 4069 U.S. veterans (4.9% SM), which assessed sociodemographic (e.g., age, sexual orientation) and military (e.g., branch) characteristics, and lifetime and current mental health symptoms. Bivariate analyses compared sociodemographic and military characteristics and mental health symptoms among veterans who have experienced MST by sexual orientation. Multivariable logistic regressions examined associations between sexual orientation and mental health symptoms among veterans who have experienced MST, while controlling for differences in sociodemographic characteristics and non-MST traumatic events. Results: The prevalence of MST (7.5% of weighted sample) was higher among SM veterans compared to heterosexual veterans, with bisexual/pansexual/queer veterans endorsing the highest prevalence (22.7%), followed by gay/lesbian (17.0%) and heterosexual (6.5%) veterans. SM veterans who experienced MST were more likely than heterosexual veterans to screen positive for lifetime and current posttraumatic stress disorder (odds ratio [OR] = 3.06 and 3.38, respectively), and current drug use disorder (OR = 3.53). Conclusions: This study adds to growing evidence that mental health symptoms associated with MST disproportionately impact SM veterans relative to heterosexual veterans. Approaches to reducing barriers and tailoring MST-related care to SM veterans, including through addressing cumulative effects of minority stress, are discussed.
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Affiliation(s)
- Aliya R Webermann
- VA Connecticut Healthcare System, West Haven, Connecticut, USA
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
| | - Addie N Merians
- VA Connecticut Healthcare System, West Haven, Connecticut, USA
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
| | - Georgina M Gross
- VA Connecticut Healthcare System, West Haven, Connecticut, USA
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
- Northeast Program Evaluation Center, VA Connecticut Healthcare System, West Haven, Connecticut, USA
| | - Galina A Portnoy
- VA Connecticut Healthcare System, West Haven, Connecticut, USA
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
| | - Marc I Rosen
- VA Connecticut Healthcare System, West Haven, Connecticut, USA
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
| | - Robert H Pietrzak
- VA Connecticut Healthcare System, West Haven, Connecticut, USA
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
- National Center for PTSD, West Haven, Connecticut, USA
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Merians AN, Gross G, Spoont MR, Bellamy CD, Harpaz-Rotem I, Pietrzak RH. Racial and ethnic mental health disparities in U.S. Military Veterans: Results from the National Health and Resilience in Veterans Study. J Psychiatr Res 2023; 161:71-76. [PMID: 36905842 DOI: 10.1016/j.jpsychires.2023.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 02/14/2023] [Accepted: 03/02/2023] [Indexed: 03/13/2023]
Abstract
Despite military veterans having a higher prevalence of several common psychiatric disorders relative to non-veterans, scarce population-based research has examined racial/ethnic differences in these disorders. The aim of this study was to examine racial/ethnic differences in the prevalence of psychiatric outcomes in a population-based sample of White, Black, and Hispanic military veterans, and to examine the role of intersectionality between sociodemographic variables and race/ethnicity in predicting these outcomes. Data were analyzed from the National Health and Resilience in Veterans Study (NHRVS), a contemporary, nationally representative survey of 4069 US veterans conducted in 2019-2020. Outcomes include self-report screening measures of lifetime and current psychiatric disorders, and suicidality. Results revealed that Hispanic and Black veterans were more likely than White veterans to screen positive for lifetime posttraumatic stress disorder (PTSD; 17.8% and 16.7% vs. 11.1%, respectively); Hispanic veterans were more likely than White veterans to screen positive for lifetime major depressive disorder (22.0% vs. 16.0%); Black veterans were more likely than White veterans to screen positive for current PTSD (10.1% vs. 5.9%) and drug use disorder (12.9% vs. 8.7%); and Hispanic veterans were more likely than Black veterans to report current suicidal ideation (16.2% vs. 8.1%). Racial/ethnic minority status interacted with lower household income, younger age, and female sex in predicting greater likelihood of some of these outcomes. Results of this population-based study suggest a disproportionate burden of certain psychiatric disorders among racial/ethnicity minority veterans, and identify high-risk subgroups that can be targeted in prevention and treatment efforts.
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Affiliation(s)
- Addie N Merians
- Department of Psychiatry, Yale School of Medicine, 300 George St #901, New Haven, CT, 06511, USA; U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, 950 Campbell Ave, West Haven, CT, 06516, USA.
| | - Georgina Gross
- Department of Psychiatry, Yale School of Medicine, 300 George St #901, New Haven, CT, 06511, USA; Northeast Program Evaluation Center, VA Connecticut Healthcare System, 950 Campbell Avenue, West Haven, CT, 06516, USA
| | - Michele R Spoont
- U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, 950 Campbell Ave, West Haven, CT, 06516, USA; Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, 1 Veterans Drive, Minneapolis, MN, 55417, USA
| | - Chyrell D Bellamy
- Department of Psychiatry, Yale School of Medicine, 300 George St #901, New Haven, CT, 06511, USA
| | - Ilan Harpaz-Rotem
- Department of Psychiatry, Yale School of Medicine, 300 George St #901, New Haven, CT, 06511, USA; U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, 950 Campbell Ave, West Haven, CT, 06516, USA
| | - Robert H Pietrzak
- Department of Psychiatry, Yale School of Medicine, 300 George St #901, New Haven, CT, 06511, USA; U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, 950 Campbell Ave, West Haven, CT, 06516, USA
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Abstract
Post-traumatic stress disorder (PTSD) is characterized by symptoms of re-experiencing, avoidance, negative alterations in cognition and mood, and marked alterations in arousal and reactivity following exposure to a traumatic event. PTSD can be assessed by structured interviews and screening measures in psychiatric and nonpsychiatric settings. Evidence-based psychotherapies are the first-line treatment of PTSD, with cognitive behavioral therapies, such as prolonged exposure, cognitive processing therapy, and eye movement desensitization and reprocessing having the largest body and highest quality of evidence. Serotonin reuptake inhibitors are the first-line pharmacologic treatments for PTSD and are often used in conjunction with other therapeutic interventions.
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Affiliation(s)
- Addie N Merians
- Clinical Neurosciences Division, United States Department of Veterans Affairs, National Center for Posttraumatic Stress Disorder, West Haven, CT, USA; Department of Psychiatry, Yale School of Medicine, 300 George Street #901, New Haven, CT 06511, USA
| | - Tobias Spiller
- Clinical Neurosciences Division, United States Department of Veterans Affairs, National Center for Posttraumatic Stress Disorder, West Haven, CT, USA; Department of Psychiatry, Yale School of Medicine, 300 George Street #901, New Haven, CT 06511, USA
| | - Ilan Harpaz-Rotem
- Clinical Neurosciences Division, United States Department of Veterans Affairs, National Center for Posttraumatic Stress Disorder, West Haven, CT, USA; Department of Psychiatry, Yale School of Medicine, 300 George Street #901, New Haven, CT 06511, USA
| | - John H Krystal
- Clinical Neurosciences Division, United States Department of Veterans Affairs, National Center for Posttraumatic Stress Disorder, West Haven, CT, USA; Department of Psychiatry, Yale School of Medicine, 300 George Street #901, New Haven, CT 06511, USA.
| | - Robert H Pietrzak
- Clinical Neurosciences Division, United States Department of Veterans Affairs, National Center for Posttraumatic Stress Disorder, West Haven, CT, USA; Department of Psychiatry, Yale School of Medicine, 300 George Street #901, New Haven, CT 06511, USA
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McGuire AP, Fagan J, Tsai J, Merians AN, Nichter B, Norman S, Southwick SM, Pietrzak RH. Dispositional gratitude predicts the development of psychopathology and suicidal behaviors: Results from a 7-year population-based study of U.S. military veterans. J Psychiatr Res 2022; 149:168-176. [PMID: 35278781 PMCID: PMC9017955 DOI: 10.1016/j.jpsychires.2022.02.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 02/15/2022] [Accepted: 02/28/2022] [Indexed: 10/19/2022]
Abstract
BACKGROUND Dispositional gratitude has been implicated as a psychological characteristic that may modulate risk for mental health outcomes. Using a population-based sample of U.S. military veterans, this study evaluated the association between dispositional gratitude and the development of psychopathology and suicidal behaviors over a 7-year period. METHODS A nationally representative sample of U.S. veterans was surveyed at four timepoints across seven years. Analyses were restricted to veterans without incident outcomes at baseline. Multivariable analyses were conducted to examine the relation between baseline levels of dispositional gratitude and risk of developing (a) major depressive disorder (MDD), generalized anxiety disorder (GAD), or posttraumatic stress disorder (PTSD); (b) suicidal ideation; and (c) suicide attempts. RESULTS A total 9.6% of veterans developed MDD, GAD, and/or PTSD, 9.5% developed suicidal ideation, and 2.8% reported having attempted suicide over the 7-year follow-up period. Among veterans with high levels of dispositional gratitude, incidence was lower for MDD/GAD/PTSD (8.0%), suicidal ideation (6.8%), and suicide attempts (1.5%). Conversely, veterans with low dispositional gratitude were at substantially higher risk of developing MDD/GAD/PTSD (27.7%), suicidal ideation (33.6%), and suicide attempts (20.3%). CONCLUSIONS High dispositional gratitude may help protect against the development of psychopathology and suicidal behaviors in U.S. military veterans, whereas low gratitude may increase risk of developing these outcomes. Collectively, these results support the potential utility of enhancing gratitude as part of primary prevention efforts for veterans, service members, and other populations at heightened risk for adverse mental health outcomes.
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Affiliation(s)
- Adam P. McGuire
- Department of Psychology and Counseling, The University of Texas at Tyler, 3900 University Blvd, Tyler, TX 75799, USA,VISN 17 Center of Excellence for Research on Returning War Veterans, 4800 Memorial Dr (151C), Waco, TX 76711, USA,Central Texas Veterans Health Care System, 1901 Veterans Memorial Dr, Temple, TX 76504, USA
| | - Joanna Fagan
- Department of Psychology and Counseling, The University of Texas at Tyler, 3900 University Blvd, Tyler, TX 75799, USA
| | - Jack Tsai
- U.S. Department of Veterans Affairs National Center on Homelessness Among Veterans, Tampa, FL, USA,School of Public Health, University of Texas Health Science Center at Houston, 1200 Pressler Street, Houston, TX 77030, USA,Department of Psychiatry, Yale School of Medicine, 300 George St #901, New Haven, CT 06511, USA
| | - Addie N. Merians
- Department of Psychiatry, Yale School of Medicine, 300 George St #901, New Haven, CT 06511, USA,U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, 950 Campbell Ave, West Haven, CT 06516, USA
| | - Brandon Nichter
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA
| | - Sonya Norman
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA,National Center for PTSD, VA Medical Center, 215 N Main St, White River Junction, VT 05005, USA,VA Center of Excellence for Stress and Mental Health, 3350 La Jolla Village Dr, San Diego, CA 92161, USA
| | - Steven M. Southwick
- Department of Psychiatry, Yale School of Medicine, 300 George St #901, New Haven, CT 06511, USA
| | - Robert H. Pietrzak
- Department of Psychiatry, Yale School of Medicine, 300 George St #901, New Haven, CT 06511, USA,U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, 950 Campbell Ave, West Haven, CT 06516, USA,Department of Social and Behavioral Sciences, Yale School of Public Health, 60 College St, New Haven, CT 06510, USA
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Merians AN, Na PJ, Tsai J, Harpaz-Rotem I, Pietrzak RH. Mental Health Burden in Enlisted and Commissioned U.S. Military Veterans: Importance of Indirect Trauma Exposure in Commissioned Veterans. Psychiatry 2022; 85:418-432. [PMID: 35532217 DOI: 10.1080/00332747.2022.2068301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To: 1) identify sociodemographic and military differences between enlisted and commissioned U.S. military veterans; (2) examine sociodemographic, military, trauma, and mental health histories of enlisted and commissioned veterans; and (3) evaluate interactions between enlistment status and trauma exposures in relation to mental health. METHOD Data were analyzed from the National Health and Resilience in Veterans Study, a nationally representative sample of U.S. military veterans. Screening instruments were used to assess posttraumatic stress disorder (PTSD), major depressive disorder (MDD), generalized anxiety disorder (GAD), alcohol and drug use disorders (AUD, DUD), and suicidal ideation (SI). Post-stratification weights were applied to analyses to permit generalizability to the U.S. veteran population. RESULTS Enlisted veterans (7.5%-13.1%) were more likely than commissioned veterans (3.5%-11.1%) to screen positive for most mental health outcomes. Multivariable analyses revealed enlisted veterans were more likely than commissioned veterans to report past-year SI (odds ratio [OR] = 2.48). Enlistment status interacted with exposure to potentially traumatic events (PTEs), such that greater exposure to indirect PTEs was associated with a greater likelihood of screening positive for PTSD (OR = 1.12) and GAD (OR = 1.10) among commissioned relative to enlisted veterans. Commissioned veterans with higher exposures to adverse childhood experiences had increased odds (OR = 1.36) of endorsing SI relative to enlisted veterans. CONCLUSIONS The study found that while enlisted veterans had higher rates of SI relative to commissioned veterans, commissioned veterans with higher exposure to indirect PTEs may have an increased risk of screening positive for PTSD and GAD.
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Merians AN, Baker MR, Frazier P, Lust K. Outcomes related to adverse childhood experiences in college students: Comparing latent class analysis and cumulative risk. Child Abuse Negl 2019; 87:51-64. [PMID: 30064695 DOI: 10.1016/j.chiabu.2018.07.020] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2017] [Revised: 04/25/2018] [Accepted: 07/16/2018] [Indexed: 05/13/2023]
Abstract
The aims of this study were to identify latent classes of adverse childhood experiences (ACEs) in a large sample of college students (N = 8997), investigate the relations between ACEs classes and life functioning, and compare results using latent class analysis to analyses using cumulative risk scores. Nine types of ACEs were assessed (three types of child abuse and six types of household dysfunction). Outcomes were self-report measures of mental health, physical health, alcohol consequences, and academic performance. Latent class analysis (LCA) results indicated that four classes fit the data best across random halves of the sample and were labeled High ACEs, Moderate Risk of Non-Violent Household Dysfunction, Emotional and Physical Child Abuse, and Low ACEs. Comparing across latent classes, the largest differences in outcomes were between the High ACEs and Low ACEs classes. There were no differences in outcomes between the Moderate Risk of Non-Violent Household Dysfunction and Emotional and Physical Child Abuse classes. The largest between-class differences were found for mental health and the smallest differences were found for academic performance. Comparing results using LCA latent classes and cumulative ACEs scores, the differences between the High and Low ACEs latent classes were similar to the differences between those with zero ACEs and those with 5 or more ACEs. Both approaches also accounted for roughly equivalent amounts of variance in all outcomes. Thus, latent class and cumulative risk analyses provided similar results with regard to predicting outcomes of interest among college students.
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Affiliation(s)
- Addie N Merians
- Department of Psychology, University of Minnesota Twin Cities, United States
| | - Majel R Baker
- Department of Psychology, University of Minnesota Twin Cities, United States
| | - Patricia Frazier
- Department of Psychology, University of Minnesota Twin Cities, United States.
| | - Katherine Lust
- Boynton Health, University of Minnesota Twin Cities, United States
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Nguyen-Feng VN, Frazier PA, Stockness A, Narayanan A, Merians AN, Misono S. Web-Based Perceived Present Control Intervention for Voice Disorders: A Pilot Study. J Voice 2018; 34:300.e1-300.e9. [PMID: 30227981 DOI: 10.1016/j.jvoice.2018.08.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 08/05/2018] [Accepted: 08/09/2018] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Voice disorders are common and negatively affect various life domains such as occupational functioning and emotional well-being. Perceived present control, a factor that is amenable to change, may reduce the effect of voice disorders on these outcomes. This pilot study aimed to (1) establish the feasibility, usability, and acceptability of a web-based perceived present control intervention for individuals with voice disorders and (2) gather preliminary data on the effectiveness of the intervention. This study is the first to assess whether a web-based psychological intervention would decrease self-reported voice handicap in this population. METHODS Participants (N = 20) were recruited from an otolaryngology clinic at a large, Midwest university and the surrounding urban community, and completed a 3-week web-based intervention that incorporated psychoeducation and written exercises on increasing perceived present control. RESULTS Supporting feasibility, the intervention components had high completion rates (75%-95%). Most participants planned to continue the perceived control exercises after study completion and would recommend the intervention to others, demonstrating usability and acceptability. There was a significant decrease in self-reported voice handicap (Voice Handicap Index-10) from pretest (M = 18.38, standard deviation = 4.41) to post-test (M = 15.22, standard deviation = 4.55) with a large effect size (within-group d = -0.86, P < 0.05). CONCLUSIONS Focusing on perceived present control as a teachable skill may be a useful addition to voice disorder treatment armamentarium. Future studies will incorporate a comparison group and larger sample sizes to assess further the role of perceived present control interventions in voice care.
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Affiliation(s)
- Viann N Nguyen-Feng
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota; Department of Otolaryngology, School of Medicine, University of Minnesota, Minneapolis, Minnesota; Department of Computer Science and Engineering, University of Minnesota, Minneapolis, Minnesota
| | - Patricia A Frazier
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota; Department of Otolaryngology, School of Medicine, University of Minnesota, Minneapolis, Minnesota; Department of Computer Science and Engineering, University of Minnesota, Minneapolis, Minnesota
| | - Ali Stockness
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota; Department of Otolaryngology, School of Medicine, University of Minnesota, Minneapolis, Minnesota; Department of Computer Science and Engineering, University of Minnesota, Minneapolis, Minnesota
| | - Arvind Narayanan
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota; Department of Otolaryngology, School of Medicine, University of Minnesota, Minneapolis, Minnesota; Department of Computer Science and Engineering, University of Minnesota, Minneapolis, Minnesota
| | - Addie N Merians
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota; Department of Otolaryngology, School of Medicine, University of Minnesota, Minneapolis, Minnesota; Department of Computer Science and Engineering, University of Minnesota, Minneapolis, Minnesota
| | - Stephanie Misono
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota; Department of Otolaryngology, School of Medicine, University of Minnesota, Minneapolis, Minnesota; Department of Computer Science and Engineering, University of Minnesota, Minneapolis, Minnesota.
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Nguyen-Feng VN, Baker MR, Merians AN, Frazier PA. Sexual victimization, childhood emotional abuse, and distress: Daily coping and perceived control as mediators. J Couns Psychol 2017; 64:672-683. [DOI: 10.1037/cou0000244] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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