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MacLean RR, Ankawi B, Driscoll MA, Gordon MA, Frankforter TL, Nich C, Szollosy SK, Loya JM, Brito L, Ribeiro MIP, Edmond SN, Becker WC, Martino S, Sofuoglu M, Heapy AA. Efficacy of Integrating the Management of Pain and Addiction via Collaborative Treatment (IMPACT) in Individuals With Chronic Pain and Opioid Use Disorder: Protocol for a Randomized Clinical Trial of a Digital Cognitive Behavioral Treatment. JMIR Res Protoc 2024; 13:e54342. [PMID: 38506917 PMCID: PMC10993119 DOI: 10.2196/54342] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 01/25/2024] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND Chronic pain is common among individuals with opioid use disorder (OUD) who are maintained on medications for OUD (MOUD; eg, buprenorphine or methadone). Chronic pain is associated with worse retention and higher levels of substance use. Treatment of individuals with chronic pain receiving MOUD can be challenging due to their increased clinical complexity. Given the acute and growing nature of the opioid crisis, MOUD is increasingly offered in a wide range of settings, where high-quality, clinician-delivered, empirically validated behavioral treatment for chronic pain may not be available. Therefore, digital treatments that support patient self-management of chronic pain and OUD have the potential for wider implementation to fill this gap. OBJECTIVE This study aims to evaluate the efficacy of Integrating the Management of Pain and Addiction via Collaborative Treatment (IMPACT), an interactive digital treatment program with asynchronous coach feedback, compared to treatment as usual (TAU) in individuals with chronic pain and OUD receiving MOUD. METHODS Adult participants (n=160) receiving MOUD and reporting bothersome or high-impact chronic pain will be recruited from outpatient opioid treatment programs in Connecticut (United States) and randomized 1:1 to either IMPACT+TAU or TAU only. Participants randomized to IMPACT+TAU will complete an interactive digital treatment that includes 9 modules promoting training in pain and addiction coping skills and a progressive walking program. The program is augmented with a weekly personalized voice message from a trained coach based on daily participant-reported pain intensity and interference, craving to use opioids, sleep quality, daily steps, pain self-efficacy, MOUD adherence, and engagement with IMPACT collected through digital surveys. Outcomes will be assessed at 3, 6, and 9 months post randomization. The primary outcome is MOUD retention at 3 months post randomization (ie, post treatment). Secondary outcomes include pain interference, physical functioning, MOUD adherence, substance use, craving, pain intensity, sleep disturbance, pain catastrophizing, and pain self-efficacy. Semistructured qualitative interviews with study participants (n=34) randomized to IMPACT (completers and noncompleters) will be conducted to evaluate the usability and quality of the program and its outcomes. RESULTS The study has received institutional review board approval and began recruitment at 1 site in July 2022. Recruitment at a second site started in January 2023, with a third and final site anticipated to begin recruitment in January 2024. Data collection is expected to continue through June 2025. CONCLUSIONS Establishing efficacy for a digital treatment for addiction and chronic pain that can be integrated into MOUD clinics will provide options for individuals with OUD, which reduce barriers to behavioral treatment. Participant feedback on the intervention will inform updates or modifications to improve engagement and efficacy. TRIAL REGISTRATION ClinicalTrials.gov NCT05204576; https://clinicaltrials.gov/ct2/show/NCT05204576. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/54342.
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Affiliation(s)
- R Ross MacLean
- VA Connecticut Healthcare System, West Haven, CT, United States
- School of Medicine, Yale University, New Haven, CT, United States
| | - Brett Ankawi
- School of Medicine, Yale University, New Haven, CT, United States
- Pain Research, Informatics, Multimorbidities, and Education (PRIME) Health Services Research and Development Center of Innovation, VA Connecticut Healthcare System, West Haven, CT, United States
| | - Mary A Driscoll
- School of Medicine, Yale University, New Haven, CT, United States
- Pain Research, Informatics, Multimorbidities, and Education (PRIME) Health Services Research and Development Center of Innovation, VA Connecticut Healthcare System, West Haven, CT, United States
| | - Melissa A Gordon
- School of Medicine, Yale University, New Haven, CT, United States
| | | | - Charla Nich
- School of Medicine, Yale University, New Haven, CT, United States
| | - Sara K Szollosy
- VA Connecticut Healthcare System, West Haven, CT, United States
| | - Jennifer M Loya
- School of Medicine, Yale University, New Haven, CT, United States
| | - Larissa Brito
- School of Medicine, Yale University, New Haven, CT, United States
| | | | - Sara N Edmond
- School of Medicine, Yale University, New Haven, CT, United States
- Pain Research, Informatics, Multimorbidities, and Education (PRIME) Health Services Research and Development Center of Innovation, VA Connecticut Healthcare System, West Haven, CT, United States
| | - William C Becker
- School of Medicine, Yale University, New Haven, CT, United States
- Pain Research, Informatics, Multimorbidities, and Education (PRIME) Health Services Research and Development Center of Innovation, VA Connecticut Healthcare System, West Haven, CT, United States
| | - Steve Martino
- VA Connecticut Healthcare System, West Haven, CT, United States
- School of Medicine, Yale University, New Haven, CT, United States
| | - Mehmet Sofuoglu
- VA Connecticut Healthcare System, West Haven, CT, United States
- School of Medicine, Yale University, New Haven, CT, United States
| | - Alicia A Heapy
- School of Medicine, Yale University, New Haven, CT, United States
- Pain Research, Informatics, Multimorbidities, and Education (PRIME) Health Services Research and Development Center of Innovation, VA Connecticut Healthcare System, West Haven, CT, United States
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Loya JM, Wagner A, Pittman B, Davis MT. Differences in diagnostic rules used to determine borderline personality disorder impact prevalence and associations with clinically relevant variables: Findings from the National Epidemiologic Survey on Alcohol and Related Conditions-III. Personal Disord 2024; 15:60-73. [PMID: 38206863 PMCID: PMC10786338 DOI: 10.1037/per0000643] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2024]
Abstract
Borderline personality disorder (BPD) is a serious and understudied mental health condition associated with profound personal and public health consequences. Methodological differences in characterizing BPD may limit understanding the scope of the disorder's prevalence and effect. For example, using different diagnostic rules for BPD can affect apparent prevalence, comorbidity, and clinical presentation. This study examined how differences in diagnostic rules used to assign BPD diagnosis impacted its prevalence and associations with clinically relevant variables (e.g., demographics, comorbidity, treatment-seeking). Participants were a nationally representative sample of 36,309 noninstitutionalized U.S. adults. All variables were assessed via clinical interview (Alcohol Use Disorder and Associated Disabilities Interview Schedule-5). Six diagnostic rules determined BPD status. We used frequencies to examine prevalence rates of and associations between BPD and other clinical variables, and logistic regressions to examine the associations between each BPD variable and the other outcomes. The prevalence of BPD ranged widely-from 0.5% to 11.4%-per the diagnostic rule used. Associations between BPD diagnosis and various outcomes and clinical variables generally remained stable across all diagnostic rules, though effects became more extreme as diagnostic rules became more restrictive. Additionally, meaningful differences emerged as a function of the number of items used (30 vs. 18 items) even with no other changes to diagnostic rules. The field examining BPD and associated problem behaviors should critically consider how to most effectively characterize BPD to understand these problems more accurately and optimize the generalizability of findings. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
| | | | | | - Margaret T. Davis
- Department of Psychiatry, Yale School of Medicine
- Department of Psychology, Yale University
- National Center for PTSD Clinical Neurosciences Division, VA Connecticut Healthcare System
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Loya JM, Benitez B, Kiluk BD. The Effect of Cognitive Behavioral Therapy on Impulsivity in Addictive Disorders: a Narrative Review. Curr Addict Rep 2023; 10:485-493. [PMID: 38269068 PMCID: PMC10805411 DOI: 10.1007/s40429-023-00491-6] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/30/2023] [Indexed: 01/26/2024]
Abstract
Purpose of Review Impulsivity is considered an important construct in the cycle of addiction, yet the effect of evidence-based treatments on impulsivity is unclear. The goal of this paper was to review the evidence regarding the effect of cognitive behavioral therapy (CBT), one of the most studied psychotherapies for addiction, on measures of impulsivity in addictive disorders. Recent Findings There is a robust literature implicating impulsivity as risk factor for development of a range of addictions and poorer treatment outcomes. However, this review identified only four randomized controlled trials evaluating CBT for an addictive behavior that included repeated assessment of impulsivity. All four were studies targeting substance use. Summary There is limited evidence that CBT has a direct effect on change in measures of impulsivity among individuals being treated for substance use. Future clinical trials should include repeated measurement of impulsivity to examine CBT's effect on the underlying characteristics of addiction.
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Affiliation(s)
- Jennifer M. Loya
- Department of Psychiatry, Yale School of Medicine, New Haven, CT 06510, USA
| | - Bryan Benitez
- Department of Psychiatry, Yale School of Medicine, New Haven, CT 06510, USA
| | - Brian D. Kiluk
- Department of Psychiatry, Yale School of Medicine, New Haven, CT 06510, USA
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Loya JM, Babuscio TA, Nich C, Alessi SM, Rash C, Kiluk BD. Percentage of negative urine drug screens as a clinically meaningful endpoint for RCTs evaluating treatment for cocaine use. Drug Alcohol Depend 2023; 248:109947. [PMID: 37276806 PMCID: PMC10498479 DOI: 10.1016/j.drugalcdep.2023.109947] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 05/03/2023] [Accepted: 05/23/2023] [Indexed: 06/07/2023]
Abstract
BACKGROUND This study examined a threshold based on the percentage of cocaine-negative (CN) urine drug screens (UDS) collected during treatment as a potential meaningful endpoint for clinical trials. We hypothesized that individuals providing at least 75% CN UDS would have better long-term outcomes than those providing less than 75% CN UDS. METHODS Two separate pooled datasets of randomized clinical trials conducted at different institutions were used for analyses: one composed of eight trials (N = 760) and the other composed of three trials (N = 416), all evaluating behavioral and/or pharmacological treatments for cocaine use. UDS were collected at least once per week (up to three times per week) during the 8- or 12-week treatment period across all trials, with substance use and psychosocial functioning measured up to 12 months following treatment. Chi-squares and ANOVAs compared within-treatment and follow-up outcomes between the groups. RESULTS Compared to those who did not achieve the threshold, participants who achieved the 75%-CN threshold were retained in treatment longer and had a longer period of continuous abstinence, and were more likely to report problem-free functioning. Additionally, participants who achieved the 75%-CN threshold were more likely to report sustained abstinence and better psychosocial functioning throughout a follow-up period up to 12 months than those who did not achieve the threshold. CONCLUSIONS A threshold of 75%-CN UDS is associated with short- and long-term clinical benefits. Future clinical trials may consider this a meaningful threshold for defining treatment responders.
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Affiliation(s)
| | | | - Charla Nich
- Yale School of Medicine, New Haven, CT06510, United States
| | - Sheila M Alessi
- UConn Health School of Medicine, Farmington, CT06030, United States
| | - Carla Rash
- UConn Health School of Medicine, Farmington, CT06030, United States
| | - Brian D Kiluk
- Yale School of Medicine, New Haven, CT06510, United States
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McCurdy LY, Loya JM, Hart-Derrick VR, Young GC, Kiluk BD, Potenza MN. Smartphone Apps for Problem Gambling: A Review of Content and Quality. Curr Addict Rep 2023; 10:178-186. [PMID: 38463534 PMCID: PMC10919356 DOI: 10.1007/s40429-023-00479-2] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2023] [Indexed: 03/12/2024]
Abstract
Purpose of review Problem gambling can have profound consequences for affected individuals, yet only a small proportion of people with problem gambling seek treatment. Mobile phone applications (apps) may provide an effective and scalable therapeutic option. The purpose of this study was to evaluate publicly available mobile apps aimed at improving problematic gambling behavior. Recent findings To date, there are no published studies that have evaluated the quality of publicly available smartphone apps for problem gambling in the US. There is thus a significant gap in knowledge of existing apps for addressing problem gambling. Summary This study included a review of 14 problem-gambling-specific apps. Apps that incorporated cognitive-behavioral therapy concepts and in-app communities were associated with better aesthetics and information quality scores. Additionally, in-app communities were associated with better engagement scores. Our results highlight the importance of evidence-based and engaging features in apps designed to help people with problem gambling.
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Affiliation(s)
- Li Yan McCurdy
- Division of Prevention and Community Research, Yale
University School of Medicine, New Haven, CT 06511, USA
- Department of Psychiatry, Yale University School of
Medicine, New Haven, CT, 06510, USA
| | - Jennifer M Loya
- Department of Psychiatry, Yale University School of
Medicine, New Haven, CT, 06510, USA
| | | | - Griffin C Young
- Department of Computer Science, Stanford University School
of Engineering, Stanford, CA 94305
| | - Brian D Kiluk
- Department of Psychiatry, Yale University School of
Medicine, New Haven, CT, 06510, USA
| | - Marc N Potenza
- Department of Psychiatry, Yale University School of
Medicine, New Haven, CT, 06510, USA
- Child Study Center, Yale University School of Medicine, New
Haven, CT 06520, USA
- Department of Neuroscience, Yale University School of
Medicine, New Haven, CT 06510, USA
- The Connecticut Council on Problem Gambling, Wethersfield,
CT 06109, USA
- The Connecticut Mental Health Center, New Haven, CT 06519,
USA
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Loya JM, Tangney JP, Stuewig JB. Are Borderline Personality Disorder Features Differentially Related to Pre-Incarceration Alcohol, Cannabis, Cocaine, and Opioid Dependence Among People Recently Incarcerated in Jail? J Pers Disord 2022; 36:623-640. [PMID: 36181491 DOI: 10.1521/pedi.2022.36.5.623] [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] [Indexed: 11/20/2022]
Abstract
Borderline personality disorder (BPD) and substance use disorders (SUDs) commonly co-occur across various settings. However, little research has examined how BPD features relate to specific types of SUDs. This study examined whether BPD features assessed shortly after incarceration were differentially related to symptoms of dependence on alcohol, cannabis, cocaine, and opioids experienced in the 12 months prior to incarceration among 510 people recently incarcerated in jail. Follow-up multigroup analyses evaluated whether gender or race moderated the relation of BPD features to the four SUDs. Using structural equational modeling, the relationships of BPD features were compared to each of the four preincarceration dependence symptoms. BPD features were significantly related to dependence on each of the four substances, but the link between BPD features and cocaine dependence was stronger than BPD's association with alcohol, cannabis, or opioid dependence. These findings generalized across men and women and across White and Black people.
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Affiliation(s)
- Jennifer M Loya
- Yale School of Medicine, New Haven, Connecticut.,George Mason University, Fairfax, Virginia
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Roth MR, Loya JM, Yi R. The role of social value orientation on delay discounting in a group context. Personality and Individual Differences 2022. [DOI: 10.1016/j.paid.2021.111401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Berry MS, Johnson PS, Collado A, Loya JM, Yi R, Johnson MW. Sexual Probability Discounting: A Mechanism for Sexually Transmitted Infection Among Undergraduate Students. Arch Sex Behav 2019; 48:495-505. [PMID: 29582269 PMCID: PMC6365211 DOI: 10.1007/s10508-018-1155-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 01/02/2018] [Accepted: 01/15/2018] [Indexed: 05/03/2023]
Abstract
Lack of condom use among youth is a major contributor to the spread of sexually transmitted infections (STIs) including HIV/AIDS, which has lifelong deleterious health consequences. College students (N = 262) completed the Sexual Probability Discounting Task in which participants reported their likelihood of condom use under various probabilities of contracting an STI. Each participant completed the task in regard to different STIs including HIV/AIDS and different partners. Results showed that the likelihood of condom-protected sex generally decreased as HIV/AIDS and other STI contraction became less probable. Moreover, condom-protected sex likelihood was related to STI type (e.g., decreased condom-protected sex in chlamydia relative to HIV/AIDS condition) and partner desirability (decreased condom-protected sex with more desirable partners). Results are the first to show that compared to other STIs, HIV/AIDS had the most influence on condom-protected sex. Results showed probability discounting contributed to lack of condom-protected sex and offers a novel framework for examining determinants of within-subject variability in condom use.
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Affiliation(s)
- Meredith S. Berry
- Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Patrick S. Johnson
- Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Anahí Collado
- Department of Psychology, University of Maryland, College Park, MD
| | - Jennifer M. Loya
- Department of Psychology, University of Maryland, College Park, MD
| | - Richard Yi
- Department of Psychology, University of Maryland, College Park, MD
| | - Matthew W. Johnson
- Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD
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Loya JM, McCauley KL, Chronis-Tuscano A, Chen SZ, Gad A, MacPherson L, Lejuez CW. An experimental paradigm examining the influence of frustration on risk-taking behavior. Behav Processes 2018; 158:155-162. [PMID: 30366109 DOI: 10.1016/j.beproc.2018.10.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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] [Received: 02/13/2018] [Revised: 10/21/2018] [Accepted: 10/22/2018] [Indexed: 11/19/2022]
Abstract
The present study examined the impact of frustration on risk-taking in college students with low and high ADHD symptomatology (L-ADHD and H-ADHD). Participants completed the Balloon Analogue Risk Task (BART) following induced frustration from a mood manipulation task (experimental session) and following no mood manipulation (control session). A manipulation check revealed a significant three-way interaction where the H-ADHD group reported higher frustration levels compared to the L-ADHD group, particularly in response to the frustration induction in the experimental condition. Primary results revealed that the L-ADHD group exploded significantly fewer balloons in the experimental condition compared to the control condition; there was a nonsignificant difference of balloon explosions across conditions for the H-ADHD group. The study provides initial laboratory-based support for the impact of frustration on the risk behavior of those with low and high levels of ADHD, with potential implications for future studies and ultimately for intervention.
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Affiliation(s)
- Jennifer M Loya
- George Mason University, 4400 University Drive, MSN 3F5, Fairfax, VA 22030, United States; Center for Addictions, Personality, and Emotion Research, 2103 Cole Student Activities Building, College Park, MD 20742, United States.
| | - Katherine L McCauley
- Center for Addictions, Personality, and Emotion Research, 2103 Cole Student Activities Building, College Park, MD 20742, United States; VA Puget Sound, 1660 South Columbian Way, Seattle, WA 98108, United States
| | - Andrea Chronis-Tuscano
- University of Maryland, 1147C Biology/Psychology Building, College Park, MD 20742, United States
| | - Starr Z Chen
- Center for Addictions, Personality, and Emotion Research, 2103 Cole Student Activities Building, College Park, MD 20742, United States
| | - Abanoub Gad
- Center for Addictions, Personality, and Emotion Research, 2103 Cole Student Activities Building, College Park, MD 20742, United States
| | - Laura MacPherson
- Center for Addictions, Personality, and Emotion Research, 2103 Cole Student Activities Building, College Park, MD 20742, United States; Greenebaum Comprehensive Cancer Center, 22 S Greene Street, Baltimore, MD 21201, United States
| | - C W Lejuez
- Center for Addictions, Personality, and Emotion Research, 2103 Cole Student Activities Building, College Park, MD 20742, United States; Cofrin Logan Center for Addiction Research and Treatment, University of Kansas, Strong Hall, Room 250, Lawrence, KS 66045, United States
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Boren EA, Folk JB, Loya JM, Tangney JP, Barboza SE, Wilson JS. The Suicidal Inmate: A Comparison of Inmates Who Attempt Versus Complete Suicide. Suicide Life Threat Behav 2018; 48:570-579. [PMID: 28816363 PMCID: PMC5816720 DOI: 10.1111/sltb.12374] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Accepted: 05/12/2017] [Indexed: 11/30/2022]
Abstract
The aim of this study was to identify risk factors distinguishing inmates who attempt suicide from inmates who complete suicide. Compared with attempters, completers tended to be older, male, more educated, and married or separated/divorced; pretrial, committed for a violent crime, incarcerated in jail, housed in an inpatient mental health unit or protective custody setting, living in a single cell, not on suicide precautions, not previously under close observation; and more likely to act during overnight hours and die by hanging/self-strangulation. Targeted assessment of a broad range of risk factors is necessary to inform suicide prevention efforts in correctional facilities.
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Affiliation(s)
- Emily A Boren
- Department of Psychology (MSN 3F5), George Mason University, Fairfax, VA, USA
| | - Johanna B Folk
- Department of Psychology (MSN 3F5), George Mason University, Fairfax, VA, USA
| | - Jennifer M Loya
- Department of Psychology (MSN 3F5), George Mason University, Fairfax, VA, USA
| | - June P Tangney
- Department of Psychology (MSN 3F5), George Mason University, Fairfax, VA, USA
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Folk JB, Loya JM, Alexoudis EA, Tangney JP, Wilson JS, Barboza SE. Differences between inmates who attempt suicide and who die by suicide: Staff-identified psychological and treatment-related risk factors. Psychol Serv 2018; 15:349-356. [PMID: 30080094 DOI: 10.1037/ser0000228] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Suicidal behavior occurs at much higher rates in correctional facilities than in the community, yet little is known about factors that distinguish inmates at risk for attempting versus dying by suicide. Individuals in the current study included 925 inmates housed in 2 large U.S. jails and 8 state correctional systems who attempted (79.5%) or died by (20.5%) suicide for whom archival data were available. Mental health professionals completed a tracking sheet after suicide-related incidents, documenting inmate psychological, diagnostic, and treatment related risk factors. Differences between inmates who attempt versus those who die by suicide indicate that when mental health staff are aware of inmates' current and historical risk factors, deaths by suicide are less likely to occur. (PsycINFO Database Record
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12
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Loya JM, Roth MR, Yi R. An examination of group size and valence in delay discounting of shared outcomes. Behav Processes 2018; 157:673-677. [PMID: 29625177 DOI: 10.1016/j.beproc.2018.04.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 01/17/2018] [Revised: 03/30/2018] [Accepted: 04/02/2018] [Indexed: 11/25/2022]
Abstract
Previous research has examined delay discounting in a group context, where the outcomes are shared with others. These studies indicate shallow delay discounting in a group context compared to an individual context. The present set of studies aimed to explore the impact of two factors, group size (the number of others in the group) and group valence (liked or disliked others in the group), that may affect delay discounting in a group context. Results of the two studies replicated previous results, where shallow delay discounting was observed in the group context compared to the individual context. While Study 1 indicated no effects of group size nor of valence, Study 2 indicated shallow delay discounting for a larger group compared to a smaller group and for liked others compared to disliked others. These results contribute the nascent literature on delay discounting in group contexts.
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Affiliation(s)
- Jennifer M Loya
- George Mason University, 4400 University Drive, MSN 3F5, Fairfax, VA 22030, United States.
| | | | - Richard Yi
- University of Florida, P.O. Box 118210, Gainesville, FL 32611, United States.
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Collado A, Johnson PS, Loya JM, Johnson MW, Yi R. Discounting of Condom-Protected Sex as a Measure of High Risk for Sexually Transmitted Infection Among College Students. Arch Sex Behav 2017; 46:2187-2195. [PMID: 27699562 PMCID: PMC5893305 DOI: 10.1007/s10508-016-0836-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Revised: 08/02/2016] [Accepted: 08/09/2016] [Indexed: 05/03/2023]
Abstract
The study examined sexual delay discounting, or the devaluation of condom-protected sex in the face of delay, as a risk factor for sexually transmitted infection (STI) among college students. Participants (143 females, 117 males) completed the sexual delay discounting task (Johnson & Bruner, 2012) and questionnaires of risky sexual behavior, risk perception, and knowledge. Participants exhibited steeper sexual delay discounting (above and beyond general likelihood of having unprotected sex) when partners were viewed as more desirable or less likely to have a STI, with males demonstrating greater sexual delay discounting than females across most conditions. Importantly, greater self-reported risky sexual behaviors were associated with higher rates of sexual delay discounting, but not with likelihood of using a condom in the absence of delay. These results provide support for considering sexual delay discounting, with particular emphasis on potential delays to condom use, as a risk factor for STI among college students.
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Affiliation(s)
- Anahí Collado
- Alvord, Baker, and Associates, LLC, 3200 Tower Oaks Blvd, Suite 200, Rockville, MD, 20852, USA.
| | - Patrick S Johnson
- Psychology Department, California State University-Chico, Chico, CA, USA
| | - Jennifer M Loya
- Psychology Department, George Mason University, Fairfax, VA, USA
| | - Matthew W Johnson
- School of Medicine, Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA
| | - Richard Yi
- Psychology Department, University of Maryland- College Park, College Park, MD, USA
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Collado A, Loya JM, Yi R. The Effects of Deprivation and Satiation on Decision-Making Related to Risky Sex. Psychol Rec 2016. [DOI: 10.1007/s40732-016-0168-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Bounoua N, Felton JF, Long K, Stadnik RD, Loya JM, MacPherson L, Lejuez CW. Childhood emotional abuse and borderline personality features: The role of anxiety sensitivity among adolescents. Personal Ment Health 2015; 9:87-95. [PMID: 25940514 DOI: 10.1002/pmh.1295] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Revised: 02/18/2015] [Accepted: 03/02/2015] [Indexed: 11/06/2022]
Abstract
Borderline personality disorder (BPD) is a pervasive personality disorder that poses a burden for affected individuals, their family members and society as a whole. Current research suggests that early childhood abuse, including emotional abuse, may be an important predictor of later BPD symptomology. Further, an emerging body of literature suggests that anxiety sensitivity (AS) may serve as a form of emotional vulnerability and be a key variable in the relation between abuse and the development of BPD symptomatology. This literature has relied on retrospective recall of abuse and AS in adult samples. As a result, there is a dearth of literature examining these variables in adolescence, which is a developmental period in which personality traits begin to emerge. This study explored the impact of AS in the development of BPD symptoms in a group of 277 adolescents. Results suggest a significant indirect effect of emotional abuse on BPD symptoms via AS, after controlling for sex, grade and prior levels of AS (indirect effect = 0.04, standard error (SE) = 0.02 (95% confidence interval (CI) = 0.001-0.070)). These findings suggest that, among adolescents, AS may serve as an important contributor to the development of BPD symptoms. Implications for interventions and future research are further discussed.
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Affiliation(s)
- Nadia Bounoua
- Center for Addictions, Personality and Emotion Research, Department of Psychology, University of Maryland, College Park, MD, 20742, USA
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