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Jackson R, Jordan JT. Reliable change in developmental outcomes of Brain Balance ® participants stratified by baseline severity. Front Psychol 2023; 14:1171936. [PMID: 37674742 PMCID: PMC10478577 DOI: 10.3389/fpsyg.2023.1171936] [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] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 08/04/2023] [Indexed: 09/08/2023] Open
Abstract
The effects of comprehensive multimodal programs on developmental outcomes have not been well-studied. Emerging evidence suggests a possible role for the Brain Balance® (BB) program, a multimodal training program, in serving as a nonpharmacologic approach to addressing cognitive, attentional, and emotional issues in youth. In this analysis, we examined the effects of 3 months of participation in the BB program on the outcomes of children and adolescents with developmental difficulties (N = 4,041; aged 4-18 years; 69.7% male). Parent-rated scores on the Brain Balance-Multidomain Developmental Survey (BB-MDS) were used to assess six areas at baseline and post-program: (1) negative emotionality; (2) reading/writing difficulties; (3) hyperactive/disruptive behavior; (4) academic disengagement; (5) motor/coordination problems; and (6) social communication problems. To estimate change from pre- to post-program, we calculated effect size (Cohen's d) and the Reliable Change Index (RCI) for groups stratified by baseline severity. There was a very large effect size for the moderate/high severity (d = 1.63) and extreme severity (d = 2.08) groups, and a large effect size for the mild severity group (d = 0.87). The average percentage of participants who observed reliable change over all BB-MDS domains was 60.1% (RCICTT) for extreme severity, 46.6% (RCICTT) for moderate/high severity, and 21.1% (RCICTT) for baseline mild severity. In additional assessments of primitive reflexes and sensory motor activity, students demonstrated significantly diminished primitive reflexes from pre- to post-participation and significant improvements in sensory motor skills including fine motor skills, gait and aerobic ability, proprioception, rhythm and timing, and eye-gaze stability. Overall, these results demonstrate improvements in primitive reflex integration and sensory motor skills, as well as statistically significant reliable change in emotionality, reading/writing, behavior, academic engagement, motor skills, and social communication in BB participants from pre- to post-program, with the probability and degree of change increasing as the participants' baseline severity increases. These results contribute to the growing literature on the need for evidence-based nonpharmacologic approaches to addressing developmental issues. Future research with well-controlled designs, longitudinal follow-up, implementation across settings, and participant groups in which diagnoses are known, will help to more fully characterize the effects of the BB program.
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Affiliation(s)
- Rebecca Jackson
- Brain Balance Achievement Centers, Naperville, IL, United States
| | - Joshua T. Jordan
- Department of Psychology, Dominican University of California, San Rafael, CA, United States
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2
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Nahum M, Sinvani RT, Afek A, Ben Avraham R, Jordan JT, Ben Shachar MS, Ben Yehuda A, Berezin Cohen N, Davidov A, Gilboa Y. Inhibitory control and mood in relation to psychological resilience: an ecological momentary assessment study. Sci Rep 2023; 13:13151. [PMID: 37573400 PMCID: PMC10423230 DOI: 10.1038/s41598-023-40242-1] [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] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 08/07/2023] [Indexed: 08/14/2023] Open
Abstract
Psychological resilience, the ability to adapt to adversity, is theorized to rely on intact inhibitory control (IC) mechanisms, which underlie one's ability to maintain goal-directed behavior by inhibiting prepotent responses. However, no study to date has explored daily fluctuations of IC performance in relation to resilience. Here, we examined the association between IC and mood measured daily in relation to psychological resilience in young adults in a stressful situation. Baseline resilience was obtained from 144 female and male soldiers during their basic combat training. Then, participants completed an ecological momentary assessment protocol, in which they reported their momentary mood and completed a short IC assessment twice/day for 2 weeks. A hierarchical linear modeling analysis revealed that psychological resilience moderated the relationship between momentary IC and momentary mood, such that better IC was associated with better mood only for those with higher, but not lower, self-reported psychological resilience at baseline. These results show that psychological resilience is manifested in the everyday association between IC and mood. Furthermore, they lend important support to cognitive models of resilience and may have significant contribution to our understanding of resilient behavior in real life.Trial Registration: MOH_2018-0-13_002451.
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Affiliation(s)
- Mor Nahum
- Faculty of Medicine, School of Occupational Therapy, The Hebrew University, Jerusalem, Israel.
| | - Rachel-Tzofia Sinvani
- Faculty of Medicine, School of Occupational Therapy, The Hebrew University, Jerusalem, Israel
| | - Anat Afek
- Faculty of Medicine, School of Occupational Therapy, The Hebrew University, Jerusalem, Israel
| | - Rina Ben Avraham
- Faculty of Medicine, School of Occupational Therapy, The Hebrew University, Jerusalem, Israel
| | - Joshua T Jordan
- Department of Psychology, Dominican University of California, San Rafael, CA, USA
| | | | - Ariel Ben Yehuda
- Department of Health and Well-Being, Medical Corps, Israel Defense Forces (IDF), Ramat Gan, Israel
- "Shalvata" Mental Health Center, "Clalit" Health Services, Hod-Hasharon, Israel
| | - Noa Berezin Cohen
- Department of Health and Well-Being, Medical Corps, Israel Defense Forces (IDF), Ramat Gan, Israel
| | - Alex Davidov
- Mental Health Section, Medical Services Center, Israel Defense Forces (IDF), Ramat Gan, Israel
| | - Yafit Gilboa
- Faculty of Medicine, School of Occupational Therapy, The Hebrew University, Jerusalem, Israel
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3
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Jordan JT, Chick CF, Rolle CE, Hantke N, Gould CE, Lutz J, Kawai M, Cotto I, Karna R, Pirog S, Berk M, Sudheimer K, O'Hara R, Beaudreau SA. Neurocognitive markers of passive suicidal ideation in late-life depression. Int Psychogeriatr 2023; 35:421-431. [PMID: 33118918 DOI: 10.1017/s1041610220003610] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 11/07/2022]
Abstract
OBJECTIVES (1) To delineate whether cognitive flexibility and inhibitory ability are neurocognitive markers of passive suicidal ideation (PSI), an early stage of suicide risk in depression and (2) to determine whether PSI is associated with volumetric differences in regions of the prefrontal cortex (PFC) in middle-aged and older adults with depression. DESIGN Cross-sectional study. SETTING University medical school. PARTICIPANTS Forty community-dwelling middle-aged and older adults with depression from a larger study of depression and anxiety (NIMH R01 MH091342-05 PI: O'Hara). MEASUREMENTS Psychiatric measures were assessed for the presence of a DSM-5 depressive disorder and PSI. A neurocognitive battery assessed cognitive flexibility, inhibitory ability, as well as other neurocognitive domains. RESULTS The PSI group (n = 18) performed significantly worse on cognitive flexibility and inhibitory ability, but not on other neurocognitive tasks, compared to the group without PSI (n = 22). The group with PSI had larger left mid-frontal gyri (MFG) than the no-PSI group. There was no association between cognitive flexibility/inhibitory ability and left MFG volume. CONCLUSIONS Findings implicate a neurocognitive signature of PSI: poorer cognitive flexibility and poor inhibitory ability not better accounted for by other domains of cognitive dysfunction and not associated with volumetric differences in the left MFG. This suggests that there are two specific but independent risk factors of PSI in middle- and older-aged adults.
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Affiliation(s)
- Joshua T Jordan
- Department of Psychology, Dominican University of California, San Rafael, CA, USA
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Christina F Chick
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
- Sierra Pacific Mental Illness Research, Education and Clinical Centers (MIRECC), VA Palo Alto Health Care System, Palo Alto, CA, USA
| | - Camarin E Rolle
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Nathan Hantke
- Mental Health and Clinical Neuroscience Division, VA Portland Health Care System, Portland, OR, USA
- Department of Neurology, Oregon Health and Science University, Portland, OR, USA
| | - Christine E Gould
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
- Geriatric Research, Education, and Clinical Centers (GRECC), VA Palo Alto Health Care System, Palo Alto, CA, USA
| | - Julie Lutz
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
| | - Makoto Kawai
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
- Sierra Pacific Mental Illness Research, Education and Clinical Centers (MIRECC), VA Palo Alto Health Care System, Palo Alto, CA, USA
| | - Isabelle Cotto
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Rosy Karna
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Sophia Pirog
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Michelle Berk
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Keith Sudheimer
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Ruth O'Hara
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
- Sierra Pacific Mental Illness Research, Education and Clinical Centers (MIRECC), VA Palo Alto Health Care System, Palo Alto, CA, USA
| | - Sherry A Beaudreau
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
- Sierra Pacific Mental Illness Research, Education and Clinical Centers (MIRECC), VA Palo Alto Health Care System, Palo Alto, CA, USA
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Samuelson KW, Dixon K, Jordan JT, Powers T, Sonderman S, Brickman S. Mental health and resilience during the coronavirus pandemic: A machine learning approach. J Clin Psychol 2021; 78:821-846. [PMID: 34633661 PMCID: PMC8657346 DOI: 10.1002/jclp.23254] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 09/12/2021] [Indexed: 12/11/2022]
Abstract
Objective This study explored risk and resilience factors of mental health functioning during the coronavirus disease (COVID‐19) pandemic. Methods A sample of 467 adults (M age = 33.14, 63.6% female) reported on mental health (depression, anxiety, posttraumatic stress disorder [PTSD], and somatic symptoms), demands and impacts of COVID‐19, resources (e.g., social support, health care access), demographics, and psychosocial resilience factors. Results Depression, anxiety, and PTSD rates were 44%, 36%, and 23%, respectively. Supervised machine learning models identified psychosocial factors as the primary significant predictors across outcomes. Greater trauma coping self‐efficacy and forward‐focused coping, but not trauma‐focused coping, were associated with better mental health. When accounting for psychosocial resilience factors, few external resources and demographic variables emerged as significant predictors. Conclusion With ongoing stressors and traumas, employing coping strategies that emphasize distraction over trauma processing may be warranted. Clinical and community outreach efforts should target trauma coping self‐efficacy to bolster resilience during a pandemic.
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Affiliation(s)
- Kristin W Samuelson
- Lyda Hill Institute for Human Resilience, University of Colorado at Colorado Springs, Colorado Springs, Colorado, USA
| | - Kelly Dixon
- Department of Psychology, University of Colorado at Colorado Springs, Colorado Springs, Colorado, USA
| | - Joshua T Jordan
- Department of Psychology, Dominican University of California, San Rafael, California, USA
| | - Tyler Powers
- Department of Psychology, University of Colorado at Colorado Springs, Colorado Springs, Colorado, USA
| | - Samantha Sonderman
- Department of Psychology, University of Colorado at Colorado Springs, Colorado Springs, Colorado, USA
| | - Sophie Brickman
- Department of Psychology, University of Colorado at Colorado Springs, Colorado Springs, Colorado, USA
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Rolle CE, Baumer FM, Jordan JT, Berry K, Garcia M, Monusko K, Trivedi H, Wu W, Toll R, Buckwalter MS, Lansberg M, Etkin A. Mapping causal circuit dynamics in stroke using simultaneous electroencephalography and transcranial magnetic stimulation. BMC Neurol 2021; 21:280. [PMID: 34271872 PMCID: PMC8283835 DOI: 10.1186/s12883-021-02319-0] [Citation(s) in RCA: 3] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 05/16/2021] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Motor impairment after stroke is due not only to direct tissue loss but also to disrupted connectivity within the motor network. Mixed results from studies attempting to enhance motor recovery with Transcranial Magnetic Stimulation (TMS) highlight the need for a better understanding of both connectivity after stroke and the impact of TMS on this connectivity. This study used TMS-EEG to map the causal information flow in the motor network of healthy adult subjects and define how stroke alters these circuits. METHODS Fourteen stroke patients and 12 controls received TMS to two sites (bilateral primary motor cortices) during two motor tasks (paretic/dominant hand movement vs. rest) while EEG measured the cortical response to TMS pulses. TMS-EEG based connectivity measurements were derived for each hemisphere and the change in connectivity (ΔC) between the two motor tasks was calculated. We analyzed if ΔC for each hemisphere differed between the stroke and control groups or across TMS sites, and whether ΔC correlated with arm function in stroke patients. RESULTS Right hand movement increased connectivity in the left compared to the right hemisphere in controls, while hand movement did not significantly change connectivity in either hemisphere in stroke. Stroke patients with the largest increase in healthy hemisphere connectivity during paretic hand movement had the best arm function. CONCLUSIONS TMS-EEG measurements are sensitive to movement-induced changes in brain connectivity. These measurements may characterize clinically meaningful changes in circuit dynamics after stroke, thus providing specific targets for trials of TMS in post-stroke rehabilitation.
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Affiliation(s)
- Camarin E Rolle
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, MC: 5797, Stanford, CA, 94305-5797, USA.,Wu Tsai Neurosciences Institute, Stanford University, Stanford, CA, USA.,Sierra-Pacific Mental Illness Research, Education, and Clinical Centers (MIRECC), Palo Alto Veterans Health Care Administration, Palo Alto, CA, USA
| | - Fiona M Baumer
- Wu Tsai Neurosciences Institute, Stanford University, Stanford, CA, USA.,Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Joshua T Jordan
- Department of Psychiatry, University of California At San Francisco, San Francisco, CA, USA
| | - Ketura Berry
- School of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Madelleine Garcia
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Karen Monusko
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, MC: 5797, Stanford, CA, 94305-5797, USA
| | - Hersh Trivedi
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, MC: 5797, Stanford, CA, 94305-5797, USA
| | - Wei Wu
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, MC: 5797, Stanford, CA, 94305-5797, USA.,Wu Tsai Neurosciences Institute, Stanford University, Stanford, CA, USA.,Sierra-Pacific Mental Illness Research, Education, and Clinical Centers (MIRECC), Palo Alto Veterans Health Care Administration, Palo Alto, CA, USA
| | - Russell Toll
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, MC: 5797, Stanford, CA, 94305-5797, USA.,Wu Tsai Neurosciences Institute, Stanford University, Stanford, CA, USA.,Sierra-Pacific Mental Illness Research, Education, and Clinical Centers (MIRECC), Palo Alto Veterans Health Care Administration, Palo Alto, CA, USA
| | - Marion S Buckwalter
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA, USA.,Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA, USA
| | - Maarten Lansberg
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Amit Etkin
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, MC: 5797, Stanford, CA, 94305-5797, USA. .,Wu Tsai Neurosciences Institute, Stanford University, Stanford, CA, USA. .,Sierra-Pacific Mental Illness Research, Education, and Clinical Centers (MIRECC), Palo Alto Veterans Health Care Administration, Palo Alto, CA, USA.
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6
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Schüssler-Fiorenza Rose SM, Bott NT, Heinemeyer EE, Hantke NC, Gould CE, Hirst RB, Jordan JT, Beaudreau SA, O'Hara R. Depression, health comorbidities, cognitive symptoms and their functional impact: Not just a geriatric problem. J Psychiatr Res 2021; 139:185-192. [PMID: 34087515 PMCID: PMC8253546 DOI: 10.1016/j.jpsychires.2021.05.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 05/15/2020] [Revised: 04/16/2021] [Accepted: 05/01/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To compare the prevalence of cognitive symptoms and their functional impact by age group accounting for depression and number of other health conditions. METHODS We analyzed data from the 2011 Behavioral Risk Factor Surveillance System, a population-based, cross-sectional telephone survey of US adults. Twenty-one US states asked participants (n = 131, 273) about cognitive symptoms (worsening confusion or memory loss in the past year) and their functional impact (interference with activities and need for assistance). We analyzed the association between age, depression history and cognitive symptoms and their functional impact using logistic regression and adjusted for demographic characteristics and other health condition count. RESULTS There was a significant interaction between age and depression (p < 0.0001). In adults reporting depression, the adjusted odds of cognitive symptoms in younger age groups (<75 years) were comparable or greater to those in the oldest age group (≥75 years) with a peak in the middle age (45-54 years) group (OR 1.9 (95% Confidence Interval: 1.4-2.5). In adults without depression, adults <75 years had a significantly lower adjusted odds of cognitive symptoms compared to the oldest age group with the exception of the middle-aged group where the difference was not statistically significant. Over half of adults under age 65 with depression reported that cognitive symptoms interfered with life activities compared to 35.7% of adults ≥65 years. CONCLUSIONS Cognitive symptoms are not universally higher in older adults; middle-aged adults are also particularly vulnerable. Given the adverse functional impact associated with cognitive symptoms in younger adults, clinicians should assess cognitive symptoms and their functional impact in adults of all ages and consider treatments that impact both cognition and functional domains.
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Affiliation(s)
| | - Nicholas T Bott
- Clinical Excellence Research Center, Stanford University School of Medicine, 365 Lasuen St, Stanford, CA, 94305, USA
| | - Erin E Heinemeyer
- PGSP-Stanford PsyD Consortium, Palo Alto University, 1791 Arastradero Rd, Palo Alto, CA, 94304, USA
| | - Nathan C Hantke
- Sierra Pacific Mental Illness Research Education and Clinical Centers (MIRECC), Veterans Affairs Palo Alto Health Care System, 3801 Miranda Ave, Palo Alto, CA, 94304, USA; Department of Neurology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR, 97239, USA
| | - Christine E Gould
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Rd, Stanford, CA, 94305, USA; Geriatric Research Education and Clinical Center (GRECC), Veterans Affairs Palo Alto Health Care System, 3801 Miranda Ave, Palo Alto, CA, 94304, USA
| | - Rayna B Hirst
- School of Psychology, Palo Alto University, 1791 Arastradero Road, Palo Alto, CA, 94304, USA
| | - Joshua T Jordan
- Department of Psychology, Domincan University of California, 50 Acacia Avenue, San Rafael, CA, 94901, USA
| | - Sherry A Beaudreau
- Sierra Pacific Mental Illness Research Education and Clinical Centers (MIRECC), Veterans Affairs Palo Alto Health Care System, 3801 Miranda Ave, Palo Alto, CA, 94304, USA; Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Rd, Stanford, CA, 94305, USA; School of Psychology, University of Queensland, Brisbane, QLD, 4072, Australia
| | - Ruth O'Hara
- Sierra Pacific Mental Illness Research Education and Clinical Centers (MIRECC), Veterans Affairs Palo Alto Health Care System, 3801 Miranda Ave, Palo Alto, CA, 94304, USA; Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Rd, Stanford, CA, 94305, USA; School of Psychology, University of Queensland, Brisbane, QLD, 4072, Australia
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Shimony O, Einav N, Bonne O, Jordan JT, Van Vleet TM, Nahum M. The association between implicit and explicit affective inhibitory control, rumination and depressive symptoms. Sci Rep 2021; 11:11490. [PMID: 34075112 PMCID: PMC8169859 DOI: 10.1038/s41598-021-90875-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Accepted: 05/19/2021] [Indexed: 11/09/2022] Open
Abstract
Inhibitory control underlies one's ability to maintain goal-directed behavior by inhibiting prepotent responses or ignoring irrelevant information. Recent models suggest that impaired inhibition of negative information may contribute to depressive symptoms, and that this association is mediated by rumination. However, the exact nature of this association, particularly in non-clinical samples, is unclear. The current study assessed the relationship between inhibitory control over emotional vs. non-emotional information, rumination and depressive symptoms. A non-clinical sample of 119 participants (mean age: 36.44 ± 11.74) with various levels of depressive symptoms completed three variations of a Go/No-Go task online; two of the task variations required either explicit or implicit processing of emotional expressions, and a third variation contained no emotional expressions (i.e., neutral condition). We found reductions in inhibitory control for participants reporting elevated symptoms of depression on all three task variations, relative to less depressed participants. However, for the task variation that required implicit emotion processing, depressive symptoms were associated with inhibitory deficits for sad and neutral, but not for happy expressions. An exploratory analysis showed that the relationship between inhibition and depressive symptoms occurs in part through trait rumination for all three tasks, regardless of emotional content. Collectively, these results indicate that elevated depressive symptoms are associated with both a general inhibitory control deficit, as well as affective interference from negative emotions, with implications for the assessment and treatment of mood disorders.
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Affiliation(s)
- Orly Shimony
- School of Occupational Therapy, Faculty of Medicine, The Hebrew University, Mount Scopus, PO Box 24026, 9124001, Jerusalem, Israel
| | - Noam Einav
- School of Occupational Therapy, Faculty of Medicine, The Hebrew University, Mount Scopus, PO Box 24026, 9124001, Jerusalem, Israel
| | - Omer Bonne
- Department of Psychiatry, Hebrew University-Hadassah Medical Center, Jerusalem, Israel
| | - Joshua T Jordan
- Department of Psychology, Dominican University of California, San Rafael, CA, USA
| | - Thomas M Van Vleet
- Department of Research & Development, Posit Science Corporation, San Francisco, CA, USA
| | - Mor Nahum
- School of Occupational Therapy, Faculty of Medicine, The Hebrew University, Mount Scopus, PO Box 24026, 9124001, Jerusalem, Israel.
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Newkirk LA, Dao VL, Jordan JT, Alving LI, Davies HD, Hewett L, Beaudreau SA, Schneider LD, Gould CE, Chick CF, Hirst RB, Rose SMSF, Anker LA, Tinklenberg JR, O'Hara R. Factors Associated with Supportive Care Service Use Among California Alzheimer's Disease Patients and Their Caregivers. J Alzheimers Dis 2021; 73:77-86. [PMID: 31743997 DOI: 10.3233/jad-190438] [Citation(s) in RCA: 3] [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] [Indexed: 01/07/2023]
Abstract
BACKGROUND Existing literature on factors associated with supportive care service (SCS) use is limited. A better understanding of these factors could help tailor SCS to the needs of frequent users, as well as facilitate targeted outreach to populations that underutilize available services. OBJECTIVE To investigate the prevalence of SCS use and to identify factors associated with, and barriers to, service use. METHODS California Alzheimer's Disease Center patients with AD (n = 220) participated in the study from 2006-2009. Patients and their caregivers completed assessments to determine SCS use. Cognitive, functional, and behavioral status of the patients were also assessed. A two-part hurdle analysis identified 1) factors associated with any service use and 2) service use frequency among users. RESULTS Forty percent of participants reported using at least one SCS. Patients with more impaired cognition and activities of daily living and more of the following: total number of medications, comorbid medical conditions, and years of education were more likely to use any SCS (p < 0.05). Factors associated with more frequent SCS use included younger age, more years of education, older age of AD onset, female gender, and having a spouse or relative for a caregiver (p < 0.05). Caregivers frequently indicated insufficient time as a reason for not receiving enough services. CONCLUSION Factors associated with any SCS use mostly differed from those associated with SCS frequency, suggesting different characteristics between those who initiate versus those who continue SCS use. Our findings highlight the importance of targeted education on services and identifying barriers to long-term SCS use.
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Affiliation(s)
- Lori A Newkirk
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford University, Stanford, CA, USA
| | - Virginia L Dao
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford University, Stanford, CA, USA.,Sierra Pacific Mental Illness Research Education and Clinical Centers, Palo Alto, CA, USA
| | - Joshua T Jordan
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford University, Stanford, CA, USA.,Department of Psychiatry, University of California, San Francisco, CA, USA
| | - Loren I Alving
- California Alzheimer's Disease Center, University of California San Francisco at Fresno, Fresno, CA, USA
| | - Helen D Davies
- Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
| | - Linda Hewett
- California Alzheimer's Disease Center, University of California San Francisco at Fresno, Fresno, CA, USA
| | - Sherry A Beaudreau
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford University, Stanford, CA, USA.,Sierra Pacific Mental Illness Research Education and Clinical Centers, Palo Alto, CA, USA.,Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA.,School of Psychology, University of Queensland, Brisbane, Australia
| | - Logan D Schneider
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford University, Stanford, CA, USA.,Sierra Pacific Mental Illness Research Education and Clinical Centers, Palo Alto, CA, USA.,Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
| | - Christine E Gould
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford University, Stanford, CA, USA.,Geriatric Research Education and Clinical Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
| | - Christina F Chick
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford University, Stanford, CA, USA
| | - Rayna B Hirst
- Pacific Graduate School of Psychology, Palo Alto University, Palo Alto, CA, USA
| | | | - Lauren A Anker
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford University, Stanford, CA, USA.,Sierra Pacific Mental Illness Research Education and Clinical Centers, Palo Alto, CA, USA.,Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
| | - Jared R Tinklenberg
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford University, Stanford, CA, USA.,Sierra Pacific Mental Illness Research Education and Clinical Centers, Palo Alto, CA, USA.,Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
| | - Ruth O'Hara
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford University, Stanford, CA, USA.,Sierra Pacific Mental Illness Research Education and Clinical Centers, Palo Alto, CA, USA.,Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
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Abstract
OBJECTIVE Homicide-suicide is an extremely heterogeneous and rare form of lethal violence. In an effort to capture this heterogeneity to enhance research and prevention efforts, typologies have been developed from literature reviews or geographically limited samples. The purpose of the present study was to develop the first empirically derived typology of homicide-suicide decedents, using a large, geographically diverse sample. METHODS Data were used from the Centers for Disease Control and Prevention's National Violent Death Reporting System from 2003 to 2015 across 27 states. Homicide-suicide decedents were included if they were ≥ 18 years of age, they were the only victim and suspect involved, they had a known relationship with the victim(s), and the circumstances surrounding the event were known. There were 2,447 decedents that met study criteria. Unsupervised machine learning was used to classify decedents by precipitating circumstances and victim types. RESULTS Eight homicide-suicide subtypes were identified and cross-validated in a holdout sample. Three subtypes consisted of only intimate partner victims, 3 subtypes had a single victim type (children, extrafamilial, other family), and there were 2 multivictim subtypes: one that could be identified as familicide and the other in which there was indiscriminate killing, which often included an intimate partner. Subtypes were distinguishable by demographic and other characteristics (median area under the curve = 0.77). Relationship problems precipitated 60%-92% of homicide-suicides across subtypes, while mental health problems were recognized as a precipitant in 7%-72% of decedents across subtypes. CONCLUSIONS The findings expand upon and validate previously proposed homicide-suicide typologies. While relationship problems are common precipitants across homicide-suicide subtypes, known mental health problems vary across subtypes.
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Affiliation(s)
- Joshua T Jordan
- Department of Psychology, Dominican University of California, San Rafael, California.,Corresponding author: Joshua T. Jordan, PhD, Department of Psychology, Dominican University of California, 50 Acacia Ave, San Rafael, CA 94901
| | - Dale E McNiel
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, California
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10
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Hirst RB, Jordan JT, Rose SMSF, Schneider L, Kawai M, Gould C, Anker L, Chick CF, Beaudreau S, Hallmayer J, O’Hara R. The 5-HTTLPR long allele predicts two-year longitudinal increases in cortisol and declines in verbal memory in older adults. Int J Geriatr Psychiatry 2020; 35:982-988. [PMID: 32400901 PMCID: PMC7755300 DOI: 10.1002/gps.5319] [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: 09/29/2019] [Revised: 04/22/2020] [Accepted: 04/25/2020] [Indexed: 11/08/2022]
Abstract
OBJECTIVES The short form or s-allele variant of the serotonin transporter polymorphism (5-HTTLPR), as compared with the long-form or l-allele variant, has been associated with the presence of cognitive dysfunction, and particularly memory impairment in older adults. This body of cross-sectional work has culminated in the hypothesis that presence of the s-allele predicts greater memory decline in older adults. Yet, to date, there are no longitudinal studies that have investigated this issue. METHODS/DESIGN Here, we examine 109 community-dwelling older adults (mean and SD of age = 70.7 ± 8.7 years) who underwent blood draw for genotyping, cognitive, and psychological testing at baseline, 12-, and 24-monthfollow-ups. RESULTS Multilevel modeling found that s-allele carriers (ss or ls) performed worse than ll homozygotes at baseline on delayed verbal recall. Yet, s-allele carriers' memory performance was stable over the two-yearfollow-up period, while l-allele homozygotes experienced significant memory decline. l-allele homozygote status was associated with both increased cortisol and decreased memory over time, resulting in attenuated verbal memory performance differences compared to s-allele carriers with age. CONCLUSIONS Overall, our findings do not support the hypothesis that presence of the 5-HTTLPRs-allele is a marker for memory decline in older adults. J Am Geriatr Soc 68:-, 2020.
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Affiliation(s)
- Rayna B. Hirst
- Palo Alto University,Corresponding author: Rayna B. Hirst, PhD, Palo Alto University, 1791 Arastradero Road, Palo Alto, California 94304, Ph. 650-417-2025,
| | - Joshua T. Jordan
- Department of Psychiatry and Behavioral Sciences, Stanford University,Department of Psychiatry, University of California, San Francisco
| | | | - Logan Schneider
- Department of Psychiatry and Behavioral Sciences, Stanford University,Stanford/VA State of California, Alzheimer Disease Center, VA Palo Alto Health Care System,Stanford University Sleep Center,Sierra Pacific, Mental Illness Research, Education, and Clinical Center (MIRECC): VISN 21: Sierra Pacific Network, Department of Veterans Affairs
| | - Makoto Kawai
- Department of Psychiatry and Behavioral Sciences, Stanford University,Stanford/VA State of California, Alzheimer Disease Center, VA Palo Alto Health Care System,Stanford University Sleep Center,Sierra Pacific, Mental Illness Research, Education, and Clinical Center (MIRECC): VISN 21: Sierra Pacific Network, Department of Veterans Affairs
| | - Christine Gould
- Department of Psychiatry and Behavioral Sciences, Stanford University,Geriatric Research, Education and Clinical Center (GRECC), VA Palo Alto Health Care System, Palo Alto, CA
| | - Lauren Anker
- Department of Psychiatry and Behavioral Sciences, Stanford University,Sierra Pacific, Mental Illness Research, Education, and Clinical Center (MIRECC): VISN 21: Sierra Pacific Network, Department of Veterans Affairs
| | - Christina F. Chick
- Department of Psychiatry and Behavioral Sciences, Stanford University,Sierra Pacific, Mental Illness Research, Education, and Clinical Center (MIRECC): VISN 21: Sierra Pacific Network, Department of Veterans Affairs
| | - Sherry Beaudreau
- Department of Psychiatry and Behavioral Sciences, Stanford University,Sierra Pacific, Mental Illness Research, Education, and Clinical Center (MIRECC): VISN 21: Sierra Pacific Network, Department of Veterans Affairs
| | - Joachim Hallmayer
- Department of Psychiatry and Behavioral Sciences, Stanford University,Sierra Pacific, Mental Illness Research, Education, and Clinical Center (MIRECC): VISN 21: Sierra Pacific Network, Department of Veterans Affairs
| | - Ruth O’Hara
- Department of Psychiatry and Behavioral Sciences, Stanford University,Stanford/VA State of California, Alzheimer Disease Center, VA Palo Alto Health Care System,Sierra Pacific, Mental Illness Research, Education, and Clinical Center (MIRECC): VISN 21: Sierra Pacific Network, Department of Veterans Affairs
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11
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Nahum M, Lee H, Fisher M, Green MF, Hooker CI, Ventura J, Jordan JT, Rose A, Kim SJ, Haut KM, Merzenich MM, Vinogradov S. Online Social Cognition Training in Schizophrenia: A Double-Blind, Randomized, Controlled Multi-Site Clinical Trial. Schizophr Bull 2020; 47:108-117. [PMID: 32614046 PMCID: PMC7825077 DOI: 10.1093/schbul/sbaa085] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [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: 12/20/2022]
Abstract
Social cognition (SC), the mental operations underlying social functioning, are impaired in schizophrenia. Their direct link to functional outcome and illness status have made them an important therapeutic target. However, no effective treatment for these deficits is currently applied as a standard of care. To address this need, we have developed SocialVille-an online, plasticity-based training program that targets SC deficits in schizophrenia. Here we report the outcomes of a double-blind, controlled, randomized, multi-site clinical trial of SocialVille. Outpatients with schizophrenia were randomized to complete 40 sessions of either SocialVille (N = 55 completers) or active control (computer games; N = 53 completers) from home. The a priori co-primary outcome measures were a social cognitive composite and a functional capacity outcome (UCSD Performance-based Skills Assessment [UPSA-2]). Secondary outcomes included a virtual functional capacity measure (VRFCAT), social functioning, quality of life, and motivation. Linear mixed models revealed a group × time interaction favoring the treatment group for the social cognitive composite (b = 2.81; P < .001) but not for the UPSA-2 measure. Analysis of secondary outcome measures showed significant group × time effects favoring the treatment group on SC and social functioning, on the virtual functional capacity measure and a motivation subscale, although these latter findings were nonsignificant with FDR correction. These results provide support for the efficacy of a remote, plasticity-based social cognitive training program in improving SC and social functioning in schizophrenia. Such treatments may serve as a cost-effective adjunct to existing psychosocial treatments. Trial Registration: NCT02246426.
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Affiliation(s)
- Mor Nahum
- School of Occupational Therapy, Faculty of Medicine, Hebrew University, Jerusalem, Israel,Department of Research and Development, Posit Science Inc., San Francisco, CA,To whom correspondence should be addressed; School of Occupational Therapy, Faculty of Medicine, The Hebrew University, PO Box 24026, Mount Scopus, Jerusalem, 91240, Israel; tel: +972-54-732-6655, fax: +972-2-5325345, e-mail:
| | - Hyunkyu Lee
- Department of Research and Development, Posit Science Inc., San Francisco, CA
| | - Melissa Fisher
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN
| | - Michael F Green
- VA Greater Los Angeles, Los Angeles, CA,Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA
| | - Christine I Hooker
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL
| | - Joseph Ventura
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA
| | - Joshua T Jordan
- Department of Psychiatry, University of California, San Francisco, CA
| | - Annika Rose
- Department of Research and Development, Posit Science Inc., San Francisco, CA
| | - Sarah-Jane Kim
- Department of Research and Development, Posit Science Inc., San Francisco, CA
| | - Kristen M Haut
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL
| | - Michael M Merzenich
- Department of Research and Development, Posit Science Inc., San Francisco, CA
| | - Sophia Vinogradov
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN
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12
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Abstract
BACKGROUND Much of suicide research focuses on suicide attempt (SA) survivors. Given that more than half of the suicide decedent population dies on their first attempt, this means a significant proportion of the population that dies by suicide is overlooked in research. Little is known about persons who die by suicide on their first attempt-and characterizing this understudied population may improve efforts to identify more individuals at risk for suicide. METHODS Data were derived from the National Violent Death Reporting System, from 2005 to 2013. Suicide cases were included if they were 18-89 years old, with a known circumstance leading to their death based on law enforcement and/or medical examiner reports. Decedents with and without a history of SA were compared on demographic, clinical, and suicide characteristics, and circumstances that contributed to their suicide. RESULTS A total of 73 490 cases met criteria, and 57 920 (79%) died on their first SA. First attempt decedents were more likely to be male, married, African-American, and over 64. Demographic-adjusted models showed that first attempt decedents were more likely to use highly lethal methods, less likely to have a known mental health problem or to have disclosed their intent to others, and more likely to die in the context of physical health or criminal/legal problem. CONCLUSIONS First attempt suicide decedents are demographically different from decedents with a history of SA, are more likely to use lethal methods and are more likely to die in the context of specific stressful life circumstances.
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Affiliation(s)
- Joshua T Jordan
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA94143, USA
| | - Dale E McNiel
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA94143, USA
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13
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Jordan JT, McNiel DE. Perceived Coercion During Admission Into Psychiatric Hospitalization Increases Risk of Suicide Attempts After Discharge. Suicide Life Threat Behav 2020; 50:180-188. [PMID: 31162700 DOI: 10.1111/sltb.12560] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [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: 01/16/2019] [Accepted: 05/09/2019] [Indexed: 11/24/2022]
Abstract
OBJECTIVE There is an elevated risk for suicide in the year following psychiatric hospitalization. The present study examined whether perceived coercion during admission into psychiatric hospitalization increases risk for postdischarge suicide attempts. METHODS Participants were 905 psychiatric inpatients from the MacArthur Violence Risk Assessment Study that were assessed every 10 weeks during the year following discharge. Perceived coercion during admission was assessed while hospitalized, and suicide attempts were assessed following discharge. Analyses adjusted for nonrandom assignment of groups via propensity score weighting and for established correlates of postdischarge suicidal behavior. RESULTS Of 905 participants, 67% endorsed perception of coercion into psychiatric hospitalization, and 168 (19%) made a postdischarge suicide attempt. Patients who perceived coercion during hospitalization admission were more likely to make a suicide attempt after discharge than those who did not, even after adjusting for established covariates (OR = 1.29, |z| = 2.87, p = .004, 95% CI = 1.08, 1.54). There was no interaction between recent self-harm or suicidal ideation at time of admission and perceived coercion on postdischarge suicide attempts. CONCLUSIONS Patients' perception of the context in which they were hospitalized is associated with a small but significant increase in their likelihood of postdischarge suicide attempts.
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Affiliation(s)
- Joshua T Jordan
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, USA
| | - Dale E McNiel
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, USA
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14
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Lutz J, Mashal N, Kramer A, Suresh M, Gould C, Jordan JT, Wetherell JL, Beaudreau SA. A Case Report of Problem Solving Therapy for Reducing Suicide Risk in Older Adults with Anxiety Disorders. Clin Gerontol 2020; 43:110-117. [PMID: 31131742 DOI: 10.1080/07317115.2019.1617378] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 01/05/2023]
Abstract
Objectives: Suicide is a global public health problem among older adults. Problem-solving therapy (PST) has demonstrated promise in reducing late-life suicide risk, chiefly in secondary analyses of studies on late-life depression. PST mitigates negative beliefs about one's problem-solving abilities and maladaptive problem-solving styles, which suicidal older adults report. The effects of PST on suicide risk in older adults with primary anxiety disorder diagnoses have not been examined. Anxiety is a risk factor for suicide, but it is less studied in research on suicide compared to depression. This paper describes two cases of older individuals with anxiety disorders and suicidal ideation who completed six sessions of PST. Methods: Assessments of suicide risk, anxiety, depressive symptoms, and problem-solving ability were administered. Results: Both cases exhibited a clinically significant reduction in suicide risk, along with reductions in anxiety, worry, and depressive symptoms by posttreatment. Conclusions & Clinical Implications: Findings highlight the potential for PST as a psychotherapeutic intervention for reducing suicide risk in older adults with anxiety disorders.
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Affiliation(s)
- Julie Lutz
- Sierra Pacific Mental Illness Research Education and Clinical Centers (MIRECC), Veterans Affairs (VA) Palo Alto Health Care System, Palo Alto, CA, USA
| | - Nehjla Mashal
- General Psychiatry Outpatient Services, VA San Francisco Health Care System, San Francisco, CA, USA
| | - Abigail Kramer
- Sierra Pacific Mental Illness Research Education and Clinical Centers (MIRECC), Veterans Affairs (VA) Palo Alto Health Care System, Palo Alto, CA, USA.,Pacific Graduate School of Psychology, Palo Alto University, Palo Alto, CA, USA
| | - Madhuvanthi Suresh
- Sierra Pacific Mental Illness Research Education and Clinical Centers (MIRECC), Veterans Affairs (VA) Palo Alto Health Care System, Palo Alto, CA, USA.,Pacific Graduate School of Psychology, Palo Alto University, Palo Alto, CA, USA
| | - Christine Gould
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA.,Geriatric Research Education and Clinical Center (GRECC), Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
| | - Joshua T Jordan
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA.,Department of Psychiatry, University of California at San Francisco, San Francisco, CA, USA
| | - Julie Loebach Wetherell
- Psychology Service, VA San Diego Healthcare System, San Diego, CA, USA.,Department of Psychiatry, University of California, San Diego, CA, USA
| | - Sherry A Beaudreau
- Sierra Pacific Mental Illness Research Education and Clinical Centers (MIRECC), Veterans Affairs (VA) Palo Alto Health Care System, Palo Alto, CA, USA.,Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
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15
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Jordan JT, Samuelson KW, Tiet QQ. Impulsivity, Painful and Provocative Events, and Suicide Intent: Testing the Interpersonal Theory of Suicide. Suicide Life Threat Behav 2019; 49:1187-1195. [PMID: 30307054 DOI: 10.1111/sltb.12518] [Citation(s) in RCA: 10] [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: 03/07/2018] [Accepted: 07/14/2018] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The Interpersonal Theory of Suicide (IPTS; Joiner, 2005. Why People Die by Suicide. Cambridge, MA: Harvard University Press) hypothesizes that repeated exposure to painful and provocative events (PPE) increases capability for suicide (CS), therefore facilitating the development of suicidal intent, and that impulsive individuals are more likely to experience these painful and provocative events, creating an indirect relationship between impulsivity and CS. Research to date largely supports this hypothesis but has not translated this theory to actual suicidal intent. METHOD The present study used data from the MacArthur Violence Risk Assessment Study to examine the relationship between PPE and intent, and the indirect relationship between impulsivity and intent among a sample of 245 recent suicide attempters, using the clinician-rated Suicide Intent Scale as an objective measure of intent. RESULTS Results supported the hypothesized direct relationship between PPE and intent, and the indirect relationship between impulsivity and intent through PPE. There was no direct relationship between impulsivity and intent, suggesting that the relationship between impulsivity and intent occurs entirely through exposure to PPE. CONCLUSIONS These findings suggest that assessing exposure to painful and provocative events is critical in evaluating risk of suicide, and that impulsivity itself does not confer an increased risk of lethal or nearly lethal attempts.
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Affiliation(s)
| | | | - Quyen Q Tiet
- California School of Professional Psychology at Alliant International University, San Francisco, CA, USA.,National Center for PTSD, Dissemination and Training Division, VA Palo Alto Health Care System, Menlo Park, CA, USA.,Department of Psychiatry, Stanford University School of Medicine, Stanford, CA, USA
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16
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Naparstek S, El-Said D, Eisenberg ML, Jordan JT, O'Hara R, Etkin A. Development of VM-REACT: Verbal memory RecAll computerized test. J Psychiatr Res 2019; 114:170-177. [PMID: 31096177 DOI: 10.1016/j.jpsychires.2019.04.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 11/05/2018] [Revised: 04/23/2019] [Accepted: 04/25/2019] [Indexed: 11/15/2022]
Abstract
When tracking the progression of neuropsychiatric or neurodegenerative diseases, assessment tools that enable repeated measures of cognition and require little examiner burden are increasingly important to develop. In the current study, we describe the development of the VM-REACT (Verbal Memory REcAll Computerized Test), which assesses verbal memory recall abilities using a computerized, automated version. Four different list versions of the test were applied on a cohort of 798 healthy adults (ages 20-80). Recall and learning scores were computed and compared to existing gender- and age-matched published norms for a similar paper-and-pencil test. Performance was similar to existing age-matched norms for all but the two oldest age groups. These adults (ages 60-80) outperformed their age-matched norms. Processing speed, initiation speed, and number of recall errors are also reported for each age group. Our findings suggest that VM-REACT can be utilized to study verbal memory abilities in a standardized and time efficient manner, and thus holds great promise for assessment in the 21st century.
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Affiliation(s)
- Sharon Naparstek
- Department of Psychiatry and Behavioral Sciences and Wu Tsai Neurosciences Institute, Stanford University, Stanford, CA, 94304, USA; Sierra Pacific Mental Illness, Research, Education, and Clinical Center (MIRECC), Veterans Affairs Palo Alto Healthcare System, Palo Alto, CA, 94304, USA
| | - Dawlat El-Said
- Department of Psychiatry and Behavioral Sciences and Wu Tsai Neurosciences Institute, Stanford University, Stanford, CA, 94304, USA; Sierra Pacific Mental Illness, Research, Education, and Clinical Center (MIRECC), Veterans Affairs Palo Alto Healthcare System, Palo Alto, CA, 94304, USA
| | - Michelle L Eisenberg
- Department of Psychiatry and Behavioral Sciences and Wu Tsai Neurosciences Institute, Stanford University, Stanford, CA, 94304, USA; Sierra Pacific Mental Illness, Research, Education, and Clinical Center (MIRECC), Veterans Affairs Palo Alto Healthcare System, Palo Alto, CA, 94304, USA
| | - Joshua T Jordan
- Department of Psychiatry and Behavioral Sciences and Wu Tsai Neurosciences Institute, Stanford University, Stanford, CA, 94304, USA; Department of Psychiatry, University of California, San Francisco, USA
| | - Ruth O'Hara
- Department of Psychiatry and Behavioral Sciences and Wu Tsai Neurosciences Institute, Stanford University, Stanford, CA, 94304, USA; Sierra Pacific Mental Illness, Research, Education, and Clinical Center (MIRECC), Veterans Affairs Palo Alto Healthcare System, Palo Alto, CA, 94304, USA
| | - Amit Etkin
- Department of Psychiatry and Behavioral Sciences and Wu Tsai Neurosciences Institute, Stanford University, Stanford, CA, 94304, USA; Sierra Pacific Mental Illness, Research, Education, and Clinical Center (MIRECC), Veterans Affairs Palo Alto Healthcare System, Palo Alto, CA, 94304, USA.
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17
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Beaudreau SA, Jordan JT, O'Hara R. Commentary on "High Occurrence of Psychiatric Disorders and Suicidal Behavior Across Dementia Subtypes". Am J Geriatr Psychiatry 2018; 26:1202-1203. [PMID: 30401607 DOI: 10.1016/j.jagp.2018.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 09/11/2018] [Indexed: 11/20/2022]
Affiliation(s)
- Sherry A Beaudreau
- Sierra Pacific Mental Illness Research, Education and Clinical Centers (SAB, RO), VA Palo Alto Health Care System, Palo Alto, CA; Department of Psychiatry and Behavioral Sciences (SAB, RO), Stanford University School of Medicine, Stanford, CA; School of Psychology (SAB), University of Queensland, Brisbane, Australia.
| | - Joshua T Jordan
- Department of Psychiatry (JTJ), University of California, CA
| | - Ruth O'Hara
- Sierra Pacific Mental Illness Research, Education and Clinical Centers (SAB, RO), VA Palo Alto Health Care System, Palo Alto, CA; Department of Psychiatry and Behavioral Sciences (SAB, RO), Stanford University School of Medicine, Stanford, CA
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18
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Jordan JT, McNiel DE. Characteristics of a suicide attempt predict who makes another attempt after hospital discharge: A decision-tree investigation. Psychiatry Res 2018; 268:317-322. [PMID: 30096659 DOI: 10.1016/j.psychres.2018.07.040] [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] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 07/06/2018] [Accepted: 07/29/2018] [Indexed: 12/18/2022]
Abstract
The year following discharge from psychiatric hospitalization is a high-risk period for suicidal behavior, particularly among patients initially hospitalized after a suicide attempt. Demographic and clinical correlates have been identified; however, characteristics of the initial attempt may provide insight into risk for subsequent attempts as well. This investigation examined whether individual or a combination of suicide attempt characteristics predicted future attempts. Two hundred and eighteen psychiatric inpatients from the MacArthur Violence Risk Assessment Study with a recent suicide attempt were administered items from the Suicide Intent Scale and followed one year after discharge. Sixty-nine (31.65%) made a subsequent attempt. Data were analyzed by a stepwise logistic regression, followed by an iterative receiver operator curve (IROC) analysis, a recursive partitioning classification tree. The cross-validated IROC, but not logistic regression, predicted subsequent suicide attempts. Furthermore, the IROC found that participants who made definite plans and underwent extensive preparation were at highest risk for subsequent attempts. These findings suggest that suicide attempt characteristics preceding psychiatric hospitalization can help identify patients at elevated risk for another attempt post-discharge.
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Affiliation(s)
- Joshua T Jordan
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, USA.
| | - Dale E McNiel
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, USA
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19
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Samuelson KW, Abadjian L, Jordan JT, Bartel A, Vasterling J, Seal K. The Association Between PTSD and Functional Outcome Is Mediated by Perception of Cognitive Problems Rather Than Objective Neuropsychological Test Performance. J Trauma Stress 2017; 30:521-530. [PMID: 29030878 DOI: 10.1002/jts.22223] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [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: 03/01/2017] [Revised: 05/13/2017] [Accepted: 06/21/2017] [Indexed: 11/06/2022]
Abstract
Posttraumatic stress disorder (PTSD) has been consistently linked to poorer functional outcomes, including quality of life, health problems, and social and occupational functioning. Less is known about the potential mechanisms by which PTSD leads to poorer functional outcomes. We hypothesized that neurocognitive functioning and perception of cognitive problems would both mediate the relationship between PTSD diagnosis and functioning. In a sample of 140 veterans of the recent wars and conflicts in Iraq and Afghanistan, we assessed PTSD symptoms, history of traumatic brain injury (TBI), depression, self-report measures of quality of life, social and occupational functioning, and reintegration to civilian life, as well as perception of cognitive problems. Veterans also completed a comprehensive neuropsychological battery of tests. Structural equation modeling revealed that perception of cognitive problems, but not objective neuropsychological performance, mediated the relationship between PTSD diagnosis and functional outcomes after controlling for TBI, depression, education, and a premorbid IQ estimate, b = -6.29, 95% bias-corrected bootstrapped confidence interval [-11.03, -2.88], showing a large effect size. These results highlight the importance of addressing appraisals of posttrauma cognitive functioning in treatment as a means of improving functional outcomes.
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Affiliation(s)
- Kristin W Samuelson
- Department of Psychology, University of Colorado at Colorado Springs, Colorado Springs, Colorado, USA
| | - Linda Abadjian
- San Francisco VA Health Care System, Department of Mental Health, San Francisco, California, USA
| | - Joshua T Jordan
- Alliant International University, Department of Clinical Psychology, San Francisco, California, USA
| | - Alisa Bartel
- Department of Psychology, University of Colorado at Colorado Springs, Colorado Springs, Colorado, USA
| | - Jennifer Vasterling
- National Center for PTSD, VA Boston Health Care System, Boston, Massachusetts, USA.,Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Karen Seal
- San Francisco VA Health Care System, Department of Mental Health, San Francisco, California, USA.,Department of Medicine and Psychiatry, University of California, San Francisco, California, USA
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20
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Samuelson KW, Bartel A, Valadez R, Jordan JT. PTSD symptoms and perception of cognitive problems: The roles of posttraumatic cognitions and trauma coping self-efficacy. ACTA ACUST UNITED AC 2017; 9:537-544. [DOI: 10.1037/tra0000210] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [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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21
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Arean PA, Hallgren KA, Jordan JT, Gazzaley A, Atkins DC, Heagerty PJ, Anguera JA. The Use and Effectiveness of Mobile Apps for Depression: Results From a Fully Remote Clinical Trial. J Med Internet Res 2016; 18:e330. [PMID: 27998876 PMCID: PMC5209607 DOI: 10.2196/jmir.6482] [Citation(s) in RCA: 182] [Impact Index Per Article: 22.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Revised: 11/14/2016] [Accepted: 11/30/2016] [Indexed: 12/26/2022] Open
Abstract
Background Mobile apps for mental health have the potential to overcome access barriers to mental health care, but there is little information on whether patients use the interventions as intended and the impact they have on mental health outcomes. Objective The objective of our study was to document and compare use patterns and clinical outcomes across the United States between 3 different self-guided mobile apps for depression. Methods Participants were recruited through Web-based advertisements and social media and were randomly assigned to 1 of 3 mood apps. Treatment and assessment were conducted remotely on each participant’s smartphone or tablet with minimal contact with study staff. We enrolled 626 English-speaking adults (≥18 years old) with mild to moderate depression as determined by a 9-item Patient Health Questionnaire (PHQ-9) score ≥5, or if their score on item 10 was ≥2. The apps were (1) Project: EVO, a cognitive training app theorized to mitigate depressive symptoms by improving cognitive control, (2) iPST, an app based on an evidence-based psychotherapy for depression, and (3) Health Tips, a treatment control. Outcomes were scores on the PHQ-9 and the Sheehan Disability Scale. Adherence to treatment was measured as number of times participants opened and used the apps as instructed. Results We randomly assigned 211 participants to iPST, 209 to Project: EVO, and 206 to Health Tips. Among the participants, 77.0% (482/626) had a PHQ-9 score >10 (moderately depressed). Among the participants using the 2 active apps, 57.9% (243/420) did not download their assigned intervention app but did not differ demographically from those who did. Differential treatment effects were present in participants with baseline PHQ-9 score >10, with the cognitive training and problem-solving apps resulting in greater effects on mood than the information control app (χ22=6.46, P=.04). Conclusions Mobile apps for depression appear to have their greatest impact on people with more moderate levels of depression. In particular, an app that is designed to engage cognitive correlates of depression had the strongest effect on depressed mood in this sample. This study suggests that mobile apps reach many people and are useful for more moderate levels of depression. ClinicalTrial Clinicaltrials.gov NCT00540865; https://www.clinicaltrials.gov/ct2/show/NCT00540865 (Archived by WebCite at http://www.webcitation.org/6mj8IPqQr)
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Affiliation(s)
- Patricia A Arean
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States
| | - Kevin A Hallgren
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States
| | - Joshua T Jordan
- Department of Neurology, University of California San Francisco, San Francisco, CA, United States.,Department of Psychiatry, University of California San Francisco, San Francisco, CA, United States
| | - Adam Gazzaley
- Department of Neurology, University of California San Francisco, San Francisco, CA, United States.,Department of Psychiatry, University of California San Francisco, San Francisco, CA, United States
| | - David C Atkins
- Department of Biostatistics in the School of Public Health, University of Washington, Seattle, WA, United States
| | - Patrick J Heagerty
- Department of Biostatistics in the School of Public Health, University of Washington, Seattle, WA, United States
| | - Joaquin A Anguera
- Department of Neurology, University of California San Francisco, San Francisco, CA, United States.,Department of Psychiatry, University of California San Francisco, San Francisco, CA, United States
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Ostrow KL, Bergner AL, Blakeley J, Evans DG, Ferner R, Friedman JM, Harris GJ, Jordan JT, Korf B, Langmead S, Leschziner G, Mautner V, Merker VL, Papi L, Plotkin SR, Slopis JM, Smith MJ, Stemmer-Rachamimov A, Yohay K, Belzberg AJ. Creation of an international registry to support discovery in schwannomatosis. Am J Med Genet A 2016; 173:407-413. [PMID: 27759912 DOI: 10.1002/ajmg.a.38024] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [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: 04/27/2016] [Accepted: 09/24/2016] [Indexed: 11/10/2022]
Abstract
Schwannomatosis is a tumor suppressor syndrome that causes multiple tumors along peripheral nerves. Formal diagnostic criteria were first published in 2005. Variability in clinical presentation and a relative lack of awareness of the syndrome have contributed to difficulty recognizing affected individuals and accurately describing the natural history of the disorder. Many critical questions such as the mutations underlying schwannomatosis, genotype-phenotype correlations, inheritance patterns, pathologic diagnosis of schwannomatosis-associated schwannomas, tumor burden in schwannomatosis, the incidence of malignancy, and the effectiveness of current, or new treatments remain unanswered. A well-curated registry of schwannomatosis patients is needed to facilitate research in field. An international consortium of clinicians and scientists across multiple disciplines with expertise in schwannomatosis was established and charged with the task of designing and populating a schwannomatosis patient registry. The International Schwannomatosis Registry (ISR) was built around key data points that allow confirmation of the diagnosis and identification of potential research subjects to advance research to further the knowledge base for schwannomatosis. A registry with 389 participants enrolled to date has been established. Twenty-three additional subjects are pending review. A formal process has been established for scientific investigators to propose research projects, identify eligible subjects, and seek collaborators from ISR sites. Research collaborations have been created using the information collected by the registry and are currently being conducted. The ISR is a platform from which multiple research endeavors can be launched, facilitating connections between affected individuals interested in participating in research and researchers actively investigating a variety of aspects of schwannomatosis. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- K L Ostrow
- Johns Hopkins University, Baltimore, Maryland
| | - A L Bergner
- Johns Hopkins University, Baltimore, Maryland
| | - J Blakeley
- Johns Hopkins University, Baltimore, Maryland
| | - D G Evans
- University of Manchester, Manchester, England
| | - R Ferner
- Guy's Hospital in London, London, England
| | - J M Friedman
- University of British Columbia, Vancouver, British Columbia, Canada
| | - G J Harris
- Massachusetts General Hospital, Boston, Massachusetts
| | - J T Jordan
- Massachusetts General Hospital, Boston, Massachusetts
| | - B Korf
- University of Alabama at Birmingham, Birmingham, Alabama
| | - S Langmead
- Johns Hopkins University, Baltimore, Maryland
| | | | - V Mautner
- University of Hamburg, Hamburg, Germany
| | - V L Merker
- Massachusetts General Hospital, Boston, Massachusetts
| | - L Papi
- University of Florence, Florence, Italy
| | - S R Plotkin
- Massachusetts General Hospital, Boston, Massachusetts
| | - J M Slopis
- MD Anderson Cancer Center, Houston, Texas
| | - M J Smith
- University of Manchester, Manchester, England
| | | | - K Yohay
- Weill Cornell Medical College, New York City, New York
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Jordan JT, Samuelson KW. Predicting Suicide Intent: The Roles of Experiencing or Committing Violent Acts. Suicide Life Threat Behav 2016; 46:293-300. [PMID: 26418043 DOI: 10.1111/sltb.12193] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [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: 03/16/2015] [Accepted: 07/10/2015] [Indexed: 11/30/2022]
Abstract
According to the interpersonal theory of suicide (Joiner, 2005), repeated exposure to painful or provocative experiences is associated with lethal or nearly lethal suicide attempts. However, suicide research often focuses on suicide ideation or attempts, rather than intent. Using data from the Collaborative Psychiatric Epidemiological Surveys, we examined traumatic experiences, with a focus on repeated exposure to traumas, in individuals who described their suicide attempts as a strong intent to die versus a cry for help. Only repeated acts of committing violence were associated with high suicide intent, suggesting that individuals who engage in violence are at heightened risk for suicide.
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Affiliation(s)
- Joshua T Jordan
- California School of Professional Psychology, Alliant International University, San Francisco, CA, USA
| | - Kristin W Samuelson
- Department of Psychology, University of Colorado at Colorado Springs, Colorado Springs, CO, USA
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Anguera JA, Jordan JT, Castaneda D, Gazzaley A, Areán PA. Conducting a fully mobile and randomised clinical trial for depression: access, engagement and expense. ACTA ACUST UNITED AC 2016; 2:14-21. [PMID: 27019745 PMCID: PMC4789688 DOI: 10.1136/bmjinnov-2015-000098] [Citation(s) in RCA: 126] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Importance Advances in mobile technology have resulted in federal and industry-level initiatives to facilitate large-scale clinical research using smart devices. Although the benefits of technology to expand data collection are obvious, assumptions about the reach of mobile research methods (access), participant willingness to engage in mobile research protocols (engagement), and the cost of this research (cost) remain untested. Objective To assess the feasibility of a fully mobile randomised controlled trial using assessments and treatments delivered entirely through mobile devices to depressed individuals. Design Using a web-based research portal, adult participants with depression who also owned a smart device were screened, consented and randomised to 1 of 3 mental health apps for treatment. Assessments of self-reported mood and cognitive function were conducted at baseline, 4, 8 and 12 weeks. Physical and social activity was monitored daily using passively collected phone use data. All treatment and assessment tools were housed on each participant's smart phone or tablet. Interventions A cognitive training application, an application based on problem-solving therapy, and a mobile-sensing application promoting daily activities. Results Access: We screened 2923 people and enrolled 1098 participants in 5 months. The sample characteristics were comparable to the 2013 US census data. Recruitment via Craigslist.org yielded the largest sample. Engagement: Study engagement was high during the first 2 weeks of treatment, falling to 44% adherence by the 4th week. Cost: The total amount spent on for this project, including staff costs and β testing, was $314 264 over 2 years. Conclusions and relevance These findings suggest that mobile randomised control trials can recruit large numbers of participants in a short period of time and with minimal cost, but study engagement remains challenging. Trial registration number NCT00540865.
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Affiliation(s)
- Joaquin A Anguera
- Departments of Neurology and Psychiatry , University of California , San Francisco, California , USA
| | - Joshua T Jordan
- Departments of Neurology and Psychiatry , University of California , San Francisco, California , USA
| | - Diego Castaneda
- Departments of Neurology and Psychiatry , University of California , San Francisco, California , USA
| | - Adam Gazzaley
- Departments of Neurology and Psychiatry , University of California , San Francisco, California , USA
| | - Patricia A Areán
- Department of Psychiatry and Behavioral Sciences , University of Washington , Seattle, Washington , USA
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Jordan JT. Coding for emergency department services. Patient Acc 1997; 20:2-3. [PMID: 10166149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Affiliation(s)
- J T Jordan
- Health Front Services, Stoneham, MA, USA
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Jordan JT. Physician services in the emergency department require accurate coding. Patient Acc 1996; 19:2. [PMID: 10159667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
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Abstract
In vitro levels of enzyme activity were measured in liver from fetal and developing hamsters to study the fetal immaturity and postnatal development of bile acid conjugation and sulfation. Sulfation and conjugation were measured in the same animals. Partial reactions of bile acid conjugation were assayed independently; sulfation of conjugated and unconjugated lithocholate was measured separately. From 3 days before to 3 days after birth, specific activity for sulfation of lithocholate and lithocholate conjugates was similar; lithocholate sulfation was 80% of adult levels. In older hamsters, specific activity for sulfation of lithocholate conjugates was significantly higher than that for lithocholate. Specific activities of both partial reactions of bile acid conjugation were 12% of adult levels from 3 days before to 3 days after birth. Thereafter both activities increased together; the ratio of glycine to taurine-dependent conjugation was similar at all ages. The data suggest early development of a separate mechanism for lithocholate sulfation. Enzymes catalyzing bile acid conjugation and sulfation of bile acid conjugates exhibit maximal development after birth.
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Killenberg PG, Jordan JT. Purification and characterization of bile acid-CoA:amino acid N-acyltransferase from rat liver. J Biol Chem 1978; 253:1005-10. [PMID: 624713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
An in vitro study of bile acid-CoA:amino acid N-acyltransferase activity of rat liver was undertaken in order to determine whether separate amino acid-specific enzymes catalyzed the formation of glycine and taurine conjugates of bile acids as postulated by others. Polyacrylamide gel electrophoresis of 200-fold purified enzyme localized the glycine- and taurine-dependent activities to a single band. Both activities were optimal at pH 7.8 and showed similar loss of activity at pH 6.0, pH 9.0, in the presence of 5,5'-dithiobis(2-nitrobenzoic acid), and at temperatures exceeding 50 degrees. With the purified fraction, Km for glycine was 31 mM and Km for taurine was 0.8 mM. Km for several bile acid-CoA substrates was approximately 20 micron and independent of the amino acid acceptor. Only amino acids with terminal alpha- or beta-amino groups were active as acyl acceptors. Acyl donors were limited to bile acid-CoA derivatives. The data support the conclusion that the rat has a single bile acid-CoA:amino acid N-acyltransferase. The substrate kinetics are consistent with previous observations that taurine conjugates predominate in rat bile at normal hepatocellular concentrations of glycine and taurine.
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