1
|
Steely Smith MK, Hinton-Froese KE, Scarbrough Kamath B, Virmani M, Walters A, Zielinski MJ. Characteristics and Outcomes of Women and Infants Who Received Prenatal Care While Incarcerated in Arkansas State Prison System, 2014-2019. Matern Child Health J 2024; 28:935-948. [PMID: 38177975 DOI: 10.1007/s10995-023-03875-2] [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] [Accepted: 12/20/2023] [Indexed: 01/06/2024]
Abstract
BACKGROUND Prisons face challenges in meeting the unique health care needs of women, especially those who are pregnant. This retrospective chart review sought to describe the maternal and infant health outcomes of incarcerated women who received prenatal care while in an Arkansas prison. METHODS Using a hospital-based electronic medical records (EMR) system, we examined the maternal health history and current pregnancy characteristics of 219 pregnant women who received prenatal care while incarcerated from June 2014 to May 2019. We also examined labor and delivery characteristics and postpartum and infant birth outcomes for the 146 women from this cohort who delivered a living child while still incarcerated. RESULTS Most records indicated complex health histories with several chronic illnesses, mental health diagnoses, history of substance use, and lifetime medical complications. Despite comorbid illness, substance use disorder (SUD), trauma-history, and post-traumatic stress disorder (PTSD) prevalence was lower than expected. Previous and current obstetrical complications were common. Although the Neonatal Intensive Care Unit (NICU) admission rate (41%) was high, few infants required extensive treatment intervention. Postpartum complications were rare; however, a small portion of women who gave birth in custody experienced severe complications and were re-admitted to the hospital post-discharge. CONCLUSIONS Incarcerated pregnant women and their infants are a marginalized population in great need of health care advocacy. To optimize maternal-infant outcomes, carceral agencies must recognize the health needs of incarcerated pregnant women and provide appropriate prenatal care. Expansion of carceral perinatal care to include screening for SUD and psychiatric symptoms (e.g., PTSD) and referral to appropriate care is highly encouraged. Policies related to NICU admission for non-medical reasons should be further examined.
Collapse
Affiliation(s)
- Mollee K Steely Smith
- University of Arkansas for Medical Sciences, 4301 W Markham Slot 568, Little Rock, AR, 72205, USA
| | | | - Brooke Scarbrough Kamath
- University of Arkansas for Medical Sciences, 4301 W Markham Slot 568, Little Rock, AR, 72205, USA
| | - Misty Virmani
- University of Arkansas for Medical Sciences, 4301 W Markham Slot 568, Little Rock, AR, 72205, USA
| | - Ashton Walters
- University of Arkansas for Medical Sciences, 4301 W Markham Slot 568, Little Rock, AR, 72205, USA
| | - Melissa J Zielinski
- University of Arkansas for Medical Sciences, 4301 W Markham Slot 568, Little Rock, AR, 72205, USA.
- University of Arkansas, Fayetteville, USA.
| |
Collapse
|
2
|
Zielinski MJ, Smith MS, Stahman A. Custodial and perinatal care patterns of women who received prenatal care while incarcerated in the Arkansas state prison system, 2014-2019. Health Justice 2024; 12:16. [PMID: 38613729 PMCID: PMC11015593 DOI: 10.1186/s40352-024-00268-7] [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] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 03/15/2024] [Indexed: 04/15/2024]
Abstract
BACKGROUND The extraordinary growth in women's incarceration over the past several decades has resulted in calls for expansion of research into their unique needs and experiences, including those related to pregnancy and perinatal care. However, while research into the health outcomes of women who are incarcerated while pregnant has grown, research on women's custodial and perinatal care patterns has remained nearly non-existent. Here, we sought to describe (1) the characteristics of the population of women who came to be incarcerated in a state prison system during pregnancy and (2) the characteristics of women's custodial and perinatal care patterns during and after incarceration. METHODS We conducted a retrospective chart review of the population of women who received perinatal care while incarcerated in the Arkansas state prison system over a 5-year period from June 2014 to May 2019. Electronic medical records and state prison records were merged to form our study population. Data were from 212 women (Mage = 28.4 years; 75.0% non-Latina White) with a singleton pregnancy who received at least one obstetric care visit while incarcerated. RESULTS Drug-related convictions were the most common crimes leading to women's incarceration while pregnant, and violent crime convictions were rare. Nearly half (43.4%) of women who gave birth in custody did so within 90 days of admission and the great majority (80.4%) released within 1-year of giving birth, including 13.3% who released within 30 days. DISCUSSION The frequency with which women who became incarcerated while pregnant released from prison either prior to or shortly after giving birth was a striking, novel finding of this study given the implications for perinatal care disruption among a high-risk population and the harms of forced separation from infants within hours of birth. CONCLUSIONS Diversionary programs for pregnant women convicted of crimes, particularly in states without current access, are urgently needed and should be a priority for future policy work.
Collapse
Affiliation(s)
- Melissa J Zielinski
- Psychiatric Research Institute, University of Arkansas for Medical Sciences, 4301 W. Markham Street, Little Rock, AR, 72205, USA.
| | - Mollee Steely Smith
- Psychiatric Research Institute, University of Arkansas for Medical Sciences, 4301 W. Markham Street, Little Rock, AR, 72205, USA
| | - Alleigh Stahman
- Psychiatric Research Institute, University of Arkansas for Medical Sciences, 4301 W. Markham Street, Little Rock, AR, 72205, USA
| |
Collapse
|
3
|
Van Deinse TB, Zielinski MJ, Holliday SB, Rudd BN, Crable EL. The application of implementation science methods in correctional health intervention research: a systematic review. Implement Sci Commun 2023; 4:149. [PMID: 38001546 PMCID: PMC10675852 DOI: 10.1186/s43058-023-00521-4] [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: 08/03/2023] [Accepted: 10/28/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND Improving access to high-quality healthcare for individuals in correctional settings is critical to advancing health equity in the United States. Compared to the general population, criminal-legal involved individuals experience higher rates of chronic health conditions and poorer health outcomes. Implementation science frameworks and strategies offer useful tools to integrate health interventions into criminal-legal settings and to improve care. A review of implementation science in criminal-legal settings to date is necessary to advance future applications. This systematic review summarizes research that has harnessed implementation science to promote the uptake of effective health interventions in adult criminal-legal settings. METHODS A systematic review of seven databases (Academic Search Premier, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, Social Work Abstracts, ProQuest Criminal Justice Database, ProQuest Sociological Abstracts, MEDLINE/PubMed) was conducted. Eligible studies used an implementation science framework to assess implementation outcomes, determinants, and/or implementation strategies in adult criminal-legal settings. Qualitative synthesis was used to extract and summarize settings, study designs, sample characteristics, methods, and application of implementation science methods. Implementation strategies were further analyzed using the Pragmatic Implementation Reporting Tool. RESULTS Twenty-four studies met inclusion criteria. Studies implemented interventions to address infectious diseases (n=9), substance use (n=6), mental health (n=5), co-occurring substance use and mental health (n=2), or other health conditions (n=2). Studies varied in their operationalization and description of guiding implementation frameworks/taxonomies. Sixteen studies reported implementation determinants and 12 studies measured implementation outcomes, with acceptability (n=5), feasibility (n=3), and reach (n=2) commonly assessed. Six studies tested implementation strategies. Systematic review results were used to generate recommendations for improving implementation success in criminal-legal contexts. CONCLUSIONS The focus on implementation determinants in correctional health studies reflects the need to tailor implementation efforts to complex organizational and inter-agency contexts. Future studies should investigate policy factors that influence implementation success, design, and test implementation strategies tailored to determinants, and investigate a wider array of implementation outcomes relevant to criminal-legal settings, health interventions relevant to adult and juvenile populations, and health equity outcomes. TRIAL REGISTRATION A study protocol (CRD42020114111) was registered with Prospero.
Collapse
Affiliation(s)
- Tonya B Van Deinse
- University of North Carolina at Chapel Hill School of Social Work, Chapel Hill, USA.
| | - Melissa J Zielinski
- University of Arkansas for Medical Sciences Psychiatric Research Institute, Little Rock, USA
| | | | | | - Erika L Crable
- Department of Psychiatry, University of California San Diego, San Diego, USA
| |
Collapse
|
4
|
Fradley MF, Kathryn Allison M, Steely Smith MK, Bossard M, Zielinski MJ. Justice-Involved, Sexually Victimized Women's Perspectives on the Acceptability of Receiving Trauma-Focused Therapy in Prison. Violence Against Women 2023; 29:2964-2985. [PMID: 37674415 DOI: 10.1177/10778012231200480] [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] [Indexed: 09/08/2023]
Abstract
Incarcerated women report high rates of sexual victimization. Interviews with 63 previously incarcerated women survivors of sexual violence explored perceptions toward receiving trauma-focused therapy while incarcerated and postrelease trauma-focused therapy utilization. Nearly all participants (97%) recommended that trauma-focused therapy be available to incarcerated women. Most believed that prisons are acceptable places to receive trauma-focused therapy, without qualification (65%); some reported mixed feelings or indicated acceptability but identified factors that would increase acceptability (33%). Notably, most were currently experiencing trauma-related symptoms, but few had attended trauma-focused therapy following release. Findings indicate that access to prison-based trauma-focused therapy is necessary and acceptable.
Collapse
Affiliation(s)
- Marley F Fradley
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - M Kathryn Allison
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Mollee K Steely Smith
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - MeeSoh Bossard
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Melissa J Zielinski
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR, USA
- Department of Psychological Science, University of Arkansas, Fayetteville, AR, USA
| |
Collapse
|
5
|
Steely Smith MK, Zielinski MJ, Sufrin C, Kramer CT, Benning SJ, Laine R, Shlafer RJ. State Laws on Substance Use Treatment for Incarcerated Pregnant and Postpartum People. Subst Abuse 2023; 17:11782218231195556. [PMID: 37746631 PMCID: PMC10517601 DOI: 10.1177/11782218231195556] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 07/27/2023] [Indexed: 09/26/2023]
Abstract
Background Incarcerated perinatal populations report high rates of substance use in the United States (US). Despite this, substance use disorder (SUD) treatment is not routinely available in carceral settings and state policies related to the provision of substance use screening and treatment are unknown. Methods We conducted a systematic search in WestLaw through the end of the 2020 legislative session combining the terms "pregnant" and "postpartum" with terms for incarceration and related terms. The search returned 453 statutes from 43 states. A deductive codebook of various maternal health topics was developed. Legislative texts related to SUD screening and treatment were extracted for textual analysis. Results Of the 43 states identified as having at least 1 state statute pertaining to pregnant or postpartum incarcerated people, 7 states had statutes relevant to SUD screening and treatment. Statutes related to substance use screening, education, treatment and diversion programs, program eligibility, aftercare and release planning, and funding appropriations. Conclusions The majority of states across the U.S. lack legislation that address SUD screening and treatment among incarcerated perinatal populations. Given the known limited access to SUD treatment for perinatal populations in custody, increasing legislative statutes could increase access to essential care.
Collapse
Affiliation(s)
- Mollee K Steely Smith
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Melissa J Zielinski
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR, USA
- Department of Psychiatry and Behavioral Sciences, University of Arkansas at Fayetteville, Fayetteville, AR, USA
| | - Carolyn Sufrin
- Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Camille T Kramer
- Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Sara J Benning
- School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Rosemary Laine
- Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - Rebecca J Shlafer
- Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| |
Collapse
|
6
|
Zielinski MJ, Roberts LT, Han X, Martel ID. A longitudinal analysis of PTSD and other mental health symptoms among people sentenced to drug treatment court. Psychol Trauma 2023; 15:1022-1026. [PMID: 34591533 PMCID: PMC8964831 DOI: 10.1037/tra0001125] [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] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Drug treatment courts offer an alternative to incarceration for people who are facing criminal charges related to addiction. Because addiction commonly co-occurs with trauma exposure and associated mental illnesses, drug treatment courts likely serve people with these difficulties. Yet whether or how mental health symptoms change over drug treatment court participation has not been studied. METHOD We sought to (1) describe the mental health symptom profiles, including PTSD, of recent drug court enrollees, (2) examine the course of these symptom profiles at baseline, 6-month follow-up, and 12-month follow-up, and (3) test posttraumatic stress symptoms (PTSS) and gender as potential moderators of any identified time effects. Participants were 983 adults sentenced to drug treatment court between 2009 and 2017. RESULTS Generalized linear mixed models revealed a significant effect of time on PTSS as measured by the PTSD Checklist and on summary indices of mental health measured by the Brief Symptom Inventory (p < .05 for all the outcomes). Gender did not moderate the effect of time on either outcome. However, those with PTSS above the clinical cut-off at baseline experienced less improvement in mental health over time. CONCLUSION Our findings suggest that drug treatment court participants' mental health, including PTSS, improved over time. However, the presence of elevated PTSS interfered with improvements in other facets of mental health. Additional work is needed to identify specific program components that may exert causal effects and to examine interventions for PTSS that can be readily integrated in drug treatment courts. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
Collapse
|
7
|
Swindle T, Baloh J, Landes SJ, Lovelady NN, Vincenzo JL, Hamilton AB, Zielinski MJ, Teeter BS, Gorvine MM, Curran GM. Evidence-Based Quality Improvement (EBQI) in the pre-implementation phase: key steps and activities. Front Health Serv 2023; 3:1155693. [PMID: 37292120 PMCID: PMC10244502 DOI: 10.3389/frhs.2023.1155693] [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] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 05/04/2023] [Indexed: 06/10/2023]
Abstract
Background Evidence-Based Quality Improvement (EBQI) involves researchers and local partners working collaboratively to support the uptake of an evidence-based intervention (EBI). To date, EBQI has not been consistently included in community-engaged dissemination and implementation literature. The purpose of this paper is to illustrate the steps, activities, and outputs of EBQI in the pre-implementation phase. Methods The research team applied comparative case study methods to describe key steps, activities, and outputs of EBQI across seven projects. Our approach included: (1) specification of research questions, (2) selection of cases, (3) construction of a case codebook, (4) coding of cases using the codebook, and (5) comparison of cases. Results The cases selected included five distinct settings (e.g., correction facilities, community pharmacies), seven EBIs (e.g., nutrition promotion curriculum, cognitive processing therapy) and five unique lead authors. Case examples include both community-embedded and clinically-oriented projects. Key steps in the EBQI process included: (1) forming a local team of partners and experts, (2) prioritizing implementation determinants based on existing literature/data, (3) selecting strategies and/or adaptations in the context of key determinants, (4) specifying selected strategies/adaptations, and (5) refining strategies/adaptations. Examples of activities are included to illustrate how each step was achieved. Outputs included prioritized determinants, EBI adaptations, and implementation strategies. Conclusions A primary contribution of our comparative case study is the delineation of various steps and activities of EBQI, which may contribute to the replicability of the EBQI process across other implementation research projects.
Collapse
Affiliation(s)
- Taren Swindle
- Department of Family and Preventive Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, United States
- Center for Implementation Research, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Jure Baloh
- Center for Implementation Research, University of Arkansas for Medical Sciences, Little Rock, AR, United States
- Department of Health Policy and Management, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Sara J. Landes
- Center for Implementation Research, University of Arkansas for Medical Sciences, Little Rock, AR, United States
- Behavioral Health Quality Enhancement Research Initiative (QUERI), Central Arkansas Veterans Healthcare System, Little Rock, AR, United States
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Nakita N. Lovelady
- Department of Health Behavior and Health Education, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Jennifer L. Vincenzo
- Department of Physical Therapy, University of Arkansas for Medical Sciences, Fayetteville, AR, United States
| | - Alison B. Hamilton
- Center for the Study of Healthcare Innovation, Implementation, & Policy; VA Greater Los Angeles Healthcare System, Los Angeles, CA, United States
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, United States
| | - Melissa J. Zielinski
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR, United States
- Department of Psychological Science, University of Arkansas, Fayetteville, AR, United States
| | - Benjamin S. Teeter
- Center for Implementation Research, University of Arkansas for Medical Sciences, Little Rock, AR, United States
- Department of Pharmacy Practice, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Margaret M. Gorvine
- Department of Health Behavior and Health Education, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Geoffrey M. Curran
- Center for Implementation Research, University of Arkansas for Medical Sciences, Little Rock, AR, United States
- Department of Pharmacy Practice, University of Arkansas for Medical Sciences, Little Rock, AR, United States
- Central Arkansas Veterans Healthcare System, Little Rock, AR, United States
| |
Collapse
|
8
|
Zielinski MJ, Veilleux JC, Fradley MF, Skinner KD. Perceived emotion invalidation predicts daily affect and stressors. Anxiety Stress Coping 2023; 36:214-228. [PMID: 35135399 PMCID: PMC9357853 DOI: 10.1080/10615806.2022.2033973] [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] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 01/19/2022] [Accepted: 01/21/2022] [Indexed: 01/10/2023]
Abstract
BACKGROUND AND OBJECTIVES Perceived emotion invalidation is linked to the development or worsening of a variety of emotional and physical health conditions. However, prior studies are largely cross-sectional and whether there are day-to-day effects of generally feeling invalidated is unknown. DESIGN We examined the relations between perceived emotion invalidation and momentary affect, average daily affect, and the experience of daily stressors among a sample of young adults using ecological momentary assessment (EMA). METHODS Participants (n = 86) completed measures of perceived emotion invalidation and emotional reactivity at baseline then completed one week of EMA including: (1) 7x/day reports of current affect and social context and (2) 1x/day index of experienced stressors and their intensity. RESULTS Higher perceived emotion invalidation predicted lower momentary positive affect. Perceived invalidation also interacted with social context such that higher emotion invalidation predicted greater negative affect when participants were with non-close others (i.e., co-workers, acquaintances). Only participants with high perceived emotional invalidation experienced increased stress alongside heightened daily negative affect. CONCLUSIONS These results provide preliminary evidence that feeling emotionally invalidated may predict affective experiences, including how emotions are momentarily experienced and how life stressors are interpreted when they are later reflected on.
Collapse
Affiliation(s)
- Melissa J Zielinski
- Psychiatric Research Institute, University of Arkansas for Medical Science, Little Rock, AR, USA
- Department of Psychological Science, University of Arkansas, Fayetteville, AR, USA
| | - Jennifer C Veilleux
- Department of Psychological Science, University of Arkansas, Fayetteville, AR, USA
| | - Marley F Fradley
- Psychiatric Research Institute, University of Arkansas for Medical Science, Little Rock, AR, USA
| | - Kayla D Skinner
- Department of Psychological Science, University of Arkansas, Fayetteville, AR, USA
| |
Collapse
|
9
|
Zielinski MJ, Alkov D, McCauley E, Aminawung JA, Shavit S, Wang EA. Characteristics of recently incarcerated primary care patients with and without a positive posttraumatic stress disorder screening upon clinic intake. Psychol Trauma 2023:2023-42017-001. [PMID: 36729519 PMCID: PMC10497219 DOI: 10.1037/tra0001427] [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] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Posttraumatic stress disorder (PTSD) is prevalent among people who have been incarcerated. Here, we examined whether screening positive for PTSD was associated with other indicators of poor health, acute healthcare utilization, and poverty among primary care patients upon release from incarceration. METHOD We conducted a cross-sectional survey in a national network of primary care clinics serving people recently released from incarceration. Participants were 416 patients who completed the Primary Care PTSD screen (PC-PTSD) and other questions about mental and physical health, acute healthcare utilization, and economic status within 6 months of release. RESULTS Screening positive for PTSD was associated with worse status across nearly all variables examined, including being more likely to report: poor/fair health (61.6% vs. 41.7%), current depressive symptoms (89.7% vs. 50.8%), lifetime depression diagnosis (63.3% vs. 35.3%), cannabis use since release (20.7% vs. 9.6%), homelessness (31.9% vs. 18.5%), having no cash on hand (56.3% vs. 39.0%) and severe food insecurity (29.3% vs. 18.2%; all ps < .01). Reporting recent suicidality (14.3% vs. 7.0%), alcohol use since release (30.2% vs. 20.0%), and emergency department utilization (20.4% vs. 12.2%) was also more likely (all ps ≤ .03). These trends were largely upheld when controlling for demographic characteristics and chronic physical health conditions using linear probability regression. CONCLUSIONS Primary care patients recently released from incarceration have a need for wrap-around services that address health challenges and poverty. Patients with significant PTSD symptoms face even greater challenges. Identification and treatment of PTSD both during and after incarceration is warranted. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
Collapse
|
10
|
Zielinski MJ, Allison MK, Smith MKS, Curran G, Kaysen D, Kirchner JE. Implementation of group cognitive processing therapy in correction centers: Anticipated determinants from formative evaluation. J Trauma Stress 2023; 36:193-204. [PMID: 36468175 PMCID: PMC10069158 DOI: 10.1002/jts.22898] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Revised: 10/20/2022] [Accepted: 10/20/2022] [Indexed: 12/07/2022]
Abstract
Nearly all people in prison have experienced trauma, and many meet the criteria for posttraumatic stress disorder (PTSD). Untreated PTSD increases the risk of substance use problems after release, contributing to a well-documented cycle of trauma, addiction, and incarceration. However, evidence-based, trauma-focused therapy for PTSD is rarely offered in prisons, and there is little research that can guide implementation efforts. In preparation for an effectiveness-implementation hybrid II pilot trial examining group-delivered cognitive processing therapy (CPT) in prisons, we conducted a formative evaluation using interviews structured according to the consolidated framework for implementation research (i.e., CFIR). Participants were correction center leadership, treatment staff, health care staff, and security staff (n = 22) and incarcerated persons (n = 14; 57.1% female). We found that CPT was highly compatible with residents' needs and the centers' available resources, culture, existing programs, and current workflow. CPT was also acceptable to all stakeholders. Potential barriers were the lower relative priority for CPT compared with programs that are reinforced at the system level, limited staff time to deliver CPT, limited staff knowledge about PTSD, and center features that could distract from CPT groups and/or training or be countertherapeutic. Taken together, CPT is a promising trauma-focused therapy for corrections, but these findings underscore the importance of identifying and matching potential barriers to effective implementation strategies a priori and work in the policy arena to promote sustainability.
Collapse
Affiliation(s)
- Melissa J. Zielinski
- Psychiatric Research Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
- Department of Psychological Science, University of Arkansas, Fayetteville, Arkansas, USA
| | - M. Kathryn Allison
- Psychiatric Research Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Mollee K. Steely Smith
- Psychiatric Research Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Geoffrey Curran
- Psychiatric Research Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Debra Kaysen
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, California, USA
| | - JoAnn E. Kirchner
- Psychiatric Research Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
- Central Arkansas Veterans Healthcare System, Little Rock, Arkansas, USA
| |
Collapse
|
11
|
Steely Smith MK, Wilson SH, Zielinski MJ. An integrative literature review of substance use treatment service need and provision to pregnant and postpartum populations in carceral settings. Womens Health (Lond) 2023; 19:17455057221147802. [PMID: 36920150 PMCID: PMC10021089 DOI: 10.1177/17455057221147802] [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] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 10/12/2022] [Accepted: 12/08/2022] [Indexed: 03/16/2023]
Abstract
Pregnancy is a critical time to provide access to substance use treatment; this is especially true among incarcerated populations, who are known to be at particularly high risk of poor health outcomes. In this integrated literature review, we (1) report what is known about the prevalence of substance use among incarcerated pregnant and postpartum populations; (2) describe substance use treatment programs and current care practices of pregnant and postpartum populations in carceral settings; and (3) explore recommendations and strategies for increasing access to substance use treatment for incarcerated pregnant and postpartum populations. A comprehensive search of seven electronic databases yielded in the retrieval of 139 articles that were assessed for inclusion. Of the retrieved articles, 33 articles met criteria for inclusion in this review. A review of the literature revealed that the understanding of substance use prevalence among pregnant incarcerated women is limited. We also found that treatment of substance use disorders among pregnant and postpartum populations is not routinely available, enhanced perinatal services are sorely needed, and substance use treatment programs are feasible with the help of community partnerships. More research is required to understand current substance use treatment initiatives and outcomes for pregnant women in prison. In addition, strategies for integrating evidence-based, substance use treatment in carceral settings is also needed. Future directions are discussed.
Collapse
Affiliation(s)
| | | | - Melissa J Zielinski
- University of Arkansas for Medical
Sciences, Little Rock, AR, USA
- University of Arkansas, Fayetteville,
AR, USA
| |
Collapse
|
12
|
Allison MK, Curran G, Walsh WA, Dworkin ER, Zielinski MJ. Factors Affecting Telemedicine Implementation in Emergency Departments and Nurses' Perceptions of Virtual Sexual Assault Nurse Examiner Consultation for Sexual Assault Survivors. J Forensic Nurs 2023; 19:41-49. [PMID: 36812373 PMCID: PMC9971634 DOI: 10.1097/jfn.0000000000000385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
INTRODUCTION Emergency department (ED) nurses play a critical role in caring for sexual assault patients, but many have not received training on how to conduct a proper sexual assault forensic medical examination. Live or real-time sexual assault nurse examiner (SANE) consultation provided via telemedicine (known as "teleSANE") during sexual assault examinations is a promising new practice to address this issue. PURPOSE The purpose of this study was to assess ED nurses' perceptions of influences on telemedicine use, as well as the utility and feasibility of teleSANE, and identify potential influences on teleSANE implementation in EDs. METHODS Guided by the Consolidated Framework for Implementation Research, this developmental evaluation involved semistructured qualitative interviews with 15 ED nurses from 13 EDs. RESULTS Interviews revealed facilitators and barriers to current telemedicine use across Consolidated Framework for Implementation Research levels. Facilitators included state-level grant funding and technical assistance. Barriers included clinician discomfort being on video and access to ongoing training. Participants believed teleSANE consultation would improve patient care and forensic evidence collection but had concerns for patient privacy and acceptability. Most participants worked in EDs that have the information technology support and telemedicine equipment needed to support teleSANE implementation, although many requested ongoing education and trainings on teleSANE and sexual assault care to improve clinician confidence and account for high staff turnover. DISCUSSION Findings highlight the unique needs of sexual assault survivors receiving telemedicine services in EDs, particularly those in rural communities with heightened privacy concerns and limited access to specialty care.
Collapse
Affiliation(s)
- M. Kathryn Allison
- Department of Health Behavior and Health Education, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Geoffrey Curran
- Center for Health Services Research, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
- Center for Implementation Research, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
- Central Arkansas Veterans Healthcare System, USA
| | | | | | - Melissa J. Zielinski
- Psychiatric Research Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| |
Collapse
|
13
|
Allison MK, Henderson H, Curran G, Zielinski MJ. Emergency Department Nurses' Perceptions of Patient Substance Use, Impact on Sexual Assault Care, and Access to Follow-up Behavioral Health Resources. J Emerg Nurs 2022; 48:698-708. [PMID: 36075768 PMCID: PMC9669220 DOI: 10.1016/j.jen.2022.07.010] [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: 10/26/2021] [Revised: 06/30/2022] [Accepted: 07/29/2022] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Patients may present to the emergency department for sexual assault care under the influence of drugs or alcohol. However, many emergency nurses are not prepared to meet their unique needs or aware of follow-up behavioral health resources. The purpose of this study was to (1) summarize current resources provided to patients and processes for referral to behavioral health services after sexual assault care, (2) explore emergency nurses' attitudes and behaviors toward patient substance use, and (3) explore nurses' perceptions of adjunct mobile health interventions for follow-up behavioral health care and describe anticipated barriers to use. METHODS Fifteen emergency nurses participated in semi-structured qualitative interviews. RESULTS Participants had mixed perceptions of patient intoxication during sexual assault care. They felt that conversations about substance use may be more appropriate after the ED visit. Participants recognized the opportunity to connect ED patients with substance use treatment or prevention resources but perceived that there are few local service providers. Most participants were not referring patients with substance use issues to behavioral health services after sexual assault care and said that their emergency departments did not have processes for referral to these services. Acceptability of mobile health for follow-up behavioral health care was high, but participants had concerns for patient privacy and internet access. Participants gave recommendations to improve referral practices and patient engagement with mobile health interventions. DISCUSSION This study highlights the need for emergency nurses to consider patient intoxication during sexual assault care and opportunities to connect patients with resources post-assault.
Collapse
Affiliation(s)
- M. Kathryn Allison
- Department of Health Behavior and Health Education, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences
| | - Hannah Henderson
- Psychiatric Research Institute, University of Arkansas for Medical Sciences
| | - Geoffrey Curran
- Center for Implementation Research, University of Arkansas for Medical Sciences
| | | |
Collapse
|
14
|
Zielinski MJ, Praseuth A, Gai MJ, Evans LJ, Zaller ND, Umar I, Barocas JA. Crisis stabilization units for jail diversion: A preliminary assessment of patient characteristics and outcomes. Psychol Serv 2022; 19:630-636. [PMID: 35099227 PMCID: PMC9339028 DOI: 10.1037/ser0000616] [Citation(s) in RCA: 2] [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] [Subscribe] [Scholar Register] [Indexed: 08/02/2023]
Abstract
Crisis stabilization units (CSUs), which offer a range of short-term psychiatric and psychological services, are one of several treatment programs that may create "alternative to arrest" options for law enforcement. Here, we examined the characteristics of the population who was referred to a newly established CSU in its first year of operation and examined the impact of the CSU on regional jail bookings. Administrative medical records and regional jail booking data were merged to form our study sample. Adults who had at least one jail booking and/or one CSU admission during our study period were included. We found that from September 1, 2018 to August 30, 2019, 458 people were admitted into the CSU. Approximately one-third (33.8%) had a jail booking during the study period. In the 3 months following CSU admission, 4.1% had an increase in jail bookings, 11.1% had a decrease, and 66.2% had no change. CSU patients self-reported high depressive and posttraumatic stress disorder symptoms, while also reporting low quality of life scores overall. We conclude that CSUs may be promising components of jail diversion efforts, providing critical services to populations experiencing significant mental health symptoms and who are at risk for incarceration. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
Collapse
|
15
|
Zielinski MJ, Smith MKS, Kaysen D, Selig JP, Zaller ND, Curran G, Kirchner JE. A participant-randomized pilot hybrid II trial of group cognitive processing therapy for incarcerated persons with posttraumatic stress and substance use disorder symptoms: study protocol and rationale. Health Justice 2022; 10:30. [PMID: 36181587 PMCID: PMC9525924 DOI: 10.1186/s40352-022-00192-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 09/09/2022] [Indexed: 06/10/2023]
Abstract
BACKGROUND Trauma exposure and drug addiction go hand-in-hand for the 2.17 million people who are incarcerated in US prisons; prevalence of both exceed 80% among this population. This manuscript describes the rationale and methods for a participant-randomized effectiveness-implementation hybrid type II pilot trial designed to: 1) examine the effectiveness of Cognitive Processing Therapy group (CPT), an evidence-based psychotherapy for posttraumatic stress disorder (PTSD), for reducing post-release drug use and PTSD symptoms when adapted for and delivered in prisons; and 2) provide data on implementation outcomes associated with the use of implementation facilitation as a strategy for supporting uptake of CPT in prisons. METHOD Participants in the effectiveness portion of the trial (N = 120) will be incarcerated men and women who are randomly assigned to one of two group therapies: CPT or a control condition (PTSD coping skills group; PCS). Participants will complete assessment measures three times: pre-treatment, post-treatment, and 3 months following release from incarceration. CPT groups will be led by prison counselors who are receiving implementation facilitation to support their efforts. PCS groups will be led by trained clinicians on the research team. Implementation outcomes will include acceptability, appropriateness, adoption, feasibility, fidelity, and sustainability. After enrollment ends, the research team will monitor CPT sustainment and recidivism outcomes of study participants for one year. DISCUSSION This study will lay the groundwork for a larger study of interventions for co-occurring PTSD and SUD in prisons and, critically, inform the development of strategies (such as implementation facilitation) for supporting their uptake in routine practice. TRIAL REGISTRATION NCT04007666 , clinicaltrials.gov, 24 June 2019, 02 September 2021.
Collapse
Affiliation(s)
- Melissa J Zielinski
- University of Arkansas for Medical Sciences, Little Rock, AR, USA.
- University of Arkansas, Fayetteville, USA.
| | | | | | - James P Selig
- University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | | | - Geoffrey Curran
- University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - JoAnn E Kirchner
- University of Arkansas for Medical Sciences, Little Rock, AR, USA
- Central Arkansas Veterans Healthcare System, North Little Rock, USA
| |
Collapse
|
16
|
Zielinski MJ, Cowell M, Bull CE, Veluvolu M, Behne MF, Nowotny K, Brinkley-Rubinstein L. Policy and public communication methods among U.S. state prisons during the first year of the COVID-19 pandemic. Health Justice 2022; 10:27. [PMID: 36048251 PMCID: PMC9435413 DOI: 10.1186/s40352-022-00187-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Accepted: 07/08/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Throughout the first year of the COVID-19 pandemic, our research team monitored and documented policy changes in United States (U.S.) prison systems. Data sources included prison websites and official prison social media accounts. Over 2500 data sources relevant to the COVID-19 pandemic in U.S. prisons were located and summarized in to five different categories: 1) prevention, 2) case identification and intervention, 3) movement, 4) social communication and connection, and 5) programming, recreation, and privileges. RESULTS All state prison systems reportedly enacted multiple policies intended to limit the spread of COVID-19 during the pandemic. Document analysis revealed that the most commonly released policies were restrictions on social contacts and privileges, basic preventive measures (e.g., distribution of masks), and basic case identification measures (e.g., verbal screening and temperature checks). Utilization of social media for policy communication varied significantly across states, though relevant data was more often released on Facebook than Twitter. CONCLUSIONS Together, our work provides foundational knowledge on the wide breadth of policies that were reportedly enacted in the first year of the pandemic that may be used as a base for quantitative work on policy effectiveness and examinations of implementation.
Collapse
Affiliation(s)
- Melissa J Zielinski
- Psychiatric Research Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
- Department of Psychological Science, University of Arkansas, Fayetteville, AR, USA.
| | - Mariah Cowell
- Department of Social Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Chelsey E Bull
- Psychiatric Research Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Manasa Veluvolu
- Psychiatric Research Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - M Forrest Behne
- Department of Social Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Kathryn Nowotny
- Department of Sociology, University of Miami, Coral Gables, FL, USA
| | | |
Collapse
|
17
|
Norris WK, Allison MK, Fradley MF, Zielinski MJ. 'You're setting a lot of people up for failure': what formerly incarcerated women would tell healthcare decision makers. Health Justice 2022; 10:4. [PMID: 35103865 PMCID: PMC8808972 DOI: 10.1186/s40352-022-00166-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 12/30/2021] [Indexed: 05/13/2023]
Abstract
BACKGROUND Incarcerated women have a higher prevalence of health problems than the general population; however, little is known about their perspectives on the healthcare they receive. Here, we conducted semi-structured interviews with women who had been incarcerated (n = 63) which asked what they would tell healthcare decision-makers about their experiences of healthcare in prisons and the community post-incarceration if provided the opportunity. All participants had a history of sexual violence victimization and had at least one period of incarceration in a community corrections center in Arkansas due to the goals of the larger study from which data were drawn. RESULTS Four themes arose when participants were asked what they would tell people who make decisions about community healthcare: 1) the healthcare system is not working (52%; n = 33), 2) have compassion for us (27%; n = 17), 3) recognize that we have specific and unique needs (17%; n = 11), and 4) the transition from incarceration is challenging and requires more support (22%; n = 14). Three themes arose when we asked participants what they would tell people who make decisions about healthcare in prisons: 1) we had experiences of poor physical healthcare in prison (44%; n = 28), 2) more specialty care is needed in prison (49%; n = 31), and 3) healthcare providers treat women in prison poorly (37%; n = 23). CONCLUSIONS Our findings underscore the need for systemic changes including greater oversight of prison-based healthcare services, enhanced access to medical subspecialties in prisons, and healthcare provider training on the unique needs of incarcerated and previously incarcerated women. Polices that expand healthcare access are also likely to benefit formerly incarcerated women given the challenges they experience seeking community-based care.
Collapse
Affiliation(s)
- Whitney K Norris
- University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | | | - Marley F Fradley
- University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Melissa J Zielinski
- University of Arkansas for Medical Sciences, Little Rock, AR, USA.
- University of Arkansas, Fayetteville, AR, USA.
| |
Collapse
|
18
|
Barocas JA, Umar I, Praseuth A, Evans L, Zaller ND, Zielinski MJ. An Economic Analysis of the Cost of a Regional Crisis Stabilization Unit. J Correct Health Care 2022; 28:54-58. [PMID: 34788552 PMCID: PMC9041403 DOI: 10.1089/jchc.20.06.0052] [Citation(s) in RCA: 1] [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] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Crisis stabilization units (CSUs) are one type of "alternative to arrest" program used for jail diversion. We aimed to estimate the economic costs of starting and operating a CSU in Arkansas. We estimated the economic costs of the Pulaski County Regional CSU (PCRCSU) located in Little Rock, Arkansas, from September 1, 2018, to August 31, 2019. We collected data through interviews about start-up and ongoing management costs. We calculated total annual economic cost, average admission cost, and average 24 hr admission cost. There were 536 admissions to the CSU during the study period. The average length of stay was 60.27 hr. The total annual cost of the PCRCSU was $1,636,831 and average per admission cost was $3,054. Our results provide valuable economic data to government stakeholders who are considering establishing a CSU.
Collapse
Affiliation(s)
- Joshua A. Barocas
- Section of Infectious Diseases, Boston Medical Center, Boston, Massachusetts, USA.,Boston University School of Medicine, Boston, Massachusetts, USA.,*Address correspondence to: Joshua A. Barocas, MD, University of Colorado School of Medicine, Divisions of General Internal Medicine and Infectious Diseases, 12631 E. 17th Ave., Mailstop B180 Aurora CO, 80045, USA,
| | - Imaan Umar
- Section of Infectious Diseases, Boston Medical Center, Boston, Massachusetts, USA
| | - Amanda Praseuth
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Lisa Evans
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Nickolas D. Zaller
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Melissa J. Zielinski
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.,Department of Psychiatry, University of Arkansas, Fayetteville, Arkansas, USA
| |
Collapse
|
19
|
Dueweke AR, Higuera DE, Zielinski MJ, Karlsson ME, Bridges AJ. Does Group Size Matter? Group Size and Symptom Reduction Among Incarcerated Women Receiving Psychotherapy Following Sexual Violence Victimization. Int J Group Psychother 2022; 72:1-33. [PMID: 36249160 PMCID: PMC9555233 DOI: 10.1080/00207284.2021.2015601] [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] [Indexed: 01/30/2023]
Abstract
Survivors Healing from Abuse: Recovery through Exposure (SHARE) is an eight-week therapy group for incarcerated women who have experienced sexual violence victimization. SHARE requires each member to complete an imaginal exposure and to listen when others share their experiences of victimization. While trauma-focused group interventions including SHARE are associated with reductions in internalizing symptoms, little work has examined how group characteristics predict symptom decreases. The purpose of this study was to examine whether group size was associated with symptom changes pre- to post-treatment. Participants (n=140 across 29 groups) completed self-report measures of posttraumatic stress symptoms before and after completing SHARE. Multilevel modeling revealed the majority of the variance in post-treatment symptoms was attributed to individual factors rather than group factors. Symptom change was comparable for groups of two to eight women; declines in symptom improvement were observed at a group size of ten participants.
Collapse
Affiliation(s)
- Aubrey R. Dueweke
- Department of Psychological Science, University of Arkansas, 216 Memorial Hall, Fayetteville, AR 72701, USA
| | - Danielle E. Higuera
- Department of Psychological Science, University of Arkansas, 216 Memorial Hall, Fayetteville, AR 72701, USA
| | - Melissa J. Zielinski
- Department of Psychological Science, University of Arkansas, 216 Memorial Hall, Fayetteville, AR 72701, USA.,Psychiatric Research Institute, University of Arkansas for Medical Sciences, 4301 W. Markham Street, Little Rock, AR 72205, USA
| | - Marie E. Karlsson
- Department of Psychology, Murray State University, 212 Wells Hall, Murray, KY 42071, USA
| | - Ana J. Bridges
- Department of Psychological Science, University of Arkansas, 216 Memorial Hall, Fayetteville, AR 72701, USA
| |
Collapse
|
20
|
Marshall SA, Barham C, Neher T, Zielinski MJ, Brinkley-Rubinstein L, Gorvine MM, Zaller N. Acceptability of a Community Health Worker Program to Link High-Risk People in Jail to HIV Pre-Exposure Prophylaxis. J Health Care Poor Underserved 2022; 33:149-166. [DOI: 10.1353/hpu.2022.0012] [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: 11/11/2022]
|
21
|
Fortney JC, Bauer AM, Cerimele JM, Pyne JM, Pfeiffer P, Heagerty PJ, Hawrilenko M, Zielinski MJ, Kaysen D, Bowen DJ, Moore DL, Ferro L, Metzger K, Shushan S, Hafer E, Nolan JP, Dalack GW, Unützer J. Comparison of Teleintegrated Care and Telereferral Care for Treating Complex Psychiatric Disorders in Primary Care: A Pragmatic Randomized Comparative Effectiveness Trial. JAMA Psychiatry 2021; 78:1189-1199. [PMID: 34431972 PMCID: PMC8387948 DOI: 10.1001/jamapsychiatry.2021.2318] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 06/29/2021] [Indexed: 11/14/2022]
Abstract
Importance Only one-third of patients with complex psychiatric disorders engage in specialty mental health care, and only one-tenth receive adequate treatment in primary care. Scalable approaches are critically needed to improve access to effective mental health treatments in underserved primary care settings. Objective To compare 2 clinic-to-clinic interactive video approaches to delivering evidence-based mental health treatments to patients in primary care clinics. Design, Setting, and Participants This pragmatic comparative effectiveness trial used a sequential, multiple-assignment, randomized trial (SMART) design with patient-level randomization. Adult patients treated at 24 primary care clinics without on-site psychiatrists or psychologists from 12 federally qualified health centers in 3 states who screened positive for posttraumatic stress disorder and/or bipolar disorder and who were not already receiving pharmacotherapy from a mental health specialist were recruited from November 16, 2016, to June 30, 2019, and observed for 12 months. Interventions Two approaches were compared: (1) telepsychiatry/telepsychology-enhanced referral (TER), where telepsychiatrists and telepsychologists assumed responsibility for treatment, and (2) telepsychiatry collaborative care (TCC), where telepsychiatrists provided consultation to the primary care team. TER included an adaptive intervention (phone-enhanced referral [PER]) for patients not engaging in treatment, which involved telephone outreach and motivational interviewing. Main Outcomes and Measures Survey questions assessed patient-reported outcomes. The Veterans RAND 12-item Health Survey Mental Component Summary (MCS) score was the primary outcome (range, 0-100). Secondary outcomes included posttraumatic stress disorder symptoms, manic symptoms, depressive symptoms, anxiety symptoms, recovery, and adverse effects. Results Of 1004 included participants, 701 of 1000 (70.1%) were female, 660 of 994 (66.4%) were White, and the mean (SD) age was 39.4 (12.9) years. Baseline MCS scores were 2 SDs below the US mean; the mean (SD) MCS scores were 39.7 (14.1) and 41.2 (14.2) in the TCC and TER groups, respectively. There was no significant difference in 12-month MCS score between those receiving TCC and TER (β = 1.0; 95% CI, -0.8 to 2.8; P = .28). Patients in both groups experienced large and clinically meaningful improvements from baseline to 12 months (TCC: Cohen d = 0.81; 95% CI, 0.67 to 0.95; TER: Cohen d = 0.90; 95% CI, 0.76 to 1.04). For patients not engaging in TER at 6 months, there was no significant difference in 12-month MCS score between those receiving PER and TER (β = 2.0; 95% CI, -1.7 to 5.7; P = .29). Conclusions and Relevance In this comparative effectiveness trial of patients with complex psychiatric disorders randomized to receive TCC or TER, significantly and substantially improved outcomes were observed in both groups. From a health care system perspective, clinical leadership should implement whichever approach is most sustainable. Trial Registration ClinicalTrials.gov Identifier: NCT02738944.
Collapse
Affiliation(s)
- John C. Fortney
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, Seattle
- Department of Veterans Affairs, Health Services Research and Development, Center of Innovation for Veteran-Centered and Value-Driven Care, Seattle, Washington
| | - Amy M. Bauer
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, Seattle
| | - Joseph M. Cerimele
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, Seattle
| | - Jeffrey M. Pyne
- Department of Psychiatry and Behavioral Sciences, College of Medicine, University of Arkansas for Medical Sciences, Little Rock
- Department of Veterans Affairs, Health Services Research and Development, Center for Mental Healthcare and Outcomes Research, Little Rock, Arkansas
| | - Paul Pfeiffer
- University of Michigan Medical School, Ann Arbor
- Department of Veterans Affairs, Health Services Research and Development, Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, Michigan
| | - Patrick J. Heagerty
- Department of Biostatistics, School of Public Health, University of Washington, Seattle
| | - Matt Hawrilenko
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, Seattle
| | - Melissa J. Zielinski
- Department of Psychiatry and Behavioral Sciences, College of Medicine, University of Arkansas for Medical Sciences, Little Rock
| | - Debra Kaysen
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, California
| | - Deborah J. Bowen
- Department of Bioethics and Humanities, University of Washington, Seattle
| | - Danna L. Moore
- School of Economic Sciences, Washington State University, Pullman
| | - Lori Ferro
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, Seattle
| | | | | | - Erin Hafer
- Community Health Plan of Washington, Seattle
| | | | | | - Jürgen Unützer
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, Seattle
| |
Collapse
|
22
|
Zielinski MJ, Karlsson ME, Bridges AJ. "I'm not alone, my story matters": Incarcerated women's perspectives on the impact and acceptability of group psychotherapy involving imaginal exposure to sexual assault memories. Health Justice 2021; 9:25. [PMID: 34591180 PMCID: PMC8482612 DOI: 10.1186/s40352-021-00148-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 07/28/2021] [Indexed: 05/27/2023]
Abstract
BACKGROUND Although it is clear that incarcerated women need access to effective therapies for trauma sequelae, some have argued that one of the most effective treatments - exposure therapy - should not be provided in carceral settings due to the presumed lack of safety and stability making such an intervention inappropriate. Group therapy, the typical mode of intervention in prisons, has also been presumed to be unacceptable for exposure-based processing due to assumptions that hearing others' trauma narratives would be traumatizing and unhelpful to listeners. However, there is a lack of data to support either of the aforementioned assumptions. This study examined the acceptability of an exposure-based group therapy for women survivors of sexual violence who were currently incarcerated (N = 61) by asking women themselves about their experiences completing an exposure-based group therapy protocol (SHARE; Survivors Healing from Abuse: Recovery through Exposure) while incarcerated. We assessed women's reasons for enrolling in the group, satisfaction with various therapy components (e.g., exposure, skill-building) and the treatment overall, and experiences of both sharing and listening to trauma narratives using a feedback survey that included a mix of multiple-choice and open-ended questions. Treatment dropout was examined as an additional index of acceptability. RESULTS Treatment completion was very high (88.8%). Nearly all women who completed the group reported that they would recommend it to other incarcerated women (96.7%, with the remaining 3.3% reporting "it depends"). Qualitative results revealed overwhelmingly positive feedback about the effect of the group and indicated that sharing and listening to trauma narratives in a group setting serve discrete but dually important functions. Specifically, women almost universally experienced listening to others' trauma narratives (i.e., exposures) in the SHARE group context as helpful-making them feel less alone and normalizing their experiences. Sharing one's own story primarily provided an emotional release and/or transformation (i.e., an intrapersonal rather than interpersonal function). CONCLUSIONS Our findings challenge common concerns about the appropriateness of 1) prison as a context for trauma-focused treatments, including exposure and 2) sharing trauma narratives in a group setting. Unless empirical evidence demonstrating harm is uncovered, best practices for PTSD and other trauma-related sequelae-those recommended in reputable treatment guidelines and interventions like SHARE that incorporate components shown to be effective (e.g., cognitive challenging, exposure)-should be offered to incarcerated women as part of standard of care.
Collapse
Affiliation(s)
- Melissa J Zielinski
- Psychiatric Research Institute, University of Arkansas for Medical Sciences, 4301 W. Markham Street Little Rock, Little Rock, AR, 72205, USA.
- Department of Psychological Sciences, University of Arkansas, AR, Fayetteville, USA.
| | - Marie E Karlsson
- Centre for Sexology and Sexuality Studies, Malmö University, Malmö, Sweden
| | - Ana J Bridges
- Department of Psychological Sciences, University of Arkansas, AR, Fayetteville, USA
| |
Collapse
|
23
|
Karlsson ME, Zielinski MJ, Calvert M, Bridges AJ. Decreases in psychiatric symptoms persist following exposure-based group therapy for sexual violence victimization among incarcerated women. Psychol Serv 2021; 19:534-540. [PMID: 34292004 PMCID: PMC8782937 DOI: 10.1037/ser0000570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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
Survivors Healing from Abuse: Recovery through Exposure (SHARE) is a brief, exposure-based group treatment for incarcerated female survivors of sexual violence. Preliminary evaluations of SHARE showed declines in depression and posttraumatic stress disorder (PTSD) symptoms from pre- to posttreatment. However, prior investigations have not included a longitudinal follow-up period and thus knowledge of whether therapeutic benefits persist following the termination of the group is lacking. Here, we examined data from 57 incarcerated women who completed SHARE and provided follow-up data while still incarcerated (M = 95 days posttreatment). Results from a one-way repeated-measures ANOVA showed significant reductions in PTSD and depression symptoms from pre- to posttreatment (large effect sizes), with symptoms further reduced during the follow-up period. In addition, McNemar tests showed a significant reduction in the proportion of participants at or above the clinical cut-off for probable PTSD and depression from pre- to posttreatment as well as from posttreatment to the follow-up assessment. Together, results suggest that the therapeutic benefits of SHARE persist after treatment is completed. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Collapse
|
24
|
Moore R, Zielinski MJ, Thompson RG, Willis DE, Purvis RS, McElfish PA. "This Pandemic Is Making Me More Anxious about My Welfare and the Welfare of Others:" COVID-19 Stressors and Mental Health. Int J Environ Res Public Health 2021; 18:5680. [PMID: 34073187 PMCID: PMC8197875 DOI: 10.3390/ijerph18115680] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 05/20/2021] [Accepted: 05/21/2021] [Indexed: 12/19/2022]
Abstract
COVID-19 and subsequent social distancing guidelines have changed many aspects of people's daily lives including the way that they interact within their social environment. Pandemics are inherently social phenomena, and public health measures intended to curtail transmission of COVID-19 (e.g., quarantine and social distancing) have consequences for individuals with anxiety and depression. Using qualitative methods, respondents with previously diagnosed anxiety or depression identified ways in which COVID-19 affected their symptoms at multiple levels of the social ecological model (SEM). Key themes reported were organized following the SEM. Emergent themes at the individual level are isolation/loneliness, fear of contracting COVID-19, and uncertainty about the future. Themes at the interpersonal level are: fears of family contracting COVID-19, separation from family members, and domestic relationships. Themes at the level of community and societal stressors are: employment, community and societal systems, media, and the COVID-19 pandemic. Our findings demonstrate the ways that mental health, physical health/safety, and social environments are interrelated in the experience of COVID-19 for individuals diagnosed with anxiety or depression. These findings make a significant contribution to the literature as this is the first article to document mental health stressors related to the COVID-19 pandemic among individuals with diagnosed anxiety and depressive disorders.
Collapse
Affiliation(s)
- Ramey Moore
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR 72703, USA; (R.M.); (D.E.W.); (R.S.P.)
| | - Melissa J. Zielinski
- Department of Psychiatry and Behavioral Sciences, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA; (M.J.Z.); (R.G.T.J.)
- Department of Psychological Science, University of Arkansas, Fayetteville, AR 72703, USA
| | - Ronald G. Thompson
- Department of Psychiatry and Behavioral Sciences, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA; (M.J.Z.); (R.G.T.J.)
| | - Don E. Willis
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR 72703, USA; (R.M.); (D.E.W.); (R.S.P.)
| | - Rachel S. Purvis
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR 72703, USA; (R.M.); (D.E.W.); (R.S.P.)
| | - Pearl A. McElfish
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR 72703, USA; (R.M.); (D.E.W.); (R.S.P.)
| |
Collapse
|
25
|
Zielinski MJ, Allison MK, Roberts LT, Karlsson ME, Bridges AJ, Kirchner JE. Implementing and Sustaining SHARE: An Exposure-Based Psychotherapy Group for Incarcerated Women Survivors of Sexual Violence. Am J Community Psychol 2021; 67:76-88. [PMID: 32985702 PMCID: PMC7969368 DOI: 10.1002/ajcp.12461] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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] [Indexed: 05/31/2023]
Abstract
Although incarcerated women are a highly victimized population, therapy for sexual violence victimization (SVV) sequela is not routinely offered in prison. SHARE is a group therapy for SVV survivors that was successfully implemented and sustained in a women's correction center. Here, we aimed to identify implementation factors and strategies that led to SHARE's success and describe incarcerated women's perspectives on the program. We conducted a retrospective process evaluation using interviews structured according to EPIS, a well-established implementation science framework. Participants (N = 22) were incarcerated women, members of the SHARE treatment team, and members of the correction center's leadership, therapeutic team, and volunteer program. Factors that facilitated SHARE implementation varied by EPIS phase and organization. Positive inter-organizational and interpersonal relationships were key across phases, as were the synergies between both the strengths and needs of each organization involved in implementation. Incarcerated women reported a strong need for SHARE and did not report any concerns about receiving trauma therapy in a carceral setting. Therapy for SVV sequelae, including exposure-based therapy, is possible to implement and sustain in carceral settings. Community-academic partnerships may be a particularly feasible way to expand access to SVV therapy for incarcerated women.
Collapse
Affiliation(s)
| | | | | | | | | | - JoAnn E. Kirchner
- University of Arkansas for Medical Sciences
- Central Arkansas Veterans Healthcare System
| |
Collapse
|
26
|
Zielinski MJ, Hinton KE, Bull CE. COVID-19 highlights the pitfalls of reliance on the carceral system as a response to addiction. J Subst Abuse Treat 2020; 122:108190. [PMID: 33221126 PMCID: PMC7855050 DOI: 10.1016/j.jsat.2020.108190] [Citation(s) in RCA: 1] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 09/11/2020] [Accepted: 10/26/2020] [Indexed: 11/30/2022]
Abstract
People who are incarcerated are likely to meet criteria for at least one substance use disorder and need access to treatment. Access to such interventions was limited prior to the COVID-19 pandemic and has almost certainly been restricted further due to implementation of procedures intended to stop the spread of the virus. In this brief commentary, we discuss how COVID-19 has revealed the already tenuous access that people who are incarcerated have to behavioral health services, and the pitfalls of reliance on the U.S. carceral system as a response to addiction.
Collapse
Affiliation(s)
- Melissa J Zielinski
- University of Arkansas for Medical Sciences, United States of America; University of Arkansas, Fayetteville, United States of America.
| | - Kendra E Hinton
- University of Arkansas for Medical Sciences, United States of America; Indiana University School of Medicine, United States of America
| | - Chelsey E Bull
- University of Central Arkansas, United States of America
| |
Collapse
|
27
|
Zielinski MJ, Allison MK, Brinkley-Rubinstein L, Curran G, Zaller ND, Kirchner JAE. Making change happen in criminal justice settings: leveraging implementation science to improve mental health care. Health Justice 2020; 8:21. [PMID: 32892276 PMCID: PMC7487468 DOI: 10.1186/s40352-020-00122-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 07/28/2020] [Indexed: 05/28/2023]
Abstract
BACKGROUND It is a constitutional right to receive health care, including mental health care, while incarcerated. Yet, even basic evidence-based mental health care practices have not been routinely integrated into criminal justice (CJ) settings. Strategies from implementation science, or the study of methods for integrating evidence-based practices into routine care, can accelerate uptake of established interventions within low-resource, high-need settings such as prisons and jails. However, most studies of mental health practices in CJ settings do not use implementation frameworks to guide efforts to integrate treatments, systematically select or report implementation strategies, or evaluate the effectiveness of strategies used. CASE PRESENTATIONS After introducing implementation science and articulating the rationale for its application within CJ settings, we provide two illustrative case examples of efforts to integrate mental health interventions within CJ settings. Each case example demonstrates how an implementation framework either was applied or could have been applied to promote intervention adoption. The first focuses on poor implementation of a mental health screener in a county jail, retrospectively highlighting how use of a determinants framework (e.g., the Consolidated Framework for Implementation Research [CFIR]) could help staff identify factors that led to the implementation failure. The second describes an investigator-initiated research study that used a process framework (the Exploration, Preparation, Implementation, Sustainment [EPIS] framework) to systematically investigate and document the factors that led to successful implementation of a psychotherapy group for survivors of sexual violence in a women's community corrections center. Both are presented in accessible language, as our goal is that this article can be used as a primer for justice health researchers, community partners, and correctional leadership who are unfamiliar with implementation science. CONCLUSIONS Scientific research on the application of implementation science to justice settings is growing, but lags behind the work done in health systems. Given the tremendous need for mental and behavioral health intervention across the full spectrum of justice settings, information on how to successfully implement evidence-based intervention and prevention efforts is sorely needed but possible to obtain with greater integration of knowledge from implementation science.
Collapse
Affiliation(s)
- Melissa J Zielinski
- Psychiatric Research Institute, University of Arkansas for Medical Sciences, 4301 W. Markham Street, Little Rock, AR, 72205, USA.
- University of Arkansas, Fayetteville, AR, USA.
| | - M Kathryn Allison
- Psychiatric Research Institute, University of Arkansas for Medical Sciences, 4301 W. Markham Street, Little Rock, AR, 72205, USA
| | | | - Geoffrey Curran
- Psychiatric Research Institute, University of Arkansas for Medical Sciences, 4301 W. Markham Street, Little Rock, AR, 72205, USA
| | - Nickolas D Zaller
- Psychiatric Research Institute, University of Arkansas for Medical Sciences, 4301 W. Markham Street, Little Rock, AR, 72205, USA
| | - Jo Ann E Kirchner
- Psychiatric Research Institute, University of Arkansas for Medical Sciences, 4301 W. Markham Street, Little Rock, AR, 72205, USA
- Central Arkansas Veterans Healthcare System, North Little Rock, AR, USA
| |
Collapse
|
28
|
Nowotny KM, Zielinski MJ, Stringer KL, Pugh T, Wu E, Metsch LR, El-Bassel N, Nunn AS, Beckwith CG. Training the Next Generation of Researchers Dedicated to Improving Health Outcomes for Justice-Involved Populations. Am J Public Health 2020; 110:S18-S20. [PMID: 31967875 DOI: 10.2105/ajph.2019.305411] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Kathryn M Nowotny
- Kathryn M. Nowotny is with the Department of Sociology, University of Miami, Miami, FL. Melissa J. Zielinski is with the College of Medicine, Psychiatric Research Institute, University of Arkansas for Medical Sciences, Little Rock. Kristi L. Stringer, Tracy Pugh, Elwin Wu, Lisa R. Metsch, and Nabila El-Bassel are with Columbia University, New York, NY. Amy S. Nunn is with Brown University School of Public Health, Department of Behavioral and Social Health Services, Providence, RI. Curt G. Beckwith is with the Department of Medicine, The Miriam Hospital/Alpert Medical School of Brown University, Providence, RI
| | - Melissa J Zielinski
- Kathryn M. Nowotny is with the Department of Sociology, University of Miami, Miami, FL. Melissa J. Zielinski is with the College of Medicine, Psychiatric Research Institute, University of Arkansas for Medical Sciences, Little Rock. Kristi L. Stringer, Tracy Pugh, Elwin Wu, Lisa R. Metsch, and Nabila El-Bassel are with Columbia University, New York, NY. Amy S. Nunn is with Brown University School of Public Health, Department of Behavioral and Social Health Services, Providence, RI. Curt G. Beckwith is with the Department of Medicine, The Miriam Hospital/Alpert Medical School of Brown University, Providence, RI
| | - Kristi L Stringer
- Kathryn M. Nowotny is with the Department of Sociology, University of Miami, Miami, FL. Melissa J. Zielinski is with the College of Medicine, Psychiatric Research Institute, University of Arkansas for Medical Sciences, Little Rock. Kristi L. Stringer, Tracy Pugh, Elwin Wu, Lisa R. Metsch, and Nabila El-Bassel are with Columbia University, New York, NY. Amy S. Nunn is with Brown University School of Public Health, Department of Behavioral and Social Health Services, Providence, RI. Curt G. Beckwith is with the Department of Medicine, The Miriam Hospital/Alpert Medical School of Brown University, Providence, RI
| | - Tracy Pugh
- Kathryn M. Nowotny is with the Department of Sociology, University of Miami, Miami, FL. Melissa J. Zielinski is with the College of Medicine, Psychiatric Research Institute, University of Arkansas for Medical Sciences, Little Rock. Kristi L. Stringer, Tracy Pugh, Elwin Wu, Lisa R. Metsch, and Nabila El-Bassel are with Columbia University, New York, NY. Amy S. Nunn is with Brown University School of Public Health, Department of Behavioral and Social Health Services, Providence, RI. Curt G. Beckwith is with the Department of Medicine, The Miriam Hospital/Alpert Medical School of Brown University, Providence, RI
| | - Elwin Wu
- Kathryn M. Nowotny is with the Department of Sociology, University of Miami, Miami, FL. Melissa J. Zielinski is with the College of Medicine, Psychiatric Research Institute, University of Arkansas for Medical Sciences, Little Rock. Kristi L. Stringer, Tracy Pugh, Elwin Wu, Lisa R. Metsch, and Nabila El-Bassel are with Columbia University, New York, NY. Amy S. Nunn is with Brown University School of Public Health, Department of Behavioral and Social Health Services, Providence, RI. Curt G. Beckwith is with the Department of Medicine, The Miriam Hospital/Alpert Medical School of Brown University, Providence, RI
| | - Lisa R Metsch
- Kathryn M. Nowotny is with the Department of Sociology, University of Miami, Miami, FL. Melissa J. Zielinski is with the College of Medicine, Psychiatric Research Institute, University of Arkansas for Medical Sciences, Little Rock. Kristi L. Stringer, Tracy Pugh, Elwin Wu, Lisa R. Metsch, and Nabila El-Bassel are with Columbia University, New York, NY. Amy S. Nunn is with Brown University School of Public Health, Department of Behavioral and Social Health Services, Providence, RI. Curt G. Beckwith is with the Department of Medicine, The Miriam Hospital/Alpert Medical School of Brown University, Providence, RI
| | - Nabila El-Bassel
- Kathryn M. Nowotny is with the Department of Sociology, University of Miami, Miami, FL. Melissa J. Zielinski is with the College of Medicine, Psychiatric Research Institute, University of Arkansas for Medical Sciences, Little Rock. Kristi L. Stringer, Tracy Pugh, Elwin Wu, Lisa R. Metsch, and Nabila El-Bassel are with Columbia University, New York, NY. Amy S. Nunn is with Brown University School of Public Health, Department of Behavioral and Social Health Services, Providence, RI. Curt G. Beckwith is with the Department of Medicine, The Miriam Hospital/Alpert Medical School of Brown University, Providence, RI
| | - Amy S Nunn
- Kathryn M. Nowotny is with the Department of Sociology, University of Miami, Miami, FL. Melissa J. Zielinski is with the College of Medicine, Psychiatric Research Institute, University of Arkansas for Medical Sciences, Little Rock. Kristi L. Stringer, Tracy Pugh, Elwin Wu, Lisa R. Metsch, and Nabila El-Bassel are with Columbia University, New York, NY. Amy S. Nunn is with Brown University School of Public Health, Department of Behavioral and Social Health Services, Providence, RI. Curt G. Beckwith is with the Department of Medicine, The Miriam Hospital/Alpert Medical School of Brown University, Providence, RI
| | - Curt G Beckwith
- Kathryn M. Nowotny is with the Department of Sociology, University of Miami, Miami, FL. Melissa J. Zielinski is with the College of Medicine, Psychiatric Research Institute, University of Arkansas for Medical Sciences, Little Rock. Kristi L. Stringer, Tracy Pugh, Elwin Wu, Lisa R. Metsch, and Nabila El-Bassel are with Columbia University, New York, NY. Amy S. Nunn is with Brown University School of Public Health, Department of Behavioral and Social Health Services, Providence, RI. Curt G. Beckwith is with the Department of Medicine, The Miriam Hospital/Alpert Medical School of Brown University, Providence, RI
| |
Collapse
|
29
|
Zaller ND, Neher TL, Presley M, Horton H, Marshall SA, Zielinski MJ, Brinkley-Rubinstein L. Barriers to linking high-risk jail detainees to HIV pre-exposure prophylaxis. PLoS One 2020; 15:e0231951. [PMID: 32302371 PMCID: PMC7164641 DOI: 10.1371/journal.pone.0231951] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 04/03/2020] [Indexed: 12/04/2022] Open
Abstract
Individuals involved in the criminal justice (CJ) system continue to be at disproportionate risk for HIV infection, and often have a greater prevalence of substance use and sexual related risk behaviors relative to their non-CJ involved peers. Pre-exposure prophylaxis (PrEP), a once daily antiretroviral medicine, is an evidence-based approach for reducing the risk of contracting HIV but limited data exist regarding the use of PrEP among CJ populations, especially in the U.S. South. This study was conducted at the Pulaski County Regional Detention Facility (PCRDF) in Little Rock, Arkansas (AR), the largest county jail in the state. We explored knowledge about PrEP and HIV, perceptions about PrEP feasibility in both the jail and community settings and barriers to PrEP program implementation, through in-depth qualitative interviews with 21 jail detainees. We purposively sampled individuals based on specific self-reported risk behavior, including sexual risk (both heterosexual and same-sex) and drug related risk (e.g. IDU), among all eligible individuals. We identified five primary themes from the interviews: 1) accessing healthcare during community reentry was a low priority; 2) perception of risk and interaction with people with HIV was low; 3) there are many barriers to disclosing HIV risk behaviors in jail settings; 4) knowledge of PrEP is low but willingness to use is high; and 5) multiple barriers exist to PrEP uptake post-release. Our findings are contextually unique and therefore have important implications for future implementation of PrEP access either within jail settings or linkage to PrEP post release.
Collapse
Affiliation(s)
- Nickolas D. Zaller
- Department of Health Behavior and Health Education, University of Arkansas for Medical Sciences, Little Rock, Arkansas, United States of America
- * E-mail:
| | - Taylor L. Neher
- Department of Health Behavior and Health Education, University of Arkansas for Medical Sciences, Little Rock, Arkansas, United States of America
| | - Makenzie Presley
- Department of Health Behavior and Health Education, University of Arkansas for Medical Sciences, Little Rock, Arkansas, United States of America
| | - Heather Horton
- Department of Health Behavior and Health Education, University of Arkansas for Medical Sciences, Little Rock, Arkansas, United States of America
| | - S. Alexandra Marshall
- Department of Health Behavior and Health Education, University of Arkansas for Medical Sciences, Little Rock, Arkansas, United States of America
| | - Melissa J. Zielinski
- Psychiatric Research Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas, United States of America
| | - Lauren Brinkley-Rubinstein
- Department of Social Medicine, University of North Carolina, Chapel Hill, North Carolina, United States of America
- Center for Health Equity Research, University of North Carolina, Chapel Hill, North Carolina, United States of America
| |
Collapse
|
30
|
Abstract
Incarcerated women evidence high rates of both interpersonal trauma and mental illness. In particular, the rates of sexual violence victimization are so high that some researchers have suggested that sexual abuse may be a pathway to prison for women, likely through the development of mental illness, including substance abuse. This review article summarizes the literature on sexual victimization (n = 32 articles; 28 independent studies) and mental illness (n = 11 articles; 8 independent studies) prevalence among samples of incarcerated women (Ns ≥ 100) in context of methodological choices within included articles. Best estimates for sexual victimization from studies using established survey methods were as follows: 50-66% for child sexual abuse, 28-68% for adult sexual abuse, and 56-82% for lifetime sexual assault. Although data directly comparing prevalence of sexual victimization among incarcerated women to prevalence for other groups are limited, the existing data indicate that incarcerated women have significantly greater exposure than incarcerated men and community samples of women. Moreover, compared to findings from the National Comorbidity Survey-Replication, incarcerated women evidence greater prevalence of most lifetime and current mental illnesses, especially depressive disorders, post-traumatic stress disorder, and substance use disorders. Surprisingly, only two independent studies have investigated the overlap between sexual victimization and mental illness in samples of incarcerated women. Both studies found disproportionally high rates of mental illness among victims of sexual violence. Suggestions and implications for research, policy, and practice are discussed.
Collapse
Affiliation(s)
| | - Melissa J. Zielinski
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| |
Collapse
|
31
|
Fortney JC, Heagerty PJ, Bauer AM, Cerimele JM, Kaysen D, Pfeiffer PN, Zielinski MJ, Pyne JM, Bowen D, Russo J, Ferro L, Moore D, Nolan JP, Fee FC, Heral T, Freyholtz-London J, McDonald B, Mullins J, Hafer E, Solberg L, Unützer J. Study to promote innovation in rural integrated telepsychiatry (SPIRIT): Rationale and design of a randomized comparative effectiveness trial of managing complex psychiatric disorders in rural primary care clinics. Contemp Clin Trials 2020; 90:105873. [PMID: 31678410 DOI: 10.1016/j.cct.2019.105873] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [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: 06/26/2019] [Revised: 10/23/2019] [Accepted: 10/24/2019] [Indexed: 01/17/2023]
Abstract
OBJECTIVE Managing complex psychiatric disorders like PTSD and bipolar disorder is challenging in Federally Qualified Health Centers (FQHCs) delivering care to U.S residents living in underserved rural areas. This protocol paper describes SPIRIT, a pragmatic comparative effectiveness trial designed to compare two approaches to managing PTSD and bipolar disorder in FQHCs. INTERVENTIONS Treatment comparators are: 1) Telepsychiatry Collaborative Care, which integrates consulting telepsychiatrists into primary care teams, and 2) Telepsychiatry Enhanced Referral, where telepsychiatrists and telepsychologists treat patients directly. METHODS Because Telepsychiatry Enhanced Referral is an adaptive intervention, a Sequential, Multiple Assignment, Randomized Trial design is used. Twenty-four FQHC clinics without on-site psychiatrists or psychologists are participating in the trial. The sample is patients screening positive for PTSD and/or bipolar disorder who are not already engaged in pharmacotherapy with a mental health specialist. Intervention fidelity is measured but not controlled. Patient treatment engagement is measured but not required, and intent-to-treat analysis will be used. Survey questions measure treatment engagement and effectiveness. The Short-Form 12 Mental Health Component Summary (SF-12 MCS) is the primary outcome. RESULTS A third (34%) of those enrolled (n = 1004) are racial/ethnic minorities, 81% are not fully employed, 68% are Medicaid enrollees, 7% are uninsured, and 62% live in poverty. Mental health related quality of life (SF-12 MCS) is 2.5 standard deviations below the national mean. DISCUSSION We hypothesize that patients randomized to Telepsychiatry Collaborative Care will have better outcomes than those randomized to Telepsychiatry Enhanced Referral because a higher proportion will engage in evidence-based treatment.
Collapse
Affiliation(s)
- John C Fortney
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, Seattle, WA, USA; Department of Veterans Affairs, Health Services Research and Development, Center of Innovation for Veteran-Centered and Value-Driven Care, Seattle, WA, USA.
| | - Patrick J Heagerty
- Department of Biostatistics, School of Public Health, University of Washington, Seattle, WA, USA
| | - Amy M Bauer
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Joseph M Cerimele
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Debra Kaysen
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Paul N Pfeiffer
- University of Michigan Medical School, Ann Arbor, MI, USA; Department of Veterans Affairs, Health Services Research and Development, Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA
| | - Melissa J Zielinski
- Department of Psychiatry, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Jeffrey M Pyne
- Department of Psychiatry, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA; Department of Veterans Affairs, Health Services Research and Development, Center for Mental Healthcare and Outcomes Research, Little Rock, AR, USA
| | - Deb Bowen
- Department of Bioethics and Humanities, University of Washington, Seattle, WA, USA
| | - Joan Russo
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Lori Ferro
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Danna Moore
- Social and Economic Sciences Research Center at Washington State University, Pullman, WA, USA
| | | | - Florence C Fee
- NHMH - No Health without Mental Health, San Francisco, CA, Arlington, VA, USA
| | | | | | - Bernadette McDonald
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Jeremey Mullins
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Erin Hafer
- Community Health Plan of Washington, Seattle, WA, USA
| | | | - Jürgen Unützer
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| |
Collapse
|
32
|
Neher TL, Udochi AL, Wilson KA, Guillory DM, Zaller ND, Zielinski MJ. Conducting Health Research in Carceral Systems: Considerations and Recommendations. Am J Public Health 2020; 110:S52-S55. [PMID: 31967891 PMCID: PMC6987919 DOI: 10.2105/ajph.2019.305449] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Although the number of people incarcerated in the United States has grown dramatically, research on how incarceration affects individuals and the communities they return to has lagged behind. This may be because of the unique challenges of doing research within carceral systems and the relatively small number of investigators who are competent to undertake these efforts.We provide a primer for investigators with limited experience conducting research in carceral settings and highlight considerations and recommendations that may aid those conducting health research with incarcerated persons. We follow this with an illustrative case example exemplifying how the considerations apply to recent health research that our team conducted on mental illness prevalence in a large regional jail.Understanding how to effectively conduct research with criminal justice populations and systems is the first step in beginning to understand the effects of mass incarceration as a driver of health disparities and health inequity.
Collapse
Affiliation(s)
- Taylor L Neher
- Taylor L. Neher and Nickolas D. Zaller are with the Department of Health Behavior & Health Education, Fay W. Boozman College of Public Health, and Aisha L. Udochi, Kayla A. Wilson, Devin M. Guillory, and Melissa J. Zielinski are with the Psychiatric Research Institute, University of Arkansas for Medical Sciences, Little Rock
| | - Aisha L Udochi
- Taylor L. Neher and Nickolas D. Zaller are with the Department of Health Behavior & Health Education, Fay W. Boozman College of Public Health, and Aisha L. Udochi, Kayla A. Wilson, Devin M. Guillory, and Melissa J. Zielinski are with the Psychiatric Research Institute, University of Arkansas for Medical Sciences, Little Rock
| | - Kayla A Wilson
- Taylor L. Neher and Nickolas D. Zaller are with the Department of Health Behavior & Health Education, Fay W. Boozman College of Public Health, and Aisha L. Udochi, Kayla A. Wilson, Devin M. Guillory, and Melissa J. Zielinski are with the Psychiatric Research Institute, University of Arkansas for Medical Sciences, Little Rock
| | - Devin M Guillory
- Taylor L. Neher and Nickolas D. Zaller are with the Department of Health Behavior & Health Education, Fay W. Boozman College of Public Health, and Aisha L. Udochi, Kayla A. Wilson, Devin M. Guillory, and Melissa J. Zielinski are with the Psychiatric Research Institute, University of Arkansas for Medical Sciences, Little Rock
| | - Nickolas D Zaller
- Taylor L. Neher and Nickolas D. Zaller are with the Department of Health Behavior & Health Education, Fay W. Boozman College of Public Health, and Aisha L. Udochi, Kayla A. Wilson, Devin M. Guillory, and Melissa J. Zielinski are with the Psychiatric Research Institute, University of Arkansas for Medical Sciences, Little Rock
| | - Melissa J Zielinski
- Taylor L. Neher and Nickolas D. Zaller are with the Department of Health Behavior & Health Education, Fay W. Boozman College of Public Health, and Aisha L. Udochi, Kayla A. Wilson, Devin M. Guillory, and Melissa J. Zielinski are with the Psychiatric Research Institute, University of Arkansas for Medical Sciences, Little Rock
| |
Collapse
|
33
|
Karlsson ME, Zielinski MJ, Bridges AJ. Replicating outcomes of Survivors Healing from Abuse: Recovery through Exposure (SHARE): A brief exposure-based group treatment for incarcerated survivors of sexual violence. Psychol Trauma 2019; 12:300-305. [PMID: 31393152 DOI: 10.1037/tra0000504] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Survivors Healing from Abuse: Recovery through Exposure (SHARE) is a group treatment for incarcerated women that targets sexual abuse sequelae. Previous research on SHARE found significant reductions in posttraumatic stress disorder (PTSD), depression, and generalized anxiety disorder (GAD) symptoms among completers. However, evidence for SHARE has been limited to open pilot studies conducted in one prison. Therefore, this study sought to replicate the results of previous SHARE studies in a separate facility. METHOD Thirty-two women incarcerated in a minimum-security prison participated in an open trial of SHARE. Six separate groups were conducted, each consisting of eight 1.5-hr sessions. RESULTS Pre- to posttreatment symptom reductions in PTSD, depression, and GAD were statistically significant with large effect sizes. Moreover, 21-37% of treatment completers evidenced reliable change in their symptom reduction during the course of treatment. Most women who did not evidence reliable change were already below the clinical cutoff on the corresponding symptom measure at pre-treatment and remained below by post-treatment. CONCLUSIONS These results are consistent with prior studies of SHARE and provide additional support for the positive outcomes of this brief, targeted trauma-focused treatment for incarcerated women. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
Collapse
Affiliation(s)
| | - Melissa J Zielinski
- Department of Psychiatry and Behavioral Sciences, Psychiatric Research Institute, University of Arkansas for Medical Sciences
| | - Ana J Bridges
- Department of Psychological Science, University of Arkansas
| |
Collapse
|
34
|
Zielinski MJ, Privratsky AA, Smitherman S, Kilts CD, Herringa RJ, Cisler JM. Does development moderate the effect of early life assaultive violence on resting-state networks? An exploratory study. Psychiatry Res Neuroimaging 2018; 281:69-77. [PMID: 30266022 PMCID: PMC6373177 DOI: 10.1016/j.pscychresns.2018.08.016] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Revised: 07/31/2018] [Accepted: 08/27/2018] [Indexed: 12/15/2022]
Abstract
Current neurocircuitry models of PTSD do not account for developmental effects, despite that early life assaultive violence is a potent risk factor for PTSD. Here, we preliminarily evaluated developmental stage as a moderator of the effect of early life assaultive violence on resting-state connectivity amongst regions associated with emotion generation and regulation using fMRI. Participants were adult women (n = 25) and adolescent girls (n = 36) who had or had not experienced early life assaultive violence. We found significant interactions between developmental stage and trauma exposure on resting-state functional connectivity (FC). Left amygdala connectivity with the left ventral anterior cingulate gyrus (BA 32) was reduced among trauma-exposed compared to control adolescents, but increased among trauma-exposed compared to control adults. A corresponding pattern of results was identified for FC between rostral anterior cingulate gyrus seed region and a similar right ventral anterior superior frontal gyrus cluster. Increased FC in both regions for assaulted adult women scaled positively with self-reported emotion regulation difficulties. Our results should be viewed tentatively due to sample limitations, but provide impetus to examine whether neurocircuitry models of PTSD may be strengthened by accounting for developmental stage.
Collapse
Affiliation(s)
- Melissa J Zielinski
- Brain Imaging Research Center, Psychiatric Research Institute, University of Arkansas for Medical Sciences, 4301 W. Markham Street, Little Rock, AR 72205, USA.
| | - Anthony A Privratsky
- Brain Imaging Research Center, Psychiatric Research Institute, University of Arkansas for Medical Sciences, 4301 W. Markham Street, Little Rock, AR 72205, USA
| | - Sonet Smitherman
- Brain Imaging Research Center, Psychiatric Research Institute, University of Arkansas for Medical Sciences, 4301 W. Markham Street, Little Rock, AR 72205, USA
| | - Clinton D Kilts
- Brain Imaging Research Center, Psychiatric Research Institute, University of Arkansas for Medical Sciences, 4301 W. Markham Street, Little Rock, AR 72205, USA
| | - Ryan J Herringa
- Department of Psychiatry, University of Wisconsin School of Medicine & Public Health, Madison, WI 53726, USA
| | - Josh M Cisler
- Brain Imaging Research Center, Psychiatric Research Institute, University of Arkansas for Medical Sciences, 4301 W. Markham Street, Little Rock, AR 72205, USA; Department of Psychiatry, University of Wisconsin School of Medicine & Public Health, Madison, WI 53726, USA
| |
Collapse
|
35
|
Zielinski MJ, Veilleux JC. The Perceived Invalidation of Emotion Scale (PIES): Development and psychometric properties of a novel measure of current emotion invalidation. Psychol Assess 2018; 30:1454-1467. [PMID: 29792500 PMCID: PMC6212305 DOI: 10.1037/pas0000584] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [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] [Indexed: 01/12/2023]
Abstract
Emotion invalidation is theoretically and empirically associated with mental and physical health problems. However, existing measures of invalidation focus on past (e.g., childhood) invalidation and/or do not specifically emphasize invalidation of emotion. In this article, the authors articulate a clarified operational definition of emotion invalidation and use that definition as the foundation for development of a new measure of current perceived emotion invalidation across a series of five studies. Study 1 was a qualitative investigation of people's experiences with emotional invalidation from which we generated items. An initial item pool was vetted by expert reviewers in Study 2 and examined via exploratory factor analysis in Study 3 within both college student and online samples. The scale was reduced to 10 items via confirmatory factor analysis in Study 4, resulting in a brief but psychometrically promising measure, the Perceived Invalidation of Emotion Scale (PIES). A short-term longitudinal investigation (Study 5) revealed that PIES scores had strong test-retest reliability, and that greater perceived emotion invalidation was associated with greater emotion dysregulation, borderline features and symptoms of emotional distress. In addition, the PIES predicted changes in relational health and psychological health over a 1-month period. The current set of studies thus presents a psychometrically promising and practical measure of perceived emotion invalidation that can provide a foundation for future research in this burgeoning area. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
Collapse
Affiliation(s)
- Melissa J. Zielinski
- University of Arkansas for Medical Sciences, Psychiatric Research Institute, Brain Imaging Research Center, Little Rock, AR 72205
- University of Arkansas, Department of Psychological Science, Fayetteville, AR 72701 USA
| | - Jennifer C. Veilleux
- University of Arkansas, Department of Psychological Science, Fayetteville, AR 72701 USA
| |
Collapse
|
36
|
Veilleux JC, Zielinski MJ, Moyen NE, Tucker MA, Dougherty EK, Ganio MS. The effect of passive heat stress on distress andself-control in male smokers and non-smokers. J Gen Psychol 2018; 145:342-361. [PMID: 30358519 DOI: 10.1080/00221309.2018.1494127] [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] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
In the current study, we tested the effects of core body temperature increases (e.g. heat stress) on affect, self-reported physical discomfort, and subsequent self-control in male smokers and nonsmokers using a novel passive heat stress paradigm, within a distress tolerance framework. Twenty-eight men (14 smokers), completed both heat stress and control sessions in randomized order. Results revealed that increases in core body temperature were associated with increased anxiety, irritability, and body discomfort as well as decreased happiness, with stronger effects for smokers. Smokers and nonsmokers both evidenced less self-control during the heat session and did not differ on this measure, nor on a measure of interoceptive sensitivity. The current study indicates that heat stress is a viable method for studying distress tolerance in men, and suggests the value in examining dynamic changes in self-control as a function of distress. Implications will be discussed for distress tolerance in general and smokers in specific.
Collapse
|
37
|
Bush KA, Privratsky A, Gardner J, Zielinski MJ, Kilts CD. Common Functional Brain States Encode both Perceived Emotion and the Psychophysiological Response to Affective Stimuli. Sci Rep 2018; 8:15444. [PMID: 30337576 PMCID: PMC6194055 DOI: 10.1038/s41598-018-33621-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 10/01/2018] [Indexed: 11/13/2022] Open
Abstract
Multivariate pattern analysis (MVPA) of functional magnetic resonance imaging (fMRI) data has critically advanced the neuroanatomical understanding of affect processing in the human brain. Central to these advancements is the brain state, a temporally-succinct fMRI-derived pattern of neural activation, which serves as a processing unit. Establishing the brain state's central role in affect processing, however, requires that it predicts multiple independent measures of affect. We employed MVPA-based regression to predict the valence and arousal properties of visual stimuli sampled from the International Affective Picture System (IAPS) along with the corollary skin conductance response (SCR) for demographically diverse healthy human participants (n = 19). We found that brain states significantly predicted the normative valence and arousal scores of the stimuli as well as the attendant individual SCRs. In contrast, SCRs significantly predicted arousal only. The prediction effect size of the brain state was more than three times greater than that of SCR. Moreover, neuroanatomical analysis of the regression parameters found remarkable agreement with regions long-established by fMRI univariate analyses in the emotion processing literature. Finally, geometric analysis of these parameters also found that the neuroanatomical encodings of valence and arousal are orthogonal as originally posited by the circumplex model of dimensional emotion.
Collapse
Affiliation(s)
- Keith A Bush
- Brain Imaging Research Center, University of Arkansas for Medical Sciences, 4301 W. Markham St., Little Rock, AR, 72205-7199, USA.
| | - Anthony Privratsky
- Brain Imaging Research Center, University of Arkansas for Medical Sciences, 4301 W. Markham St., Little Rock, AR, 72205-7199, USA
- College of Medicine, University of Arkansas for Medical Sciences, 4301 W. Markham St., Little Rock, AR, 72205-7199, USA
| | - Jonathan Gardner
- College of Medicine, University of Arkansas for Medical Sciences, 4301 W. Markham St., Little Rock, AR, 72205-7199, USA
| | - Melissa J Zielinski
- Brain Imaging Research Center, University of Arkansas for Medical Sciences, 4301 W. Markham St., Little Rock, AR, 72205-7199, USA
| | - Clinton D Kilts
- Brain Imaging Research Center, University of Arkansas for Medical Sciences, 4301 W. Markham St., Little Rock, AR, 72205-7199, USA
| |
Collapse
|
38
|
Roley-Roberts ME, Zielinski MJ, Hurtado G, Hovey JD, Elhai JD. Functions of Nonsuicidal Self-Injury Are Differentially Associated with Suicide Ideation and Past Attempts among Childhood Trauma Survivors. Suicide Life Threat Behav 2017; 47:450-460. [PMID: 27767234 DOI: 10.1111/sltb.12306] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [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: 10/24/2015] [Accepted: 06/09/2016] [Indexed: 11/30/2022]
Abstract
Research into factors for suicide has revealed relations between trauma exposure and suicidality (e.g., Bridge, Goldstein, & Brent, ; Joiner, Sachs-Ericson, Wingate, Brown, Anestis, & Selby, ) wherein painful and provocative experiences (e.g., nonsuicidal self-injury [NSSI]) are an important link (e.g., Van Orden, Witte, Cukrowicz, Braithwaite, Selby, & Joiner, ; Smith, ). No prior research has assessed the relationship between functions of NSSI and suicidality among childhood trauma survivors. Participants who endorsed childhood trauma exposure (N = 121; Mage = 18.69, range 18-22) completed measures of posttraumatic stress disorder (PTSD) symptoms, NSSI, and suicidality. Multiple regressions assessing whether the four functions of NSSI predicted suicide ideation and past attempts after controlling for PTSD symptom severity found that only social negative reinforcement was associated with SI (β = .304, SE = .243, t = 2.23, p = .028), while only automatic negative reinforcement was associated with past attempts (β = .470, SE = .066, t = 2.25, p = .028). Findings highlight the importance of assessing NSSI functions when assessing suicidality among trauma survivors.
Collapse
Affiliation(s)
- Michelle E Roley-Roberts
- The Ohio State University Wexner Medical Center, Columbus, OH, USA.,University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Melissa J Zielinski
- Psychoiatry, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Gabriela Hurtado
- Eating Recovery Center, Austin, TX, USA.,University of Toledo, Toledo, OH, USA
| | - Joseph D Hovey
- Psychology, University of Texas - Rio Grande Valley, Edinburg, TX, USA
| | - Jon D Elhai
- Psychology, University of Toledo, Toledo, OH, USA
| |
Collapse
|
39
|
Veilleux JC, Pollert GA, Zielinski MJ, Shaver JA, Hill MA. Behavioral Assessment of the Negative Emotion Aspect of Distress Tolerance: Tolerance to Emotional Images. Assessment 2017; 26:386-403. [PMID: 28135808 DOI: 10.1177/1073191116689819] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The current behavioral tasks assessing distress tolerance measure tolerance to frustration and tolerance to physical discomfort, but do not explicitly assess tolerance to negative emotion. We closely evaluated the conceptual distinctions between current behavioral tasks and self-report tasks assessing distress tolerance, and then developed a new behavioral distress tolerance task called the Emotional Image Tolerance (EIT) task. The EIT task retains elements of existing behavioral tasks (e.g., indices of persistence) while augmenting the reliability and content sufficiency of existing measures by including multiple trials, including a variety of negative affect stimuli, and separating overall task persistence from task persistence after onset of distress. In a series of three studies, we found that the EIT correlated with extant behavioral measures of distress tolerance, the computerized mirror-tracing task and a physical cold pressor task. Across all of the studies, we also evaluated whether the EIT correlated with self-report measures of distress tolerance and measures of psychopathology (e.g., depression, anxiety, and binge eating). Implications for the refinement of the distress tolerance construct are discussed.
Collapse
|
40
|
Zielinski MJ, Borders A, Giancola PR. Does hostile rumination mediate the associations between reported child abuse, parenting characteristics and borderline features in adulthood? Personal Ment Health 2015; 9:288-97. [PMID: 26314272 PMCID: PMC7013275 DOI: 10.1002/pmh.1306] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [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: 10/19/2014] [Revised: 05/31/2015] [Accepted: 07/19/2015] [Indexed: 11/12/2022]
Abstract
This cross-sectional study investigated whether hostile rumination mediated the association between several indicators of a negative childhood environment (retrospectively reported child abuse and perceived parental care and overprotection) and borderline features. Community participants (N = 524) completed self-report measures in the laboratory. Results showed that adults exhibiting borderline features reported less parental care and more parental overprotection, as well as greater abuse. Additionally, hostile rumination statistically mediated the associations between all childhood environmental variables and borderline features, even controlling for depressive symptoms, alcohol use and impulsivity. Although cross-sectional data cannot test causal mediation, this pattern of results provides preliminary evidence that hostile rumination may partially account for the well-established connection between negative environments and borderline features. Future directions, including a discussion of longitudinal and experimental work that might help build on and strengthen the current findings, are explored.
Collapse
Affiliation(s)
- Melissa J Zielinski
- Department of Psychological Science, University of Arkansas, Fayetteville, AR, 72701, USA.,Department of Psychology, The College of New Jersey, Ewing, NJ, 08628, USA
| | - Ashley Borders
- Department of Psychology, The College of New Jersey, Ewing, NJ, 08628, USA
| | - Peter R Giancola
- Department of Psychology, University of Kentucky, Lexington, KY, 40506, USA
| |
Collapse
|
41
|
Zielinski MJ, Veilleux JC. Examining the relation between borderline personality features and social support: The mediating role of rejection sensitivity. Personality and Individual Differences 2014. [DOI: 10.1016/j.paid.2014.07.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
42
|
Bujarski SJ, Craig JT, Zielinski MJ, Badour CL, Feldner MT. A multimodal examination of emotional responding to a trauma-relevant film among traumatic motor vehicle accident survivors. Assessment 2014; 22:216-23. [PMID: 25139384 DOI: 10.1177/1073191114548030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 11/16/2022]
Abstract
The Facial Action Coding System (Ekman & Friesen) has shown promise as a behavioral measure of emotional experience. The current study examined the degree of (de)synchrony between self-reported and facial expressions of fear, disgust, and sadness in response to a traumatic event-relevant film among individuals who had experienced a traumatic motor vehicle accident. Given high rates of comorbidity between posttraumatic stress symptoms (PTSS) and depressive symptoms, the potential impacts of both PTSS and depressive symptoms on emotional responding were examined. Results demonstrated synchrony between self-reported and facial expressions of disgust and sadness; however, no association between measures of fear was observed. Furthermore, depressive symptoms were associated with greater fear responding and PTSS were associated only with self-reported fear. Together, results support the importance of examining discrete negative emotions, rather than broad valence categories, when examining fear-based responding in traumatic event-exposed populations. Additional research examining the psychometric properties of the Facial Action Coding System as a measure of discrete emotional experiences among traumatic event-exposed individuals is needed to advance multimodal assessment approaches that yield incremental information for understanding emotional responding in this population.
Collapse
Affiliation(s)
| | - James T Craig
- University of Arkansas-Fayetteville, Fayetteville, AR, USA
| | | | - Christal L Badour
- University of Arkansas-Fayetteville, Fayetteville, AR, USA Medical University of South Carolina, Charleston, SC, USA
| | - Matthew T Feldner
- University of Arkansas-Fayetteville, Fayetteville, AR, USA Laureate Institute for Brain Research, Tulsa, OK, USA
| |
Collapse
|
43
|
Veilleux JC, Salomaa AC, Shaver JA, Zielinski MJ, Pollert GA. Multidimensional assessment of beliefs about emotion: development and validation of the emotion and regulation beliefs scale. Assessment 2014; 22:86-100. [PMID: 24835246 DOI: 10.1177/1073191114534883] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [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: 11/16/2022]
Abstract
Recent work has extended the idea of implicit self-theories to the realm of emotion to assess beliefs in the malleability of emotions. The current article expanded on prior measurement of emotion beliefs in a scale development project. Items were tested and revised over rounds of data collection with both students and nonstudent adult online participants. Exploratory and confirmatory factor analyses revealed a three-factor structure. The resulting scale, the Emotion and Regulation Beliefs Scale, assesses beliefs that emotions can hijack self-control, beliefs that emotion regulation is a worthwhile pursuit, and beliefs that emotions can constrain behavior. Preliminary findings suggest that the Emotion and Regulation Beliefs Scale has good internal consistency, is conceptually distinct from measures assessing individuals' beliefs in their management of emotions and facets of emotional intelligence, and predicts clinically relevant outcomes even after controlling for an existing short measure of beliefs in emotion controllability.
Collapse
|
44
|
Scisco JL, Blades C, Zielinski MJ, Muth ER. Dividing a fixed portion into more pieces leads to larger portion size estimates of JELL-O squares. Perception 2013; 41:988-90. [PMID: 23362675 DOI: 10.1068/p7199] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
How visual qualities of a food impact perceptions of the amount of food present and consumed have been studied. Previous research has investigated many factors affecting these perceptions, including the height of a glass, the size of a serving bowl, and other food intake cues. We investigated how the number of pieces a serving is divided into impacts perceptions of the amount of food present and consumed. Results indicate that dividing a fixed portion into a greater number of pieces leads people to perceive a greater amount of food in the serving.
Collapse
Affiliation(s)
- Jenna L Scisco
- Department of Psychology, Clemson University, Clemson, SC 29634, USA
| | | | | | | |
Collapse
|