Development, implementation, and acceptability of a bedside mindfulness intervention for adults with sickle cell disease.

Acute and chronic pain are the most frequent complications of sickle cell disease (SCD), often severely reducing quality of life and requiring management with long-term pharmacological interventions. A biopsychosocial approach conceptualizing pain in SCD as the result of complex biological, psychological, and social factors could facilitate targeted behavioral interventions. Mindfulness is one procedure for management of pain in individuals with chronic pain/illness. The goal of the current project was to design and implement a bedside mindfulness intervention to help patients with SCD enhance self-efficacy of pain management and reduce distress. As part of a quality improvement project in SCD clinics in a large health system, we developed a bedside mindfulness intervention to be provided during infusion sessions for patients presenting for acute vaso-occlusive episodes (VOE). The approach to development and implementation involved engagement of professionals working directly with patients. Concept planning meetings with these professionals along with qualitative patient and provider feedback informed feasibility, design, and intervention application. During a quantitative phase, patients completed validated surveys items on acceptability. Interview data (N = 11) supported patient interest in mindfulness skills and highlighted a need for tailored, person-centered interventions and non-pharmacological treatment strategies. On quantitative items, participants (N = 14) liked the intervention and agreed mindfulness skills would help manage disease-related distress. Following the interventions, participants reported increased mindfulness (p = .005). While preliminary, these results provide support for the continued development of evidence-based, mindfulness-oriented services to help individuals with SCD manage pain and other psychological difficulties.

Behavioral activation is associated with post-disaster mental health: Secondary longitudinal analysis from a population-based study.

OBJECTIVE: Interventions in post-disaster environments may be accelerated by identifying protective behavioral factors adding incremental value to models of psychopathology using longitudinal methods. One protective behavior applicable to post-disaster contexts is behavioral activation (BA). BA is defined here as a behavioral pattern involving presence of valued activity engagement. While relevant post-disaster, the incremental value of BA behaviors in predicting longitudinal post-disaster outcomes is not well understood. We hypothesized that higher baseline engagement in behaviors consistent with a BA framework would predict decreased posttraumatic stress disorder (PTSD) symptom severity, depression symptom severity, and sleep disturbance approximately 3, 6, and 12 months after hurricane survivors completed baseline measures. METHODS: The current study is a secondary analysis from a randomized controlled trial of a disaster mental health digital intervention. Participants completed surveys at baseline and approximately 3, 6, and 12 months post-enrollment. Correlations and hierarchical regression analyses were calculated following data screening to predict PTSD symptom severity, depression symptom severity, and sleep disturbances. RESULTS: Controlling for alcohol use, prior trauma, displacement, and intervention condition, higher baseline BA consistently predicted less PTSD symptom severity, depression symptom severity, and sleep disturbances. CONCLUSION: Results suggest that post-disaster interventions should consider addressing BA. The study provides evidence that BA is potentially an important protective factor longitudinally predicting sleep disturbances and psychopathology after natural disasters.

Differential relations between breathing retraining, in vivo exposure, and imaginal exposure homework completion and treatment outcomes in veterans receiving prolonged exposure for PTSD.

OBJECTIVES: Limited research exists that outlines the predictive relevance of the treatment components of prolonged exposure (PE) for post-traumatic stress disorder (PTSD) on PTSD and depression symptom outcomes. The goal of the present study was to investigate relations between participant completion of breathing retraining, in vivo exposure, and imaginal exposure exercises and symptom outcomes. METHODS: A total of 58 participants completed a trial of PE as part of a larger trial on peer involvement and treatment adherence. Diagnostic and self-report measures were completed throughout treatment. Participants also recorded weekly completion of breathing retraining, in vivo exposure, and imaginal exposure exercises. Pearson correlations and hierarchical regression analyses were used to investigate relations between average weekly treatment component completion and treatment outcomes, controlling for relevant variables. RESULTS: Although breathing retraining and in vivo exposures were associated with PTSD outcomes in the correlational findings, use of breathing retraining, in vivo exposures, and imaginal exposures were not reliably associated with PTSD symptom outcomes when controlling for other variables in the regression analysis. However, when investigating changes in comorbid symptoms of depression, greater use of breathing retraining was associated with decreased symptoms of depression at posttreatment. CONCLUSIONS: Present findings demonstrate the differential relations between participation in various PE treatment components and posttreatment symptom outcomes. The importance of breathing retraining in addressing comorbid depressive symptoms is discussed, with emphasis on potentially increasing relaxation and positive activities more broadly to encourage further treatment benefits.

Anxiety sensitivity and social support in veterans with emotional disorders.

OBJECTIVE: An understanding of the incremental value of social support in predicting psychopathology above transdiagnostic risk factors could speak to the benefit of leveraging social factors into existing, evidence-based interventions in veterans with emotional disorders. This cross-sectional study aimed to expand our understanding of associations between domains of anxiety sensitivity and facets of psychopathology in veterans with emotional disorders. We also determined whether social support predicted psychopathology above anxiety sensitivity domains and combat exposure and explored these relationships with a path model. METHODS: One hundred and fifty-six treatment-seeking veterans with emotional disorders completed diagnostic interviews and assessments of demographics, social support, symptom measures (e.g., PTSD, depression, anxiety, and stress), and transdiagnostic risk factors (i.e., anxiety sensitivity). After data screening, 150 were included in regressions. RESULTS: Using regression analyses with cross-sectional data, cognitive anxiety sensitivity concerns predicted PTSD and depression above combat exposure. Cognitive and physical concerns predicted anxiety, and cognitive and social concerns predicted stress. Above combat exposure and anxiety sensitivity, social support predicted PTSD and depression. CONCLUSION: Focusing on social support in tandem with transdiagnostic mechanisms in clinical samples is critical. These findings inform transdiagnostic interventions and recommendations related to incorporation of assessment of transdiagnostic factors in clinical contexts.

Investigating Relations Between the Symptoms of Panic, Agoraphobia, and Suicidal Ideation: The Significance of Comorbid Depressive Symptoms in Veterans with Panic Disorder.

Although panic disorder has been frequently associated with increased suicidal ideation and behaviors, there are multiple explanations for this association in the literature. For example, some research has demonstrated panic disorder symptoms to mediate agoraphobia and suicidal ideation, while other researchers have hypothesized that comorbid depression symptoms contribute to suicidal ideation across anxiety disorders. Of note, none of these studies were completed in veterans, a population at higher risk for suicide relative to civilian samples. The present study investigated relations between the symptoms of panic, agoraphobia, depression, and suicidal ideation in 58 veterans diagnosed with panic disorder via correlations, hierarchical regression, and exploratory path analyses. Multiple models were investigated based on prior research. The final path model demonstrated that symptoms of panic disorder predicted agoraphobia symptoms, with agoraphobia predicting symptoms of depression. Symptoms of depression, then, predicted suicidal ideation. Discussion of the findings related to comorbid depressive symptoms highlight considerations for the assessment and treatment practices for panic disorder, with a particular focus on veterans receiving care within Veterans Affairs Healthcare System.

Perceived meaning, pandemic self-efficacy, social support, and discrimination predict trajectories of peri-pandemic growth and distress for international students.

OBJECTIVE: International students face unique COVID-19-related stressors, such as financial aid loss, limited social support, and discrimination (e.g., verbal harassment, physical assault). Additionally, pandemic and chronic stress research is largely cross-sectional, and trajectories over time remain unclear for psychological and environmental factors predicting distress and peri-pandemic growth. Accordingly, the current study examined trajectories of psychological distress and growth, as well as weekly psychological and environmental predictors of psychological distress and growth, in international students during the early stages of the pandemic. METHOD: International students (N = 42) at a U.S. university were surveyed weekly for 14 weeks. RESULTS: Latent growth mixture modeling resulted in three trajectories over time of distress (Minimal Impact, Emergent Resilience, and Increasing Distress) and peri-pandemic growth (Limited PrTG, Decreasing PrTG, and Increasing PrTG). For multilevel models, within-person increases in meaning and self-efficacy as well as between-person changes in discrimination and emotional social support predicted distress. Within-person changes in meaning and self-efficacy and between-person changes in self-efficacy and discrimination predicted peri-pandemic growth. CONCLUSIONS: Despite the stressors they face, many international students demonstrated a trajectory of resilience. Positive coping factors and environmental factors predicted distress or peri-pandemic growth, which can inform interventions and studies examining trajectories of distress during prolonged adversity. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Collective Efficacy and Perceived COVID-19 Severity Predict Preparedness and Response Behaviors: A Longitudinal Study of Intersectionally Vulnerable University Students.

OBJECTIVE: To promote equity for intersectionally disaster-vulnerable individuals and address three literature gaps: (1) incremental effects of collective and self-efficacy as preparedness predictors, (2) differentiation of fear and perceived severity of a disaster, and (3) clarification of the relationship between fear and preparedness. METHODS: Due to infection risks associated with communal housing, early in the coronavirus disease (COVID-19) pandemic, many universities permitted students to remain in campus housing only if they were housing insecure, including many international students. We surveyed intersectionally-vulnerable students and their partners at a southeast US university, N = 54, who were international (77.8%), Asian (55.6%), and/or housing insecure at baseline (79.6%). In 14 waves from May-October 2020, we assessed pandemic preparedness/response behaviors (PPRBs) and potential PPRB predictors. RESULTS: We examined within- and between-person effects of fear, perceived severity, collective efficacy, and self-efficacy on PPRBs. Within-person perceived severity and collective efficacy both significantly, positively predicted greater PPRBs. All effects of fear and self-efficacy were not significant. CONCLUSIONS: Perceived severity and confidence that one's actions positively impact one's community fluctuated throughout the pandemic and are linked to greater PPRB engagement. Public health messages and interventions to improve PPRB may benefit from emphasizing collective efficacy and accuracy over fear.

The Psychological Science Accelerator's COVID-19 rapid-response dataset.

In response to the COVID-19 pandemic, the Psychological Science Accelerator coordinated three large-scale psychological studies to examine the effects of loss-gain framing, cognitive reappraisals, and autonomy framing manipulations on behavioral intentions and affective measures. The data collected (April to October 2020) included specific measures for each experimental study, a general questionnaire examining health prevention behaviors and COVID-19 experience, geographical and cultural context characterization, and demographic information for each participant. Each participant started the study with the same general questions and then was randomized to complete either one longer experiment or two shorter experiments. Data were provided by 73,223 participants with varying completion rates. Participants completed the survey from 111 geopolitical regions in 44 unique languages/dialects. The anonymized dataset described here is provided in both raw and processed formats to facilitate re-use and further analyses. The dataset offers secondary analytic opportunities to explore coping, framing, and self-determination across a diverse, global sample obtained at the onset of the COVID-19 pandemic, which can be merged with other time-sampled or geographic data.

Advocating for the Use of Restorative Justice Practices: Examining the Overlap between Restorative Justice and Behavior Analysis.

Broadly defined, restorative justice (RJ) is a set of procedures based in Indigenous peacemaking practices that reduces recidivism and guides the effective reparation of harm. RJ practices provide harm-affected parties an opportunity for engagement in the resolution process, which theoretically enhances community well-being. RJ practices overlap significantly with behavior-analytic principles. Implementing RJ practices from a context-focused, appetitive-based approach that focuses on classes of behaviors may address harmful behaviors within police organizations. RJ practices may also facilitate changes in contexts that support behaviors valued by the community. The current review discusses criminal and restorative justice, RJ processes and practices, the effectiveness of RJ in various contexts, how RJ overlaps with behavior-analytic principles and existing behavior science models in general, research suggestions, and recommendations for behavior analysts implementing RJ within police organizations and communities to address officer misconduct.

Examining daily-level associations between nightly alcohol use and next-day valued behavior in college students.

ObjectiveAdverse consequences of binge drinking episodes are well-established, but fewer studies have investigated how incremental changes in daily alcohol use relate to well-being. We examined within- and between-person associations in alcohol use and next-day valued living to enhance our understanding of the impact of alcohol use on following-day outcomes in college students. Participants. During November 2018, 73 undergraduate participants (65.7% female) completed surveys through Qualtrics. Method: Using daily diary methodology, participants completed nightly surveys (N = 784) on their cellular devices over a two-week period. Results: Within-participant variations in evening alcohol use demonstrated a negative linear association with next-day valued living, controlling for relevant variables. Conclusions: Findings supplement other studies demonstrating the impact of individual variability in alcohol use on engagement in valued behaviors. Knowledge of the hazards of alcohol use within the context of valued living has the potential to inform alcohol use prevention and intervention programs.

Validating military culture: The factor analysis of a military-related adaptation of acculturation in veterans.

Differences between military and civilian culture can impact a veteran's ability to effectively navigate the transition to the civilian setting after separating from military service. However, systems providing psychological services to veterans lack reliable and valid methods of identifying the extent to which the dissonance between military and civilian cultures is associated with postseparation adjustment (e.g., ability to integrate profound deployment experiences into civilian life) and psychological outcomes. Utilization of a theory-driven, acculturation framework to assess military and civilian cultural affiliation may address this gap. While several quantitative measures exist for evaluating acculturation in reference to different ethnocultural experiences and that evaluate military culture-related adjustment or reintegration, there are no existing validated measures rooted in cultural theory that explicitly assess military-related acculturation. The aim of the present study was to develop and examine the psychometric properties of theoretically grounded, military-related adaptations of validated acculturation measures. Data from 364 veterans were collected with an online survey including four military-related adaptations of acculturation measures. Results suggest that the proposed adaptation of the original ethnocultural measurement model was not a good fit to the data, χ² = 2396.99, p < .001, TLI = .73. An evaluation of localized areas of strain in the confirmatory model and results from an exploratory factor analysis suggest support for the continued development of a military-related model of acculturation after considering further measure restructuring and validation. Opportunities for future research and measure validation are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Meaning, social support, and resilience as predictors of posttraumatic growth: A study of the Louisiana flooding of August 2016.

Individuals who survive natural hazards often develop posttraumatic stress symptoms or other forms of psychological distress. However, some experience psychological growth. Given that natural hazards will increase in the near future due to global warming, it would be helpful to examine predictors of growth across different kinds of natural hazards. The present study examined positive psychological factors that may serve as buffers against the negative effects of exposure to a natural hazard, specifically following the Louisiana flooding of August 2016. Volunteer participants (N = 120) self-reported perceived presence and search for meaning in life, social support, resilience, and posttraumatic growth (PTG). After controlling for amount of property damaged, posttraumatic stress symptoms, gender, religion, and ethnicity or race, presence and search for meaning, social support, and resilience explained significant additional variance in PTG scores. This research adds to the growing understanding of how individuals respond to natural hazards. (PsycInfo Database Record (c) 2020 APA, all rights reserved).