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1.
Cogn Behav Ther ; : 1-17, 2024 Apr 09.
Artigo em Inglês | MEDLINE | ID: mdl-38593029

RESUMO

This pilot study tested a single-session digital values affirmation for behavioral activation (VABA) intervention. Hypotheses predicted the VABA intervention would be more effective than an active control condition in improving mood, decreasing COVID-19 fear/worry and depressive symptoms, and promoting positively reinforcing behaviors during early weeks of the COVID-19 pandemic. Participants were a diverse sample of undergraduate students (N = 296) under a state-wide lockdown. Students were randomized to either VABA, a 10-min values clarification and affirmation task, or Control, a time- and attention-matched task. Positive and negative affects were assessed pre- and post-intervention. At next-day follow-up, positive and negative affects were reassessed, as well as past 24-h behavioral activation and depressive symptoms. Within-group increases in positive affect were observed in both conditions (VABA d = 0.39; Control d = 0.19). However, VABA produced a significantly larger increase than Control (F[2] = 3.856, p = .022, d = 0.22). At 24-h follow-up, behavioral activation, which was significantly higher in VABA versus Control (t[294] = -5.584, p < .001, d = 0.65), predicted fewer depressive symptoms (R2 change = .019, ß = -.134, p = .003). VABA is an ultra-brief intervention that appears to have acute effects on mood-enhancement and behavioral activation.

2.
PLoS One ; 19(2): e0299462, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38408056

RESUMO

Health anxiety, which is defined as fear of having or contracting serious physical illness, is particularly salient in light of the COVID-19 pandemic. We conducted a mixed methods study in which 578 narrative samples were analyzed using Linguistic Inquiry and Word Count (LIWC) software to determine linguistic markers from six LIWC categories relevant to cognitive-behavioral features of health anxiety. Broad linguistic predictors were analyzed through three backward elimination regression models in order to inform subcategory predictors of each area of health anxiety. Thus, both broad and specific linguistic predictors of general health anxiety, virus-relevant body vigilance, and fears of viral contamination were examined. Greater use of affective category words in written narratives predicted general health anxiety, as well as body vigilance and viral contamination fears. These findings represent the first direct demonstration of linguistic analysis of health anxiety and provide nuanced information about the nature and etiology of health anxiety.


Assuntos
COVID-19 , Pandemias , Humanos , COVID-19/epidemiologia , Linguística , Ansiedade/epidemiologia , Transtornos de Ansiedade
3.
Exp Clin Psychopharmacol ; 32(1): 35-44, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37523300

RESUMO

Little is known about the naturalistic use of cannabis oil vaporization, a high-potency product with the ability to be administered discreetly. This pilot study evaluated the feasibility of utilizing a "smart" vaporizer and application to assess the timing, frequency, socioenvironmental factors, and substance use involved in cannabis oil vaporization. Adults with a medical cannabis registration card were recruited from a dispensary in Rhode Island and completed a 2-week study monitoring period using the Gram1 vaporizer, followed by a poststudy qualitative interview. The sample included nine adults who were predominantly male (89%), 100% White, and 100% non-Hispanic. The Gram1 collected topographical vaping data, and the cellphone application utilized ecological momentary assessment (EMA) to assess socioenvironmental factors and other substance use. Qualitative interview data were coded, and illustrative quotations were selected to support quantitative findings. A total of 224 vaping sessions were recorded reflecting 76.4% of the study monitoring period. There was an average of 1.79 vaping sessions per day across all days. Participants took 8.76 puffs on average (SD = 8.23) per vaping session, and the session lasted 2.59 min on average (SD = 4.19). Regular vaporization was exhibited across days of the week and hours of the day. EMA reports indicated that smoking cannabis flower was the most common additional mode of cannabis administration. This study utilized a naturalistic design with novel topographical data and EMA to characterize cannabis oil vaporization. These findings establish the feasibility of collecting objective, momentary data to better understand use behaviors which are critical to informing safe consumption. (PsycInfo Database Record (c) 2024 APA, all rights reserved).


Assuntos
Cannabis , Alucinógenos , Fumar Maconha , Transtornos Relacionados ao Uso de Substâncias , Adulto , Humanos , Masculino , Feminino , Projetos Piloto , Volatilização , Agonistas de Receptores de Canabinoides
4.
Front Psychiatry ; 14: 1267753, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38076702

RESUMO

Two primary ovarian hormones that fluctuate across the female menstrual cycle-estradiol and progesterone-have been independently linked in separate literatures to nicotine reinforcement and anxiety psychopathology. We identify existing methodological limitations in these literatures, describe an example protocol that was developed to address such limitations, highlight case examples, and offer insights on the resulting advantages and challenges. This protocol was an observational, prospective, within-subjects study of female cigarette smokers who were followed over the course of a complete menstrual cycle. Non-treatment seeking, female cigarette smokers (N = 50), between the ages of 18-40 who have a normal menstrual cycle (25-35 days in length) were recruited from the community. Females with anxiety or mood psychopathology represented 38.0% of the sample. Salivary progesterone and estradiol were assessed each morning via at-home saliva collection methods. Self-reported within-day momentary ratings of anxiety and nicotine reinforcement were collected using ecological momentary assessment (EMA) via a mobile app. Protocol compliance was >85%. Within- and between-subjects heterogeneity was observed in the progesterone and estradiol, anxiety, and nicotine craving measures, especially in the context of anxiety psychopathology. We aimed to integrate the anxiety and nicotine dependence literatures and advance the empirical study of the role of ovarian hormones. This protocol reflects an intensive, yet feasible approach to collecting daily-level naturalistic data related to estradiol, progesterone, anxiety, and nicotine reinforcement.

5.
Int J Behav Med ; 2023 Aug 09.
Artigo em Inglês | MEDLINE | ID: mdl-37555897

RESUMO

BACKGROUND: Exercise fear and low exercise self-efficacy are common in patients attending cardiac rehabilitation (CR). This study tested whether exercise prescription methods influence exercise fear and exercise self-efficacy. We hypothesized that the use of graded exercise testing (GXT) with a target heart rate range exercise prescription, relative to standard exercise prescription using rating of perceived exertion (RPE), would produce greater reductions in exercise fear and increase self-efficacy during CR. METHOD: Patients in CR (N = 32) were randomized to an exercise prescription using either RPE or a target heart rate range. Exercise fear and self-efficacy were assessed with questionnaires at three time points: baseline; after the GXT in target heart rate range group; and at session 6 for the RPE group and CR completion. Items were scored on a five-point Likert-type scale with higher mean scores reflecting higher fear of exercise and higher self-efficacy. To analyze mean differences, a mixed effects analysis was run. RESULTS: There were no significant changes in exercise self-efficacy between baseline and discharge from CR; these were not statistically significant (mean differences baseline - 0.63; end - 0.27 (p = 0.13)). Similarly, there was no change in fear between groups (baseline 0.30; end 0.51 (p = 0.37)). CONCLUSION: Patients in the RPE and target heart rate groups had non-significant changes in exercise self-efficacy over the course of CR. Contrary to our hypothesis, the use of GXT and target heart rate range did not reduce fear, and we noted sustained or increases in fear of exercise among patients with elevated baseline fear. A more targeted psychological intervention seems warranted to reduce exercise fear and self-efficacy in CR.

6.
J Clin Med ; 12(5)2023 Feb 22.
Artigo em Inglês | MEDLINE | ID: mdl-36902529

RESUMO

Obesity and migraine are often comorbid. Poor sleep quality is also common among individuals with migraine and may be influenced by comorbidities such as obesity. However, understanding of migraine's relationship with sleep and the potential exacerbating effect of obesity remains limited. This study evaluated the associations of migraine characteristics and clinical features with sleep quality among women with comorbid migraine and overweight/obesity and assessed the interplay between obesity severity and migraine characteristics/clinical features in relation to sleep quality. Women seeking treatment for migraine and obesity (n = 127; NCT01197196) completed a validated questionnaire assessing sleep quality (Pittsburgh Sleep Quality Index-PSQI). Migraine headache characteristics and clinical features were assessed using smartphone-based daily diaries. Weight was measured in-clinic, and several potential confounders were assessed using rigorous methods. Nearly 70% of participants endorsed poor sleep quality. Greater monthly migraine days and the presence of phonophobia related to poorer sleep quality, and specifically poorer sleep efficiency, controlling for confounders. Obesity severity was neither independently associated nor interacted with migraine characteristics/features to predict sleep quality. Poor sleep quality is common among women with comorbid migraine and overweight/obesity, although obesity severity does not appear to uniquely relate to or exacerbate the association between migraine and sleep in this population. Results can guide research on mechanisms of the migraine-sleep link and inform clinical care.

7.
Addict Behav ; 137: 107498, 2023 02.
Artigo em Inglês | MEDLINE | ID: mdl-36240535

RESUMO

INTRODUCTION: Despite the well-known linkages between poor emotion regulation and subjective smoking motives, little is known about the role of emotion regulation in predicting smoking reinforcement behavior. This study examined the relation between difficulties in emotion regulation and puff velocity data, a behavioral index of smoking reinforcement, in adult daily cigarette smokers. METHOD: The current study was a secondary analysis of data collected from non-treatment seeking daily smokers (N = 124). Participants completed the Difficulties in Emotion Regulation Scale (DERS) followed by an ad libitum smoking period during which puff topography data was collected via a handheld puffing device. Puff velocity served as our puff topography index and was examined at the average and puff-to-puff level using regression and multi-level models, respectively. RESULTS: Regression analyses showed no significant association between DERS scores and average puff velocity. In contrast, multi-level modeling found a significant quadratic time × DERS effect at the puff-to-puff level, such that those with greater emotion regulation difficulties inhaled more quickly at the initiation of the cigarette, whereas those with lower emotion regulation difficulties evidenced consistent puffing over the course of the cigarette. DISCUSSION: Smokers with greater difficulties in emotion regulation appear to smoke in a way that maximizes delivery of nicotine, perhaps to self-regulate distress. One's style of puffing may reflect a possible behavioral marker of negative reinforcement smoking, especially in the context of emotional distress. IMPLICATIONS: This study was the first to explore the relationship between difficulties in emotion regulation and a behavioral measure of smoking reinforcement.


Assuntos
Regulação Emocional , Adulto , Humanos , Fumantes/psicologia , Nicotina , Reforço Psicológico , Fumar
8.
Eur J Pain ; 26(8): 1611-1635, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-35727200

RESUMO

BACKGROUND AND OBJECTIVE: Biopsychosocial conceptualizations of clinical pain conditions recognize the multi-faceted nature of pain experience and its intersection with mental health. A primary cognitive-behavioural framework is the Fear-Avoidance Model, which posits that pain catastrophizing and fear of pain (including avoidance, cognitions and physiological reactivity) are key antecedents to, and drivers of, pain intensity and disability, in addition to pain-related psychological distress. This study aimed to provide a comprehensive analysis of the magnitude of the cross-sectional association between the primary components of the Fear-Avoidance Model (pain catastrophizing, fear of pain, pain vigilance) with negative affect, anxiety, depression, pain intensity and disabilities in studies of clinical pain. DATABASES AND DATA TREATMENT: A search of MEDLINE and PubMed databases resulted in 335 studies that were evaluated in this meta-analytic review, which represented 65,340 participants. RESULTS: Results from the random effect models indicated a positive, medium- to large-sized association between fear of pain, pain catastrophizing, and pain vigilance measures and outcomes (pain-related negative affect, anxiety, depression and pain-related disability) and medium-sized associations with pain intensity. Fear of pain measurement type was a significant moderator of effects across all outcomes. CONCLUSIONS: These findings provide empirical support, aligned with the components of the fear-avoidance (FA) model, for the relevance of both pain catastrophizing and fear of pain to the pain experience and its intersection with mental health. Implications for the conceptualization of the pain catastrophizing and fear of pain construct and its measurement are discussed. SIGNIFICANCE: This meta-analysis reveals that, among individuals with various pain conditions, pain catastrophizing, fear of pain, and pain vigilance have medium to large associations with pain- related negative affect, anxiety, and depression, pain intensity and disability. Differences in the strength of the associations depend on the type of self-report tool used to assess fear of pain.


Assuntos
Dor Crônica , Ansiedade/psicologia , Catastrofização/psicologia , Dor Crônica/psicologia , Estudos Transversais , Depressão/psicologia , Medo/psicologia , Humanos , Medição da Dor , Transtornos Fóbicos , Inquéritos e Questionários
9.
Cogn Behav Ther ; 51(4): 273-294, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-35195055

RESUMO

Exercise sensitivity, fear of physical sensations of exertion, is particularly elevated in individuals with cardiovascular disease and can promote fear-avoidance of physical activity. We developed an ACT-informed exposure intervention to target exercise sensitivity, called Behavioral Exposure For Interoceptive Tolerance (BE-FIT). In this Stage I pilot trial, we developed and evaluated the feasibility, safety, and initial efficacy of BE-FIT in low active patients with elevated exercise sensitivity enrolled in outpatient cardiac rehabilitation. BE-FIT is a 6-session, manualized, program-adjunctive treatment delivered during the initial weeks of cardiac rehabilitation and involves exposure to feared bodily sensations and exercise situations, bolstered by acceptance and values-focused processes. Patients (Mage = 70.7 years) were assigned to BE-FIT (n = 12) or an activity monitoring-only control (n = 7). Patients in the BE-FIT condition reported high satisfaction, completed 100% of sessions, and 86.3% (SD = 16.4%) of homework exposures. There were no adverse events reported. BE-FIT produced large-sized effects on reductions in exercise sensitivity and increases in both average steps/day and moderate-to-vigorous physical activity (MVPA) mins/day, from baseline to end-of-treatment. In contrast, the monitoring-only cohort evidenced small-sized reductions in exercise sensitivity and no change in average steps/day or MVPA mins/day. BE-FIT is safe, feasible, acceptable with promising findings from this Stage I trial.


Assuntos
Exercício Físico , Medo , Idoso , Terapia por Exercício , Humanos , Projetos Piloto
10.
J Nerv Ment Dis ; 209(6): 415-420, 2021 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-33966016

RESUMO

ABSTRACT: This study explored demographic and clinical features, plus clinical outcomes, in a smoke-free acute partial hospital (PH) among current smokers, former smokers, and those who had never smoked (nonsmokers). Compared with nonsmokers, current smokers were younger and more likely to be unmarried and unpartnered, unemployed, or receiving disability benefits. They had more prior inpatient (IP) and PH episodes. They also had more problems with interpersonal relationships, mood lability, psychosis, and substance use. Compared with nonsmokers, current smokers were more likely to miss PH treatment days and drop out. They also had longer time to readmission to PH or IP. Former smokers resembled nonsmokers, except that former smokers also had a high rate of dropout. Changes in symptoms and functioning for patients who completed PH were the same among all groups. In an acute PH setting, smoking is a marker for psychiatric and psychosocial impairment plus treatment interruption.


Assuntos
Fumar Cigarros , Hospital Dia/estatística & dados numéricos , Hospitais Psiquiátricos/estatística & dados numéricos , Transtornos Mentais/terapia , Pacientes não Comparecentes/estatística & dados numéricos , Avaliação de Resultados em Cuidados de Saúde/estatística & dados numéricos , Pacientes Desistentes do Tratamento/estatística & dados numéricos , Fatores Socioeconômicos , Doença Aguda , Adulto , Transtornos de Ansiedade/epidemiologia , Transtornos de Ansiedade/terapia , Transtorno Bipolar/epidemiologia , Transtorno Bipolar/terapia , Fumar Cigarros/epidemiologia , Comorbidade , Transtorno Depressivo/epidemiologia , Transtorno Depressivo/terapia , Emprego/estatística & dados numéricos , Feminino , Humanos , Masculino , Estado Civil/estatística & dados numéricos , Transtornos Mentais/epidemiologia , Pessoa de Meia-Idade , Características de Residência/estatística & dados numéricos , Esquizofrenia/epidemiologia , Esquizofrenia/terapia , Fatores Sexuais
11.
Transl Behav Med ; 11(8): 1495-1506, 2021 08 13.
Artigo em Inglês | MEDLINE | ID: mdl-33823051

RESUMO

Given the potential for obesity to complicate migraine treatment outcomes, there is a need to understand patterns and correlates of acute medication use among individuals with this comorbidity. Experience sampling methodology (ESM) was used to characterize patterns of acute medication use among those with migraine and overweight/obesity and to examine individual and momentary factors related to medication use (both migraine-specific and nonspecific medications). Women with migraine and overweight/obesity (N = 170) seeking behavioral migraine treatment completed questionnaires followed by 28 days of daily ESM headache diaries. Participants used medications to treat 71.9% of attacks, 20% of which were treated with migraine-specific medications. Participants were more likely to use medication in the context of longer and more severe attacks that started earlier in the day. Presence of aura and greater work-related pain interference uniquely related to migraine-specific medication use. Questionnaire-assessed factors were not related to medication use, although older age and higher educational attainment related to more frequent use. A substantial proportion of attacks were left untreated, suggesting unmet treatment needs in this population. Results also suggest that ESM-assessed factors are more salient correlates of medication use compared to questionnaires. Additional investigation of barriers to medication use is needed.


Obesity may contribute to more severe migraine symptoms and negatively impact migraine treatment outcomes. The present study aimed to understand patterns of acute medication use among 170 women with migraine and obesity who were seeking behavioral migraine treatment. Data were collected in participants' natural environment using experience sampling methodology, during which participants reported daily migraine symptoms for 4 weeks. Approximately, 30% of attacks were not treated with any medications, and one in five attacks (i.e., 20%) was treated with migraine-specific medication. Participants were more likely to use medication during longer and more severe attacks that started earlier in the day. Participants were also more likely to use migraine-specific medication when attacks were precipitated by an aura and associated with work-related pain interference. Questionnaire-assessed factors were not related to medication use, although older age and higher educational attainment related to more frequent use. In general, these results also suggest that naturalistically assessed factors are more salient correlates of medication use compared to questionnaires. Additional investigation of barriers to medication use is needed among younger individuals and those of lower socioeconomic status.


Assuntos
Transtornos de Enxaqueca , Idoso , Comorbidade , Feminino , Cefaleia , Humanos , Transtornos de Enxaqueca/tratamento farmacológico , Transtornos de Enxaqueca/epidemiologia , Obesidade/complicações , Obesidade/epidemiologia , Sobrepeso/complicações , Sobrepeso/epidemiologia
12.
Drug Alcohol Depend ; 221: 108522, 2021 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-33582490

RESUMO

INTRODUCTION: Cigarette demand, or relative value, can be assessed via analysis of performance on a hypothetical behavioral economic cigarette purchase task (CPT). Substance purchase tasks are highly amenable to manipulation, namely, external stimuli, instructional changes, or acute stressors. In this regard, the current secondary analysis evaluates the role a novel, computerized stress induction paradigm, the Contextual-Frustration Intolerance Typing Task (C-FiTT), plays in eliciting varying levels of stress and resulting demand. METHOD: Daily smokers (n = 484) completed the C-FiTT wherein they were randomly assigned to one of five distress conditions: combination of task difficulty (low or high difficulty) with neutral or withdrawal cues, and a neutral control group. Tobacco demand was assessed immediately following the distress task using the hypothetical CPT. RESULTS: The C-FiTT distress-induction task significantly increased key cigarette demand indices, including price at maximum expenditure (Pmax) and first price where consumption was suppressed to zero (breakpoint). Moreover, demand increased with severity of C-FiTT condition, with the high-difficulty condition resulting in significantly higher breakpoint and Pmax, compared to other conditions. C-FiTT condition was not related to a significant increase in Omax, intensity, or elasticity. DISCUSSION: The novel C-FiTT paradigm produced comparable effects on tobacco demand relative to in vivo withdrawal induction, indicating that the C-FiTT is a viable procedure by which to influence demand. Reduction of internal and external stressors may be effective in lowering motivation for tobacco. These results highlight the importance of state distress in tobacco demand, and offer a potential avenue for intervention.


Assuntos
Tabagismo/psicologia , Adulto , Comportamento do Consumidor , Sinais (Psicologia) , Economia Comportamental , Feminino , Humanos , Masculino , Motivação , Fumantes , Nicotiana , Produtos do Tabaco/economia , Uso de Tabaco , Tabagismo/economia , Adulto Jovem
13.
Cogn Behav Ther ; 50(3): 217-233, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33587026

RESUMO

The COVID-19 pandemic is positioned to exact a substantial mental health toll on the global population. Heightened fears of viral contamination and fears of the negative consequences of social distancing (e.g., fears related to home confinement, fears of loneliness and isolation) might contribute to the distress caused by the pandemic. Cross-sectional data were collected from undergraduates (N = 608) residing in a U.S. pandemic "hotspot" at the time of data collection (between 7 April to 9 May, 2020). Outcome variables included viral contamination fears and social distancing fears. Predictor variables included biological sex, underlying medical vulnerability, number of recent viral symptoms, presence of positive COVID-19 test in social network, anxiety, depression, stress, emotion dysregulation, intolerance of uncertainty, body vigilance, and health anxiety. Female sex, anxiety severity, intolerance of uncertainty, and health anxiety uniquely predicted fears of viral contamination. Female sex and depression severity uniquely predicted fears of social distancing. Multiple anxiety-related vulnerabilities are potential intervention targets for reducing viral contamination fears. Depression is a potential intervention target for social distancing fears. Females might be at greater risk for both types of fears.


Assuntos
Ansiedade/psicologia , COVID-19/psicologia , Medo/psicologia , Solidão/psicologia , Saúde Mental , Distanciamento Físico , Adolescente , Adulto , Estudos Transversais , Depressão/psicologia , Feminino , Humanos , Masculino , Pandemias , Estudantes/psicologia , Adulto Jovem
14.
Cogn Behav Ther ; 50(5): 409-421, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-33433271

RESUMO

Evidence of the psychological distress associated with the COVID-19 pandemic, including depression, anxiety, and health anxiety, has been documented globally. College students are a unique sub-set of the population with consistently elevated psychological distress associated with the pandemic, and well-informed intervention is urgently needed. The current study is the first, to our knowledge, to document the effects of the COVID-19 pandemic on the mental health of undergraduates in a heavily impacted area in the United States. Cross-sectional, self-report data on psychological distress and COVID-19 exposure were collected from a racially and ethnically diverse sample of 641 undergraduates between April 7-9 May 2020. Nearly half of the students reported elevated psychological distress, including health anxiety, general anxiety, and depression. Heightened risk of psychological distress was associated with female sex, a COVID-19 case in one's immediate social network, underlying medical vulnerabilities, and recent experience of ≥3 viral symptoms. Vigilance to viral symptoms and worry about coronavirus were also factors associated with more severe psychological distress. The current study highlights some of the factors associated with a greater risk of developing psychological distress due to COVID-19 and can be used to inform the dissemination of psychological interventions.


Assuntos
Ansiedade/epidemiologia , COVID-19/epidemiologia , Depressão/epidemiologia , Pandemias , Estresse Psicológico/epidemiologia , Estudantes/psicologia , Estudantes/estatística & dados numéricos , Universidades , Estudos Transversais , Feminino , Humanos , Masculino , Angústia Psicológica , SARS-CoV-2 , Estados Unidos/epidemiologia , Adulto Jovem
15.
Pers Individ Dif ; 1552020 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-32863505

RESUMO

Cigarette smoking is associated with autonomic dysregulation and altered stress responsivity. There exists a reciprocal relation between subjective and physiological stress reactivity and recovery in smokers. Emotion regulation may impact the extent to which these domains influence each other. The current study examined the moderating role of lack of emotional awareness, lack of emotional clarity, and nonacceptance of emotions, in the relation between heart rate reactivity to, and subjective recovery from, stress, and vice versa. To determine specificity of cross-domain findings, these relations were also examined within domain. Fifty-six daily smokers (46.4% female; M age = 29.33, SD = 11.92) participated in a biological challenge. Heart rate and subjective distress were assessed continuously before, during, and after the challenge. Individual growth curve models revealed that deficits in emotional clarity significantly moderated the effect of heart rate reactivity on subjective recovery. Lack of emotional awareness also moderated the association between subjective reactivity and heart rate recovery. Emotion regulation processes did not affect relations within the same domain, but altered the relation across domains.

16.
Health Psychol ; 39(10): 927-933, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32658497

RESUMO

OBJECTIVE: Pain catastrophizing and cutaneous allodynia represent two risk factors for greater headache-related disability. Yet, there is limited knowledge of the extent to which these risk factors are modifiable and whether nonpharmacological treatment-related changes are associated with migraine improvements. Using data from the Women's Health and Migraine (WHAM) study, a randomized controlled trial that compared effects of behavioral weight loss (BWL) and migraine education (ME) in women with migraine and overweight/obesity, we tested whether: (a) BWL versus ME produced greater changes in pain catastrophizing and allodynia from baseline across posttreatment and follow-up time points, and (b) whether these improvements were associated with improvements in headache disability. METHOD: Women (N = 110) were randomly assigned to 16 weeks of either BWL or ME and assessed at baseline, posttreatment, and follow up (32 weeks). Multilevel mixed effects modeling tested: (a) for between-groups differences in pain catastrophizing and allodynia changes over time, and (b) associations of changes in pain catastrophizing and allodynia with changes in headache disability, adjusting for migraine severity and weight loss. RESULTS: Both BWL and ME had significant reductions in pain catastrophizing and allodynia from baseline to posttreatment and follow up, and the improvements were comparable across conditions. Reductions in pain catastrophizing and cutaneous allodynia were associated with significant reductions in headache disability, even when controlling for intervention-related improvements in migraine and weight loss. CONCLUSION: Pain catastrophizing and allodynia are not only reduced after nonpharmacologic treatments for migraine, but greater improvements are associated with greater reductions in headache-related disability, independent of migraine severity. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


Assuntos
Hiperalgesia/terapia , Transtornos de Enxaqueca/terapia , Obesidade/complicações , Sobrepeso/complicações , Dor/fisiopatologia , Adolescente , Adulto , Feminino , Humanos , Hiperalgesia/etiologia , Pessoa de Meia-Idade , Transtornos de Enxaqueca/etiologia , Adulto Jovem
17.
Obes Sci Pract ; 6(2): 119-125, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32313669

RESUMO

BACKGROUND: Migraine and obesity are comorbid particularly in women of reproductive age. Obesity treatment involves reducing energy intake and improving dietary quality but the effect of these changes on migraine is largely unknown. OBJECTIVE: To determine if adherence to dietary intervention targets (ie, total energy, dietary fat intake, and dietary quality) were associated with improvements in migraine and weight. METHODS: Eighty-four women with overweight/obesity and migraine were randomized to and completed either a 16-week behavioral weight loss (BWL) or a migraine education (ME) intervention. For 28 days at baseline and posttreatment, women recorded monthly migraine days, duration, and maximum pain intensity via smartphone-based diary. At each assessment, weight was measured and dietary intake (total energy intake, percent (%) energy from fat, and diet quality, as measured by the Healthy Eating Index, 2010 [HEI-2010]) was assessed using three nonconsecutive 24-hour diet recalls. RESULTS: There were no significant group differences in change mean migraine days per month (BWL: -2.6+4.0, ME: -4.0+4.4; p = 0.1). Participants in BWL significantly reduced their percent fat intake 3.8% (p = 0.004) and improved total diet quality (HEI-2010) by 6.7 points (p = 0.003) relative to baseline and those in ME (%fat: +0.3%; p = 0.821; HEI-2010: +0.7; p = 0.725). After controlling for race/ethnicity and weight change, changes in dietary intake were not related to changes in migraine characteristics or weight loss among BWL participants (p's > 0.05). CONCLUSIONS: Changes in dietary intake among participants were small and may have been insufficient to improve migraine in women with overweight/obesity and migraine.

18.
J Behav Med ; 43(3): 487-492, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32246293

RESUMO

Smokers report weight and appetite control as motivators to smoking continuance. These concerns are particularly salient for smokers who use cigarettes to suppress appetite and manage weight. Dieting may influence weight, shape, and appetite-related smoking motivation; however, this has not yet been examined. This study tested associations between five diet types and smoking motivation to control weight, shape, and appetite among adult daily cigarette smokers (N = 550). A multivariate analysis was used to test the incremental association between diet types and Smoking-Related Weight and Eating Episodes Test (SWEET) subscales, adjusting for age, body mass index, sex, and cigarette dependence. Smokers who diet (n = 83, 15.1%) reported higher scores on all SWEET subscales compared to smokers not on a diet. Low-calorie dieting was associated with greater smoking motivation to cope with body dissatisfaction, and low-sugar dieting was associated with greater motivation for smoking to prevent withdrawal-related appetite increases. Treatment implications for smoking cessation are discussed.


Assuntos
Restrição Calórica , Motivação , Fumar/psicologia , Adaptação Psicológica , Adulto , Apetite , Índice de Massa Corporal , Peso Corporal , Dieta , Ingestão de Energia , Feminino , Humanos , Masculino , Fumantes , Abandono do Hábito de Fumar , Açúcares , Inquéritos e Questionários , Produtos do Tabaco
19.
Int J Behav Med ; 27(2): 247-254, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32124245

RESUMO

BACKGROUND: Distress intolerance, one's inability to withstand distressing emotional or physical states, is a transdiagnostic vulnerability implicated in affect-based health behaviors, including cigarette smoking and poor weight control. The current study evaluated associations between distress intolerance and the reliance on cigarettes for management of weight, appetite, or body dissatisfaction, which may pose a burden for cessation and increase risk of weight-related health problems. METHOD: Daily smokers (n = 577) completed an online survey assessing distress tolerance and reliance on cigarettes for weight and shape control with the four subscales of the Smoking and Weight Eating Episodes Test (SWEET). Four hierarchical regression models were constructed to test the association between distress intolerance and SWEET scores, accounting for the effect of relevant covarying factors. RESULTS: After adjusting for model covariates, distress intolerance was significantly incrementally associated with greater tendency to rely on cigarettes to suppress appetite (adjR2 = .040), prevent overeating (adjR2 = .034), cope with body dissatisfaction (adjR2 = .046), and cope with nicotine withdrawal-related appetite increases (adjR2 = .030). CONCLUSION: Distress intolerance may play an etiological role in maladaptive use of cigarettes to control appetite, weight, and body dissatisfaction among daily smokers, particularly those with weight- or shape-related concerns. Interventions aimed at increasing perceived ability to withstand distress could potentially reduce reliance on cigarettes for the aforementioned purposes.


Assuntos
Adaptação Psicológica , Apetite/fisiologia , Fumantes/psicologia , Fumar/psicologia , Adulto , Peso Corporal , Feminino , Humanos , Hiperfagia/psicologia , Masculino , Pessoa de Meia-Idade , Abandono do Hábito de Fumar/psicologia , Inquéritos e Questionários
20.
Bull Menninger Clin ; 84(4): 337-372, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33779237

RESUMO

Lifestyle physical activity (LPA) interventions are a promising alternative to structured exercise interventions for addressing mental health problems. The authors conducted a systematic review of the literature on LPA interventions in any population in order to determine (a) the extent to which mental health outcomes were examined and (b) whether benefits in mental health outcomes were observed. Mental health outcomes were defined as depression, anxiety, perceived stress, health-related quality of life, and psychological well-being. A total of 73 articles were identified as LPA intervention, of which 24.7% (n = 18) reported the effect of LPA intervention on mental health outcomes. The most commonly evaluated mental health outcome was depression, and to a lesser extent anxiety and perceived stress. Overall, findings point to promising effects of LPA interventions across common mental health problems. Key areas for future research are discussed in light of emergent limitations in existing published studies.


Assuntos
Saúde Mental , Qualidade de Vida , Ansiedade/terapia , Exercício Físico , Humanos , Estilo de Vida
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