Association Between Communicative Participation and Psychosocial Factors in Patients With Voice Disorders.

IMPORTANCE: Communicative participation can be conceptualized as taking part in life situations in which people are socially engaged. Communicative participation is an important aspect in the lives of patients with voice disorders, although it has not been formally assessed among a broad sample of patients with voice disorders. The associations between communicative participation and associated concepts (vocal impairment, psychosocial distress, and voice-specific perceived control) are unknown yet important for integrated treatment approaches. OBJECTIVE: The primary objective was to examine the associations between communicative participation and vocal impairment, psychosocial distress, and voice-specific perceived control. The secondary objective was to examine whether perceived control moderates the association of distress with communicative participation and vocal impairment, the latter of which would replicate previous research. The hypotheses were that communicative participation would be associated with lower vocal impairment, lower distress, and higher perceived control and that higher perceived control would moderate the association between communicative participation and both vocal impairment and psychosocial distress. DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study was conducted from June 2014 to May 2017 among a consecutive sample of adult patients with voice disorders at an academic voice clinic affiliated with the University of Minnesota. Of the 744 patients approached to participate in the survey study, 590 patients agreed. Data analysis was performed from January to June 2020. MAIN OUTCOMES AND MEASURES: Communicative participation (measured by the 10-item general short form of the Communicative Participation Item Bank), vocal impairment (measured by the 10-item version of the Voice Handicap Index), psychosocial distress (measured by the 18-item version of the Brief Symptom Inventory), and voice-specific perceived control (measured by the 8-item present control subscale of the Perceived Control Over Stressful Events Scale). RESULTS: The sample comprised 590 patients (mean [SD] age, 51.9 [17.1] years; 390 women [66.1%]) with voice disorders. Communicative participation was associated with lower vocal impairment (r = -0.73; 95% CI, -0.77 to -0.69), lower overall psychosocial distress (r = -0.22; 95% CI, -0.30 to -0.14), and higher voice-specific perceived control (r = 0.30; 95% CI, 0.23-0.37). Moderation analyses indicated that communicative participation was negatively associated with distress at all levels of perceived control and, replicating previous findings, greater vocal impairment was associated with higher psychosocial distress only in patients with lower perceived control. CONCLUSIONS AND RELEVANCE: In this study, communicative participation was associated with, but distinct from, vocal impairment and was also associated with psychosocial distress and voice-specific perceived control. The study's results suggest that communicative participation is an important addition to voice research and clinical care.

Post-sexual assault cigarette smoking: Findings from a randomized clinical trial of a video-based intervention.

Sexual assault (SA) is associated with elevated risk for cigarette smoking. The current study tested whether a brief video intervention delivered in the emergency department was effective at reducing smoking following SA. Participants were 233 girls and women (age 15+) who received a SA medical forensic examination (SAMFE) and were randomized to one of three conditions: 1) Prevention of Post-Rape Stress (PPRS), a brief video designed to reduce post-SA psychopathology; 2) Pleasant Imagery and Relaxation Information (PIRI), an active control video involving relaxation training; and 3) treatment as usual (TAU). Among those who participated at baseline, 154 participants completed at least one follow-up at 1.5, 3, and 6 months after the SAMFE. Participants reported the number of days of smoking and the average number of cigarettes smoked per day in the two weeks prior to the sexual assault as well as in the two weeks prior to each follow-up. Two-thirds (68.8%) of participants smoked prior to the SA or during any follow-up. One-fifth of participants who did not smoke prior to the SA smoked at one or more follow-ups. Smoking declined on average over follow-up although TAU was associated with increased initial smoking compared to PPRS; PPRS and PIRI did not differ. SA contributes to increases in smoking and the PPRS, a brief and cost-effective video-based intervention delivered during the SAMFE, can protect against increases in post-SA smoking. Trial registration: NCT01430624.

Beyond Criterion A1: the effects of relational and non-relational traumatic events.

Trauma research has historically focused on Criterion A1 traumas, neglecting many other negative interpersonal events that have been shown to lead to posttraumatic stress disorder (PTSD; S. L. Anders, P. A. Frazier, & S. Frankfurt, 2011 ). Trauma research has also focused primarily on PTSD and neglected other important outcomes, such as relationship functioning. This study aimed to assess a broader range of events, including many Criterion A1 interpersonal events; assess the cumulative impact of event exposure; and examine the relation between event exposure and a broad range of outcomes, including relationship functioning. A sample of 181 undergraduate students completed measures assessing exposure to a broad range of events, their worst lifetime event, and current psychological (e.g., psychological distress) and relationship (e.g., partner trust) functioning. Results suggested that non-Criterion A1 relational events were very common in our sample. The number of lifetime relational events experienced, whether Criterion A1 or non-Criterion A1, was strongly and consistently associated with all outcomes. The number of lifetime Criterion A1 non-relational events experienced was significantly associated with current PTSD symptoms but was not associated with other mental health and relationship outcomes. No differences were found between Criterion A1 relational, non-Criterion A1 relational, and Criterion A1 non-relational worst events on any of the mental health or relationship measures. Implications for further research and interventions are discussed.

Assessing the validity of self-reported stress-related growth.

The purpose of these studies was to assess the validity of self-reported stress-related growth (SRG). In Study 1, individuals with breast cancer (n = 70) generally did not report greater well-being than a matched comparison group (n = 70). In Study 2, there were no significant differences in well-being between undergraduate students who said that something positive had come out of their worst stressor (n = 34) and those who reported no positives (n = 34). In Study 3, specific domains of SRG assessed in undergraduate students (n = 96) generally were not uniquely related to corresponding well-being measures. Thus, the authors found fairly little evidence for the validity of self-reported SRG. Future research directions are highlighted.

Mediation and moderation of the relationship between intrinsic religiousness and mental health.

The present study examined specific aspects of individuals' personal strivings as mediators, and religious tradition as a moderator, of the relationship between intrinsic religiousness and mental health. In a sample of 268 university students, the negative relationship between intrinsic religiousness and hostility was mediated by the degree of sanctification within individuals' strivings. The relationships between intrinsic religiousness and both anxiety and depression were moderated by religious tradition, with Catholics' intrinsic religiousness significantly associated with greater anxiety and depression but Protestants' intrinsic religiousness not significantly associated with either of these mental health variables. Implications of these results for future research on religiousness are discussed.