A WNT4- and DKK3-driven canonical to noncanonical Wnt signaling switch controls multiciliogenesis.

Multiciliated cells contain hundreds of cilia whose directional movement powers the mucociliary clearance of the airways, a vital host defense mechanism. Multiciliated cell specification requires canonical Wnt signaling, which then must be turned off. Next, ciliogenesis and polarized ciliary orientation are regulated by noncanonical Wnt/planar cell polarity (Wnt/PCP) signaling. The mechanistic relationship between the Wnt pathways is unknown. We show that DKK3, a secreted canonical Wnt regulator and WNT4, a noncanonical Wnt ligand act together to facilitate a canonical to noncanonical Wnt signaling switch during multiciliated cell formation. In primary human airway epithelial cells, DKK3 and WNT4 CRISPR knockout blocks, whereas ectopic expression promotes, multiciliated cell formation by inhibiting canonical Wnt signaling. Wnt4 and Dkk3 single-knockout mice also display defective ciliated cells. DKK3 and WNT4 are co-secreted from basal stem cells and act directly on multiciliated cells via KREMEN1 and FZD6, respectively. We provide a novel mechanism that links specification to cilium biogenesis and polarization for proper multiciliated cell formation.

Emotion Regulation Moderates the Association Between Proximal Negative Affect and Intimate Partner Violence Perpetration.

Negative affect is a central component of many theories of aggressive behavior. Though understudied, it is likely that proximal negative affect increases the odds of aggression perpetration when individuals have poor emotion regulation, but not when individuals have more adaptive emotion regulation. Thus, the current study examined (1) the proximal effect of various indicators of negative affect (e.g., anger, hostility, depression) on intimate partner violence (IPV) perpetration and (2) whether poor emotion regulation moderated these associations. For up to 90 consecutive days, male college students (N = 67) in a current dating relationship completed daily surveys on their negative affect and IPV perpetration. Results demonstrated that emotion regulation moderated many of the associations between proximal negative affect and physical aggression perpetration, such that negative affect was associated with increased odds of violence when poor emotion regulation was high but not low. This is the first study to demonstrate the moderating role of emotion regulation in the link between proximal negative affect and IPV perpetration. As such, these findings have important implications for existing theories of IPV and emotion regulation and suggest that interventions may effectively reduce IPV by targeting emotion regulation.

The Relation Between Moment-to-Moment Mindful Attention and Anxiety Among Young Adults in Substance Use Treatment.

BACKGROUND: A growing body of research has examined the intersection of mindfulness and substance use, and a large body of research has examined the relation between mindfulness and anxiety. Unfortunately, no research has been conducted on the relation between mindfulness and anxiety symptoms among young adults (i.e., 18-25 years old) in treatment for substance use. The purpose of the current study was to examine the relation between one facet of mindfulness, moment-to-moment attention, and anxiety (panic and generalized anxiety) among young adults in treatment for substance use. METHODS: Preexisting patient records from a residential substance use treatment center for young adults were reviewed (N = 148). Patient records were examined from May 2012 to August 2013, which represented all young adult patients admitted to the residential treatment facility during this time. RESULTS: Findings demonstrated that moment-to-moment mindful attention was associated with symptoms of panic disorder and generalized anxiety disorder even after controlling for gender, age, education, alcohol use, drug use, and the shared variance in generalized and panic symptoms. There were no gender differences in moment-to-moment mindful attention. CONCLUSIONS: These findings provide preliminary evidence that moment-to-moment mindful attention is associated with panic and generalized anxiety in young adults in substance use treatment. Combined with previous research on mindfulness-based interventions among adults in substance use treatment, research should examine the efficacy of mindfulness-based interventions for young adults in substance use treatment.

The moderating effect of women's alcohol misuse on the relationship between intimate partner violence victimization and postpartum depression.

BACKGROUND AND OBJECTIVES: We examined the moderating effect of women's alcohol misuse on the relationship between intimate partner violence (IPV) victimization and postpartum depression. METHODS: Self-report data were collected from 122 women. Analyses controlled for women's baseline depression severity and partner alcohol misuse. RESULTS: Women's alcohol misuse moderated the relationship between psychological IPV victimization and postpartum depression only at high levels of the moderator. DISCUSSION AND CONCLUSIONS: Findings highlight the mental health risk posed by the combination of psychological IPV and alcohol misuse postpartum. SCIENTIFIC SIGNIFICANCE: Findings emphasize the need to investigate the understudied topic of women's postpartum alcohol misuse.

Risk factors for intimate partner violence during pregnancy and postpartum.

This longitudinal investigation examined potential risk factors for intimate partner violence (IPV) among women during pregnancy and 6 weeks postpartum. A sample of 180 pregnant women was collected in order to investigate (1) whether associations between partner alcohol misuse, partner jealousy, partner suspicion of infidelity, and stress were associated with IPV victimization; (2) the indirect effects of alcohol misuse on these relationships; and (3) factors related to changes in IPV victimization over time. At baseline, partner alcohol misuse was associated with each type of IPV victimization and the combination of partner alcohol misuse, partner jealousy, and partner suspicion of infidelity was most strongly associated with severe physical victimization. Partner alcohol misuse mediated the relationship between partner jealousy and psychological and severe physical victimization. At follow-up, partner jealousy and stress were related to women's psychological victimization and partner alcohol misuse was related to women's severe physical victimization. Findings suggest that partner alcohol misuse is a risk factor for women's IPV victimization during pregnancy and jealousy and that stress may increase risk for some types of IPV. Findings also suggest that intervention should target parents early in pregnancy in order to reduce the risk for future IPV.

Women's intimate partner violence perpetration during pregnancy and postpartum.

The purpose of this longitudinal study was to examine the prevalence of women's psychological, minor physical, and severe physical intimate partner violence (IPV) perpetration during the first 18 weeks of pregnancy and at 6 weeks postpartum and to compare women who used each type of IPV to those who did not. Women who increased their IPV perpetration over time were also compared to women who decreased or did not change their IPV perpetration over time. A sample of 180 women participated in a larger study of the well-being of pregnant women. Data were collected via self-report survey and 122 participants were retained at follow-up. At both time points, more women in the sample reported IPV perpetration (baseline n = 132; follow-up n = 73) than IPV victimization (baseline n = 114; follow-up n = 66). Women who perpetrated IPV reported higher levels of IPV victimization, reported partner alcohol misuse, stress, depression, and lower dyadic adjustment compared to women who did not. Women's IPV perpetration was associated with several negative outcomes. Findings suggest that IPV screening during pregnancy and postpartum should include women's IPV perpetration and should be conducted at multiple time points, since women's IPV experiences may change over time.

Preliminary validation of the Diversion Risk Scale (DRS): Using environmental and individual factors to predict opioid-related diversion events.

The standard of care calls for the assessment of patients with chronic pain prior to the initiation of opioids, with one part of this assessment including assessment of the risk of misuse of medications. However, traditional opioid risk assessment tools focus almost entirely on individual factors and on the risk of misuse and addiction to opioids. Diversion of opioid medications has been found to be not uncommon, but to date, there have been no assessment tools specifically designed to assess the risk of diversion. In this study, we developed a measure designed specifically to assess the risk of an opioid medication ending up in the hands of someone other than the chronic pain patient to whom they were prescribed. A 15-item measure, the Diversion Risk Scale, was created and administered to 85 patients at a chronic pain practice. Results found that the measure had acceptable predictive validity. It was moderately correlated with traditional opioid risk assessment tools and showed improved ability to predict specific indicators of diversion. Diversion has been an understudied phenomenon, and the clinical value of an assessment tool that can help predict diversion in the chronic pain population is discussed.

Patient reported goals for medications for opioid use disorder: A theory of proximal goal attainment.

Background: There exist substantial patient barriers to accessing medications for opioid use disorder (MOUD), including travel distance, stigma, and availability of MOUD providers. Yet, despite these barriers, there exists a subset of patients who possess the requisite motivation to seek and remain adherent to treatment. Objective: To explore patient-derived goals in MOUD treatment-adherent patients. Methods: This study used in-depth interviews with patients receiving methadone who were enrolled in opioid treatment programs (OTPs) across Tennessee. Participants were recruited from 12 different OTPs to participate in telephonic semi-structured interviews to a point of saturation. Participants had to be adherent to treatment, in treatment for 6 months or greater, and English speaking. Analysis occurred inductively using a constructivist approach to Grounded Theory. Results: In total, 17 patient interviews were conducted in the spring of 2021. Participants described goal setting across three general stages of treatment: (1) addressing acute physical and emotional needs upon treatment entry, (2) development of supportive structure and routine to develop healthy skills facilitated by treatment team, and (3) identifying and pursuing future-focused goals not directly linked to treatment. A Proximal Goals in MOUD Framework is introduced. Conclusion: In this qualitative study on patient reported goals in MOUD it was found that goals are transitory and relative to the stage of treatment. Further research is needed to better understand goal evolution over the course of treatment and its impact on treatment retention.

Community-Centered Patient Journey Map in Opioid Use Disorder: A Tool to Address Compassion Fatigue among Community Pharmacists.

Community pharmacists have become increasingly exposed to opioid use disorders in recent decades. However, both pharmacist training and traditional practice environments have not been adequate to prepare the pharmacist for both the patient care needs and regulatory barriers of patients experiencing opioid use disorders (OUD). As a result, there is a need to increase pharmacists' awareness of both the overall patient experience as they navigate their OUD and the role of the community pharmacy as a touchpoint within that experience. To this end, a Community-Centered Patient Journey in Drug Addiction Treatment journey map was developed with expert insights, clinical experience, and in-depth interviews (conducted in spring of 2021) with 16 participants enrolled in licensed opioid treatment programs in Tennessee. Patients, policymakers, clinicians, and academic researchers were involved in the map development. Lived experiences of key informants were captured via in-depth interviews. A consensus decision-making approach was used throughout the patient journey map development process. The final patient journey map illustrates a non-linear pathway, describes the central role of the patient's community, and emphasizes three major "pain points" within the system (access, adherence, and affordability). Future research should investigate the impact of such a journey map on pharmacy personnel's knowledge, attitudes, and behaviors.

The Role of Impulsivity and Stress Mind-Set in Understanding the Mindfulness-Intimate Partner Aggression Relationship.

Perpetration of relational aggression, which is estimated to occur in 60% to 90% of relationships, has been demonstrated to have lasting negative effects both systemically and for its victims. Relational aggression has also been demonstrated to be impacted, in part by impulsivity, stress mind-set, and mindfulness. The present study examined a path analysis model of the relation between mindfulness and relational aggression, utilizing impulsivity as the mediating variable. Furthermore, the present study incorporated an examination of the potential moderating effects of stress mind-set on the relation between impulsivity and relational aggression. Three hundred eighty-three participants were recruited from across the United States, using Facebook ads. Participants completed online questionnaires assessing key study variables. We hypothesized that the negative urgency aspect of impulsivity would mediate the relation between the five facets of mindfulness and relational aggression, and further that this relationship would be moderated by stress mind-set, such that a stress mind-set which conceptualizes stress as negative would make the relation between impulsivity and relational aggression stronger. We hypothesized that the negative urgency aspect of impulsivity would mediate the relation between mindfulness and relational aggression. Furthermore, we hypothesized that the relation between impulsivity and aggression would be moderated by stress mind-set. Results indicated that the negative urgency component of impulsivity mediated the relation between all five facets of mindfulness and perpetration of relational aggression. Furthermore, stress mind-set moderated the relation between negative urgency and relational aggression, such that a lower stress mind-set was related to a stronger association between negative urgency and aggression. Implications for clinical intervention and future research efforts are discussed.

Antisociality and intimate partner violence: the facilitating role of shame.

Numerous theories classify distinct subtypes of men who perpetrate violence against female partners. These theories contend that a large portion of these men possess antisocial characteristics that may increase risk for violence. Affectively, these men have been found to externalize their emotions, including shame and guilt, and it has been suggested that this process contributes to the perpetration of partner violence. Therefore, this study sought to examine the role of shame and guilt in the association between antisociality and partner violence perpetration (i.e., psychological, physical, and sexual). Based on a sample of 423 undergraduate men, this study found that shame moderated the association between antisociality and partner violence perpetration such that as shame increases, the associations between antisociality and all three types of partner violence perpetration increase. These findings contribute to the theoretical understanding of typological models of partner violence and have clinical implications for batterer intervention programs.

Exploring Changes in Gang Involvement and Associated Risk Factors for American Indian Adolescents in Reservation Communities.

Reservation communities are among emerging communities for gang activity, in which reports of a rise in youth and/or criminal gangs began occurring after the 1980s. Gang membership has been found to pose a public health risk, strain community resources, and risk a number of individual negative life outcomes. Perceived increases in reservation gang activity have been observed by law-enforcement and community stakeholders, but comparatively little empirical research has focused specifically on these communities. Utilizing data from an existing public dataset, analysis of variance and regression analysis were utilized to examine cross sectional trends in gang involvement among 14,457 American Indian adolescents in reservation communities between 1993-2013. Results of this study failed to establish a consistent pattern of either growth or decline in gang membership across time when examining all reservations communities, with data suggesting that consistent trends may exist only within specific communities. Gang members were found to endorse significantly more alcohol and marijuana use, anger, depressed mood, and victimization as a whole. Only alcohol and marijuana use, violent behavior, and depressed mood demonstrated a significant interaction with time and gang membership. Finally, self-reported substance use, criminal behavior/delinquency, and violence perpetration significantly increased as gang affiliation increased.

The Relationship Between Food Deserts, Farmers' Markets, and Food Assistance Programs in Hawai'i Census Tracts.

Due to inadequate resources and limited access to healthy foods, residents who live in food deserts struggle to maintain a healthful diet. Living in a food desert increases the risk of developing diet-related chronic diseases such as obesity. Local farmers' markets serve as community-level interventions, bringing healthy food options to food deserts. This study explores the relationship between food deserts, placement of farmers' markets, and availability of food assistance programs in the state of Hawai'i. Data are from the 2017 United States Department of Agriculture (USDA) Food Access Research Atlas and the USDA Farmers' Market Directory. Farmers' market addresses were geocoded in ArcGIS 10.3. Descriptive statistics and spatial visualization were used to explore census tract level relationships. Of the Hawai'i census tracts, 10% are food deserts. Sixteen of the 101 registered farmers markets are located within a food desert. Of these markets, 28.7% accept Farmers' Market Nutrition Program coupons, 0% accept Women, Infants, and Children Fruit and Vegetable Checks, and 39.6% accept Supplemental Nutrition Assistance Program benefits. Fewer than 20% of farmers' markets in Hawai'i are located in food deserts, and few accept food assistance programs. Fresh food is less accessible to low-income residents in these areas and lack of access to fresh food is associated with diet-related chronic diseases. To reduce food insecurity, farmers' markets could accept food assistance program funds. Additional farmers' markets could be established in food deserts to increase availability of healthy food, thereby reducing the population's risk of developing obesity and diet-related chronic diseases.

A 20-year study of the bidirectional relationship between anxious and depressive symptomology and pain medication usage.

Aim: To investigate the 20-year relationship between anxiety, depression and pain medication use. Patients: A total of 521 individuals reporting chronic pain from the National Survey of Midlife Development in the USA (MIDUS) study. Methods: Structural equation modeling of 20-year longitudinal survey data. Results: Over 20 years, a bidirectional relationship between depression and anxiety in individuals with chronic pain was indicated. Pain medication utilization predicted later use at 10 years. Pain medication use was not strongly related to later anxiety; however, heightened anxiety was associated with later use. Conclusion: Depression and anxiety show an extensive long-term bidirectional relationship. While there was little indication of a relationship between pain medication use and later negative mood, anxiety was associated with subsequent pain medication use.

A Longitudinal Investigation on the Relation between Self-Compassion and Alcohol Use in a Treatment Sample: A Brief Report.

Alcohol misuse is often a chronic problem such that relapses following treatment are common. One potential protective factor for alcohol misuse is self-compassion, which includes self-kindness, feelings of common humanity, and mindfulness when faced with personal suffering and hardships. This study tested the hypothesis that self-compassion, and specifically self-compassion promoting facets including self-kindness, common humanity, and mindfulness, were longitudinally associated with reduced alcohol use among a sample of men and women in substance use disorder treatment (N = 62). Results partially supported the hypothesis, in that only the mindfulness facet of self-compassion was associated with decreased alcohol use over time. Sex and age differences as they related to the positive facets of self-compassion and alcohol use emerged. These findings suggest that positive facets of self-compassion may be beneficial factors to cultivate in alcohol treatment programs.

A comparison of common screening methods for predicting aberrant drug-related behavior among patients receiving opioids for chronic pain management.

OBJECTIVE: The ability to predict risk for violating opioid medication policies, known as aberrant drug-related behavior, is critical for providing optimal treatment. Many pain management centers measure risk using one of several partially validated measures: the Screener and Opioid Assessment for Patients with Pain (SOAPP), the Diagnosis, Intractability, Risk, and Efficacy inventory (DIRE), and/or the Opioid Risk Tool (ORT). However, little is known about how these measures compare with each other in predicting aberrant drug-related behavior and discontinuance of opioid pain medications. The current study aimed to address this research question. PATIENTS: Participants were 48 patients who attended a pain management center in Tennessee but were later discontinued from opioids for aberrant drug-related behavior. Patients referred for opioid medication for pain management participated in a semi-structured clinical interview with the staff psychologist and completed the aforementioned measures. Patients generally returned to the pain clinic on a monthly basis for medication management. Results. Analyses compared the sensitivity of each self-report measure and the clinical interview in predicting discontinuance for aberrant drug-related behavior. RESULTS: showed the highest sensitivity for the clinical interview (0.77) and the SOAPP (0.72), followed by the ORT (0.45) and the DIRE (0.17). Combining the clinical interview with the SOAPP increased sensitivity to 0.90. CONCLUSIONS: Among patients who were discontinued from opioids for aberrant drug-related behaviors, the clinical interview and the SOAPP were most effective at predicting risk at baseline. Implications for future research and clinical practice are discussed.

The effects of PTSD symptomatology on laboratory-based aggression.

The present study sought to examine the relationship between posttraumatic stress disorder (PTSD) symptomatology and aggression using a highly controlled, quasi-experimental laboratory-based aggression paradigm among a sample of 85 undergraduate students not help-seeking for current PTSD phenomena. Congruent with theory and past research, results showed that PTSD symptomatology was positively associated with aggression. In demonstrating this effect using a laboratory-based methodology, the present study provides a heuristic for future researchers to explore potential mediators and moderators of the PTSD-aggression relationship.

The Impact of History of Aggression and Alcohol Use on Aggressive: Responding in the Laboratory.

The current study examines how different levels of past aggression combined with self-reported levels of alcohol use impacted lab-based aggressive responding. Data were collected from 160 male undergraduate college students. Participants completed online measures of drinking (Alcohol Use Disorders Identification Test) and past aggression (Buss Perry Aggression Questionnaire) prior to a lab session assessing aggressive responding [Point Subtraction Aggression Paradigm (PSAP)]. Regression analyses revealed participants with "high" levels of past alcohol use and a history of "high" aggression were more likely to respond aggressively on the PSAP, a trend primarily driven by those with a history of physical aggression. For proactively aggressive participants, the risk for aggressive responding is greater in individuals with a history of physically aggressive behavior as they report higher alcohol use, relative to those "low" in past aggression. The interaction of alcohol use and past aggression was associated with continued aggressive behavior.

Drug abuse and aggression between intimate partners: a meta-analytic review.

The present investigation employed meta-analytic procedures to quantitatively evaluate the empirical evidence on the relationship between drug abuse and aggression between intimate partners. Data from 96 studies yielding 547 effect sizes indicated that increases in drug use and drug-related problems were significantly associated with increases in aggression between intimate partners (d= .27). Cocaine emerged as the illicit substance with the strongest relationship to psychological, physical, and sexual aggression (ds= .39 to .62). Marijuana was also identified as having a significant association with partner aggression. Results showed comparable effect sizes for men and women, regardless of the sex of the drug user and/or perpetrator of partner aggression, with female reports of aggression having yielded larger effect sizes than male reports. Moderator analyses revealed that relative to other groups, married or cohabiting couples and Black participants evidenced significantly stronger effect sizes. The findings are discussed in relation to possible mechanisms linking drugs to partner aggression, and implications for future research are discussed in terms of focusing on conducting studies that assess the interaction of context and temporal sequencing of drugs and partner aggression.

The role of drug use in a conceptual model of intimate partner violence in men and women arrested for domestic violence.

In a previous study, alcohol problems in perpetrators and their partners contributed directly and indirectly to intimate partner violence (IPV), even after including other correlates of violence in the model (G. L. Stuart et al., 2006). The present study extends these findings by examining the role of illicit drug use. We recruited 271 men and 135 women arrested for IPV and used structural equation modeling to examine the data. Results showed that drug use, as reported by the perpetrators, was a stronger predictor of IPV than were alcohol problems in perpetrators and their partners. Arrested males' marijuana use and stimulant use (i.e., cocaine and amphetamines) were associated with perpetration of IPV, and their report of their female partners' stimulant use was associated with her violence perpetration. In arrested women, specific substances used did not predict violence perpetration beyond other model variables; however, female perpetrators' report of male partners' stimulant use predicted male psychological and physical aggression, after controlling for other variables. These results provide further evidence that drug problems by both partners may be important in the evolution of aggression. Implications for batterer intervention programs are discussed.