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1.
BMC Psychiatry ; 24(1): 107, 2024 Feb 07.
Artigo em Inglês | MEDLINE | ID: mdl-38326791

RESUMO

BACKGROUND: Nonsuicidal self-injury (NSSI) is highly prevalent in adolescents. In survey and interview studies assessing NSSI, methods of assessment have been shown to influence prevalence estimates. However, knowledge of which groups of adolescents that are identified with different measurement methods is lacking, and the characteristics of identified groups are yet to be investigated. Further, only a handful of studies have been carried out using exploratory methods to identify subgroups among adolescents with NSSI. METHODS: The performance of two prevalence measures (single-item vs. behavioral checklist) in the same cross-sectional community sample (n = 266, age M = 14.21, 58.3% female) of adolescents was compared regarding prevalence estimates and also characterization of the identified groups with lifetime NSSI prevalence. A cluster analysis was carried out in the same sample. Identified clusters were compared to the two groups defined using the prevalence measures. RESULTS: A total of 118 (44.4%) participants acknowledged having engaged in NSSI at least once. Of these, a group of 55 (20.7%) adolescents confirmed NSSI on a single item and 63 (23.7%) adolescents confirmed NSSI only on a behavioral checklist, while denying NSSI on the single item. Groups differed significantly, with the single-item group being more severely affected and having higher mean scores on difficulties in emotion regulation, self-criticism, number of methods, higher frequency of NSSI, higher rates of suicidal ideation and suicidal behavior and lower mean score on health-related quality of life. All cases with higher severity were not identified by the single-item question. Cluster analysis identified three clusters, two of which fit well with the groups identified by single-item and behavioral checklist measures. CONCLUSIONS: When investigating NSSI prevalence in adolescents, findings are influenced by the researchers' choice of measures. The present study provides some directions toward what kind of influence to expect given the type of measure used, both with regards to the size of the identified group and its composition. Implications for future research as well as clinical and preventive work are discussed.


Assuntos
Qualidade de Vida , Comportamento Autodestrutivo , Humanos , Adolescente , Feminino , Masculino , Estudos Transversais , Comportamento Autodestrutivo/epidemiologia , Comportamento Autodestrutivo/psicologia , Ideação Suicida , Inquéritos e Questionários
2.
Alcohol Alcohol ; 59(4)2024 May 14.
Artigo em Inglês | MEDLINE | ID: mdl-38832908

RESUMO

OBJECTIVE: Alcohol use disorder (AUD) is among the most prevalent substance use disorders in the USA. Despite availability of effective interventions, treatment initiation and engagement remain low. Existing interventions target motivation and practical barriers to accessing treatment among individuals established within treatment systems. In contrast, Cognitive Behavioral Therapy for Treatment-Seeking (CBT-TS) aims to elicit and modify treatment-seeking beliefs to increase treatment-seeking behaviors among treatment-naïve samples. We aim to understand which beliefs were endorsed by those who did/did not initiate treatment, including changes in number of drinking days. METHOD: We examined treatment seeking beliefs elicited during CBT-TS among community-based adults with moderate-severe AUD with no treatment history. In this study, we discuss which beliefs were modifiable (i.e. those discussed during the intervention among individuals who subsequently attended treatment and may be associated with treatment-seeking behaviors). RESULTS: Of the 194 participants who received the intervention, 16 categories of beliefs were endorsed. Of the 38 participants (19.6%) who attended treatment, the most frequently endorsed belief was 'Not wanting specific types of substance use treatment or supports' (50%), a belief that may inhibit treatment seeking. The idea 'Treatment is positive' (47%) was also frequently cited, a belief that may facilitate treatment seeking. CONCLUSIONS: This study describes the beliefs that were more frequently endorsed among adults with moderate-severe, but untreated AUD who reported attending treatment following CBT-TS. Findings point to the potential of discussing and modifying treatment-seeking beliefs among treatment-naïve adults with severe AUD to increase treatment-seeking behaviors.


Assuntos
Alcoolismo , Terapia Cognitivo-Comportamental , Aceitação pelo Paciente de Cuidados de Saúde , Humanos , Masculino , Feminino , Alcoolismo/terapia , Alcoolismo/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Pessoa de Meia-Idade , Adulto , Conhecimentos, Atitudes e Prática em Saúde , Serviços de Saúde Mental
3.
Aggress Behav ; 50(3): e22149, 2024 05.
Artigo em Inglês | MEDLINE | ID: mdl-38757986

RESUMO

Aggression is a costly public health problem with severe and multi-faceted negative consequences and thus, identifying factors that contribute to aggression, particularly in understudied populations, is necessary to develop more effective interventions to reduce the public health cost of aggression. The goal this study was to test whether difficulties regulating emotions moderated the association between posttraumatic stress disorder (PTSD) symptoms and aggression in a community sample of predominantly Black females with high levels of trauma exposure. Furthermore, we explored unique relations between PTSD symptom clusters and distinct subscales of difficulties regulating emotions and aggression. The sample included 601 community participants recruited from an urban public hospital. Symptoms were assessed using self-report measures including the Difficulties in Emotion Regulation Scale (DERS) and Behavioral Questionnaire-Short. Regression analyses were conducted using PTSD symptoms and total DERS to test their interaction as predictors for aggression (using BQ-Short). We found that higher levels of PTSD arousal symptoms and difficulty controlling impulses when upset were positively related to aggression. We also conducted an exploratory analysis to examine the association between PTSD symptom clusters using the Alternative Symptom Clusters hybrid model. The results suggest that some PTSD symptoms (externalizing behavior) and some emotion dysregulation processes (difficulties controlling impulses when upset), relate to aggression in independent, rather than multiplicative ways. These results offer insights for new directions of research that focuses on the independent association between specific emotion dysregulation processes and PTSD symptoms on aggression.


Assuntos
Agressão , Negro ou Afro-Americano , Regulação Emocional , Transtornos de Estresse Pós-Traumáticos , Humanos , Feminino , Transtornos de Estresse Pós-Traumáticos/psicologia , Agressão/psicologia , Agressão/fisiologia , Adulto , Regulação Emocional/fisiologia , Masculino , Pessoa de Meia-Idade , Negro ou Afro-Americano/psicologia , Negro ou Afro-Americano/etnologia , Adulto Jovem , Grupos Minoritários/psicologia , Adolescente , Idoso
4.
Psychol Med ; 53(9): 4172-4180, 2023 07.
Artigo em Inglês | MEDLINE | ID: mdl-35443907

RESUMO

BACKGROUND: Depression, the most frequent and harmful mental disorder, has been associated with specific somatic diseases as the leading cause of death. The purposes of this prospective study were to predict incident chronic diseases based on baseline depressive symptoms and to test sex-dependent effects. METHODS: In a representative German community sample of over 12 000 participants, baseline depressive symptoms (assessed using the Patient Health Questionnaire-9) were tested as a predictor of new onset of cardiovascular disease (CVD), chronic obstructive lung disease, diabetes, cancer, and migraine at 5-year follow-up. To study disease incidence, we created subsamples for each chronic disease by excluding participants who already had the respective disease at baseline. Potential confounders were included in logistic regression models and sex-specific analyses were performed. RESULTS: Controlling for demographic characteristics and loneliness, in men and women, baseline depressive symptoms were predictive of CVD, chronic obstructive lung disease, diabetes, and migraine, but not of cancer. When we additionally adjusted for metabolic and lifestyle risk factors, there was an 8% increase of chronic obstructive lung disease and migraine per point of depressive symptoms. There was a trend for CVD (4%; p = 0.053). Sex-sensitive analyses revealed trends for the relevance of depressive symptoms for CVD in men (p = 0.065), and for diabetes in women (p = 0.077). CONCLUSIONS: These findings underscore the need to implement screening for depression in the treatment of major somatic illnesses. At the same time, depressed patients should be screened for metabolic and lifestyle risk factors and for somatic diseases and offered lifestyle interventions.


Assuntos
Doenças Cardiovasculares , Neoplasias , Doença Pulmonar Obstrutiva Crônica , Masculino , Humanos , Feminino , Incidência , Depressão/diagnóstico , Estudos Prospectivos , Estudos Longitudinais , Doença Crônica , Doenças Cardiovasculares/epidemiologia , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Fatores de Risco , Neoplasias/epidemiologia
5.
Public Health Nutr ; 26(10): 1968-1975, 2023 10.
Artigo em Inglês | MEDLINE | ID: mdl-37565497

RESUMO

OBJECTIVE: The present study examined military families' use of food distribution resources and military (e.g. rank) and non-military (e.g. race/ethnicity) characteristics associated with using food distribution resources. DESIGN: Secondary data analyses from a cross-sectional survey in the first 6 months of 2021. SETTING: A national sample of eligible families completed an online survey. PARTICIPANTS: 8326 enlisted military families with an active duty service member in the United States Army or Air Force who applied for supplemental childcare funding distributed by National Military Family Association. RESULTS: 13·2 % of the families reported utilising a food distribution resource in the past 12 months. Those with lower financial well-being were more likely to utilise such resources. Older (OR = 1·04, 95 % CI = 1·02, 1·05, P < 0·001), single-earner (OR = 0·73, 95 % CI = 0·61, 0·89, P = 0·001) families with a lower rank (OR = 0·69, 95 % CI = 0·64, 0·75, P < 0·001) and Army affiliation (compared with Air Force) (OR = 2·31, 95 % CI = 2·01, 2·67, P < 0·001) were more likely to utilise food distribution resources. Members of certain racial/ethnic minority groups were more likely to utilise food distribution resources than White respondents (OR from 1·47 for multi-racial to 1·69 for Asians), as were families with more dependent children (OR = 1·35, 95 % CI = 1·25, 1·47, P < 0·001). CONCLUSIONS: These results identify the extent of food distribution resource utilisation in military families with young children approximately 1 year into the COVID-19 pandemic. The results also identify characteristics associated with their use of food distribution resources. Findings are discussed with an emphasis on prevention and intervention implications for military families.


Assuntos
COVID-19 , Família Militar , Militares , Humanos , Criança , Estados Unidos/epidemiologia , Pré-Escolar , COVID-19/epidemiologia , Etnicidade , Estudos Transversais , Pandemias , Grupos Minoritários
6.
J Trauma Dissociation ; 24(2): 268-283, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36653975

RESUMO

The study of psychopathy has largely centered on samples of incarcerated offenders with a focus on primary psychopathy traits. Less is known, however, about how experiences of childhood betrayal trauma and dissociation influence the development of these traits in non-institutionalized individuals. In the present study, we utilized structural equation modeling to investigate the relationships among childhood betrayal trauma, adult dissociation, and adult psychopathy traits and callous affect traits in a community sample (N = 746). Childhood betrayal trauma was associated with psychopathy and callous affect traits, and mediated by dissociative experiences. These results are consistent with theory and prior empirical findings associating childhood betrayal trauma with dissociation, psychopathy, and callous affect traits. The results will help influence the design of future studies that can further inform the developmental course of psychopathy.


Assuntos
Experiências Adversas da Infância , Criminosos , Humanos , Adulto , Traição , Transtorno da Personalidade Antissocial , Transtornos Dissociativos
7.
Eat Weight Disord ; 28(1): 98, 2023 Nov 22.
Artigo em Inglês | MEDLINE | ID: mdl-37991644

RESUMO

Sleep quality is linked to disordered eating, obesity, depression, and weight-related functioning. Most research, however, has focused on clinical populations. The current study investigated relationships between sleep quality, disordered eating, and patterns of functioning in a community sample to better understand relationships among modifiable health behaviors. Participants (N = 648) recruited from Amazon Mechanical Turk completed assessments of eating, depression, weight-related functioning, and sleep. Self-reported height and weight were used to calculate body mass index (M = 27.3, SD = 6.9). Participants were on average 37.6 years (SD = 12.3), primarily female (65.4%), and White, not Hispanic (72.7%). Over half of participants endorsed poor sleep quality, and average sleep scores were above the clinical cutoff for poor sleep quality. Sleep scores were significantly positively correlated with disordered eating, depression, and weight-related functioning, even after adjusting for age, body mass index, and sex. Multivariate regression models predicting weight-related functioning and depression showed that both sleep quality and disordered eating independently predicted depression. Sleep quality did not independently predict weight-related functioning; however, disordered eating did. To the best of our knowledge, this is the first study to assess sleep behaviors, disordered eating, and weight-related functioning in a community sample of weight diverse participants. Results indicate that most participants endorsed poor sleep quality, which was associated with disordered eating patterns, including binge eating and poorer weight-related functioning, even after controlling for body mass index, highlighting that this relationship exists across the weight spectrum. These results speak to the importance of health behavior assessment and intervention within nonclinical samples.Level of evidence Level III: evidence obtained from well-designed cohort or case-control analytic studies.


Assuntos
Transtorno da Compulsão Alimentar , Bulimia , Transtornos da Alimentação e da Ingestão de Alimentos , Feminino , Humanos , Sono , Índice de Massa Corporal
8.
BMC Psychiatry ; 22(1): 594, 2022 09 06.
Artigo em Inglês | MEDLINE | ID: mdl-36068500

RESUMO

BACKGROUND: This study investigates a broad spectrum of psychiatric disorders, substance use disorders, gambling, and internet gaming disorders in Swedish 18-year-old boys and girls with the aim of estimating the prevalence of disorders and comorbidity. METHODS: We used a two-phase design with screening to detect candidates for clinical interviews. Screening included 949 adolescents (55.6% girls), out of which 758 adolescents (57.0% girls) were selected for interview with at least one of four instruments: M.I.N.I., ADDIS, NODS and IGDS. Of these, 387 (61.2% girls) were interviewed. Gender separated prevalence was estimated on the assumption that those selected but not interviewed had the same distribution as those interviewed based on similar outcomes above screening cut-offs. Comorbidity between types of disorders was estimated on similar assumptions. In addition, comorbidity between dyads of the ten most common specified disorders was calculated based on recorded data without these assumptions. RESULTS: We estimated that 14.6% met the criteria of a substance use disorder (SUD), mostly concerning alcohol and more frequent in girls than in boys. Those meeting the criteria lifetime of at least one of 16 other psychiatric disorders were 26.7%, more than twice as frequent in girls compared to boys, and with depression being the most common disorder. Gambling and gaming disorders were found almost exclusively in boys, of which 5.8% met the criteria for gambling, and 2.3% for gaming disorders. Of girls with a SUD, 40% also had a psychiatric disorder, while on the other hand more than 28% of girls with a psychiatric disorder also had a SUD. In boys with a SUD, 22% had another psychiatric disorder, while 15% of those with a psychiatric disorder also had a SUD. CONCLUSIONS: Psychiatric comorbidity is common in SUDs in adolescents, which calls for screening and diagnostic efforts in young patients presenting with symptoms of SUDs. Girls with SUDs are at higher risk of also suffering from psychiatric conditions. Gambling and gaming disorders appear in a substantial minority of adolescents and warrant further study of their comorbidity. Since prevalences and comorbidity were estimated on the assumptions mentioned, some caution in interpreting the results is needed.


Assuntos
Jogo de Azar , Transtornos Relacionados ao Uso de Substâncias , Jogos de Vídeo , Adolescente , Comorbidade , Feminino , Jogo de Azar/diagnóstico , Jogo de Azar/epidemiologia , Jogo de Azar/psicologia , Humanos , Masculino , Prevalência , Transtornos Relacionados ao Uso de Substâncias/diagnóstico , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Suécia/epidemiologia
9.
Dev Psychopathol ; : 1-11, 2022 Dec 29.
Artigo em Inglês | MEDLINE | ID: mdl-36579629

RESUMO

Sensory-based subtypes among autistic children have been well documented, but little is known about longitudinal sensory subtypes beyond autistic populations. This prospective study aimed to identify subtypes based on trajectories of parent-reported sensory features measured at 6-19 months, 3-4, and 6-7 years of age among a community-based birth cohort (N = 1,517), and to examine their associations with school-age clinical and adaptive/maladaptive outcomes on a subset sample (N = 389). Latent class growth analysis revealed five trajectory subtypes varying in intensity and change rates across three sensory domains. In contrast to an Adaptive-All Improving subtype (35%) with very low sensory features and overall better school-age outcomes, an Elevated-All Worsening subtype (3%), comprised of more boys and children of parents with less education, was associated with most elevated autistic traits and poorest adaptive/maladaptive outcomes. Three other subtypes (62% in total) were generally characterized by stable or improving patterns of sensory features at mild to moderate levels, and challenges in certain outcome domains. Our findings indicate that characterizing children based on early sensory trajectories may contribute to earlier detection of subgroups of children with sensory challenges who are more likely to experience developmental challenges by school age, followed by early targeted interventions for improved long-term outcomes.

10.
Scand J Public Health ; 50(3): 340-346, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-33461403

RESUMO

Background: Some studies suggest that favourable socioeconomic circumstances are associated with better parent-child relations but the documentation of such an association is limited and inconsistent. Few studies focused on infancy, few studies relied on objective measurement of parent-infant relations, and few studies included more than one measurement of parent-infant relations in the first year of life. Aims: To report the prevalence of objectively measured problems in parent-infant relations during the first year of life and to examine the association between socioeconomic circumstances and parent-infant relations in an unselected community sample of infants. Methods: Cross-sectional study of a community sample of children from birth to 10 months in 15 municipalities in Denmark, n = 11,765. The exposure variables were population register data about socioeconomic circumstances: (a) parents' education, (b) family composition, (c) parents' origin, and (d) parents' occupational status. The outcome variable was the health visitor's concerns about the parent-infant relation assessed at four home visits from birth to 10 months after delivery. Results: The proportion of children with concerns about the parent-infant relation was 10.5%, 7.8% at one home visit and 2.8% at two or more home visits. Logistic regression analyses showed that all four indicators of socioeconomic circumstances were associated with concerns about the parent-infant relation in the first year of life. Conclusions: The risk of problematic parent-infant relations were significantly elevated among, children of immigrant parents, and children of parents with shorter education and not in education or work.


Assuntos
Relações Pais-Filho , Pais , Estudos Transversais , Visita Domiciliar , Humanos , Lactente , Fatores Socioeconômicos
11.
BMC Public Health ; 22(1): 2271, 2022 12 05.
Artigo em Inglês | MEDLINE | ID: mdl-36471268

RESUMO

BACKGROUND: During recent decades, the consumption of the stimulant khat (catha edulis) has profoundly changed in countries around the Horn of Africa, and excessive use patterns have emerged-especially evident among displaced Somalis. This is related to the development of severe somatic and psychiatric disorders. There are currently no preventive or interventional studies targeting khat use. This study's aim was to test screening and brief intervention (SBI) to reduce khat use among urban Somali refugees living in Kenya with limited access to public healthcare. METHODS: In this controlled study, 330 male Somali khat users from the community were either assigned to SBI (161) or an assessment-only control condition (AC; 169); due to field conditions a rigorous experimental design could not be implemented. The World Health Organization's (WHO) Alcohol, Smoking and Substance Involvement Screening Test (ASSIST)-linked brief intervention was adapted to khat and Somali culture. Trained local counselors administered the intervention. The amount and frequency of khat use was assessed using the time-line-follow-back method. We compared the month before the intervention (t1) to the two months after it (t2, t3). Baseline differences in khat use frequency were corrected by partial matching and mixed effect models used to evaluate intervention effects. RESULTS: SBI was well accepted and feasible for khat users. Over the complete observation period and from t1 to t2, khat use amount and frequency decreased (p < .001) and the intervention group showed a greater reduction (group x time effects with p ≤ .030). From t2 to t3, no further reduction and no group differences emerged. CONCLUSION: The results provide preliminary evidence that khat use amount and frequency can be reduced in community settings by SBI, requiring little resources. Thorough assessment alone might have intervention-like effects. The non-treatment-seeking community sample and the non-professional counselors are distinct from SBI studies with other substances in other countries, but support the feasibility of this approach in khat use countries and especially in Somali populations with limited access to healthcare. Future studies that employ rigorous experimental design are needed. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT02253589. Date of first registration 01/10/2014, retrospectively registered https://clinicaltrials.gov/ct2/show/NCT02253589 . First participant 16/09/2014.


Assuntos
Catha , Transtornos Relacionados ao Uso de Substâncias , Humanos , Masculino , Somália , Intervenção em Crise , Projetos Piloto , Quênia , Transtornos Relacionados ao Uso de Substâncias/prevenção & controle
12.
Appetite ; 179: 106303, 2022 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-36067871

RESUMO

OBJECTIVE: Adolescence is a critical period for the onset of unhealthy eating habits. One important contributing factor is poor inhibitory control (IC), a cognitive skill that enables behavior regulation. IC training appears successful in countering unhealthy eating in adults, but evidence in adolescents is scarce. In addition, the mechanism of change from IC training remains unclear. Therefore, the present study aimed to assess changes in IC during a single session of IC training in adolescents. The effectiveness of the training was assessed by comparing the experimental group to a matched control group. METHOD: A community sample of 57 adolescents between 10 and 18 years was recruited (Mage = 16.61, SDage = 2.52, 73.7% girls, Madj.BMI = 105.17, SDadj.BMI = 18.81). IC was assessed before, during, and after the training using a GO/NO-GO task. Indices of IC were commission errors (CE; incorrectly responding on a no-go trial) and reaction time (RT) on go trials. RESULTS: CE rates among adolescents who received the IC training were the highest during the training and decreased significantly after the training. However, there were no differences in CE before compared to after the training. No differences were found in RT before, during or after the training. In addition, compared to the control group, the experimental group showed no significant differences in either CE or RT before, during or after the training. DISCUSSION: To the best of our knowledge, the present study is the first to assess changes in IC after an IC training in a community sample of adolescents. Results of this study further elucidate the complex role of IC in adolescents' unhealthy eating habits. Future studies should seek to corroborate these findings in a larger sample.


Assuntos
Comportamento Alimentar , Inibição Psicológica , Adolescente , Adulto , Comportamento Alimentar/psicologia , Feminino , Humanos , Masculino , Tempo de Reação
13.
Artigo em Inglês | MEDLINE | ID: mdl-36515855

RESUMO

Sleep problems are common in individuals with autism spectrum disorder (ASD). How sleep problems reflect specific ASD phenotypes is unclear. We studied whether sleep problems indexed functional impairment in a heterogeneous community sample of individuals with ASD. We analyzed 977 probands (233 females; age = 11.27 ± 4.13 years) from the Rhode Island Consortium for Autism Research and Treatment dataset, a unique public-private-academic collaboration involving all major points of service for families in Rhode Island. We found that individuals with a confirmed diagnosis of ASD were more likely to have sleep problems. However, across the whole sample and above and beyond a formal diagnosis, sleep problems were dimensionally associated with worse social impairment and poorer adaptive functioning. By using a large dataset reflective of the diversity of presentations in the community, this study underscores the importance of considering sleep problems in clinical practice to improve adaptive functioning in individuals with ASD.

14.
Eat Weight Disord ; 27(2): 495-504, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33846936

RESUMO

PURPOSE: To compare community girls at risk and not at risk for binge eating (BE) in attachment representations through a narrative interview and to test the predictive role of attachment pattern(s) on the risk of binge eating among community girls. METHODS: From 772 community adolescents of both sexes (33% boys) screened through the Binge Eating Scale (BES), 112 girls between 14 and 18 years, 56 placed in a group at risk for binge eating (BEG), and 56 matched peers, not at risk (NBEG), were assessed in attachment representations through the Friends and Family Interview (FFI). RESULTS: (1) Compared to NBEG, girls in the BEG showed more insecure-preoccupied classifications and scores, together with lower narrative coherence, mother's representation as a secure base/safe haven, reflective functioning, adaptive response, and more anger toward mother. (2) Both insecure-dismissing and preoccupied patterns predicted 15% more binge-eating symptoms in the whole sample of community girls. CONCLUSIONS: Insecure attachment representations are confirmed risk factors for more binge eating, affecting emotional regulation and leading to "emotional eating", thus a dimensional assessment of attachment could be helpful for prevention and intervention. Implications and limits are discussed. LEVEL OF EVIDENCE: III. Evidence obtained from cohort or case-control analytic studies.


Assuntos
Transtorno da Compulsão Alimentar , Bulimia , Adolescente , Atitude , Transtorno da Compulsão Alimentar/psicologia , Bulimia/psicologia , Emoções , Feminino , Humanos , Masculino , Apego ao Objeto
15.
J Med Internet Res ; 23(3): e18348, 2021 03 11.
Artigo em Inglês | MEDLINE | ID: mdl-33704070

RESUMO

BACKGROUND: Randomized controlled trials (RCTs) with vigorous study designs are vital for determining the efficacy of treatments. Despite the high internal validity attributed to RCTs, external validity concerns limit the generalizability of results to the general population. Bias can be introduced, for example, when study participants who self-select into a trial are more motivated to comply with study conditions than are other individuals. These external validity considerations extend to e-mental health (eMH) research, especially when eMH tools are designed for public access and provide minimal or no supervision. OBJECTIVE: Clustering techniques were employed to identify engagement profiles of RCT participants and community users of a self-guided eMH program. This exploratory approach inspected actual, not theorized, RCT participant and community user engagement patterns. Both samples had access to the eMH program over the same time period and received identical usage recommendations on the eMH program website. The aim of this study is to help gauge expectations of similarities and differences in usage behaviors of an eMH tool across evaluation and naturalistic contexts. METHODS: Australian adults signed up to myCompass, a self-guided online treatment program created to reduce mild to moderate symptoms of negative emotions. They did so either by being part of an RCT onboarding (160/231, 69.6% female) or by accessing the program freely on the internet (5563/8391, 66.30% female) between October 2011 and October 2012. During registration, RCT participants and community users provided basic demographic information. Usage metrics (number of logins, trackings, and learning activities) were recorded by the system. RESULTS: Samples at sign-up differed significantly in age (P=.003), with community users being on average 3 years older (mean 41.78, SD 13.64) than RCT participants (mean 38.79, SD 10.73). Furthermore, frequency of program use was higher for RCT participants on all usage metrics compared to community users through the first 49 days after registration (all P values <.001). Two-step cluster analyses revealed 3 user groups in the RCT sample (Nonstarters, 10-Timers, and 30+-Timers) and 2 user groups in the community samples (2-Timers and 20-Timers). Groups seemed comparable in patterns of use but differed in magnitude, with RCT participant usage groups showing more frequent engagement than community usage groups. Only the high-usage group among RCT participants approached myCompass usage recommendations. CONCLUSIONS: Findings suggested that external validity concerns of RCT designs may arise with regards to the predicted magnitude of eMH program use rather than overall usage styles. Following up RCT nonstarters may help provide unique insights into why individuals choose not to engage with an eMH program despite generally being willing to participate in an eMH evaluation study. Overestimating frequency of engagement with eMH tools may have theoretical implications and potentially impact economic considerations for plans to disseminate these tools to the general public.


Assuntos
Saúde Mental , Autocuidado , Adulto , Austrália , Pré-Escolar , Análise por Conglomerados , Feminino , Humanos , Masculino , Ensaios Clínicos Controlados Aleatórios como Assunto
16.
J Clin Psychol ; 77(9): 2057-2076, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-33871878

RESUMO

OBJECTIVES: Posttraumatic stress disorder (PTSD) severity relates to positive memory retrieval difficulties. One variable potentially influencing this relation is sleep difficulties. We examined moderating effects of sleep difficulties (duration and quality) on relations between PTSD severity and count of specific positive memories covarying for age, gender, and depression. METHODS: Participants were an Amazon Mechanical Turk-recruited trauma-exposed community sample of 205 respondents (M age = 35.44; 61.40% women). RESULTS: Moderated regression analyses indicated significant interaction effects between sleep quality (b = 0.03; p = 0.036) and PTSD severity on specific positive memory count. Among individuals reporting better sleep quality, there were negative associations between PTSD severity and specific positive memory count (b = -0.04, SE = 0.02, p = 0.010). Similar results were obtained for PTSD's intrusion and arousal clusters. CONCLUSION: Results support targeting sleep quality and PTSD severity to improve positive memory retrieval in PTSD and memory interventions, and the importance of considering sleep when examining links between PTSD and positive memory retrieval.


Assuntos
Transtornos do Sono-Vigília , Transtornos de Estresse Pós-Traumáticos , Adulto , Nível de Alerta , Cognição , Feminino , Humanos , Masculino , Memória , Transtornos do Sono-Vigília/epidemiologia , Transtornos de Estresse Pós-Traumáticos/epidemiologia
17.
Eat Weight Disord ; 26(3): 829-838, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32424560

RESUMO

PURPOSE: The current study examined the predictive utility of emotional valence (i.e., positive and negative emotions) on weight loss intentions and behaviors, beyond theory of planned behavior constructs (i.e., attitude, subjective norm, and perceived control), among a community sample of people who were overweight (BMI > 25 kg/m2). METHODS: Participants were recruited for a longitudinal study via an online panel. They completed a baseline survey (N = 732) and a follow-up survey 6 months later (N = 526), both administered online. The surveys included measures of attitude, subjective norms, perceived control, positive and negative emotions regarding one's current weight, intentions to engage in weight loss behaviors (time 1), and having engaged in weight loss behaviors in the past 6 months (time 2). RESULTS: Emotion explained additional variance in weight loss intentions (range ΔR2 = 0.03-0.10, all ps < 0.01) and behaviors (range ΔR2 = 0.01-0.02, all ps < 0.05) beyond theory of planned behavior constructs. Negative emotions mainly predicted the intake of unhealthy food and seeking social support, whereas positive emotions predicted physical activity (intention and behavior). These results suggested that the differential relations might be based on whether the strategy is approach or avoidance oriented. CONCLUSIONS: Based on these findings, comprehensive models of weight loss behaviors should consider emotion, and the valence of such emotion, regarding current weight. LEVEL OF EVIDENCE: Level IV, multiple time series without intervention.


Assuntos
Intenção , Redução de Peso , Emoções , Humanos , Estudos Longitudinais , Teoria Psicológica , Inquéritos e Questionários
18.
Arch Sex Behav ; 49(5): 1463-1475, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32394111

RESUMO

Scientific evidence regarding sexual minority populations has generally come from studies based on two types of samples: community-derived samples and probability samples. Probability samples are lauded as the gold standard of population research for their ability to represent the population of interest. However, while studies using community samples lack generalizability, they are often better able to assess population-specific concerns (e.g., minority stress) and are collected more rapidly, allowing them to be more responsive to changing population dynamics. Given these advantages, many sexual minority population studies rely on community samples. To identify how probability and community samples of sexual minorities are similar and different, we compared participant characteristics from two companion samples from the Generations Study, each designed with the same demographic profile of U.S. sexual minority adults in mind. The first sample was recruited for a national probability survey, whereas the second was recruited for a multicommunity sample from four U.S. cities. We examined sociodemographic differences between the samples. Although there were several statistical differences between samples, the effect sizes were small for sociodemographic characteristics that defined the sample inclusion criteria: sex assigned at birth, race/ethnicity, and age cohort. The samples differed across other characteristics: bisexual respondents, respondents with less education, and those living in non-urban areas were underrepresented in the community sample. Our findings offer insights for recruiting community samples of sexual minority populations and for measuring sexual identity on probability surveys. They also bolster confidence in well-designed community samples as sources for data on sexual minority populations.


Assuntos
Comportamento Sexual/estatística & dados numéricos , Minorias Sexuais e de Gênero/estatística & dados numéricos , Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos de Amostragem , Inquéritos e Questionários , Adulto Jovem
19.
Soc Psychiatry Psychiatr Epidemiol ; 55(3): 319-327, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31501909

RESUMO

PURPOSE: Adolescent suicide ideation (SI) often portends more grievous suicidal behavior; yet, long-term studies of what risk factors predict SI are limited. We employ a multi-wave longitudinal design to investigate the impact of earlier social contexts on change in SI. METHOD: A community sample of 748 youths drawn from the Children in the Community (CIC) study was first assessed with the CIC Youth SI Scale at mean age 13.7 (range 9-18) (baseline) and in two follow-ups over 10 years. GEE Poisson Regression was used to estimate SI between ages 10 and 25 (intercept set at age midpoint of 17), and to examine associations between baseline measures of parent, peer, and school social contexts and subsequent change in SI. Analyses were controlled for demographic characteristics and known risks for SI: sexual or physical abuse before age 18 (obtained by official reports) and major depressive disorder (MDD, diagnosed by psychiatric interview at baseline and follow-ups). RESULTS: SI declined significantly by age 17 with greater mother affection (ß = - 0.091, SE = 0.037), peer friendship quality (ß = - 0.115, SE = 0.034), peer social support (ß = - 0.116, SE = 0.042), and school engagement (ß = - 0.083, SE = 0.045, trend), but increased significantly with more parent punishment (ß = 0.143, SE = 0.045) and school conflict (ß = 0.168, SE = 0.042). SI associations with sexual or physical abuse (ß = 0.299, SE = 0.137) and MDD (ß = 0.777, SE = 0.130) were independent of other effects. CONCLUSIONS: Earlier social contexts influence change in SI independent of each other and of known risks for SI in community youths, and may be a resource for intervention efforts to deter future SI.


Assuntos
Meio Social , Apoio Social , Ideação Suicida , Adolescente , Criança , Transtorno Depressivo Maior , Feminino , Humanos , Estudos Longitudinais , Masculino , Grupo Associado , Fatores de Risco , Instituições Acadêmicas
20.
Eur Child Adolesc Psychiatry ; 29(7): 969-978, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31559500

RESUMO

Evidence points to an independent relationship among childhood maltreatment, impairments in executive functions (EF) and disruptive behavior disorders (DBD). However, it is still not fully understood how these three factors are interrelated. This study evaluated the association between childhood maltreatment and DBD testing the role of EF performance as a mediator or moderator. We studied a probabilistic school-based sample of 2016 children from 6 to 12 years. Mental disorders were assessed using the Development and Well-Being Assessment with parents and children. Children answered questions about exposure to child maltreatment and were evaluated with a set of cognitive tasks addressing inhibitory control, working memory, cognitive flexibility and planning. Childhood maltreatment was strongly associated with DBD (OR = 7.7, CI 95% 4.5-12.9). No association was found between childhood maltreatment and EF performance. Children with DBD showed worse performance in cognitive flexibility, which was not identified as a mediator or moderator of the association between childhood maltreatment and DBD. Results indicate that the association between maltreatment and disruptive behavior occurs regardless of performance in executive function in a community sample. Future studies are essential to confirm these findings and elucidate the cognitive mechanisms involved in this association.


Assuntos
Maus-Tratos Infantis/psicologia , Função Executiva/fisiologia , Comportamento Problema/psicologia , Criança , Feminino , Humanos , Masculino
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