Artificial Neural Network Analysis Examining Substance Use Problems Co-Occurring with Anxiety and Depressive Disorders Among Adults Receiving Mental Health Treatment.

Objective: The co-occurrence of anxiety disorders, depressive disorders, and substance use problems was examined. Methods: The Mental Health Client-Level Data dataset was used to conduct logistic regression models and an artificial neural network analysis. Logistic regression analyses were conducted among adults with anxiety (n = 547,473) or depressive disorders (n = 1,610,601) as their primary diagnosis who received treatment in a community mental health center. The artificial neural network analysis was conducted with the entire sample (N = 2,158,074). Results: Approximately 30% of the sample had co-occurring high-risk substance use or substance use disorder. Characteristics including region of treatment receipt, age, education, gender, race and ethnicity, and the presence of co-occurring anxiety and depressive disorders were associated with the co-occurring high-risk substance use or a substance use disorder. Conclusions: Findings from this study highlight the importance of mental health facilities to screen for and provide integrated treatment for co-occurring disorders.

Substance use problems and disorders among adults 50 years and older receiving mental health treatment for a primary neurocognitive disorder.

OBJECTIVES: This study sought to (1) identify the percentage of high-risk substance use or substance use disorder (SUD) and (2) examine the factors associated with high-risk substance use or SUD in adults aged 50 years and older receiving mental health treatment with a primary delirium or dementia diagnosis. METHOD: This study used 7 years (2013-2019) of national administrative data on community mental health center patients aged 50 years and older with a primary delirium or dementia diagnosis receiving treatment in the United States (U.S.). To examine factors associated with the dependent variable (high-risk substance use or SUD), a multivariable binary logistic regression model was utilized. RESULTS: The sample included 77,509 individuals who were mostly aged 65 years and older (69.7%), and did not have co-occurring high-risk substance use or SUD (90.1%). Receiving treatment in a U.S. region other than the Northeast, being younger, male, not non-Hispanic White, and having multiple mental health diagnoses had greater odds of co-occurring high-risk substance use or SUD. CONCLUSION: One in ten persons in this sample having high-risk substance use or SUD highlights the clinical necessity for screening and subsequent treatment for co-occurring high-risk substance use among persons receiving treatment for a neurocognitive disorder.

Mental health facilities with eating disorder treatment programs and substance use disorder treatment in the United States.

Eating disorders (EDs) and substance use disorders (SUDs) often co-occur. However, not all providers that treat persons with an ED provide SUD treatment. Using the National Mental Health Services Survey, this study examined 1,387 ED treatment providers in the U.S. Facilities were categorized according to whether they provided SUD treatment. Differences based on facilities' profit status, available treatment settings, payment options, and treatment services were examined. Most ED facilities in the sample offered SUD treatment services (67.2%). Differences in proportions of the facility type, availability of outpatient treatment, sliding fee scale payment option, whether the facility had a program for individuals with co-occurring mental health and SUD, couples/family therapy, dual disorders treatment, and if the facility provided telemedicine/telehealth were identified. Although most facilities in this sample offered SUD services, more should be done to increase such facilities' capacity to provide treatment for co-occurring ED and SUD nationwide.

Nearly 70% of all ED treatment facilities reported offering SUD treatment.Geographic disparities in these integrated services exist.Eighty-six percent of these facilities had outpatient treatment.

Affect reactivity and lifetime racial discrimination among Black college students: The role of coping.

Black individuals face psychological distress resulting from lifetime experiences of racial discrimination, and these experiences may be especially harmful to Black college students as they forge their social identities. One way to examine psychological distress induced by racial discrimination is by assessing affect reactivity, or the degree to which aspects of individuals' mood changes in response to a stressor. This quantitative investigation examines the association between lifetime racial discrimination frequency and stress responses to acute racial discrimination via two aspects of affect reactivity, valence and arousal, and if coping strategies moderate this association. A sample of 239 Black college students (Mage = 19.59, SDage = 2.15, 68.6% female) completed an online questionnaire that included measures of racial discrimination, coping, and demographics. They then attended a laboratory visit during which their affective responses to a stress task were collected. Regression analyses indicated an interaction between lifetime racial discrimination and social support coping on arousal reactivity in response to acute racial discrimination. For individuals who reported low levels of social support coping, more frequent lifetime racial discrimination was associated with a decrease in arousal. For individuals who reported high levels of social support coping, more frequent lifetime racial discrimination was associated with an increase in arousal. Implications for the mental health of Black college students exposed to racial discrimination and avenues for further investigation are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

State-Level Sexism and Women's Health Care Access in the United States: Differences by Race/Ethnicity, 2014-2019.

Objectives. To quantify racial/ethnic differences in the relationship between state-level sexism and barriers to health care access among non-Hispanic White, non-Hispanic Black, and Hispanic women in the United States. Methods. We merged a multidimensional state-level sexism index compiled from administrative data with the national Consumer Survey of Health Care Access (2014-2019; n = 10 898) to test associations between exposure to state-level sexism and barriers to access, availability, and affordability of health care. Results. Greater exposure to state-level sexism was associated with more barriers to health care access among non-Hispanic Black and Hispanic women, but not non-Hispanic White women. Affordability barriers (cost of medical bills, health insurance, prescriptions, and tests) appeared to drive these associations. More frequent need for care exacerbated the relationship between state-level sexism and barriers to care for Hispanic women. Conclusions. The relationship between state-level sexism and women's barriers to health care access differs by race/ethnicity and frequency of needing care. Public Health Implications. State-level policies may be used strategically to promote health care equity at the intersection of gender and race/ethnicity. (Am J Public Health. 2021;111(10):1796-1805. https://doi.org/10.2105/AJPH.2021.306455).