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1.
Am Psychol ; 79(2): 241-253, 2024.
Article in English | MEDLINE | ID: mdl-37471006

ABSTRACT

Older adults from racially and ethnically diverse backgrounds and with preexisting mental illness have been disproportionately vulnerable to severe illness, disability, and death due to the adverse impacts of the COVID-19 pandemic. This study used a sample of older adults (60 +; N = 307) from a randomized clinical trial (Positive Minds-Strong Bodies [PMSB]) conducted between May 25, 2015, and March 5, 2019. Participants were recontacted to assess symptoms of anxiety, depression, general distress, and physical functioning during the COVID-19 pandemic between March 2, 2021, and July 18, 2022 (62.7% recontacting rate excluding ineligible participants; N = 165). We estimated an analysis of covariance model to evaluate whether or not prior differences between the PMSB intervention and enhanced usual care (EUC) groups continued to be observed at the COVID-19 follow-up. Results showed that, compared to EUC, participants who received the PMSB intervention reported fewer depression symptoms (Geriatric Depression Scale-15 scores) and greater physical functioning (Late-Life Functioning and Disability Instrument scores) at the COVID-19 follow-up. No significant differences were observed between the PMSB intervention and EUC groups on anxiety symptoms (Generalized Anxiety Disorder-7 scores) during the pandemic. Last, findings suggested that the lower depression symptoms and greater physical functioning observed after treatment completion were sustained, though not further improved, over time. These findings provide evidence that the PMSB intervention is a powerful intervention to promote resilience and prevent disability associated with major life stressors, such as the COVID-19 pandemic. Future research is needed to examine the underlying mechanisms of psychosocial and exercise training interventions that lead to lasting resilience. (PsycInfo Database Record (c) 2024 APA, all rights reserved).


Subject(s)
COVID-19 , Resilience, Psychological , Humans , Aged , Pandemics , Ethnic and Racial Minorities , Ethnicity , Minority Groups , Anxiety , Depression/therapy
2.
Rehabil Psychol ; 68(2): 112-120, 2023 May.
Article in English | MEDLINE | ID: mdl-37166940

ABSTRACT

PURPOSE/OBJECTIVE: Individuals with historically oppressed identities, such as disabled or racialized minorities, face inequities across all societal institutions, including education, criminal justice, and healthcare. Systems of oppression (e.g., ableism, racism) lead to inequities that have ultimately contributed to disproportionate rates of COVID-19 morbidity and mortality in the United States. In the midst of the COVID-19 pandemic, increased public attention regarding police brutality toward Black people and the reinvigoration of the national Black Lives Matter (BLM) movement further highlighted the detrimental effects of oppressive systems and the urgent need to promote equity in the United States. The disproportionate number of COVID-19-related deaths and police brutality are inextricably connected, as both are products of oppression toward minoritized communities. The co-occurrence of the pandemic and BLM movement protests also creates an opportunity for critical discourse on the intersection of ableism and anti-Black racism specifically within the field of rehabilitation psychology. RESEARCH METHOD/DESIGN: The overarching goals of this review are to apply the Intersectional Ecological Model with the addition of the chronosystem to illustrate how systems of oppression lead to health disparity in COVID-19 survivorship and to provide recommendations to promote health equity. Conclusions/Implication: As the COVID-19 pandemic shifts to an endemic and efforts to eliminate oppressive systems continue, rehabilitation psychologists have an ongoing, evolving, and shared responsibility to employ socially-responsive solutions to promote optimal functioning for patients, families, and communities. (PsycInfo Database Record (c) 2023 APA, all rights reserved).


Subject(s)
COVID-19 , Racism , Humans , United States , Survivorship , Pandemics , Health Promotion , Racism/psychology
3.
Am J Geriatr Psychiatry ; 31(7): 514-524, 2023 07.
Article in English | MEDLINE | ID: mdl-36906396

ABSTRACT

BACKGROUND/OBJECTIVE: Given the chronicity of depression and anxiety disorders in late life, maintenance treatments may have a role in preserving healthy functioning. This study aims to understand the state of the science on maintenance psychotherapies for Black, Asian, and Latinx older adults. DESIGN: Scoping review. METHODS: A priori protocol was prospectively published. Four databases were searched up to December 1, 2021. Eligible studies were conducted in the United States or Puerto Rico and focused on maintenance psychotherapies treating depression, anxiety, or both in adults 60+. Due to the underrepresentation of Black, Asian, and Latinx participants, studies were included irrespective of the participant's racial or ethnic background. RESULTS: A total of 3,623 unique studies were retrieved, and eight studies were included. Two studies represented randomized clinical trials, and six were studies of post hoc analyses. All studies were from the same research team, had similar maintenance treatments, and focused on depression. Studies included racially homogenous samples (94-98% White). The primary outcome was the recurrence of a major depressive episode. Across studies, maintenance psychotherapy shows promise in preventing the recurrence of depression in some older adults. CONCLUSION: Expanding the scope of knowledge from achieving optimal functioning to sustaining those changes in older adults is a significant public health challenge given symptom recurrence. The small body of knowledge on maintenance psychotherapies shows a promising direction in maintaining healthy functioning following recovery from depression. However, opportunities remain to expand the evidence of maintenance psychotherapies with a more significant commitment to the inclusion of diverse populations.


Subject(s)
Depressive Disorder, Major , Humans , Aged , Depressive Disorder, Major/therapy , Psychotherapy/methods , Anxiety Disorders/therapy , Anxiety
4.
J Appl Gerontol ; 41(3): 680-689, 2022 Mar.
Article in English | MEDLINE | ID: mdl-33985379

ABSTRACT

OBJECTIVE: Older adults of color face systemic obstacles in seeking mental health care. Unaddressed late-life mental health issues can challenge independent living and increase disability and mortality risk. This study examined factors associated with mental health service use among community-dwelling older adults. METHOD: This cross-sectional analysis used data from the Positive Minds-Strong Bodies trial (N= 1,013). RESULTS: Higher anxiety, depressive, and posttraumatic stress disorder (PTSD) symptoms increased odds of service use (odds ratio [OR] = 1.05-2.11). Asian and Latinx, but not Black, older adults had lower odds of service use than Whites (OR = 0.15-0.35). Yet Asian and Latinx older adults with higher anxiety and depression symptoms and Asians with at least one PTSD symptom had higher odds of service use than Whites with the same symptomatology (OR = 1.16-2.88). CONCLUSION: White older adults might be more likely to seek mental health care at lower levels of need, while Asian and Latinx older adults might seek services when they perceive greater need.


Subject(s)
Community Health Services , Mental Health Services , Aged , Anxiety , Asian People , Cross-Sectional Studies , Humans
5.
J Clin Psychol ; 75(2): 260-270, 2019 02.
Article in English | MEDLINE | ID: mdl-30589440

ABSTRACT

Telehealth can overcome access and availability barriers that often impede receiving needed mental health services. This case report describes an interdisciplinary approach to treatment for an individual with chronic physical health conditions and comorbid mental health concerns, which resulted in high utilization (and associated costs) of preventable emergency services. The report describes clinical case progression on anxiety symptoms and emergency service utilization while concurrently highlighting telehealth-specific practice implications, especially as they pertain to training settings.


Subject(s)
Anxiety Disorders/therapy , Mental Health Services , Patient Care Team , Primary Health Care , Somatoform Disorders/therapy , Telemedicine , Adult , Female , Humans , Primary Health Care/methods , Rural Health Services , Telemedicine/methods
6.
Front Psychol ; 5: 600, 2014.
Article in English | MEDLINE | ID: mdl-24987384

ABSTRACT

Children's books may provide an important resource of culturally appropriate emotions. This study investigates emotion displays in children's storybooks for preschoolers from Romania, Turkey, and the US in order to analyze cultural norms of emotions. We derived some hypotheses by referring to cross-cultural studies about emotion and emotion socialization. For such media analyses, the frequency rate of certain emotion displays can be seen as an indicator for the salience of the specific emotion. We expected that all children's storybooks would highlight dominantly positive emotions and that US children's storybooks would display negative powerful emotions (e.g., anger) more often and negative powerless emotions (e.g., sadness) less often than Turkish and Romanian storybooks. We also predicted that the positive and negative powerful emotion expressions would be more intense in the US storybooks compared to the other storybooks. Finally, we expected that social context (ingroup/outgroup) may affect the intensity emotion displays more in Turkish and Romanian storybooks compared to US storybooks. Illustrations in 30 popular children's storybooks (10 for each cultural group) were coded. Results mostly confirmed the hypotheses but also pointed to differences between Romanian and Turkish storybooks. Overall, the study supports the conclusion that culture-specific emotion norms are reflected in media to which young children are exposed.

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