A Randomized Trial Evaluating Acceptance and Commitment Therapy and Smart Phone Care Management Application to Augment Buprenorphine Therapy for Opioid Use and Chronic Pain.

There is high comorbidity of opioid use disorder (OUD) and chronic pain (CP), which is often addressed by prescribing buprenorphine (BUP). While BUP is effective in preventing overdose, it does not address the psychological aspects of OUD and CP comorbidity and treatment retention rates are as low as 50%. The Virtual Opioid use disorder Integrated Chronic Pain Treatment (VOICE) study (NCT05039554) is a novel effectiveness-implementation trial to test a 12-week virtual group Acceptance and Commitment Therapy (ACT) protocol and a care management smartphone application (app; Valera Health) on pain and opioid use in patients with OUD and CP receiving BUP. Using a 2 × 2 factorial design, participants (expected N = 280) are randomized into: ACT, Valera app, ACT + Valera, or Treatment as Usual arm. This study is taking place in the Bronx, NY, a racially/ethnically diverse community that faces numerous socioeconomic stressors and is one of the nation's epicenters of the opioid epidemic. We created a culturally responsive ACT group protocol, and Valera psychoeducational material. Outcome measures include NIH HEAL Common Data Elements and ACT and Valera-specific measures. We are conducting a novel 2 × 2 trial investigating augmenting BUP treatment with ACT and Valera, with the goal that improved mental health and access to care will result in decreased and opioid use and pain interference.

Measurement of Intersectional Microaggressions: Conceptual Barriers and Recommendations.

Since Crenshaw coined the term "intersectionality" in 1989, researchers of bias have struggled with how to capture the complexity and intricacies of intersectional identities and microaggressions experienced by individuals holding these identities within the quantitative framework that dominates psychology. Although scholarship has grown in the exploration of experiences such as racialized sexual harassment, or sexual racism within queer and trans communities, there is no strong consensus on how this might be measured systematically in ways that allow for inferences regarding the experiences of populations of interest. With an emphasis on the experiences of queer and trans people of color, this article explores intersectional identities through three main points: First, we define what is meant by intersectionality and the real-world experiences that are important for advancing an understanding of microaggressions; second, we review the existing measures and their ability to capture the breadth and depth of the lived experience of those with intersectional identities; and third, we propose a framework for the development of a more accurate and comprehensive measure of microaggressions.

The Role of Psychological Flexibility as a Mediator Between Experienced Sexual Racism and Psychological Distress Among Men of Color Who Have Sex with Men.

Previous research has shown that individuals belonging to multiple marginalized groups experience higher levels of psychological distress, which is linked to experiencing discrimination based on their multiple marginalized identities. One way that gay and bisexual men of color face discrimination is in the dating and sexual situations within the men who have sex with men community, which is sometimes termed sexual racism. Previous research has found that experienced discrimination on the basis of their race/ethnicity is positively related to depressive symptoms. The present study examined whether psychological flexibility mediates the effect of experiencing sexual racism on psychological distress. In this study, 439 men of color who have sex with men completed a series of questionnaires online on Amazon Mechanical Turk. Results showed that the indirect effects of experiencing sexual racism through psychological flexibility on depression (95% CI .22, .39), anxiety (95% CI .15, .29), and stress (95% CI .18, .33) were significant while controlling for demographic variables. Therefore, this model showed that psychological flexibility mediated and explained the effect of experiencing sexual racism on psychological distress. Clinical implications and future avenues of research are discussed.

Examining sexual racism and body dissatisfaction among men of color who have sex with men: The moderating role of body image inflexibility.

Body image research with men who have sex with men (MSM) has largely focused on White MSM. The current study aimed to investigate whether men of color who have sex with men (MCSM) report similar levels of body dissatisfaction as White MSM. We also studied whether (a) the experience of sexual racism, a unique stressor for MCSM, is related to body dissatisfaction and (b) body image inflexibility moderates the relationship between sexual racism and muscularity-oriented behaviors. White MSM and MCSM (total N = 887) recruited through Amazon Mechanical Turk completed questionnaires assessing body dissatisfaction, body image flexibility, and experienced sexual racism on Qualtrics. We found that MCSM report more engagement in behaviors aimed at changing their bodies than White MSM. Additionally, experiencing sexual racism was related to higher body dissatisfaction and body image inflexibility in MCSM. In addition, body image inflexibility moderated by strengthening the association between experiencing sexual racism and muscularity-oriented behaviors. The present study highlights the need for further research with this understudied population, including intervention studies on mitigating the impact of experiencing sexual racism by increasing psychological and body image flexibility and studies aimed at reducing the incidence of sexual racism.

Evaluating Nonattachment and Decentering as Possible Mediators of the Link Between Mindfulness and Psychological Distress in a Nonclinical College Sample.

Although increasing evidence shows that mindfulness is positively related to mental health, the nature and mechanisms of this relationship are not fully understood. Based on previous research findings and suggestions, the authors of the current study hypothesized that decentering and nonattachment are 2 variables that mediate the relationship between mindfulness and psychological distress. A nonclinical, non-treatment-seeking sample of 308 students and employees from a middle-class, primarily Caucasian university filled out mindfulness, decentering, nonattachment, and mental distress measures online. Mediational analyses failed to support the hypothesis. Results suggest that mindfulness and nonattachment are independent predictors of nonclinical psychological distress and fully explain the effect of decentering on psychological distress. Results should be interpreted with caution and not generalized to clinical issues. A more comprehensive look into the mechanisms of mindfulness, especially with rigorous experimental, longitudinal studies, is warranted. The authors stress the importance of checking alternative, equivalent models in mediation studies.