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1.
JMIR Res Protoc ; 13: e52090, 2024 Apr 24.
Artículo en Inglés | MEDLINE | ID: mdl-38657227

RESUMEN

BACKGROUND: Black adults who smoke and have HIV experience immense stressors (eg, racial discrimination and HIV stigma) that impede smoking cessation success and perpetuate smoking-related health disparities. These stressors also place Black adults who smoke and have HIV at an increased risk of elevated interoceptive stress (eg, anxiety and uncomfortable bodily sensations) and smoking to manage symptoms. In turn, this population is more likely to smoke to manage interoceptive stress, which contributes to worse HIV-related outcomes in this group. However, no specialized treatment exists to address smoking cessation, interoceptive stress, and HIV management for Black smokers with HIV. OBJECTIVE: This study aims to test a culturally adapted and novel mobile intervention that targets combustible cigarette smoking, HIV treatment engagement and adherence, and anxiety sensitivity (a proxy for difficulty and responsivity to interoceptive stress) among Black smokers with HIV (ie, Mobile Anxiety Sensitivity Program for Smoking and HIV [MASP+]). Various culturally tailored components of the app are being evaluated for their ability to help users quit smoking, manage physiological stress, and improve health care management. METHODS: This study is a pilot randomized controlled trial in which Black combustible cigarette smokers with HIV (N=72) are being recruited and randomly assigned to use either (1) the National Cancer Institute's QuitGuide app or (2) MASP+. Study procedures include a web-based prescreener; active intervention period for 6 weeks; smartphone-based assessments, including daily app-based ecological momentary assessments for 6 weeks (4 ecological momentary assessments each day); a video-based qualitative interview using Zoom Video Communications software at week 6 for participants in all study conditions; and smartphone-based follow-up assessments at 0, 1, 2 (quit date), 3, 4, 5, 6, and 28 weeks postbaseline (26 weeks postquitting date). RESULTS: Primary outcomes include biochemically verified 7-day point prevalence of abstinence, HIV-related quality of life, use of antiretroviral therapy, and HIV care appointment adherence at 26 weeks postquitting date. Qualitative data are also being collected and assessed to obtain feedback that will guide further tailoring of app content and evaluation of efficacy. CONCLUSIONS: The results of this study will determine whether the MASP+ app serves as a successful aid for combustible cigarette smoking cessation, HIV treatment engagement, and physiological stress outcomes among Black people with HIV infection. If successful, this study will provide evidence for the efficacy of a new means of addressing major mental and physical health difficulties for this high-risk population. If the results are promising, the data from this study will be used to update and tailor the MASP+ app for testing in a fully powered randomized controlled trial that will evaluate its efficacy in real-world behavioral health and social service settings. TRIAL REGISTRATION: ClinicalTrials.gov NCT05709002; https://clinicaltrials.gov/study/NCT05709002. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/52090.


Asunto(s)
Negro o Afroamericano , Infecciones por VIH , Aplicaciones Móviles , Cese del Hábito de Fumar , Telemedicina , Humanos , Cese del Hábito de Fumar/psicología , Cese del Hábito de Fumar/métodos , Infecciones por VIH/psicología , Negro o Afroamericano/psicología , Telemedicina/métodos , Masculino , Adulto , Femenino , Fumadores/psicología , Proyectos Piloto , Persona de Mediana Edad
2.
J Consult Clin Psychol ; 92(4): 202-212, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38206858

RESUMEN

OBJECTIVES: In this study, the effectiveness of a couples-based group intervention to prevent intimate partner violence (IPV), Strength at Home Couples (SAH-C), was examined on a military installation relative to a comparison intervention, Supportive Prevention (SP). It was expected that greater reductions in use of physical, psychological, and sexual IPV behaviors, as well as reduced suicidality, would be found among service members and their partners in SAH-C relative to SP. METHOD: Participants included 138 couples randomized to SAH-C and SP through a clinical controlled trial embedded in a hybrid effectiveness implementation study which took place on a military installation. The Revised Conflict Tactics Scales and Multidimensional Measure of Emotional Abuse were used to measure IPV, and 13 Military Suicide Research Consortium common data elements were used to assess suicidality. RESULTS: Service members randomized to SAH-C evidenced greater reductions based on effect sizes across the assessment time points for all IPV variables, including use of overall physical IPV, severe physical IPV, sexual IPV, psychological IPV, and coercive control IPV relative to those randomized to SP. Partners of service members demonstrated a similar general pattern for reductions in use of IPV, but findings were not as robust as for service members. Both service members and partners demonstrated greater reductions in suicidality based on effect sizes when randomized to SAH-C relative to SP. CONCLUSIONS: Findings extend prior work demonstrating the promising effects of SAH-C delivered in the military context and highlight the possible benefits of SAH-C in preventing self-harm thoughts and behaviors. (PsycInfo Database Record (c) 2024 APA, all rights reserved).


Asunto(s)
Violencia de Pareja , Personal Militar , Humanos , Personal Militar/psicología , Violencia de Pareja/prevención & control , Violencia de Pareja/psicología , Conducta Sexual , Parejas Sexuales/psicología
3.
Psychol Trauma ; 16(3): 488-495, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-37498720

RESUMEN

OBJECTIVE: Gratitude and hope are well-established predictors of well-being and buffers against posttraumatic stress disorder (PTSD) and anxiety symptoms. However, scarce literature exists that investigates these relationships in a Hispanic/Latino sample. The current study investigates gratitude's and hope's relationship to PTSD and anxiety symptoms and different domains of well-being in trauma-exposed Hispanic/Latino young adults at a large southern university. METHOD: The sample was composed of 732 undergraduate students who were mostly female (80.7%) and young adults, (Mage = 21.8, SD = 4.3), who endorsed experiencing one or more traumatic events via the Life Events Checklist. Students completed an online survey for course credit. RESULTS: Structural equation models were used to analyze the data. Gratitude had a stronger inverse relationship with PTSD symptoms (ß = -.43, 95% CI [-0.50, -0.35]) and anxiety symptoms (ß = -.28, 95% CI [-0.36, -0.20]) compared to hope (ß = .06, 95% CI [-0.01, 0.14]) (ß = -.06, 95% CI [-0.14, 0.02]). Both gratitude and hope were robust predictors of the three domains of well-being. CONCLUSIONS: The current study found that hope and gratitude predicted resilience in trauma-exposed Hispanic/Latino young adults. Decreased levels of gratitude were a stronger predictor of psychological distress and subjective well-being than decreased levels of hope, but hope was a robust predictor of the three well-being domains. The findings of this study may lend support for the development of hope and gratitude interventions in a Hispanic/Latino population for the prevention of PTSD symptoms and anxiety symptoms via engendering higher levels of resilience. (PsycInfo Database Record (c) 2024 APA, all rights reserved).


Asunto(s)
Distrés Psicológico , Resiliencia Psicológica , Trastornos por Estrés Postraumático , Adulto , Femenino , Humanos , Masculino , Adulto Joven , Ansiedad/psicología , Hispánicos o Latinos , Trastornos por Estrés Postraumático/psicología , Esperanza
4.
Psychol Med ; 54(2): 385-398, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-37458212

RESUMEN

BACKGROUND: Anxiety disorders are highly prevalent and debilitating conditions that show high comorbidity rates in adolescence. The present article illustrates how Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents (UP-A) was adapted for Iranian adolescents with anxiety disorders. METHODS: A total of 54 adolescents with comorbid anxiety disorders participated in a randomized, waitlist-controlled trial of group weekly sessions of either UP-A or waitlist control (WLC). Primary and process of change outcomes were assessed at baseline, posttreatment, and 1-month follow-up. RESULTS: Significant changes were observed over time on major DSM-5 anxiety disorder symptoms (F(2, 51) = 117.09, p < 0.001), phobia type symptoms (F(2, 51) = 100.67, p < 0.001), and overall anxiety symptoms (F(2, 51) = 196.29, p < 0.001), as well as on emotion regulation strategies of reappraisal (F(2, 51) = 17.03, p < 0.001), and suppression (F(2, 51) = 21.13, p < 0.001), as well as on intolerance of uncertainty dimensions including prospective (F(2, 51) = 74.49, p < 0.001), inhibitory (F(2, 51) = 45.94, p < 0.001), and total intolerance of uncertainty (F(2, 51) = 84.42, p < 0.001), in favor of UP-A over WLC. CONCLUSION: Overall, results provide a cultural application of the UP-A and support the protocol as useful for improving anxiety disorders as well as modifying of emotion regulation strategies and intolerance of uncertainty dimensions in Iranian adolescents. Future directions and study limitations are discussed.


Asunto(s)
Trastornos de Ansiedad , Adolescente , Humanos , Trastornos de Ansiedad/terapia , Irán , Estudios Prospectivos
5.
Curr Opin Psychol ; 53: 101684, 2023 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-37659285
6.
Psychol Trauma ; 2023 Aug 03.
Artículo en Inglés | MEDLINE | ID: mdl-37535536

RESUMEN

OBJECTIVE: More than 550 million people speak Spanish and, yet, psychometric data on psychological instruments in Spanish lags. Given evidence of significant traumatic exposure and distress among Spanish speakers, the aim of the current study was to examine the factor structure of the Impact of Events Scale-Revised (IES-R), in a large sample of Spanish-speaking adults. METHOD: Participants (n = 725) were university students living in Latin America (M = 21.02; SD = 3.12). Most were born in Mexico (77.6%) and the next largest subgroup was from Ecuador (18.9%). Respondents completed the 22-item IES-R. RESULTS: The IES-R mean score was 20.08 (SD = 21.34) and 26.6% of the sample met the cutoff score for clinically significant symptoms. Regarding factor structure, eight different factor structures that have demonstrated a good fit in the extant literature were examined. The one-factor model demonstrated an acceptable fit, χ²(209) = 839.13, p < .0001; root-mean-square error (RMSEA) = 0.06, 95% confidence interval (CI) [0.06, 0.07]; comparative fit index (CFI) = 0.91, Tucker-Lewis index (TLI) = 0.90. The two-factor model demonstrated good fit, χ²(208) = 746.70, p < .0001; RMSEA = 0.06, 95% CI [0.05, 0.06]; CFI = 0.92, TLI = 0.91, and nested model comparisons of the two-factor and one-factor models using the chi-square difference test supported the two-factor model. CONCLUSIONS: The most parsimonious of the multifactor models, a two-factor model with Avoidance symptoms as one factor and Intrusions and Hyperarousal combined into a second may be of greatest use for this particular version of the IES-R. The current research demonstrates strong psychometric support for Intrusion/Hyperarousal and Avoidance subscales when measuring traumatic stress in Spanish speakers and underscores the need for culturally and contextually sensitive assessment in this population, in which posttraumatic stress is prevalent. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

7.
JAMA Psychiatry ; 80(11): 1093-1100, 2023 11 01.
Artículo en Inglés | MEDLINE | ID: mdl-37610727

RESUMEN

Importance: Evidence-based treatments for posttraumatic stress disorder (PTSD) exist, but all require 8 to 15 sessions and thus are less likely to be completed than brief treatments. Written exposure therapy (WET) is a brief and efficacious treatment that has not been directly compared with prolonged exposure therapy (PE), a more time-intensive, exposure-based treatment. Objective: To determine whether WET is noninferior to PE in treating PTSD among veterans. Design, Setting, and Participants: A randomized noninferiority clinical trial was conducted between September 9, 2019, and April 30, 2022. Participants were 178 veterans with PTSD presenting to 1 of 3 Veterans Affairs medical centers. Inclusion criteria consisted of a primary diagnosis of PTSD and stable medication. Exclusion criteria included current psychotherapy for PTSD, high suicide risk, active psychosis, unstable bipolar disorder, and severe cognitive impairment. Independent evaluations were conducted at baseline and 10, 20, and 30 weeks after the first treatment session. Data were analyzed from January 1 to March 31, 2023. Interventions: Participants assigned to WET (n = 88) received five to seven 45- to 60-minute sessions. Participants assigned to PE (n = 90) received eight to fifteen 90-minute sessions. The WET sessions included 30 minutes of writing-based imaginal exposure conducted in session, whereas PE sessions included 40 minutes of in-session imaginal exposure and between-session in vivo exposures. Main Outcomes and Measures: The primary outcome was change in PTSD symptom severity measured with the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) from baseline to the 20-week assessment; noninferiority was defined as a less than 10-point difference between the 2 treatment groups. Difference in treatment dropout was also examined. Results: Of the 178 participants, 134 (75.3%) were men, and the mean (SD) age was 44.97 (13.66) years. In terms of race, 37 participants (20.8%) were Black, 112 (62.9%) were White, 11 (6.2%) were more than 1 race, and 18 (10.1%) were of other race (including American Indian or Alaska Native, Asian, and Native Hawaiian or Other Pacific Islander [some participants did not specify their race when selecting the category "other"]); in terms of ethnicity, 19 participants (10.7%) were Hispanic. Changes in PTSD symptom severity from baseline to all subsequent assessments among individuals randomized to WET were noninferior relative to individuals randomized to PE. The largest difference between treatments was observed at 10 weeks and was in favor of WET (mean difference, 2.42 [95% CI, 0.35-1.46] points). Participants were significantly less likely to drop out of WET compared with PE (11 [12.5%] vs 32 [35.6%]; χ2 = 12.91; Cramer V = 0.27). Conclusions and Relevance: In this study, WET was noninferior to PE in PTSD symptom change and was associated with significantly less attrition. Findings suggest that WET may transcend previously observed barriers to PTSD treatment for both patients and clinicians. Trial Registration: ClinicalTrials.gov Identifier: NCT03962504.


Asunto(s)
Terapia Implosiva , Trastornos por Estrés Postraumático , Veteranos , Masculino , Humanos , Adulto , Persona de Mediana Edad , Femenino , Trastornos por Estrés Postraumático/diagnóstico , Veteranos/psicología , Resultado del Tratamiento , Escritura
8.
J Community Psychol ; 51(7): 2774-2789, 2023 09.
Artículo en Inglés | MEDLINE | ID: mdl-37453085

RESUMEN

In 2017, Hurricane Harvey flooded more than 300,000 buildings causing an estimated $125 billion in damages and resulting in 68 deaths (National Hurricane Center). This actual or threatened loss of life and physical harm led many to report negative effects on mental well-being and greater mental illness. However, many individuals have been able to experience similar adverse events without a significant negative impact on their mental health and well-being. Positive thinking factors such as hope, optimism, and self-efficacy have been proposed as protective factors in the face of difficult life events. Hope, optimism, and self-efficacy are related but distinct constructs that have often been studied separately, but whose unique impact on well-being and mental illness is less clear, especially in the context of a natural hazard. The current study uses structural equation modeling to measure the unique contribution of hope, optimism, and hurricane-coping self-efficacy on mental well-being and mental illness in a community sample of 300 subjects who experienced Hurricane Harvey, recruited from Mechanical Turk.


Asunto(s)
Tormentas Ciclónicas , Salud Mental , Humanos , Autoeficacia , Optimismo , Adaptación Psicológica
9.
J Clin Psychol ; 79(9): 2124-2136, 2023 09.
Artículo en Inglés | MEDLINE | ID: mdl-37212250

RESUMEN

OBJECTIVE: Firefighters represent an understudied population with high rates of chronic exposure to stress and potentially traumatic events. Thus, there is a need to identify modifiable resilience factors to address posttraumatic stress disorder (PTSD) symptoms (PTSD) and chronic pain in firefighters to inform prevention and intervention efforts. METHODS: The current sample included 155 firefighters (93.5% male; Mage = 42.2, SD = 9.8) recruited online from career, volunteer, and combination (i.e., volunteer and career) departments in a large metropolitan area in the southern United States. RESULTS: Structural equation modeling (SEM) was used to investigate the associations between/among resilience and hope on PTSD symptoms, chronic pain, well-being, and posttraumatic growth (PTG). Resilience had a stronger, negative relationship with PTSD and chronic pain compared to hope, while hope had a stronger, positive relationship with PTG and well-being compared to resilience. Hope and resilience combined predicted 10%-33% of the variance in the outcomes. CONCLUSION: The current findings may provide evidence to promote interventions that increase resilience and hope in firefighters.


Asunto(s)
Dolor Crónico , Bomberos , Crecimiento Psicológico Postraumático , Trastornos por Estrés Postraumático , Humanos , Masculino , Estados Unidos , Adulto , Femenino , Trastornos por Estrés Postraumático/epidemiología
10.
Psychol Health Med ; 28(7): 1950-1962, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36882375

RESUMEN

Pain tolerance, defined as the ability to withstand physical pain states, is a clinically important psychobiological process associated with several deleterious outcomes, including increased pain experience, mental health problems, physical health problems, and substance use. A significant body of experimental work indicates that negative affect is associated with pain tolerance, such that increased negative affect is associated with decreased pain tolerance. Although research has documented the associations between pain tolerance and negative affect, little work has examined these associations over time, and how change in pain tolerance is related to changes in negative affect. Therefore, the current study examined the relationship between intraindividual change in self-reported pain tolerance and intraindividual change in negative affect over 20 years in a large, longitudinal, observation-based national sample of adults (n = 4,665, Mage = 46.78, SD =12.50, 53.8% female). Results from parallel process latent growth curve models indicated that slope of pain tolerance and negative affect were associated with each other over time (r = .272, 95% CI [.08, .46] p = .006). Cohen's d effect size estimates provide initial, correlational evidence that changes in pain tolerance may precede changes in negative affect. Given the relevance of pain tolerance to deleterious health outcomes, better understanding how individual difference factors, including negative affect, influence pain tolerance over time, are clinically important to reduce disease-related burden.


Asunto(s)
Afecto , Trastornos Relacionados con Sustancias , Adulto , Humanos , Femenino , Masculino , Dolor/epidemiología , Dolor/psicología
11.
Contemp Clin Trials ; 128: 107145, 2023 05.
Artículo en Inglés | MEDLINE | ID: mdl-36905980

RESUMEN

BACKGROUND: Electronic cigarette (ECIG) use has become a popular method for nicotine delivery. Combustible cigarette (CC) cessation or reduction are the primary reasons for ECIG uptake among adults. Yet, most CC smokers who initiate ECIG use do not fully transition from CC to ECIG, despite intending to quit CC completely. Retraining approach bias, or the approach action tendency toward stimuli related to the substance of interest, has been effective in alcohol and CC use treatments. However, approach bias retraining for both CC and (ECIG) users has not been explored. Therefore, the objective of the study is to evaluate the initial efficacy of approach bias retraining among dual CC and ECIG users. METHODS: Eligible dual CC/ECIG using adults (N = 90) will complete a phone-screener, baseline assessment, 4 treatment sessions over 2 weeks, ecological momentary assessments (EMAs) post-intervention, and follow-ups at 4- and 6-week post-intervention. Participants will be assigned to one of three conditions at baseline: (1) CC + ECIG retraining; (2) CC only retraining; and (3) sham retraining. Participants will engage in a self-guided quit attempt to abstain from all nicotine products starting at treatment session 4. CONCLUSIONS: The study may lead to a more effective treatment for at-risk nicotine users while simultaneously isolating explanatory mechanisms. The findings should guide advances in the theoretical conceptualization of nicotine addiction for dual users and mechanisms involved in maintaining and abstaining from CC and ECIG, and provide initial effect size data for a brief intervention, thus providing necessary data for a large-scale follow-up trial. Clinical Trials ID: NCT05306158.


Asunto(s)
Sistemas Electrónicos de Liberación de Nicotina , Cese del Hábito de Fumar , Tabaquismo , Adulto , Humanos , Nicotina , Fumadores , Cese del Hábito de Fumar/métodos , Tabaquismo/terapia , Estudios de Evaluación como Asunto
12.
Eval Health Prof ; 46(1): 69-83, 2023 03.
Artículo en Inglés | MEDLINE | ID: mdl-36520096

RESUMEN

Higher emotional capital is associated with enhanced positive emotions, social relationships, social capital and human capital. The present study developed and evaluated a personal emotional capital questionnaire for adolescents (PECQ-A) that assessed 10 components of this capital. The PECQ-A was administrated to two samples of Iranian 15-year-olds from two Iranian cities (N1 = 600, N2 = 300, total N = 900) recruited using multistage random cluster sampling. A confirmatory factor analysis of the first sample confirmed the ten-factor structure of the PECQ-A. The reliability of PECQ-A was acceptable (Cronbach's α = .90, McDonald's ω = .88, AVE = .57, Composite reliability CR = .89). Analyses of the second sample revealed that the PECQ-A and its components exhibited convergent validity when compared to the Mental Health Continuum-Short Form (MHC-SF), the students' GPAs, and the students' mathematics and natural sciences scores. The PECQ-A demonstrated divergent validity when contrasted with the Depression Anxiety and Stress Scale (DASS21). Test-retest reliability was acceptable. Invariance measurement was confirmed for the PECQ-A. A MANOVA identified several gender differences. PECQ-A scores were not sensitive to the order that the questionnaires were administered. The results suggest that the PECQ-A is a valid and reliable measure of personal emotional capital suitable for use with adolescents.


Asunto(s)
Emociones , Humanos , Adolescente , Psicometría/métodos , Reproducibilidad de los Resultados , Irán , Encuestas y Cuestionarios
13.
Addict Behav ; 139: 107593, 2023 04.
Artículo en Inglés | MEDLINE | ID: mdl-36563479

RESUMEN

Black smokers demonstrate higher nicotine dependence and experience higher rates of smoking-related diseases and mortality relative to European American/White smokers. A potential factor relevant to race-specific smoking health disparities may be smoking motives (i.e., motivational basis of smoking). Yet, little research has been conducted to understand psychological factors that may be associated with specific smoking motives among Black smokers. To address this gap in the literature, the current study explored the association between anxiety sensitivity and smoking motives within a subset sample of Black smokers who were interested in participating in a smoking cessation trial (N = 105; 70.5 % male; Mage = 44.8 years, SD = 11.6 years). Hierarchical regression analyses indicated anxiety sensitivity was associated with smoking motives related to habit (ß = 0.39, p <.001), negative affect reduction (ß = 0.32, p <.001), stimulation (ß = 0.31, p <.001), and sensorimotor manipulation (ß = 0.26, p =.008). Limited support was found for the effect of motives on past quit attempt engagement. These results may broaden understanding of the psychological mechanisms related to smoking motivation among Black smokers and may inform future intervention efforts to reduce smoking motivation among this health disparities population.


Asunto(s)
Cese del Hábito de Fumar , Tabaquismo , Masculino , Humanos , Adulto , Femenino , Fumadores/psicología , Fumar/epidemiología , Fumar/psicología , Cese del Hábito de Fumar/psicología , Tabaquismo/psicología , Ansiedad/psicología , Motivación
14.
JMIR Res Protoc ; 11(12): e40713, 2022 Dec 05.
Artículo en Inglés | MEDLINE | ID: mdl-36409958

RESUMEN

BACKGROUND: Clear health disparities have emerged in the rates of COVID-19 exposure, hospitalization, and death among Black, Hispanic, and American Indian (BHAI) individuals, relative to non-Hispanic White (NHW) individuals. BHAI populations have been disproportionately affected by lower behavioral health access and heightened negative mental health outcomes during the pandemic. OBJECTIVE: This project directly addresses health disparities in access to behavioral health care during the COVID-19 pandemic among BHAI populations via an adaptation of the established, initially validated, low-cost, mobile app Easing Anxiety Sensitivity for Everyone (EASE) among individuals with symptoms of elevated anxiety or depression or both. METHODS: The EASE trial is a 2-arm, prospective, randomized, blinded-assessor study with intention-to-treat analysis. Participants (N=800; n=200, 25%, Black; n=200, 25%, Hispanic; n=200, 25%, American Indian; and n=200, 25%, NHW) are randomized to receive either EASE or an active comparison condition for anxiety and depression. Participants compete an online prescreener, an enrollment call to provide informed consent, a baseline survey, a 6-month intervention period, and 3- and 6-month postbaseline assessments. Select participants also complete a 3- and 6-month postbaseline qualitative interview via phone or an online platform (eg, Zoom). Participants complete 2 scheduled daily ecological momentary assessments (EMAs) during the 6-month study period. These twice-daily EMAs guide a just-in-time approach to immediate, personalized behavioral health care. RESULTS: Outcomes include reductions in anxiety and depressive symptoms and functional impairment at 3 and 6 months postrandomization. We also will examine putative mechanisms (eg, anxiety sensitivity [AS] and COVID-19-specific stress and fear) of the intervention effects. Further, as treatment effects may differ across sociocultural factors, perceived discrimination, social support, and socioeconomic status (SES) will be evaluated as potential moderators of treatment effects on the primary outcomes. Process evaluation using data collected during the study, as well as individual interviews with participants, will complement quantitative data. CONCLUSIONS: Data from this efficacy trial will determine whether EASE successfully improves symptoms of anxiety and depression and whether these improvements outperform an active comparison control app. If successful, findings from this study have the potential to decrease anxiety and depression symptoms among vulnerable populations determined to be most at risk of exacerbated, long-lasting negative health sequelae. Data from this study may be used to support an implementation and dissemination trial of EASE within real-world behavioral health and social service settings. TRIAL REGISTRATION: ClinicalTrials.gov NCT05074693; https://clinicaltrials.gov/ct2/show/NCT05074693. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/40713.

15.
J Clin Exp Neuropsychol ; 44(4): 281-292, 2022 05.
Artículo en Inglés | MEDLINE | ID: mdl-35930244

RESUMEN

OBJECTIVE: The Memory for Intentions Test (MIsT) is a clinical measure of prospective memory that has strong evidence for convergent, discriminative, and ecological validity. This study uses a conceptual replication design to evaluate the latent structure of the MIsT in two parallel samples who commonly experience prospective memory deficits: older adults and people living with HIV disease. PARTICIPANTS AND METHODS: Study participants included 303 people with HIV disease (ages 18-67) and 267 community-dwelling older adults (ages 50-91). Confirmatory factor analyses of the MIsT were conducted separately in each sample. We evaluated a one-factor model, as well as three two-factor models with the MIsT items loading onto each factor based on cue type, delay interval, or response modality. RESULTS: The one-factor model provided the best (and most parsimonious) fit to the data in both study samples. All two-factor models also demonstrated good fit statistics, although correlations between the two factors in each model were high and none of the two-factor models provided a significantly better fit than the one-factor model. CONCLUSIONS: Results of this conceptual replication study provide support for a robust factor structure of the MIsT across older adults and people with HIV disease. A total score for the MIsT provides the most parsimonious solution, although available evidence and theory also support the potential use of subscales (e.g., cue type). Future studies of the MIsT would be useful to determine its psychometrics in different clinical populations and across demographic factors (e.g., race/ethnicity).


Asunto(s)
Infecciones por VIH , Memoria Episódica , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Infecciones por VIH/complicaciones , Humanos , Intención , Persona de Mediana Edad , Pruebas Neuropsicológicas , Psicometría/métodos , Reproducibilidad de los Resultados , Adulto Joven
16.
JMIR Res Protoc ; 11(5): e38905, 2022 May 30.
Artículo en Inglés | MEDLINE | ID: mdl-35635746

RESUMEN

BACKGROUND: Black smokers have greater difficulty in quitting and higher rates of smoking-related diseases and disabilities than the general population. The smoking disparities experienced by this group are, in part, a consequence of multiple chronic life stressors (eg, racial discrimination) that engender increased exposure to interoceptive stress symptoms (eg, anxiety), which can ultimately lead to smoking as a means of immediate emotion regulation. OBJECTIVE: This study aimed to culturally adapt and initially test a novel mobile intervention (ie, Mobile Anxiety Sensitivity Program for Smoking [MASP]) that targets anxiety sensitivity (AS; a proxy for difficulty and responsivity to interoceptive stress) among Black smokers. The MASP intervention is culturally informed to address interoceptive stress management difficulties among Black smokers and is thus hypothesized to facilitate smoking cessation. METHODS: In phase 1, a total of 25 Black smokers with elevated AS will be administered MASP for 6 weeks. Following the completion of phase 1, we will further refine the MASP based on qualitative and quantitative data from participants to produce the final MASP iteration. In phase 2, a total of 200 Black smokers with elevated AS will be enrolled and randomly assigned to receive nicotine replacement therapy and either the smartphone-based National Cancer Institute QuitGuide app for standard mobile smoking cessation treatment or the MASP intervention. All participants in phases 1 and 2 will be enrolled remotely and will complete a web-based study screener; smartphone-based baseline assessment; daily smartphone-based ecological momentary assessments for 6 weeks; phone-based end-of-treatment qualitative interviews; and smartphone-based follow-up assessments at postbaseline weeks 1, 2 (quit date), 3, 4, 5, 6, 28, and 54 (weeks 28 and 54 follow-ups will be completed by phase 2 participants only). The MASP intervention is intended to offset barriers to treatment and encourage treatment engagement via smartphones. RESULTS: This project was funded in September 2020. Phase 1 data collection began in January 2022. Phase 2 data collection is scheduled to begin in July 2022. CONCLUSIONS: If successful, data from this study will support culturally informed treatment approaches for Black smokers and, pending findings of efficacy, provide an evidence-based mobile intervention for smoking cessation that is ready for dissemination and implementation. TRIAL REGISTRATION: ClinicalTrials.gov NCT04838236; https://clinicaltrials.gov/ct2/show/NCT04838236. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/38905.

17.
Behav Ther ; 53(1): 105-118, 2022 01.
Artículo en Inglés | MEDLINE | ID: mdl-35027152

RESUMEN

Recent models propose reward system dysfunction as a key mediator of the relationship between sleep and depression and anhedonia. This study explored interrelationships among sleep disturbance, depressive symptoms, anhedonia, and reward responsiveness. Two-hundred and sixty undergraduate students completed questionnaires and a daily diary paradigm assessing sleep, reward responsiveness, depression, anhedonia, and positive affect over 1 week. Baseline sleep disturbance was associated with depressive symptoms, anhedonia, and reward responsiveness. Daily diary sleep parameters showed differential associations with anticipatory versus consummatory reward responsiveness and positive affect. Poorer sleep quality, shorter sleep duration, and longer awakening after sleep onset predicted blunted anticipatory and consummatory reward responsiveness, while increased sleep onset latency and lower sleep efficiency predicted only decreased consummatory reward responsiveness. All sleep indices, except sleep onset latency, were associated with positive affect. Findings demonstrate unique associations between disparate sleep disturbance and reward responsiveness elements, highlighting new treatment mechanisms for anhedonia and depression.


Asunto(s)
Anhedonia , Depresión , Humanos , Recompensa , Sueño , Calidad del Sueño
18.
Cogn Behav Ther ; 51(5): 353-370, 2022 09.
Artículo en Inglés | MEDLINE | ID: mdl-35037832

RESUMEN

Obesity is one the fastest growing public health problems related to numerous chronic diseases and frequently co-occurs with negative mood states. One promising approach to address the heterogeneity of affective vulnerabilities and obesity is to focus on processes (e.g. anxiety sensitivity [AS]) that underpin both conditions. Thus, this study aimed to evaluate the feasibility, acceptability, and initial efficacy of a brief, computer-delivered AS reduction program (AST) for adults with obesity and elevated AS. Participants were 131 individuals with obesity and elevated AS who received either AST or a health information control (HC). Latent growth curve modeling was utilized to examine the effect of treatment condition on change in AS, emotional eating, expectancies of eating to manage mood, and exercise self-efficacy from baseline to 1-week, 2-weeks, and 1-month follow-up. Results indicated it was feasible to recruit and retain individuals with obesity and elevated AS through the 1-month follow-up. Positive qualitative feedback was also provided for both AST and HC. AST was a statistically significant predictor of change in expectancies of eating to manage negative affect. No other statistically significant treatment effects were indicated. Current data provide initial empirical support for future work focused on persons with obesity and elevated AS.


Asunto(s)
Ejercicio Físico , Obesidad , Adulto , Ansiedad/complicaciones , Ansiedad/terapia , Computadores , Ejercicio Físico/psicología , Estudios de Factibilidad , Humanos , Obesidad/psicología , Obesidad/terapia
19.
Psychol Trauma ; 14(3): 431-436, 2022 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33734768

RESUMEN

OBJECTIVE: Sexual aggression between intimate partners is a serious problem. This study examined this problem in returning male veterans and their female partners, and the effectiveness of an intervention for intimate partner violence (IPV) in preventing sexual aggression using data gathered during a randomized controlled trial. METHOD: Rates of sexual aggression and the effectiveness of the Strength at Home Couples (SAH-C) intervention were examined in a sample of 69 couples with a returning male veteran from Iraq/Afghanistan who participated in a randomized controlled trial for intimate partner violence (IPV) prevention. Couples were assessed at 4 timepoints: immediately prior to the intervention, immediately following the intervention, 6 months postintervention, and 12 months postintervention. RESULTS: It was found that 57% of couples reported the presence of intimate partner sexual aggression in their relationship across the assessment points, with higher rates reported at baseline than other time points and for veterans relative to their partners. The most commonly endorsed items were "I insisted on sex when my partner didn't want to" and "I made my partner have sex without a condom." Overall, couples randomized to SAH-C showed greater declines in sexual aggression than couples who were randomized to Supportive Prevention, with particularly strong differences across conditions from baseline to posttreatment. CONCLUSIONS: These data suggest that this trauma-informed couples-based intervention based on a social information processing model may assist in reducing intimate partner sexual aggression and builds on prior findings demonstrating the program be associated with the prevention of physical and psychological IPV. (PsycInfo Database Record (c) 2022 APA, all rights reserved).


Asunto(s)
Violencia de Pareja , Veteranos , Agresión/psicología , Femenino , Humanos , Violencia de Pareja/prevención & control , Violencia de Pareja/psicología , Masculino , Conducta Sexual , Parejas Sexuales/psicología , Veteranos/psicología
20.
Anxiety Stress Coping ; 35(6): 701-718, 2022 11.
Artículo en Inglés | MEDLINE | ID: mdl-34632890

RESUMEN

BACKGROUND AND OBJECTIVES: The majority of patients suffering from anxiety disorders in low- and middle-income countries do not receive evidence-based treatments. The Unified Protocol (UP) for the Transdiagnostic Treatment of Emotional Disorders is an evidence-based cognitive-behavioral intervention designed to treat the range of emotional disorders. DESIGN AND METHODS: Using a single-case experimental design five patients with panic disorder were assigned to a 3-week baselines assessment phase followed by eight sessions of UP treatment and 4-week follow-up phases. Multiple outcome measures of panic severity, anxiety sensitivity, affectivity, and overall anxiety severity and impairment were administered weekly during the baseline, intervention, and follow-up phases. RESULTS: At post treatment, all participants showed significant reductions in outcome measures, with changes functionally related to treatment and most improvements maintained at 4-week follow-up. CONCLUSION: Findings provide preliminary cross-cultural support for UP and add to the growing body of literature showing UP can be useful for patients with anxiety disorders in low- and middle-income countries with non-Western cultures.


Asunto(s)
Trastorno de Pánico , Trastornos de Ansiedad/psicología , Humanos , Irán , Trastorno de Pánico/terapia , Proyectos de Investigación , Resultado del Tratamiento
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