Life is precious: A quasi-experimental study of a community-based program to prevent suicide among Latina adolescents in New York City.

INTRODUCTION: Rising rates of suicidal thoughts and behaviors (STBs) among U.S. Latina adolescents urgently need attention. Life is Precious (LIP) is a culturally responsive, community-based, afterschool-model program offering wellness-support services to supplement outpatient mental health treatment for Latina adolescents experiencing STB's. This 12-month quasi-experimental pilot study explored LIP's impact on clinical outcomes. METHODS: Latina adolescents newly enrolled in LIP and receiving outpatient treatment (n = 31) and those newly starting outpatient treatment only (n = 12; Usual Care) were assessed for Suicidal Ideation (Suicidal Ideation Questionnaire; SIQ) and depressive symptoms (Patient Health Questionnaire-9). We estimated differences in mean scores using longitudinal linear mixed models and adjusted risk ratios (ARRs) of SIQ-25%, SIQ-50%, and PHQ-9-5-point improvements using exact logistic models. RESULTS: The direction of the estimated impact of LIP was positive [differences (95% CIs): -15.5 (-34.16, 3.15) for SIQ; -1.16 (-4.39, 2.07) for PHQ-9], with small-to-moderate nonsignificant effect sizes (0.19-0.34). LIP participants saw two to three times higher prevalence than controls of SIQ-25%, SIQ-50%, and PHQ-9-5-point improvements; ARRs (95% CIs) were 1.91 (0.61, 3.45), 3.04 (0.43, 11.33), and 1.97 (0.44, 5.07), respectively. Suicidal behaviors also decreased in LIP. CONCLUSION: The effects of LIP were in positive directions across clinical outcomes, warranting further research on its effectiveness in decreasing STBs.

Perspectives From Black and White Participants and Care Partners on Return of Amyloid and Tau PET Imaging and Other Research Results.

PURPOSE: Alzheimer disease (AD) biomarker testing is now common in research and approaching clinical translation. Disclosure protocols must be informed by diverse participants' perspectives on if/how the information would be useful. METHODS: This study utilized semistructured interviews assessing interest in receiving positron emission tomography (PET) amyloid and tau results, as well as perceived risks and benefits of hypothetical PET disclosure as a function of race and participant diagnosis. PARTICIPANTS: Participants [39% Black; 61% White; Mage =74.28 (5.98)] included 57 adults diagnosed as either cognitively healthy (58%) or with mild cognitive impairment (42%) and their respective care partners [33% Black; 67% White; Mage =66.93 (10.92)]. RESULTS: Most dyads endorsed strong interest in PET results (82.5% of both participants and partners) regardless of race or diagnosis. Black care partners were less interested in receiving the participant's results than White care partners ( χ2(4) =8.31, P =0.047). Reasons for disclosure were diverse and highly personalized, including access to treatments or clinical trials (23.2% participants; 29.8% partners), advance planning (14.3% participants; 17.5% partners), and improved health knowledge (12.5% participants; 15.8% partners). In contrast, over 80% of respondents denied any risks of disclosure. DISCUSSION: Results suggest that predisclosure education, decisional capacity assessment, and a flexible disclosure approach are needed.

Finding strength in adversity: Exploring the process of posttraumatic growth among multicultural individuals.

OBJECTIVES: We explore the process of posttraumatic growth for multicultural individuals after experiences of cumulative multicultural identity-relevant adversity. METHOD: We conducted an exploratory sequential mixed methods study with two parts. Study 1 utilized Photovoice methodology and individual interviews (N = 27; 13 women, 14 men) with multicultural individuals living in a Midwestern college town. In Study 2, we tested the relationships between themes revealed by our qualitative analysis in Study 1 in a sample of multicultural individuals living across the U.S. (N = 526; 40.1% men, 59.9% women) using a conditional process analysis. RESULTS: Findings from Study 1 indicate that participants appreciated environments that valued diversity, and this helped participants positively frame their cumulative adversities. Participants also described how the struggle with these adversities fostered psychological wellbeing outcomes of personal growth and positive relations with others. Results from Study 2 indicate that appreciation of diversity mediates and positive framing moderates the relationship between discrimination and personal growth, thus supporting and building on the findings in Study 1. CONCLUSIONS: Together, these studies highlight the significance of including cumulative adversity in the posttraumatic growth process for multicultural individuals, while identifying appreciation of diversity and positive framing as potential postadversarial growth mechanisms. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Diagnosis of Alzheimer's disease and related dementia among people with multiple sclerosis: Large cohort study, USA.

BACKGROUND: Alzheimer's disease and related dementia (ADRD) and multiple sclerosis (MS) are two neurodegenerative diseases with some shared pathophysiological characteristics. While the salient attribute of ADRD is a progressive decline in cognitive function, MS is mainly known for causing physical weakness, vision loss, and muscle stiffness. Progressive cognitive decline, however, is not uncommon among MS patients, and many case reports of MS were indicative of ADRD coexistence. Due to a lack of large epidemiological studies on this topic, we aimed to examine time to diagnosis of and adjusted hazard for ADRD using administrative claims data, comparing adults with and without MS. METHODS: Using 2007-2017 private claims data from Optum Clinformatics Data Mart in the U.S., we identified adults (45+) with a MS diagnosis (n = 6151) as well as adults without MS for comparison (n = 916,143). We propensity score matched people with MS with those without (n = 6025) using age, sex, race/ethnicity, chronic conditions including cardiometabolic, psychologic, and musculoskeletal, U.S. Census Division, and socioeconomic variables. In addition to incidence estimates of ADRD diagnosis compared at 4-years, survival models were utilized to quantify unadjusted, fully adjusted, and adjusted propensity-matched hazard ratios. RESULTS: Unmatched data revealed that incidence of early-onset ADRD diagnosis was 7 times higher among adults 45-64 years old with MS (1.4%) compared to those without (0.2%); among older adults (65+) with MS, incident ADRD was 4.0% compared to 3.3% among those without MS. Adjusted survival models indicated that adults with MS had a substantially high risk for early-onset ADRD diagnosis (among 45-64 years old: unmatched hazard ratio (HR): 4.25 (95% CI: 3.40 -5.32), matched HR: 4.49 (95% CI:2.62-7.69); among 65+ years old: unmatched HR: 1.39 (95% CI: 1.22, 1.58), matched HR: 1.26 (1.04, 1.54)). CONCLUSIONS: Individuals with MS had a greater incidence of and risk for early- and late-onset ADRD diagnosis compared to those without MS. It is not clear whether this greater risk is due to an accelerated dementia risk or at least partially due to clinical misdiagnosis. Advancements in the development of clinical and imaging biomarkers should be more commonly used in clinical settings to facilitate future research on this topic.

Validation of the National Alzheimer's Coordinating Center (NACC) Lewy Body Disease Module neuropsychological tests.

INTRODUCTION: This study assessed the construct validity and clinical utility of the National Alzheimer's Coordinating Center Lewy Body Dementia (LBD) Module, consisting of the Speeded Attention and Noise Pareidolia Tasks. METHODS: Participants included 459 older adults diagnosed as cognitively normal (n = 202), or with non-amnestic mild cognitive impairment (n = 61), amnestic mild cognitive impairment (n = 96), Alzheimer's disease dementia (n = 44), or LBD (n = 56). RESULTS: Speeded Attention demonstrated strong convergent validity and moderate discriminant validity when compared to established neuropsychological tests. Noise Pareidolia demonstrated strong discriminant validity, but limited convergent validity. Noise Pareidolia scores were significantly lower in those with reported hallucinations, delusions, or REM sleep behavior disorder symptoms. LBD Module tests discriminated well between cognitively normal adults and those with LBD. DISCUSSION: The LBD Module demonstrates promising construct validity and clinical utility, which support its use across research and clinical settings.

What makes us complete: Hybrid multicultural identity and its social contextual origins.

Our research explores the experience of holding a Hybrid Multicultural Identity (a superordinate cultural identity; HMI) and the social contextual experiences hybrid multiculturals describe as influential to the development of an HMI. We conducted a Photovoice study with 10 hybrid multiculturals (age 18-32; 6 women and 4 men) living in a college town in the Midwestern US. The participants valued HMI for the psychological advantages they attributed to this identity. We also found the participants described three broad categories of their social environment that were key to the development of HMI: cultural composition in living environments, perceptions of macro-level marginalization, and culturally related interpersonal experiences. Our research documents (1) the lived experience of being a hybrid multicultural (2) the importance of cultural mixing for HMI development, and (3) how people with HMI describe primarily negative perceptions of the social environment as instrumental to the development of HMI.