Baseline health-related self-efficacy for individuals following stroke, traumatic brain injury, and spinal cord injury prior to enrollment in a weight-loss intervention.

PURPOSE: To examine health-related self-efficacy for individuals following acquired brain or spinal cord injury prior to enrollment in a weight-loss intervention and associations with demographics, injury characteristics, and additional physiologic variables. MATERIALS AND METHODS: Cross-sectional analysis of baseline data for community-dwelling adults following stroke (CVA), traumatic brain injury (TBI), or spinal cord injury (SCI) across three disability-adapted weight-loss interventions. RESULTS: Overall results suggest a significant difference between injury type and self-efficacy as measured by the Self Rated Abilities for Health Practices (SRAHP) scale. On average, individuals with SCI had the lowest overall perceived self-efficacy of the three groups (11.2-unit difference; (CI: -17.4, -5.0), followed by those with TBI (9.5-unit difference; (CI: -16.7, -2.4). There were also differences between groups in age, number of household members, time since injury, sex, race, marital status, physiological measures, and employment status. CONCLUSIONS: Results suggest that individuals with different disabilities following neurological injuries have different baseline perceptions in their ability to eat a healthy diet and exercise regularly. Health interventions should be tailored for these groups based on disability-specific barriers and should include components to enhance health-related self-efficacy to address weight management among these populations.IMPLICATIONS FOR REHABILITATIONEvidence suggests that health-related self-efficacy may differ following different injury types and level of disability may impact one's ability to maintain health-related behaviorsResults suggest that individuals with a spinal cord injury may have different baseline perceptions of self-efficacy related to their ability to eat a healthy diet and exercise regularly compared to those with a traumatic brain injury or stroke.Health interventions should be tailored to encompass disability-specific barriers which may impact an individual's health-related self-efficacy.

Associations of Mental Health and Experience of the COVID-19 Pandemic with United States Adults' Intentions to Be Vaccinated.

COVID-19 vaccine uptake in the United States has proved challenging. A deeper characterization extending beyond demographics and political ideologies of those hesitating or resisting is needed to guide ongoing conversations. This study examined associations between US adults' vaccination intentions and mental health history, experience of the COVID-19 pandemic, and mental health outcomes. An online population-based cross-sectional survey was administered nationwide during January 4-7, 2021. Participants were questioned about past and current mental health, and completed the Patient Health Questionnaire 8 (PHQ-8), Generalized Anxiety Disorder 7-item (GAD-7), and Posttraumatic Diagnostic Scale (PDS)-5 (to capture symptoms of depression, anxiety, and traumatic stress, respectively). Experience of the pandemic included cumulative county-level COVID case and death rates, self-reported COVID-19 testing/exposure/diagnosis, and self-reported impact on routines, resources, and relationships. Of 936 respondents, 66% intended to be vaccinated, 14.7% responded "maybe," and 19.6% "no." Past diagnosis of obsessive compulsive disorder, less impact on routines or social supports, not having been screened or tested for COVID-19, not knowing someone who tested positive, and not self-isolating were associated with less intention to vaccinate. After controlling for demographic and pandemic experience factors, symptoms of traumatic stress, but not other mental health outcomes, were associated with less intention to vaccinate. The apparent contradiction between less negative impact of the pandemic and symptoms of traumatic stress being associated with less intention to be vaccinated indicates the complex nature of barriers to vaccine uptake. Results from this study contribute to the evidence base needed to improve ongoing and future communications about, and strategies to increase uptake of, vaccination.

Efficacy of a group-based education intervention for people with traumatic brain injury: supplementary results from a 12-month randomized controlled trial.

OBJECTIVE: Our team developed an attention control condition, called the Brain Health Group (BHG), for a randomized controlled trial (RCT; NCT03594734). The focus of the BHG was on brain health education and self-management. The objectives of this supplementary analysis are to (1) Describe compliance with the 12-month BHG; (2) Examine efficacy for improving general self-efficacy (GSE, primary) and secondary outcomes; and (3) Describe findings from the program evaluation. DESIGN: English-speaking adults (18-64 years old) who were ≥6 months post a moderate-to-severe TBI were randomized to the BHG (n = 29) or active intervention (n = 28). Data were collected at baseline and 12 months, including GSE, depression, satisfaction with life (SWL), self-rated abilities for health practices (SRAHP), and alcohol use. Program evaluation was conducted at 12 months. RESULTS: Attendance was 89%, and goal tracking was 63%. Within group analysis showed a significant increase in SRAHP scores (p = 0.018). Non-significant increases in GSE and SWL were observed, and participants perceived the BHG as helpful. No significant changes in depression or alcohol use were reported. CONCLUSION: People with TBI can engage in and benefit from the BHG and perceive the program as helpful for improving knowledge about brain health and awareness of self-management skills.

Longitudinal validation of the Fear of COVID-19 Scale in a nationwide United States sample: An item response theory model across three inflection points of the pandemic.

The COVID-19 pandemic's global emergence/spread caused widespread fear. Measurement/tracking of COVID-19 fear could facilitate remediation. Despite the Fear of COVID-19 Scale (FCV-19S)'s validation in multiple languages/countries, nationwide United States (U.S.) studies are scarce. Cross-sectional classical test theory-based validation studies predominate. Our longitudinal study sampled respondents to a 3-wave, nationwide, online survey. We calibrated the FCV-19S using a unidimensional graded response model. Item/scale monotonicity, discrimination, informativeness, goodness-of-fit, criterion validity, internal consistency, and test-retest reliability were assessed. Items 7, 6, and 3 consistently displayed very high discrimination. Other items had moderate-to-high discrimination. Items 3, 6, and 7 were most (items 1 and 5 the least) informative. [Correction added on 18 May 2023, after first online publication: In the preceding sentence, the term 'items one-fifth least' has been changed to 'items 1 and 5 the least'.] Item scalability was 0.62-0.69; full-scale scalability 0.65-0.67. Ordinal reliability coefficient was 0.94; test-retest intraclass correlation coefficient 0.84. Positive correlations with posttraumatic stress/anxiety/depression, and negative correlations with emotional stability/resilience supported convergent/divergent validity. The FCV-19S validly/reliably captures temporal variation in COVID-19 fear across the U.S.

BDNF and stress/mood-related interactions on emotional disorder symptoms, executive functioning, and deliberate self-harm.

Some prior research has suggested that the brain-derived neurotrophic factor (BDNF) gene may amplify responses related to life stress (e.g., depression and anxiety) or associated with negative moods (e.g., self-harm and diminished cognitive functioning). The purpose of this study was to investigate whether stress/mood-related associations with depressive and anxiety symptoms, deliberate self-harm, and executive functioning (EF) are moderated by genotypic variations in BDNF rs10835210 (a relatively understudied BDNF polymorphism) in a nonclinical sample. As part of a larger study, European American social drinkers (N = 132; 43.9% female; M age = 26.0, SD = 7.6) were genotyped for BDNF rs10835210 and were administered self-report measures of subjective life stress, depressive and anxiety symptoms, and history of non-suicidal self-injury (NSSI) and behavioral measures of EF and deliberate self-harm. Results indicated that BDNF significantly moderated the life stress associations with depressive symptoms and NSSI, the anxious mood association with EF, and the depressed mood association with deliberate self-harm behavior. Each of these BDNF × stress/mood interactions were characterized by stress/mood associations that were stronger in individuals with the AA genotype (homozygous for the minor allele) than in individuals possessing a genotype that included the major allele (AC or CC). The main limitations of the present study were use of a cross-sectional design, modest sample size, and investigating only one BDNF polymorphism. Despite these limitations and though preliminary, current findings suggest that variations in BDNF may confer vulnerability to stress or mood, which may result in more adverse emotional, cognitive, or behavioral outcomes.

Intentions to receive COVID-19 vaccines in the united states: Sociodemographic factors and personal experiences with COVID-19.

OBJECTIVES: Information regarding vaccination and the association with individuals' characteristics, experiences, and information sources is important for crafting public health campaigns to maximize uptake. Our objective was to investigate factors associated with intentions for COVID-19 vaccination among a sample of U.S. adults using a population-based cross-sectional survey. METHOD: Data were collected via an online questionnaire administered nationwide from January 4, to January 7, 2021 following the emergency use authorization for two SARS-CoV-2 mRNA-based vaccines. RESULTS: Of 936 U.S. adult respondents, 66% stated an intention to be vaccinated once a COVID-19 vaccine was available to them; 14.7% responded "maybe" and 19.6% "no." Unadjusted and multivariate associations revealed "no/maybe" vaccination intentions were associated with younger age, female, Black race, lower income, history of not receiving the influenza vaccine, lower fear of COVID-19, suffering moderate to severe reduction in access to food/nutrition, and lower trust in health care authorities, personal health care providers, and/or traditional news media as sources of COVID-19 information. Of respondents "maybe" intending to be vaccinated, 65% reported "a lot" of trust in personal health care providers as sources of COVID-19 information. Respondents stating "no" intention to be vaccinated were skeptical of all COVID-19 information sources considered. CONCLUSIONS: Our findings confirm observations predating COVID-19 vaccine availability regarding sociodemographic characteristics associated with vaccine hesitancy in the United States. We further identify personal health care providers as the most trusted information source among people who "maybe" intend to get vaccinated and demonstrate the challenge in reaching people not intending to be vaccinated. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Prevention of posttraumatic stress during inpatient rehabilitation post spinal cord injury: Study protocol for a randomized controlled trial of Brief Prolonged Exposure Therapy (Brief PE).

Background: Scant research has focused on posttraumatic stress disorder (PTSD) in the SCI population, despite high prevalence estimates. Fortunately, prolonged exposure therapy (PE) is a well-researched and highly effective treatment for PTSD. Our recent clinical trial showed that standard 12-session PE was effective for PTSD treatment among inpatients with SCI. Early intervention with brief PE (3-sessions) delivered in the emergency department has also been effective for PTSD prevention, but has not been tested among people post-SCI. Thus, we aim to conduct the first test of the Brief PE intervention to prevent PTSD among patients with SCI. Methods: Adults who have experienced a SCI (N = 200) will be randomly assigned during inpatient rehabilitation to either: (a) 3 60-min sessions of Brief PE (intervention group) or (b) treatment as usual (control group). Results: The primary outcome measure (PTSD symptoms measured by the PSSI-5) and secondary outcome measures (depression, anxiety, pain, quality of life, sleep disturbance, and resilience) will be assessed at baseline, 1-month, 3-months, and 6-months. Hierarchical linear modeling (HLM) will be used to evaluate the effectiveness of the PE intervention on PTSD and secondary outcomes. Descriptive statistics will examine feasibility and will include the number of participants enrolled, the number of sessions completed, fidelity of Brief PE delivery, and average scores for difficulty and helpfulness of the intervention scales for those randomized to intervention. Conclusions: Successful completion of this study will provide an evidence-based program to alleviate posttraumatic distress post spinal cord injury and prevent long-term development of PTSD.

Theory of planned behavior and college student 24-hour dietary recalls.

Objective: The transition to college is marked by poorer eating behaviors, making emerging adulthood a particularly salient intervention point for improving lifelong health. The present study aims to better understand what psychosocial factors predict eating behaviors of college students using the Theory of Planned Behavior (TPB). Participants & Methods: Dietary recalls were analyzed the Healthy Eating Index (HEI)-2015 scoring system for 67 university students between the ages of 18 and 25 (70.1% female; 49.3% White, 20.9% Black/African American, 13.4% Asian). Results: Haye's PROCESS Model 6 was used. The full model accounted for a significant amount of variance in HEI-2015 scores (F[3, 63] = 3.09, p = .033, R2 = .12). The final model suggested a significant indirect effect of PBC on the relation between ATT and HEI-2015 (ß = .859, SE = .637, 95% CI [.009, 2.482]). Conclusions: Although some college students might have favorable attitudes, only those who believe this is within their control actually ate a (somewhat) healthier diet.

Desire to drink as a function of laboratory-induced social stress among adolescents.

BACKGROUND AND OBJECTIVES: Research consistently demonstrates a link between social anxiety and alcohol-related problems; however, the majority of work has been retrospective, and conducted with adults. Despite an extensive literature highlighting coping-related motives as an underlying mechanism, real-time work presents mixed findings, and no published research has examined an adolescent sample using experimental psychopathology techniques. METHODS: The current study tested whether (1) history of social anxiety symptoms positively correlated with alcohol-related cognitions following laboratory-induced social stress, (2) state anxiety was positively correlated with alcohol-related cognitions, and (3) whether the nature of the stressor (performance versus rejection) impacted the strength of identified relations, in a sample of community-recruited adolescents reporting recent alcohol use. Participants (n = 114; Mage = 16.01; 64% girls) were randomly assigned to either a performance- or rejection-oriented task. RESULTS: Findings indicated that history of social anxiety symptoms was positively correlated with state anxiety elicited by both tasks. Further, history of social anxiety symptoms was not related to change in desire to drink, but was positively related to the belief that alcohol 'would make me feel better.' State anxiety was positively related to both desire to drink and relief outcome expectancies across both tasks. Finally, the nature of the task did not moderate responding. LIMITATIONS: Single site, community sampling confines interpretations, and the tasks did not fully perform as expected. CONCLUSIONS: Further study is needed; however, the current findings support the contention that socially-oriented distress may be a developmentally-relevant, malleable target for prevention efforts aimed at problematic alcohol use among adolescents.

Pain and emotional eating: further investigation of the Yale Emotional Overeating Questionnaire in weight loss seeking patients.

Providers frequently report pain as a barrier to weight loss yet the relationship between the pain experience and eating behavior is poorly understood. The current study examines overeating in response to physical pain (Pain Overeating). Weight-loss seeking Veterans (N = 126) completed the Yale Emotional Overeating Questionnaire, a measure used to assess the frequency of overeating in response to a range of emotions that was adapted to include a Pain Overeating item, and validated measures of pain, eating pathology, and mental health. Fifty-one participants (42.5%) engaged in at least one Pain Overeating episode in the past month, and 14.2% engaged in this behavior daily. Pain Overeating was significantly related to pain intensity and interference, and accounted for statistically significant variance in predicting BMI, eating pathology and depression. Findings suggest eating in response to physical pain is common among weight-loss seeking Veterans and may have important implications for weight management treatment.

Indirect Associations of Anxiety Sensitivity with Tobacco, Alcohol, and Other Drug Use Problems Through Emotional Disorder Symptoms in Adolescents.

Theoretically, anxiety sensitivity-fear of anxiety symptoms-enhances perception of and emotional reactivity to autonomic arousal and mental distress, thereby increasing negative affect and motivation to use substances for negative reinforcement. Because no prior study of adolescents has tested if anxiety sensitivity is indirectly associated with substance use problems through symptoms of emotional disorders (i.e., disorders involving high levels of negative affect), the current cross-sectional study examined this theoretical pathway. Participants included ninth-grade students from 10 different high schools in the Los Angeles metropolitan area (N = 3005; 54.3% female). Self-report measures of anxiety sensitivity, emotional disorder symptoms, tobacco dependence, and alcohol and other drug problems were administered. Controlling for sex, race/ethnicity, parental education, school, and impulsiveness, we tested the associations of anxiety sensitivity with tobacco, alcohol, and other drug use problems as well as the indirect effects of anxiety sensitivity on each domain of substance use problems through emotional disorder symptoms. Anxiety sensitivity was associated with more severe tobacco dependence and greater alcohol problems and other drug problems, and anxiety sensitivity further was indirectly associated with all three domains of substance use problems through emotional disorder symptoms. Current findings suggest that adolescents high in anxiety sensitivity tend to experience emotional disorder symptoms, which may increase risk for substance use problems. Interventions that target anxiety sensitivity and enhance negative-affect coping skills may assist in preventing and reducing adolescent substance use problems.

Real-time social stress response and subsequent alcohol use initiation among female adolescents.

Adolescents who are particularly sensitive to social stress may be vulnerable to earlier alcohol consumption and related problems. Although a small literature supports this contention, previous studies mostly relied on retrospective self-report. The current study used discrete-time survival analysis (DTSA) to test whether real-time social stress responding (via laboratory induction) and social anxiety symptoms predicted 12-month alcohol onset in an alcohol-naïve sample of young female adolescents. Anxiety elicited by the task was expected to predict greater and earlier rates of alcohol incidence, particularly among girls with higher levels of self-reported social anxiety symptoms. Participants were 104 community-recruited girls (ages 12-15 years) who completed a modified Trier Social Stress Test and questionnaires; follow-up calls were conducted at 3, 6, 9, and 12 months after the laboratory visit. Self-reported anxiety was assessed in response to the stressor following acclimation (baseline), instruction (anticipation), and speech (posttask). By 12 months, 30.8% of the sample had consumed a full alcoholic beverage. The DTSA revealed that girls with higher levels of social anxiety and greater elevations in anticipatory (but not posttask) anxiety compared to baseline had earlier alcohol initiation. This is the first study to examine the role of both laboratory-induced anxious responding and retrospective reports of social anxiety as prospective predictors of alcohol incidence. These preliminary findings suggest that adolescent girls who are more sensitive to social stress may be at risk for experimenting with alcohol earlier than their peers. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Social anxiety, disengagement coping, and alcohol-use behaviors among adolescents.

BACKGROUND AND OBJECTIVES: Although research indicates that social anxiety (SA) is associated with problematic drinking, few studies have examined these relations among adolescents, and all alcohol-related assessments have been retrospective. Socially anxious youth may be at risk to drink in an effort to manage negative affectivity, and a proclivity toward disengagement coping (e.g. avoidance of aversive stimuli) may enhance the desire to drink and learning of coping-related use. DESIGN: Adding to research addressing adolescent SA and alcohol use, the current study examined (1) proportional drinking motives (subscale scores divided by the sum of all subscales), (2) current desire to drink in a socially relevant environment (introduction to research laboratory), and (3) the indirect effect of retrospectively reported disengagement in social stress contexts on proportional coping motives and desire to drink. METHOD: Participants were 70 community-recruited adolescents who reported recent alcohol use. Level of SA, disengagement coping, drinking motives, and desire to drink following laboratory introduction were assessed. RESULTS: Proclivity toward disengagement in prior socially stressful contexts accounted for significant variance in the positive relations between SA and both proportional coping motives and current desire to drink. CONCLUSIONS: These data complement existing work. Continued efforts in building developmentally sensitive models of alcohol use are needed.