Therapeutic setting as an essential component of psychedelic research methodology: Reporting recommendations emerging from clinical trials of 3,4-methylenedioxymethamphetamine for post-traumatic stress disorder.

Research of psychedelic assisted therapies is at an all-time high, though few studies highlight extra-pharmacological factors that may affect treatment efficacy. One critical set of attributes includes the therapeutic setting itself, which describe the physical and socio-cultural environments in which the drug-assisted session occurs. Despite enduring consensus of the influence of setting, recommendations for establishing and reporting key setting variables remain sparse across clinical trial protocols and published research methodologies. The purpose of this paper is to: (1) present what is known of the influence and implications of setting to psychedelic-assisted therapies, with a particular focus on 3,4-methylenedioxymethamphetamine (MDMA); and (2) propose a set of reporting guidelines for operationalizing and reporting key setting variables in clinical trials of psychedelic-assisted therapies, based on recommendations emerging from clinical trials of MDMA for PTSD. In fact, recommendations should be expanded to "set" - the subject's mood, expectations, and broader psychological condition - once this is more fully developed in the field. The proposed reporting guidelines offer a means of increasing the volume and variability of data necessary for future empirical examination of key setting attributes influencing treatment efficacy, while preserving practitioner and patient autonomy to co-construct adaptive therapy settings according to their respective needs and expertise.

An improved method for the determination of cannabidiol in topical products using ultrasound-assisted extraction and gas chromatography-mass spectrometry.

The recent surge in the sale of cannabidiol (CBD)-based topicals has risen rapidly in recent years, as it can be used to treat a multitude of skin disorders. However, there is minimal regulation concerning actual CBD content in these products. Topicals on the market may contain various concentrations of CBD and may be combined with a range of other compounds. The concentration of CBD has to be determined before the products enter the market. For this reason, a selective analytical method was developed using a 23 factorial design; and validated to determine CBD content in various topicals based on ultrasound-assisted extraction (UAE) followed by gas chromatography coupled to mass spectrometry (GC-MS). The method showed good precision (relative standard deviation ≤ 7.7%), accuracy at three concentration levels (recovery > 97.9%) for three different matrices, acceptable linearity (R2 > 0.99), and limit of detection (0.05 µg/mg). The method was successfully applied to the analysis of five commercial topicals. The proposed method is rapid, sensitive, precise, and accurate. In addition, it does not require derivatization and it is suitable for the determination of CBD in topicals for quality control purposes.

The Family Health Scale: Reliability and Validity of a Short- and Long-Form.

Families strongly influence the health of communities and individuals across the life course, but no validated measure of family health exists. The absence of such a measure has limited the examination of family health trends and the intersection of family health with individual and community health. The purpose of this study was to examine the reliability and validity of the Family Health Scale (FHS), creating a multi-factor long-form and a uniform short-form. The primary sample included 1,050 adults recruited from a national quota sample Qualtrics panel. Mplus version 7 was used to analyze the data using a structural equation modeling framework. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) confirmed a 32-item, 4-factor long-form scale. The four factors included (1) family social and emotional health processes; (2) family healthy lifestyle; (3) family health resources; and (4) family external social supports. A 10-item short-form of the FHS was also validated in the initial sample and a second sample of 401 adults. Both the long-form and short-form FHS correlated in the expected direction with validated measures of family functioning and healthy lifestyle. A preliminary assessment of clinical cutoffs in the short-form were correlated with depression risk. The FHS offers the potential to assess family health trends and to develop accessible, de-identified databases on the well-being of families. Important next steps include validating the scale among multiple family members and collecting longitudinal data.

Building a Foundation for Family Health Measurement in National Surveys: A Modified Delphi Expert Process.

INTRODUCTION: Families are the most proximal and powerful context for the development, promotion, and disruption of health of individuals across the life course. Despite families' critical role in health, U.S. nationally representative health surveys lack comprehensive and standardized assessments of family health and functioning. METHODS: To foster research on family health in population surveys, we developed a conceptualization of family health using a modified Delphi process with family health experts. Experts responded online to produce consensus definitions of 'family' and 'family health.' Guided by these definitions, they responded to a survey to create a list of concepts for measurement of family health and ranked the importance and measurability of those concepts. RESULTS: We achieved consensus among 15 family health experts on definitions of 'family' and 'family health.' Thirty-one family health concepts were organized into six domains, then ranked by relevance and importance as follows: (1) "Family relationships" and "family social context" tied for first priority, (2) "family member health, (3) "family health-related practices," (4) "family health resources," and (5) "management of time and activities." DISCUSSION: Social relationships and social environment were prioritized as more essential than other aspects of family environments typically assessed in population surveys, such as health practices and family members' illness and disease. This study develops the scientific groundwork needed to advance routine monitoring of family health in national health surveys and in child/family performance measures.

Differential effects of internalizing behaviors on academic functioning for girls versus boys: An analysis of developmental cascades from elementary to high school.

Youth's academic and emotional functioning are closely related, yet little is known about the timing and direction of relationships involving internalizing problems, which are characterized by over control of emotions, anxiety, and depression as well as multiple aspects of academic achievement. This study addresses these gaps using data from the Study of Early Child Care and Youth Development (N = 1,048) to examine the processes by which problems in one domain of functioning lead to problems in another, known as a "cascade effect." Results of longitudinal structural equation modeling indicate (a) a direct and indirect negative cascade effect from girls' internalizing problems to their school achievement in high school, (b) a positive contemporaneous association of 9th grade boys' internalizing problems with their cognitive achievement; and (c) ways in which demographic characteristics and adolescent social and maturational processes account for variation in functioning yet do not alter the processes by which the emotional and academic functioning interact. Results are discussed with regard to identifiying adolescents' internalizing problems, gender differences in the effects of internalizing problems on academic functioning, timing of evidence-based interventions, and implications for mental health promotion among girls.

Maternal psychosocial stress and children's ADHD diagnosis: a prospective birth cohort study.

Objective: Examine the association of mothers' psychosocial stressors before and during pregnancy with their children's diagnosis of attention deficit hyperactivity disorder (ADHD). Methods: This study included 2140 mother-child pairs who had at least one postnatal pediatric visit at the Boston Medical Center between 2003 and 2015. Child ADHD was determined via International Classification of Diseases, Ninth Revision (ICD-9) codes documented in electronic medical records. Latent factors of maternal stress and social support and measures of the physical home environment and psychosocial adversities were constructed using exploratory factor analysis. The association between the latent factors and child ADHD diagnosis was examined using multiple logistic regression, controlling for known risk factors for ADHD. Results: Children were 1.45 (95% CI: 1.06, 1.99) and 3.03 (95% CI: 2.19, 4.20) times more likely to receive an ADHD diagnosis if their mother experienced a major stressful event during pregnancy or reported a high level of perceived stress, respectively. The number of family adversities increases the risk of ADHD diagnosis [second quartile: OR = 1.90; CI (1.31, 2.77); third quartile: OR = 1.96 CI (1.34, 2.88); fourth quartile: OR = 2.89 CI (2.01, 4.16)] compared to first quartile. Conclusions: In this prospective, predominantly urban, low-income, minority birth cohort, mothers' psychosocial stress before and during pregnancy appears to be an independent risk factor for the development of ADHD in their children.

Prevalence of HIV Testing Provision at Community Organizations Serving Young People in a Mid-Atlantic City, 2013-2014.

OBJECTIVES: Little is known about the prevalence of human immunodeficiency virus (HIV) testing at community organizations or the organizational characteristics associated with testing. The objective of this study was to describe (1) the prevalence of HIV testing at community organizations serving young people in a mid-Atlantic urban city and (2) the characteristics associated with organizations that provide such testing. METHODS: We conducted telephone or in-person surveys between February 2013 and March 2014 with 51 directors and administrators of community organizations serving young people. We asked whether the organization provided HIV screening or testing, and we collected data on organizational characteristics (eg, setting, client, and staff member characteristics; services offered). We generated frequencies on measures and used Poisson regression analysis to examine the association between testing and organizational characteristics. RESULTS: Of the 51 organizations surveyed, 21 provided HIV testing. Of the 30 organizations that did not provide HIV testing, only 7 had a relationship with programs that did provide it. Characteristics associated with the provision of HIV testing included offering general health services (relative risk [RR] = 4.57; 95% confidence interval [CI], 1.68-12.48; P = .003) and referral services for sexually transmitted infection screening (RR = 5.77; 95% CI, 1.70-19.59; P = .005) and HIV care (RR = 4.78; 95% CI, 1.61-14.21; P = .005), as well as among administrators who perceived their staff members were comfortable talking with young people about sexual health (RR = 3.29; 95% CI, 1.28-8.49; P = .01). CONCLUSIONS: The prevalence of HIV testing provision at organizations serving young people in this mid-Atlantic city was low, and few organizations offered linkages to HIV testing. Strategies are needed to increase the provision of HIV testing at community organizations serving young people, whether through direct or linked approaches.