Feasibility and Acceptability of a Pediatric Primary Care Physician Training for Anxiety Screening and Evidence-based Intervention.

Anxiety is one of the most prevalent psychological conditions in the pediatric population, and its associated impairments often persist into adulthood. Pediatricians are in a unique position to screen, briefly intervene, and facilitate treatment to prevent long-term impacts. However, they often do not have adequate training to do so. The current study addressed this gap by providing a brief online educational workshop aimed to promote: (1) screening for anxiety and (2) follow-up with appropriate evidence-based interventions. Fifty-three providers participated, and 38 completed surveys pre- and post-training. Findings indicate acceptability of the training to providers, improved knowledge related to anxiety, and increased readiness to manage anxiety during a medical visit. This study supports the utility of a brief, online training on screening and provision of evidence-based treatment for anxiety in pediatric primary care.

Flourishing after traumatic spinal cord injury: Results from a multimethod study.

PURPOSE/OBJECTIVE: Adverse outcomes after traumatic spinal cord injury (TSCI) are not ubiquitous; that is, it is possible to thrive in the years after injury. Accordingly, we examined both the association between various factors and psychological flourishing, or ideal mental health, after TSCI, as well as the characteristics of adults with average or higher levels of psychological flourishing in terms of personality, social support, and executive functioning. RESEARCH DESIGN: This study included two phases. In Phase 1, we collected information on demographic, health, and psychosocial variables from 449 adults with chronic TSCI using a mail survey. In Phase 2, we completed individual in-person assessments with a subset of 58 individuals from Phase 1 who had endorsed at least average levels of psychological flourishing and collected data using standardized measures of personality, social support, and executive functioning. RESULTS: Phase 1 data indicated that being married, viewing oneself favorably in comparison to others, and reporting better subjective health ratings were significantly associated with higher levels of psychological flourishing. Phase 2 data suggested that, as a cohort, participants tended to display a resilient personality profile, report high-average levels of social support, and perform grossly within normal limits on a measure of executive functioning. CONCLUSION/IMPLICATIONS: Our findings highlight factors associated with positive psychological outcomes after TSCI. A resilient personality profile, good social support, and unimpaired executive functioning capabilities appear to characterize adults who flourish with chronic TSCI. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Using the novel functional purchase task to examine prescription stimulant drug effect preferences in college students.

Nonmedical prescription stimulant use (NMPSU) is a rising trend among college-age adults (18-25 years old). Survey research has identified several reasons for use, including enhancing cognitive, athletic, and social performance. Less is known about how relative reinforcing value differs based on the self-reported reasons for use. The commodity purchase task (CPT) is used to assess demand for substances such as alcohol and cigarettes and has been extended for NMPSU among college student users. However, this work has not been replicated for NMPSU or expanded to determine how reason for use affects drug demand. The aim of this study was to develop a novel functional purchase task (FPT) to measure demand for preferred stimulant-like drug effects (e.g., focus, academic achievement, energy). Undergraduate students (n = 116) recruited from two universities who endorsed lifetime NMPSU completed five hypothetical stimulant purchase tasks, one for stimulant medication and four based on their ordinal ranking of eight possible reasons for stimulant use. Results support using a CPT to measure the reinforcing value of prescription stimulants and found demand predicts past year NMPSU, but not other variables associated with use. Furthermore, there are multiple reinforcing functions of NMPSU among college students, and more preferred reasons for use corresponded with higher demand intensity and inelasticity on the FPT at the aggregate level but less so at the individual participant level. These results suggest the need for further work exploring the utility of a functional approach to measure demand as reinforcing value. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Characteristics of Individuals with Spinal Cord Injury Who Use Cannabis for Therapeutic Purposes.

Background: People with spinal cord injury (SCI) are accessing cannabis for therapeutic purposes (CTP), the use of which has been legalized in more than 20 states. In the past, illicit marijuana use had positive correlations with other health risk behaviors. It is not known whether access to CTP has shifted patterns of use and altered health outcomes. Objective: To describe the self-reported patterns of CTP use among individuals with SCI and correlations with health behaviors and health indicators. Method: Secondary analysis of data from a cross-sectional study involving community-dwelling individuals with chronic SCI and neurogenic bladder and bowel, at least 5 years post injury. Data were collected via structured interviews. Results: 92.2% of the current sample (n = 244) lived in states that, at the time of the study, permitted the use of CTP. 22.5% reported using CTP at least monthly to relieve pain (70.4%) and spasticity (46.3%). Of those 54 participants, 52.7% were daily users. Whereas 23.0% of non-CTP users endorsed having prescriptions for at least one opioid-based medication, 38.1% of CTP users did so, suggesting that CTP use does not mitigate opioid use. Users were more likely to be single and live alone, report more bladder complications, and perceive their psychosocial functioning as more compromised than non-users. Conclusion: A relatively large percentage of individuals with chronic SCI appear to use CTP on a regular basis. Results suggest that they may be more vulnerable to complications and to risk factors for substance use disorders in SCI, such as social isolation. Although the generalizability of these findings is limited by the sampling strategies and the eligibility criteria of the larger study, CTP use should be assessed and considered when planning health interventions.

A DBT Skills training group for family caregivers of persons with dementia.

A Dialectical Behavior Therapy Skills training manual (DBT Skills) was adapted for use with caregivers of individuals with dementia. Implementation occurred in a community clinic with a heterogeneous caregiver group at risk for elder abuse. Sixteen caregivers completed the 9-week group. The results point to improved psychosocial adjustment, particularly increased problem-focused coping, enhanced emotional well-being, and less fatigue. Caregivers tended to utilize individual therapeutic services at a higher rate during the period of group attendance, indicative of appropriate help-seeking behavior in highly demanding situations. Six of the 16 caregivers repeated the training sequence in "booster" groups. Follow-up data from the booster groups suggest that high-risk caregivers may require continuing support to maintain treatment gains. In addition to demonstrating the feasibility of DBT Skills with caregivers, the results warrant a controlled outcome evaluation.

A parametric study of cognitive defusion and the believability and discomfort of negative self-relevant thoughts.

A previous time-series study showed that rapidly repeating a single-word version of a negative self-referential thought reduced the discomfort and the believability associated with that thought. The present parametric study examined whether durations of word repetition were differentially effective in altering the discomfort and believability of negative self-referential thought. In two studies, both discomfort and believability varied systematically with the duration of word repetition. The effects of rapid repetition on emotional discomfort bottomed out after 3 s to 10 s of rapid repetition, whereas the effects on believability did so after 20 s to 30 s of repetition. This study lends support to the cognitive defusion interpretation of the effect of word repetition, suggesting that emotional discomfort and believability may be distinctive functional aspects of cognitive events.