A pilot study of experiencing racial microaggressions, obsessive-compulsive symptoms, and the role of psychological flexibility.

BACKGROUND: Experiencing racial microaggressions has clear effects on physical and psychological health, including obsessive-compulsive disorder symptoms (OCS). More research is needed to examine this link. Psychological flexibility is an important process to examine in this work. AIMS: This study aimed to examine if, while controlling for depression and anxiety, experiences of microaggressions and psychological flexibility helped explain OCD symptoms within a university-affiliated sample (undergraduate, graduate and law students). This was a pilot exploration of the relationships across themes. METHOD: Initial baseline data from a longitudinal study of psychological flexibility, OCD symptoms, depression, anxiety and experience of microaggressions was utilized. Correlations and regressions were utilized to examine which OCD symptom dimensions were associated with experiencing racial microaggressions in addition to anxiety and depression, and the added role of psychological flexibility was examined. RESULTS: OCD symptoms, experiences of microaggressions and psychological flexibility were correlated. Experiences of racial microaggressions explained responsibility for harm and contamination OCD symptoms above and beyond psychological distress. Exploratory results support the relevance of psychological flexibility. CONCLUSION: Results support other work that experiences of racial microaggressions help explain OCS and they add some support for psychological flexibility as a relevant risk or protective factor for mental health in marginalized populations. These topics should be studied longitudinally with continued consideration of all OCD themes, larger sample sizes, intersecting identities, clinical samples, and continued exploration of psychological flexibility and mindfulness and values-based treatments.

Media guidelines for the responsible reporting and depicting of non-suicidal self-injury.

Media coverage of non-suicidal self-injury (NSSI) ranges from providing helpful education to displaying graphic images. We offer the first research-informed, consensus-based guidelines for the responsible reporting and depicting of NSSI in the media, while also advising on ideas for dissemination and collaboration between media professionals and healthcare experts.

Outcomes of a Tailored Intervention for Cigarette Smoking Cessation Among Latinos Living With HIV/AIDS.

INTRODUCTION: Tobacco use has emerged as a leading killer among persons living with HIV, with effective approaches to tobacco treatment still unknown. HIV infection is nearly 3 times as prevalent in Latinos than in non-Latino Whites. This study reports the results of a randomized trial comparing a tailored intervention to brief counseling for smoking cessation among Latino smokers living with HIV (LSLWH). METHODS: LSLWH (N = 302; 36% female, 10% employed full-time, 49% born in United States) were randomized to 4 in-person sessions of a tailored intervention (Aurora) or 2 in-person sessions of brief advice (enhanced standard care [ESC]). Both groups received 8 weeks of nicotine replacement therapy (NRT) patch. Biochemically validated 6- and 12-month 7-day point-prevalence abstinence (PPA) rates were compared, along with secondary outcomes (e.g., reduction to light smoking, NRT adherence). RESULTS: Seven-day PPA rates reached 8% versus 11% at 6 months and 6% versus 7% at 12 months, for Aurora and ESC, respectively, with no between-group differences (p values > .40). Significant changes from baseline to 6 and 12 months among intervention targets were noted (percentage reduction in heavy smoking and dependence; increases in knowledge and self-efficacy). Baseline smoking frequency, older age, and higher intensity of patch use during the trial emerged as significant predictors of abstinence at 6 months. CONCLUSIONS: There was no evidence that the tailored intervention improved cessation rates. Interventions that encourage use of, and adherence to, empirically validated cessation aids require further development to reduce tobacco-related death and disease in this vulnerable population.

Longitudinal associations among change in overweight status, fear of negative evaluation, and weight-related teasing among obese adolescents.

OBJECTIVE: To examine longitudinal bidirectional associations between changes in adolescents' weight status and psychosocial constructs. METHOD: 118 obese adolescents aged 13-16 years participated in a behavioral weight control intervention. Percent overweight (OW), fear of negative evaluation (FNE), and frequency of weight-related teasing (WRT) were collected at baseline, end of intervention, and 12 and 24 months post-randomization. 3 multivariate latent change score models were estimated to examine longitudinal cross-lagged associations between: (1) OW and FNE; (2) OW and WRT; and (3) FNE and WRT. RESULTS: Decreases in OW were prospectively associated with subsequent decreases in both FNE and WRT; however, changes in FNE and WRT were not prospectively associated with subsequent change in OW. Decreases in FNE were prospectively associated with subsequent decreases in WRT. CONCLUSION: Moderate weight loss in the context of a behavioral weight control intervention has positive long-term implications for obese adolescents' peer relations.

Concrete images of the sugar content in sugar-sweetened beverages reduces attraction to and selection of these beverages.

In the present research, we offer a novel method for informing consumers about the sugar content in sugar-sweetened beverages (SSBs). With a series of experiments, we present evidence that this method curbs preference for SSBs and leads to more negative attitudes toward SSBs. We propose that people view SSBs more negatively and show less preference for SSBs when they are able to concretely visualize the quantity of sugar in SSBs. For example, we suggest that people might have more negative views toward the idea of consuming 28 sugar cubes (concrete information), compared to consuming "70g" of sugar (abstract information). Indeed, we found that, without any intervention, people struggle to convert sugar grams into a concrete, physical sugar representation (Experiment 1). But, when people are provided ways to convert abstract sugar-nutrition information into a concrete representation, they find SSBs less attractive (Experiment 2) and are less likely to select SSBs in favor of sugar-free beverage options (Experiments 3 and 4). These findings offer direct applications to the design of public-health messages and nutrition-education interventions. Such applications might benefit society in its battle with the obesity epidemic.

Anxiety, OCD, Psychological Flexibility, and Depression: A Replication With Racially Minoritized University Students.

OCD and anxiety are both associated with depression and suicide, but there is a need for comprehensive assessment and screening of depression risk factors within ethnically and racially minoritized college students. In total, 128 university students were surveyed in 2022 in the northeastern United States who all endorsed at least one non-white racial identity. They completed measures of anxiety, depression, OCD symptoms and psychological flexibility. Results supported that anxiety and OCD symptoms were positively associated with high depression, and high psychological flexibility was associated with low depression. Results support continued screening and intervention for anxiety and OCD symptoms to address depression in diverse young adults. Future work should continue to assess the protective effects of targeting psychological flexibility constructs and to assess longitudinal impacts of OCD symptoms and anxiety on depression.

Associations between parent behavior and adolescent weight control.

OBJECTIVE: To evaluate associations between parent behaviors (i.e., parent weight change, self-monitoring of their behavior, and feeding practices and attitudes) and changes in adolescent BMI and weight following 16-weeks of behavioral weight control (BWC) intervention. METHOD: Adolescents (N = 86) 13-16 years old and 30-90% overweight (M = 60.54%, SD = 15.10%) who completed BWC intervention and their parents. Adolescents were randomized to 1 of 2 interventions involving 16 consecutive weeks of active treatment with 4 biweekly maintenance sessions. Adolescent weight and BMI were measured at baseline and 16-weeks. Feeding practices were measured at baseline. Parent self-monitoring was measured during the intervention. RESULTS: The only independently significant predictor of adolescent BMI change (p < .01) was parent BMI change. Greater parent self-monitoring (p < .01) predicted greater adolescent weight loss. Greater parent pressure to eat predicted less adolescent weight loss (p < .01). CONCLUSIONS: Findings highlight the potential importance of parent weight-related behaviors and feeding practices in the context of adolescent BWC.

Behavioral weight control treatment with supervised exercise or peer-enhanced adventure for overweight adolescents.

OBJECTIVE: To evaluate the efficacy of behavioral weight control intervention with a peer-enhanced activity intervention versus structured aerobic exercise in decreasing body mass index (BMI) and z-BMI in overweight adolescents. STUDY DESIGN: Participants were randomized to 1 of 2 group-based treatment conditions: (1) cognitive behavioral treatment with peer-enhanced adventure therapy or (2) cognitive behavioral weight control treatment with supervised aerobic exercise. Participants included 118 overweight adolescents, ages 13 to 16 years, and a primary caregiver. Changes in BMI, standardized BMI, percent over BMI, and waist circumference were examined. RESULTS: Analysis of variance on the basis of intent-to-treat indicated significant decreases in all weight change outcomes at the end of treatment, with significant decreases maintained at the 12-month follow-up. No differences in treatment conditions were observed. Secondary analyses indicated that adherence with attendance and completion of weekly diet records contributed significantly to reductions in BMI. CONCLUSIONS: A cognitive behavioral weight control intervention combined with supervised aerobic exercise or peer-enhanced adventure therapy is equally effective in short-term reduction of BMI and z-BMI in overweight adolescents. Adherence, as measured with session attendance and self-monitoring, is a key dimension of weight change.

Advocacy for improved response to self-injury in schools: A call to action for school psychologists.

Over the past several years, nonsuicidal self-injury (NSSI) has emerged as a widespread concern in school settings worldwide. However, despite significant strides in NSSI research, there remains a substantial knowledge gap with respect to what school staff know. Unfortunately, this can contribute to stigma and ineffective responding when working with students who self-injure. In light of its high rates and the risks with which NSSI associates, including death by suicide, this is worrisome. Accordingly, there is a pressing need for advocacy in schools to ensure that NSSI is prioritized and for proper knowledge and training be offered to school staff. The current article serves as a call to action for school psychologists as leaders and advocates in meeting these needs. We begin by articulating the central issues pertinent to low NSSI literacy and high NSSI stigma in schools, followed by a series of research-informed recommendations for timely and effective advocacy. By virtue of undertaking these initiatives, school staff will be better able to respond to the needs of youth who self-injure and advocate for them. This, in turn, can foster an enhanced school climate and greater student well-being. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Addressing Self-Injury in Schools, Part 1: Understanding Nonsuicidal Self-Injury and the Importance of Respectful Curiosity in Supporting Youth Who Engage in Self-Injury.

Nonsuicidal self-injury (NSSI) is defined as the deliberate, self-inflicted damage of body tissue without suicidal intent and for purposes not socially or culturally sanctioned. School nurses are often a first point of contact for young people experiencing mental health challenges, and yet they often report they lack knowledge and training to provide care for persons who engage in NSSI. In the first of two parts, this article provides school nurses with a better understanding of NSSI and the distinctions between NSSI and suicidal behaviors, discusses the role of nurses' knowledge and attitudes on their ability to care for their patients' mental health needs, and discusses approaches for developing a respectful, empathic manner for working with and supporting youth who engage in self-injury. Part 2 will offer a strategy for brief assessment of NSSI and reflect on two case studies and their implications for school nursing practice.

Addressing Self-Injury in Schools, Part 2: How School Nurses Can Help With Supporting Assessment, Ongoing Care, and Referral for Treatment.

Nonsuicidal self-injury (NSSI) is defined as the deliberate, self-inflicted damage of body tissue without suicidal intent and for purposes not socially or culturally sanctioned. School nurses are often a first point of contact for young people experiencing mental health challenges, and yet they often report they lack knowledge and training to provide care for persons who engage in NSSI. In the second of two parts, this article offers a strategy for brief assessment of NSSI, as well as reflection on two case studies and how to offer support, ongoing care, and referral for treatment to youth who engage in self-injury.

A prospective study of weight gain during the college freshman and sophomore years.

OBJECTIVE: To assess the prevalence of weight gain among male and female college freshmen. METHODS: Study 1 examined weight change over freshman and sophomore years among 904 students attending a state university in Indiana, from 2002-2004. Study 2 examined weight and BMI change over the freshman year among 382 students attending a private university in Rhode Island, from 2004-2006. RESULTS: 77% of Study 1 participants and 70% of Study 2 participants gained weight during their freshman year, largely during the first semester. In Study 1, weight gain averaged 3.5 kg in females and males; in Study 2, weight gain averaged 1.6 kg for females and 2.5 kg for males. Students continued to gain weight their sophomore year, with females 4.2 kg and males 4.3 kg heavier than at start of college. Overweight/obesity rates increased from baseline to end of freshman year for Study 1 (21.6% to 36%) and Study 2 participants (14.7% to 17.8%). CONCLUSION: The first years of college may be a critical developmental window for establishing weight gain prevention efforts.

HIV-positive smokers considering quitting: differences by race/ethnicity.

OBJECTIVE: To better characterize smoking in HIV-positive individuals and to identify critical components of a targeted smoking cessation intervention for multiethnic HIV-positive smokers. METHODS: Differences in baseline characteristics of 444 HIV-positive smokers were examined by race, and a multivariate linear regression model evaluated factors associated with nicotine dependence in an HIV-positive population, with a particular emphasis on race/ethnic differences. RESULTS: Low smoking self-efficacy and higher contemplation of quitting were predictive of greater nicotine dependence. An interaction between age and race was noted, with older Hispanic Americans less likely to be nicotine dependent. CONCLUSIONS: Efforts should be made to tailor smoking cessation intervention content to HIV-positive racial/ethnic minority groups.

The relationship between alcohol use, eating habits and weight change in college freshmen.

PURPOSE: This study aims to improve understanding of how alcohol consumption in college freshmen affects eating patterns before, during, and after drinking, as well as its relation to body weight change. METHODS: Two hundred eighty-two college freshmen (61% female; 59% Caucasian) completed measures of alcohol use, measured body mass index (BMI), and eating and activity habits before, during and following drinking episodes. Students were categorized by drinking status (non-drinker, low-risk, and moderate/high-risk) in order to explore group differences. RESULTS: Seventy-five percent of the sample reported past-month alcohol consumption, with 65% (N=134) of these categorized as "low-risk" drinkers and 35% (N=72) as "moderate-risk" drinkers. Moderate-risk drinkers were more likely than low-risk drinkers to report increases in appetite after drinking, with nearly half of students reporting overeating and making unhealthy food choices following drinking. Moderate-risk drinkers also demonstrated significant increases in 1st semester BMI change, relative to non-drinkers and low-risk drinkers. CONCLUSIONS: Eating patterns for a significant number of college students are altered before, during, and following drinking episodes, which related to change in freshman year BMI.

Consistency of self-reported smoking over a 6-year interval from adolescence to young adulthood.

AIMS: To examine the reliability of self-report cigarette smoking questions by describing recanting (denial of previous smoking reports) in a nationally representative sample of US adolescents followed throughout young adulthood. Predictors of recanting across stages of smoking uptake/progression are examined. DESIGN: A total of 12 985 respondents to cigarette smoking questions during in-home interviews at waves I and III (6 years apart) of the National Longitudinal Study of Adolescent Health (Add Health). The sample survey procedures of Stata 9.0 were used to produce nationally representative estimates, with standard errors adjusted for both clustering at the school level and stratification by geographical region. MEASUREMENTS: Recanting probabilities determined by reports of stages of smoking uptake/progression at each time-point were predicted by race/ethnicity, parental education, household income, poverty level, depression and peer daily smoking. FINDINGS: Stage-specific results indicated that recanting is higher when the earlier smoking was less frequent/intense. Recanters were older, from lower-income households and had higher baseline depression levels. Non-Hispanic black youth were significantly more likely to recant previous smoking compared to non-Hispanic white youth, even in multivariate models controlling for socio-demographic variables. Predictors of recanting differed by level of tobacco involvement. The greater likelihood of non-Hispanic black respondents to deny previous smoking may be a reflection of less intense or more intermittent use of tobacco that leads to recall differences over time. CONCLUSIONS: Racial/ethnic subgroups and/or respondents endorsing depressive symptoms may be more vulnerable to misclassification during interpretation of national survey data and subsequently not identified properly for prevention/intervention programs.

Sex differences in biological response to peer rejection and performance challenge across development: A pilot study.

A pilot study of sex differences in biological response to peer rejection and performance challenges across development was conducted. Participants were 59 typically-developing children (ages 8-17; 58% girls); 59 children completed one challenge: 37 completed both challenges. Following a habituation session, participants completed peer rejection (exclusion challenges) and/or performance (speech, arithmetic, tracing) stress sessions. Saliva cortisol and alpha amylase (AA) were measured throughout. Post-pubertal girls showed increased AA and equivalent cortisol output in response to rejection vs. performance; pre-pubertal girls showed heightened cortisol and AA response to performance vs. rejection. Boys showed similar biological responses across puberty, with pre- and post-pubertal boys demonstrating heightened cortisol, but equivalent AA output in response to performance vs. rejection stressors. Although results are preliminary, they suggest increases in relative sensitivity to rejection vs. performance stressors and malleability of stress response across development in girls, but stability of stress response across development in boys. Future, larger-scale, longitudinal studies are needed.

The natural history of college smoking: trajectories of daily smoking during the freshman year.

Although the initiation of cigarette use typically occurs prior to age 18, there is evidence for considerable change in smoking behavior after this age. College may be a particularly important period to study smoking because it is a time when adolescents transition into a new social context where substance use is normative. Using a longitudinal design, daily assessments of smoking were collected during the entire first year of college for a large cohort of freshman (N=496). Findings suggested a weekly cycle of smoking such that the probability of smoking was much higher on weekends (Friday and Saturday) than on remaining days of the week. In addition to this weekly cycle, there was an overall trend for smoking to decline over the course of the year. Substantial individual variability in levels of smoking was observed. These findings provide new insights into college smoking, and have implications for assessment, policy, intervention, and future directions for research.

Research with adolescents who engage in non-suicidal self-injury: ethical considerations and challenges.

Non-suicidal self-injury (NSSI) has emerged as a significant psychiatric issue among youth. In addition to its high prevalence rates, NSSI is associated with a number of psychiatric issues and confers risk for varying degrees of physical injury. It is also a risk factor for attempted suicide. Thus, youth who engage in NSSI represent a vulnerable and high-risk population and researchers are likely to encounter a variety of ethical challenges when conducting NSSI research. Accordingly, it is critical that researchers be familiar with the major ethical issues involved in NSSI research and how to effectively account for and address them. This is important both prior to obtaining clearance from their Institutional Review Boards and when carrying out their research. To date, there is no consolidated resource to delineate the ethical challenges inherent to NSSI research and how these can be effectively navigated throughout the research process. The goals of this paper are to review international best practices in NSSI research across the various contexts within which it is studied, to offer guidelines for managing these issues, to identify areas in which variation in approaches prohibits decisive recommendations, and to generate questions in need of further consideration among scholars in this field.

Differentiating stages of smoking intensity among adolescents: stage-specific psychological and social influences.

Researchers' understanding of the impact of sociocultural and psychological factors on the various stages of adolescent smoking uptake is limited. Using national data, the authors examined transitions across smoking stages among adolescents (N = 20,747) as a function of interpersonal, familial, and peer domains. Peer smoking was particularly influential on differentiating regular smoking, whereas alcohol use was most influential on earlier smoking. Although significant, depression and delinquency were attenuated in the context of other variables. Higher school grade was more likely to differentiate regular smoking from earlier smoking stages, whereas African American ethnicity and connectedness to school and family were protective of smoking initiation. Results lend support for an interactional approach to adolescent smoking, with implications for stage-matched prevention and intervention applications.