Meta‐Analysis of Integrated Primary and Behavioral Health Care Interventions for Treating Substance Use Among Adults

This meta‐analysis detected low effects in reducing substance use (Hedges's g = –0.11) in favor of using integrated primary and behavioral health care (IPBH) compared with treatment‐as‐usual approaches for adult patients with substance use. The impact of IPBH was limited.     

Age differences in the neural response to negative feedback

Affective processing is one domain that remains relatively intact in healthy aging. Investigations into the neural responses associated with reward anticipation have revealed that older and younger adults recruit the same midbrain reward regions, but other evidence suggests this recruitment may differ depending on the valence (gain, loss) of the incentive cue. The goal of the current study was to examine functional covariance during gain and loss feedback in younger and healthy older adults. A group of 15 older adults (mean age = 68.5) and 16 younger adults (mean age = 25.4) completed a revised Monetary Incentive Delay task (rMID; Knutson, Westdorp, Kaiser, &; Hommer, 2000) while in the fMRI scanner. The rMID is a reaction time task where successful performance, either gaining a reward or avoiding a loss, is defined by hitting a button during the brief presentation of a visual target. Participants receive gain and loss anticipation cues before each trial and feedback after each trial with four possible outcomes: +$5.00, +0.00, -$5.00, and -Affective processing is one domain that remains relatively intact in healthy aging. Investigations into the neural responses associated with reward anticipation have revealed that older and younger adults recruit the same midbrain reward regions, but other evidence suggests this recruitment may differ depending on the valence (gain, loss) of the incentive cue. The goal of the current study was to examine functional covariance during gain and loss feedback in younger and healthy older adults. A group of 15 older adults (mean age = 68.5) and 16 younger adults (mean age = 25.4) completed a revised Monetary Incentive Delay task (rMID; Knutson, Westdorp, Kaiser, & Hommer, 2000) while in the fMRI scanner. The rMID is a reaction time task where successful performance, either gaining a reward or avoiding a loss, is defined by hitting a button during the brief presentation of a visual target. Participants receive gain and loss anticipation cues before each trial and feedback after each trial with four possible outcomes: +$5.00, +0.00, -$5.00, and -$0.00. Using seed-voxel partial least squares analyses, with seed voxels in the caudate and ventromedial prefrontal cortex, whole-brain functional covariance revealed that younger and older adults engage the same network of regions to support general feedback processing. However, older adults engaged two additional networks to support processing of negative feedback, gain_miss (+0), loss_miss (-$5), and loss_hit (?0), specifically. These findings are in line with theories of a positivity effect in aging and may have implications for reward-stimulus learning and decision making following performance-contingent negative feedback.     

Psychological Factors that Link Socioeconomic Status to Depression/Anxiety in Patients with Systemic Lupus Erythematosus

Our analyses examined whether reserve capacity factors would explain the relationship between socioeconomic status (SES) and symptoms of depression/anxiety in patients with systemic lupus erythematosus (SLE). We assessed disease activity, depression/anxiety symptoms, and intrapersonal and interpersonal reserve capacity measures in 128 patients with SLE. Multiple meditational analyses revealed that intrapersonal and interpersonal psychosocial aspects of reserve capacity fully mediated the relationship between SES and depression/anxiety. Lower SES was indirectly associated with higher symptoms of depression and anxiety through the effects of psychosocial resilience. Interventions aimed at improving modifiable reserve capacity variables, such as self-esteem and optimism, may improve anxious/depressive symptomatology in patients with SLE.     

Does social environment influence learning ability in a family-living lizard?

Early developmental environment can have profound effects on individual physiology, behaviour, and learning. In birds and mammals, social isolation during development is known to negatively affect learning ability; yet in other taxa, like reptiles, the effect of social isolation during development on learning ability is unknown. We investigated how social environment affects learning ability in the family-living tree skink (Egernia striolata). We hypothesized that early social environment shapes cognitive development in skinks and predicted that skinks raised in social isolation would have reduced learning ability compared to skinks raised socially. Offspring were separated at birth into two rearing treatments: (1) raised alone or (2) in a pair. After 1 year, we quantified spatial learning ability of skinks in these rearing treatments (N = 14 solitary, 14 social). We found no effect of rearing treatment on learning ability. The number of skinks to successfully learn the task, the number of trials taken to learn the task, the latency to perform the task, and the number of errors in each trial did not differ between isolated and socially reared skinks. Our results were unexpected, yet the facultative nature of this species’ social system may result in a reduced effect of social isolation on behaviour when compared to species with obligate sociality. Overall, our findings do not provide evidence that social environment affects development of spatial learning ability in this family-living lizard.     

Complexity of online gender confirmation resources surpass patient literacy

Background: Increasing transgender health care coverage has resulted in easier access to gender confirmation surgery. Patients considering surgery consistently access medical information online to improve knowledge regarding surgical options, complications, recovery, and life after transitioning. As a result, national health institutes recommend that patient educational materials be written at a sixth-grade–reading level. The purpose of this study is to assess the complexity of online gender confirmation surgery information.

Methods: An Internet search was performed using the key phrase “transgender surgery”. Health care and non–health care websites were evaluated for pertinent articles regarding gender confirmation surgery. Readability analyses were conducted using Flesch-Kincaid Grade Level, Gunning Fog Index, Coleman-Liau Index, Simple Measure of Gobbledygook Index, and Automated Readability Index. A two-tailed z test was used to compare means; significance was set at p ≤ 0.05.

Results: A total of 108 articles from 87 websites were analyzed. The average readability for all online gender confirmation-surgery information was at an 11th-grade reading level. Materials written by health care entities were written at a 12th-grade–reading level compared to non–health care articles, which were written at a 10th-grade level (p < 0.001). Male-to-female surgery materials were written at a 12th-grade level, significantly higher than the 11th-grade reading level of female-to-male surgery materials (p = 0.04).

Conclusion: Online information regarding gender confirmation surgery is written at a level that is too complex for patients to understand. Informational materials should be written at lower grade levels to improve patient education, informed consent, and outcomes.     

Family Resource Allocation after Firstborns Leave Home: Implications for Secondborns' Academic Functioning

This study assessed secondborn adolescents' perceptions of changes in the allocation of family resources following their firstborn siblings' departure from home after high school, and whether perceived changes were related to changes over 1 year in secondborns' academic functioning. Participants were secondborn siblings (mean age = 16.58, SD = 0.91) from 115 families in which the older sibling had left the family home in the previous year. Allocation of resources was measured via coded qualitative interviews. Most (77%) secondborns reported increases in at least one type of family resource (i.e., parental companionship, attention, material goods), and many reported an increase in multiple types of resources in the year following their older sibling's departure. Consistent with resource dilution theory, perceptions of increases in fathers' companionship, fathers' attention, and mothers' companionship were related to improvements over time in secondborns' academic functioning.     

Preparing the Field for Feasibility Testing of a Parenting Intervention for War‐Affected Mothers in Northern Uganda

In this article, we discuss the successful implementation of an adapted evidence‐based parenting intervention for families affected by two decades of war in Northern Uganda. The adaptation and adoption of such interventions to support mental health and family functioning is widely endorsed by prevention scientists and considered a priority in global mental health. The preparation and early adoption phases of engaging with a highly vulnerable community affected by war trauma are documented in this paper along with a discussion of the steps taken to adapt a parenting intervention for cultural and contextual fit. This study is a component of an overall program of research aimed at reducing the long‐term negative effects of war on parenting practices and childhood outcomes, which have considerable implications for preventing mental, neurological, and substance‐use disorders. The processes described here cover a 4‐year period culminating in the implementation of the nine‐session Enhancing Family Connection intervention piloted with a group of 14 mothers. The lessons in cultural adaptation have been valuable and the feasibility results promising for further testing the intervention.     

Effects of Social Norms Information and Self-Affirmation on Sugar-Sweetened Beverage Consumption Intentions and Behaviors

The separate and combined efficacy of a social norms and a self-affirmation intervention to motivate decreased sugar-sweetened beverage (SSB) consumption was examined in 2 experiments. College students were randomly assigned to receive information about SSB consumption risks, norms, both, or neither. In addition, participants performed either a self-affirmation or control task. Self-affirmation only weakly affected SSB consumption intentions and behaviors. However, participants in Experiment 2 who received risks information, norms information, or both reported greater SSB reduction intentions than did those who received no information. Two weeks later, those who received both types of information reported more frequent behavior change preparations, and it appears this effect may have been partially mediated by the changes in intentions to reduce SSB consumption.     

A First Step to a Conceptual Framework of Parent Empowerment: Exploring Relationships Between Parent Empowerment and Academic Performance in a National Sample

This study tested a parent empowerment framework using a national sample of 9,982 parents from the Parent and Family Involvement Survey (National Center for Education Statistics, 2007 ) to investigate relationships between parent empowerment and children's academic performance. A multinomial logistic regression demonstrated significant relationships between parents' competence, self‐determination, community belonging, community participation, and academic performance, which differentiate among parents based on racial/ethnic, language, and socioeconomic backgrounds. Findings highlight the importance of parent empowerment interventions that consider structural barriers in schools.