Depression symptom profiles and long-term response to cognitive behavioral therapy plus contingency management for smoking cessation

Latent class analysis of depressive symptoms and associations with suicidal thoughts, plans, and attempts among a large national sample

BACKGROUND

Depression is strongly associated with risk for suicidal behaviors. However, depression is a highly heterogeneous condition (i.e. there are more than 200 combinations of DSM-5-TR depressive symptoms to correspond to a depression diagnosis). Limited research to date has taken an empirical approach to see how people cluster together based on their classification of depressive symptoms and whether people in certain classes are more likely to report suicide outcomes than other classes. This analysis leverages the National Survey on Drug Use and Health and examines classes of depressive symptoms to explore differences in suicide-related outcomes by class among adults endorsing depressive symptoms (n = 41 969).

METHODS

We used latent class analysis (LCA) to identify classes of individuals' DSM-5 depressive symptoms presentation and then explored differences in suicide-related outcomes (i.e. suicide plans, suicide attempts) by the resulting classes.

RESULTS

A four-class model was determined to optimize the fit criteria. Class 3 (high depressive symptoms) had significantly greater rates of suicide-related outcomes, followed by class 1 (high depressed mood and moderate worthlessness), with classes 4 and 2 having significantly lower rates of suicide-related outcomes.

CONCLUSIONS

The use of LCA provided valuable findings on the importance of leveraging both a multi-faceted assessment of depressive symptoms to identify cases where a high number of depressive symptoms are endorsed, and review of the specific symptoms endorsed. Worthlessness, in particular, may be of particular value to focus on within the context of suicide prevention.

Effectiveness of Contingency Management in Tobacco Smokers with Depressive Symptoms: A Systematic Review

Background: Effective interventions are required to address tobacco smoking in people with depressive symptomatology. In this context, contingency management could be one useful therapeutic strategy. Objectives: This study is a systematic review of tobacco cessation interventions for smokers with depressive symptomatology including a contingency management component, evaluating their efficacy with regards to tobacco abstinence, depressive symptomatology, adherence to treatment and other variables related to tobacco use. For this purpose, a search was carried out in Pubmed, PsycINFO, Cochrane, Web of Science and ClinicalTrials.gov in September 2022. The quality of the studies was assessed using the Cochrane Risk of Bias tool. Results: Of the 208 articles identified, six were included in this review. Results: For the most part, the research included suggests that contingency management is an effective strategy for improving abstinence outcomes, adherence, and other smoking-related variables such as delay discounting and intensity of cigarette demand in smokers with depressive symptomatology. Conclusions: Although contingency management could be a promising intervention in tobacco smokers with depressive symptomatology, further research in this area is still required.

Maintaining Engagement in Adults with Neurofibromatosis Type 1 to Use the iCanCope Mobile Application (iCanCope-NF)

INTRODUCTION

Neurofibromatosis Type 1 (NF1) is an autosomal dominant genetic condition in which chronic pain is a predominant issue. Given the rarity of the disease, there are limited psychosocial treatments for individuals with NF1 suffering with chronic pain. Using mobile applications can facilitate psychosocial treatments; however, there are consistent issues with engagement. Utilizing a mixed methodology, the current study evaluated the customized iCanCope mobile application for NF1 on increasing engagement through the usage of contingency management.

METHODS

A mixed methods study from a subset of data coming from a randomized clinical trial that occurred from January 2021 to August 2022 was undertaken. Two groups (iCC and iCC + CM) were exposed to the customized iCanCope mobile application in which engagement data were captured in real-time with daily check-ins for interference, sleep, mood, physical activity, energy levels, goal setting, and accessing article content (coping strategies). Additionally, semi-structured interviews were conducted to gain insight into the participants' experience at the end of the trial.

RESULTS

Adults (N = 72) were recruited via NF patient advocacy groups. Significant differences were noted between the groups in total articles read (p = 0.002), goals achieved (p = 0.017), and goals created (p = 008). Additionally, there were significant differences observed between user-generated goals and those that were app recommended (p < 0.001). Both groups qualitatively reported positive feedback on the customized mobile application, indicating that continued usage and engagement of the mobile application were acceptable.

CONCLUSIONS

Employing customized mobile applications for adults with NF1 along with contingency management can leverage self-managed pain treatments while providing auxiliary resources to this population.