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O'Brien B, Shrestha S, Stanley MA, Pargament KI, Cummings J, Kunik ME, Fletcher TL, Cortes J, Ramsey D, Amspoker AB. Positive and negative religious coping as predictors of distress among minority older adults. Int J Geriatr Psychiatry 2019; 34:54-59. [PMID: 30375027 DOI: 10.1002/gps.4983] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Accepted: 08/06/2018] [Indexed: 11/07/2022]
Abstract
OBJECTIVES The study replicated and extended previous findings by investigating relationships between positive and negative religious coping and psychological distress in minority older adults. METHODS Older adults were evaluated during screening and baseline procedures of a psychotherapy clinical trial for late-life worry and anxiety. Participants were age 50 years or older and recruited from low-income and predominantly minority neighborhoods. Participants screening positive for worry (PSWQ-A ≥ 23) with no significant cognitive impairment (Six-Item Screener for cognitive impairment ≤2) completed a diagnostic interview and baseline assessments. Positive and negative religious coping were assessed with the positive and negative coping subscales of the Brief Religious Coping scale. Psychological distress was assessed with measures of depression, anxiety, and worry. A set of multiple linear regression models were used to evaluate the relationship between religious coping and each measure of psychological distress. RESULTS Negative religious coping was associated with greater anxiety, worry, and depression. Positive and negative religious coping interacted such that positive religious coping buffered the effects of negative religious coping on anxiety and depression. Significant main effects and interactions remained after controlling for age, gender, race, years of education, and study. CONCLUSIONS The findings of this study are consistent with prior work showing that negative religious coping is associated with greater psychological distress. This study replicates previous findings that positive religious coping may buffer the harmful effects of negative religious coping and extends understandings of the specific psychological impacts that positive and negative religious coping may have on older, minority adults.
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Affiliation(s)
- Brittany O'Brien
- Baylor College of Medicine, Houston, TX, USA.,Michael E. DeBakey VA Medical Center, Houston, TX, USA
| | - Srijana Shrestha
- Baylor College of Medicine, Houston, TX, USA.,Wheaton College, Norton, MA, USA
| | - Melinda A Stanley
- Baylor College of Medicine, Houston, TX, USA.,Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Houston, TX, USA.,VA South Central Mental Illness Research, Education and Clinical Center, Houston, TX, USA
| | - Kenneth I Pargament
- Baylor College of Medicine, Houston, TX, USA.,Bowling Green State University, Bowling Green, OH, USA
| | | | - Mark E Kunik
- Baylor College of Medicine, Houston, TX, USA.,Michael E. DeBakey VA Medical Center, Houston, TX, USA.,Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Houston, TX, USA.,VA South Central Mental Illness Research, Education and Clinical Center, Houston, TX, USA
| | - Terri L Fletcher
- Baylor College of Medicine, Houston, TX, USA.,Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Houston, TX, USA.,VA South Central Mental Illness Research, Education and Clinical Center, Houston, TX, USA
| | - Jose Cortes
- Baylor College of Medicine, Houston, TX, USA.,Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Houston, TX, USA
| | - David Ramsey
- Baylor College of Medicine, Houston, TX, USA.,Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Houston, TX, USA
| | - Amber B Amspoker
- Baylor College of Medicine, Houston, TX, USA.,Michael E. DeBakey VA Medical Center, Houston, TX, USA.,Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Houston, TX, USA
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Stanley MA, Wilson NL, Shrestha S, Amspoker AB, Wagener P, Bavineau J, Turner M, Fletcher TL, Freshour J, Kraus-Schuman C, Kunik ME. Community-Based Outreach and Treatment for Underserved Older Adults With Clinically Significant Worry: A Randomized Controlled Trial. Am J Geriatr Psychiatry 2018; 26:1147-1162. [PMID: 30224269 DOI: 10.1016/j.jagp.2018.07.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 07/05/2018] [Accepted: 07/24/2018] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To determine whether Calmer Life (CL) improved worry, generalized anxiety disorder-related (GAD-related) symptoms, anxiety, depression, sleep, trauma-related symptoms, functional status, and quality of life better than Enhanced Community Care with Resource Counseling (ECC-RC) at 6 months and 9 months. METHODS A randomized, controlled, comparative-effectiveness study involving underserved, low-income, mostly minority neighborhoods in Houston, Texas, looked at individuals ≥50 with significant worry and interest in psychosocial treatment. Interventions were CL, cognitive behavioral therapy with resource counseling, facilitation of communication with primary care providers about worry/anxiety, integration of religion/spirituality, person-centered skill content and delivery and nontraditional community providers, ECC-RC, and enhanced standard community-based information/ resource counseling addressing basic unmet and mental health needs. Primary outcomes were worry and GAD-related symptom severity. Secondary outcomes were anxiety, depression, sleep difficulties, trauma-related symptoms, functional status, quality of life, service use and satisfaction. RESULTS Similar, moderate improvements followed CL and ECC-RC on worry, GAD-related symptoms, anxiety, depression, sleep, trauma-related symptoms, and mental health quality of life at 6 and 9 months, but with symptoms at both times and higher satisfaction with CL at both. Fewer ECC-RC participants reported a hospital admission in the prior 3 months than those in CL at 6 and 9 months; at 9 months, fewer reported a visit with a provider in the previous 3 months. CONCLUSION Both interventions showed similar improvements at 6 and 9 months, but symptoms remained that might require care. Either intervention or a combination may be useful for low-income older adults with identified worry/anxiety.
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Affiliation(s)
- Melinda A Stanley
- HSR&D Center for Innovations in Quality, Effectiveness and Safety (MAS, NLW, ABA, PW, TLF, MEK), Michael E. DeBakey VA Medical Center, Houston; Baylor College of Medicine (MAS, NLW, SS, ABA, PW, TLF, JF, CKS, MEK), Houston; the VA South Central Mental Illness Research, Education and Clinical Center (MAS, TLF, MEK), Houston.
| | - Nancy L Wilson
- HSR&D Center for Innovations in Quality, Effectiveness and Safety (MAS, NLW, ABA, PW, TLF, MEK), Michael E. DeBakey VA Medical Center, Houston; Baylor College of Medicine (MAS, NLW, SS, ABA, PW, TLF, JF, CKS, MEK), Houston
| | - Srijana Shrestha
- St. Thomas University (SS), Houston; Baylor College of Medicine (MAS, NLW, SS, ABA, PW, TLF, JF, CKS, MEK), Houston
| | - Amber B Amspoker
- HSR&D Center for Innovations in Quality, Effectiveness and Safety (MAS, NLW, ABA, PW, TLF, MEK), Michael E. DeBakey VA Medical Center, Houston; Baylor College of Medicine (MAS, NLW, SS, ABA, PW, TLF, JF, CKS, MEK), Houston
| | - Paula Wagener
- HSR&D Center for Innovations in Quality, Effectiveness and Safety (MAS, NLW, ABA, PW, TLF, MEK), Michael E. DeBakey VA Medical Center, Houston; Baylor College of Medicine (MAS, NLW, SS, ABA, PW, TLF, JF, CKS, MEK), Houston
| | | | | | - Terri L Fletcher
- HSR&D Center for Innovations in Quality, Effectiveness and Safety (MAS, NLW, ABA, PW, TLF, MEK), Michael E. DeBakey VA Medical Center, Houston; Baylor College of Medicine (MAS, NLW, SS, ABA, PW, TLF, JF, CKS, MEK), Houston; the VA South Central Mental Illness Research, Education and Clinical Center (MAS, TLF, MEK), Houston
| | - Jessica Freshour
- Michael E. DeBakey VA Medical Center (JF, CKS), Houston, TX; Baylor College of Medicine (MAS, NLW, SS, ABA, PW, TLF, JF, CKS, MEK), Houston
| | - Cynthia Kraus-Schuman
- Michael E. DeBakey VA Medical Center (JF, CKS), Houston, TX; Baylor College of Medicine (MAS, NLW, SS, ABA, PW, TLF, JF, CKS, MEK), Houston
| | - Mark E Kunik
- HSR&D Center for Innovations in Quality, Effectiveness and Safety (MAS, NLW, ABA, PW, TLF, MEK), Michael E. DeBakey VA Medical Center, Houston; Baylor College of Medicine (MAS, NLW, SS, ABA, PW, TLF, JF, CKS, MEK), Houston; the VA South Central Mental Illness Research, Education and Clinical Center (MAS, TLF, MEK), Houston
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