1
|
Broos HC, Dev AS, Llabre MM, Saab PG, Timpano KR. Trait and situation-specific intolerance of uncertainty predict affective symptoms during the COVID-19 pandemic. J Affect Disord 2024; 352:115-124. [PMID: 38350541 PMCID: PMC11167600 DOI: 10.1016/j.jad.2024.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 01/16/2024] [Accepted: 02/06/2024] [Indexed: 02/15/2024]
Abstract
BACKGROUND The COVID-19 pandemic, a high-uncertainty situation, presents an ideal opportunity to examine how trait intolerance of uncertainty (IU) and situation-specific IU relate to each other and to mental health outcomes. The current longitudinal study examined the unique associations of trait and COVID-specific IU with general distress (anxiety and depression) and pandemic-specific concerns (pandemic stress and vaccine worry). METHODS A community sample of Florida adults (N = 2152) was surveyed online at three timepoints. They completed measures of trait IU at Wave 1 (April-May 2020) and COVID-specific IU at Wave 2 (May-June 2020). At Wave 3 (December-February 2021), they reported symptoms of depression, anxiety, pandemic stress, and vaccine worry. RESULTS We used structural equation modeling to test our overall model. Trait IU significantly predicted later COVID-specific IU, however there was no significant effect of trait IU on any outcome measure after accounting for COVID-specific IU. Notably, COVID-specific IU fully mediated the relationship between trait IU and all four symptom measures. LIMITATIONS There were several limitations of the current study, including the use of a community sample and high participant attrition. CONCLUSIONS Results suggest that COVID-specific IU predicts mental health outcomes over and above trait IU, extending the existing literature. These findings indicate that uncertainty may be more aversive when it is related to specific distressing situations, providing guidance for developing more specific and individualized interventions. Idiographic treatments which target situation-specific IU may be more efficacious in reducing affective symptoms and related stress during the COVID-19 pandemic or other similar events.
Collapse
Affiliation(s)
- Hannah C Broos
- University of Miami, Department of Psychology, 5665 Ponce de Leon Blvd, Coral Gables, FL 33146, United States of America.
| | - Amelia S Dev
- University of Miami, Department of Psychology, 5665 Ponce de Leon Blvd, Coral Gables, FL 33146, United States of America
| | - Maria M Llabre
- University of Miami, Department of Psychology, 5665 Ponce de Leon Blvd, Coral Gables, FL 33146, United States of America
| | - Patrice G Saab
- University of Miami, Department of Psychology, 5665 Ponce de Leon Blvd, Coral Gables, FL 33146, United States of America
| | - Kiara R Timpano
- University of Miami, Department of Psychology, 5665 Ponce de Leon Blvd, Coral Gables, FL 33146, United States of America
| |
Collapse
|
2
|
Boyd DT, Ramos SR, Maragh-Bass AC, Dyer TV, Zigah EY, Abu-Ba'are GR. Influence of families and other adult support on HIV prevention outcomes among black men who have sex with men. BMC Public Health 2024; 24:822. [PMID: 38491379 PMCID: PMC10941365 DOI: 10.1186/s12889-024-18171-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 02/21/2024] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND Prior research has consistently shown that the involvement of families plays a vital role in reducing risk behaviors, such as engaging in condomless sex, and promoting HIV prevention behaviors among young Black men who have sex with men (YBMSM). With the aim of expanding the existing knowledge, this study aimed to examine the specific influence of families and other supportive adults in facilitating casual condom use, partner condom use, HIV testing, and preexposure prophylaxis (PrEP) utilization among young Black MSM. METHODS A sample of YBMSM aged 18-29 years (N = 400) was collected online. We used a path analysis to examine the influence of family factors on PrEP stigma and PrEP use. Respondents were recruited from December 1, 2021, to January 31, 2022. We used a path analysis to examine the direct and indirect effects of family factors on PrEP use through HIV testing and encouraging condom use. RESULTS Among BMSM, other adult support was positive and directly associated with condom use by both casual partners (β = 0.04, p < .05) and partners (β = 0.17, p < .01). Condom use by casual partners was negative and was directly associated with HIV testing (β = - 0.15, p < .01). CONCLUSION The primary aim of this research was to examine the influence of family and adult support on HIV prevention behaviors among young Black MSM, including condom use, HIV testing, and PrEP use. Our findings highlight the significance of implementing interventions that incorporate families and other supportive adults to enhance the engagement of young Black MSM in HIV prevention behaviors.
Collapse
Affiliation(s)
- Donte T Boyd
- College of Social Work, The Ohio State University, 1047 College RD, #325K, Columbus, OH, 43215, USA.
- Center for Interdisciplinary Research on AIDS (CIRA), Yale University School of Public Health, New Haven, CT, USA.
- University of California Center for AIDS Prevention Studies, University of California, San Francisco, San Francisco, CA, USA.
| | - S Raquel Ramos
- Center for Interdisciplinary Research on AIDS (CIRA), Yale University School of Public Health, New Haven, CT, USA
- School of Nursing, Yale University, Orange, CT, USA
| | - Allysha C Maragh-Bass
- University of California Center for AIDS Prevention Studies, University of California, San Francisco, San Francisco, CA, USA
- FHI 360, Durham, NC, USA
- Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Typhanye V Dyer
- University of California Center for AIDS Prevention Studies, University of California, San Francisco, San Francisco, CA, USA
- Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park, MD, USA
| | - Edem Yaw Zigah
- Behavioral, Sexual, and Global Health Lab, Jama'a Action, West Legon, Accra, Ghana
| | - Gamji Rabiu Abu-Ba'are
- Behavioral, Sexual, and Global Health Lab, Jama'a Action, West Legon, Accra, Ghana
- School of Nursing, University of Rochester, Rochester, NY, USA
| |
Collapse
|
3
|
Edison B, Bhochhibhoya S, Baumler ER, Markham CM, Peskin MF, Shegog R, Emery ST, Addy RC, Temple JR, Reidy DE. Self-Efficacy to Refuse Sex Mediates the Relationship Between Dating Violence Victimization and Sexual Risk Behavior. J Adolesc Health 2024; 74:531-536. [PMID: 38085211 DOI: 10.1016/j.jadohealth.2023.10.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 10/11/2023] [Accepted: 10/13/2023] [Indexed: 02/05/2024]
Abstract
PURPOSE While cross-sectional studies have shown that teen dating violence (TDV) victimization is linked to sexual risk behavior (SRB), the pathway between these variables is not well-understood. To address this knowledge gap, we explore the mediating role of self-efficacy to refuse sex in the longitudinal relationship between physical TDV victimization and subsequent SRB among adolescents. METHODS Self-report data from three prior longitudinal studies were harmonized to create a single aggregated sample of primarily racial and ethnic minority adolescents (N = 4,620; 51.4% Hispanic, 38.5% Black, and 58% female) from 44 schools in the southwest U.S. Participants' physical TDV victimization at baseline (seventh and eighth grade), self-efficacy to refuse sex at 12-month follow-up, and SRB at 24-month follow-up was tested using mediation models with bias corrected bootstrapped confidence intervals. All regression models controlled for age, race, parental education, SRB at baseline, and intervention status. RESULTS Physical TDV victimization at baseline was associated with refusal self-efficacy at 12 months and SRB (e.g., frequency of vaginal and oral sex, lifetime number of vaginal sex partners, and number of vaginal sex partners in the past three months without condom use) at 24 months. Refusal self-efficacy mediated the link between physical TDV victimization and increased risk of SRB for females and males, to a lesser extent. DISCUSSION Adolescent victims of physical TDV report diminished self-efficacy to refuse sex, predisposing them to engage in SRBs, including condomless sex.
Collapse
Affiliation(s)
- Briana Edison
- School of Public Health, Center for Research on Interpersonal Violence, Georgia State University, Atlanta, Georgia; Department of Health, Human Performance, and Recreation, University of Arkansas, Fayetteville, Arkansas
| | - Shristi Bhochhibhoya
- School of Public Health, Center for Research on Interpersonal Violence, Georgia State University, Atlanta, Georgia; Department of Health, Human Performance, and Recreation, University of Arkansas, Fayetteville, Arkansas
| | - Elizabeth R Baumler
- Center for Violence Prevention, University of Texas Medical Branch, Galveston, Texas
| | - Christine M Markham
- School of Public Health, The University of Texas Health Science Center at Houston, Houston, Texas
| | - Melissa F Peskin
- School of Public Health, The University of Texas Health Science Center at Houston, Houston, Texas
| | - Ross Shegog
- School of Public Health, The University of Texas Health Science Center at Houston, Houston, Texas
| | - Susan T Emery
- School of Public Health, The University of Texas Health Science Center at Houston, Houston, Texas
| | - Robert C Addy
- School of Public Health, The University of Texas Health Science Center at Houston, Houston, Texas
| | - Jeff R Temple
- Center for Violence Prevention, University of Texas Medical Branch, Galveston, Texas
| | - Dennis E Reidy
- School of Public Health, Center for Research on Interpersonal Violence, Georgia State University, Atlanta, Georgia; Department of Health, Human Performance, and Recreation, University of Arkansas, Fayetteville, Arkansas.
| |
Collapse
|
4
|
Liu S, Curenton SM, Sims J, Fisher PA. The promotive and protective effects of parents' perceived changes during the COVID-19 pandemic on emotional well-being among U.S. households with young children: an investigation of family resilience processes. Front Psychol 2024; 14:1270514. [PMID: 38259548 PMCID: PMC10800496 DOI: 10.3389/fpsyg.2023.1270514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 12/18/2023] [Indexed: 01/24/2024] Open
Abstract
Introduction The COVID-19 pandemic may constitute a traumatic event for families with young children due to its acute onset, the unpredictable and ubiquitous nature, and the highly distressing disruptions it caused in family lives. Despite the prevalent challenges such as material hardships, child care disruptions, and social isolation, some families evinced remarkable resilience in the face of this potentially traumatic event. This study examined domains of changes perceived by parents of young children that were consistent with the post-traumatic growth (PTG) model as factors that facilitate family resilience processes. Methods This study drew data from the RAPID project, a large ongoing national study that used frequent online surveys to examine the pandemic impact on U.S. households with young children. A subsample of 669 families was leveraged for the current investigation, including 8.07% Black, 9.57% Latino(a), 74.44% non-Latino(a) White families, and 7.92% households of other racial/ethnic backgrounds. In this subsample, 26.36% were below 200% federal poverty level. Results Approximately half of the parents reported moderate-to-large degrees of changes during the pandemic, and the most prevalent domain of change was appreciation of life, followed by personal strengths, new possibilities, improved relationships, and spiritual growth. Black and Latino(a) parents reported more changes in all five domains than White parents and more spiritual growth than parents of the other racial/ethnic groups. Moreover, parent-reported improved relationships were found to indirectly reduce young children's overall fussiness/defiance and fear/anxiety symptoms through reducing parents' emotional distress. Perceived changes in the new possibilities, personal strengths, and appreciation of life domains were found to serve as protective factors that buffered the indirect impacts of material hardship mean levels on child behavioral symptoms via mitigating parents' emotional distress. Discussion These findings shed light on resilience processes of a family system in a large-scale, disruptive, and stressful socio-historical event such as the COVID-19 pandemic. The five PTG domains could inform therapeutic and intervention practices in the face of future similar events. Importantly, these findings and the evinced family resilience should not negate the urgent needs of policy and program efforts to address material hardships, financial instabilities, and race/ethnicity-based structural inequalities for families of young children.
Collapse
Affiliation(s)
- Sihong Liu
- Stanford Center on Early Childhood, Stanford University, Stanford, CA, United States
| | - Stephanie M. Curenton
- Center on Ecology of Early Development, Boston University, Boston, MA, United States
| | - Jacqueline Sims
- Center on Ecology of Early Development, Boston University, Boston, MA, United States
| | - Philip A. Fisher
- Stanford Center on Early Childhood, Stanford University, Stanford, CA, United States
| |
Collapse
|
5
|
Burger KS. Food reinforcement architecture: A framework for impulsive and compulsive overeating and food abuse. Obesity (Silver Spring) 2023; 31:1734-1744. [PMID: 37368515 DOI: 10.1002/oby.23792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 03/01/2023] [Accepted: 03/06/2023] [Indexed: 06/29/2023]
Abstract
Few reward-based theories address key drivers of susceptibility to food cues and consumption beyond fullness. Decision-making and habit formation are governed by reinforcement-based learning processes that, when overstimulated, can drive unregulated hedonically motivated overeating. Here, a model food reinforcement architecture is proposed that uses fundamental concepts in reinforcement and decision-making to identify maladaptive eating habits that can lead to obesity. This model is unique in that it identifies metabolic drivers of reward and incorporates neuroscience, computational decision-making, and psychology to map overeating and obesity. Food reinforcement architecture identifies two paths to overeating: a propensity for hedonic targeting of food cues contributing to impulsive overeating and lack of satiation that contributes to compulsive overeating. A combination of those paths will result in a conscious and subconscious drive to overeat independent of negative consequences, leading to food abuse and/or obesity. Use of this model to identify aberrant reinforcement learning processes and decision-making systems that can serve as markers of overeating risk may provide an opportunity for early intervention in obesity.
Collapse
Affiliation(s)
- Kyle S Burger
- Department of Nutrition, University of North Carolina, Chapel Hill, North Carolina, USA
| |
Collapse
|
6
|
Nelson TD, Stice E. Contextualizing the Neural Vulnerabilities Model of Obesity. Nutrients 2023; 15:2988. [PMID: 37447312 DOI: 10.3390/nu15132988] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 06/26/2023] [Accepted: 06/28/2023] [Indexed: 07/15/2023] Open
Abstract
In recent years, investigators have focused on neural vulnerability factors that increase the risk of unhealthy weight gain, which has provided a useful organizing structure for obesity neuroscience research. However, this framework, and much of the research it has informed, has given limited attention to contextual factors that may interact with key vulnerabilities to impact eating behaviors and weight gain. To fill this gap, we propose a Contextualized Neural Vulnerabilities Model of Obesity, extending the existing theory to more intentionally incorporate contextual factors that are hypothesized to interact with neural vulnerabilities in shaping eating behaviors and weight trajectories. We begin by providing an overview of the Neural Vulnerabilities Model of Obesity, and briefly review supporting evidence. Next, we suggest opportunities to add contextual considerations to the model, including incorporating environmental and developmental context, emphasizing how contextual factors may interact with neural vulnerabilities to impact eating and weight. We then synthesize earlier models and new extensions to describe a Contextualized Neural Vulnerabilities Model of Obesity with three interacting components-food reward sensitivity, top-down regulation, and environmental factors-all within a developmental framework that highlights adolescence as a key period. Finally, we propose critical research questions arising from the framework, as well as opportunities to inform novel interventions.
Collapse
Affiliation(s)
- Timothy D Nelson
- Department of Psychology, University of Nebraska-Lincoln, Lincoln, NE 68588, USA
| | - Eric Stice
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305, USA
| |
Collapse
|
7
|
Yokum S, Stice E. Relation of Overweight/Obesity to Reward Region Response to Food Reward and the Moderating Effects of Parental History of Eating Pathology in Adolescent Females. Nutrients 2023; 15:nu15112558. [PMID: 37299520 DOI: 10.3390/nu15112558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 05/04/2023] [Accepted: 05/29/2023] [Indexed: 06/12/2023] Open
Abstract
OBJECTIVE To test whether overweight/obesity is associated with an elevated reward region response to milkshake cues and a low reward region response to milkshake receipt. To test whether the risk for eating pathology moderates the effects of weight status on the neural response to milkshake cues and milkshake receipt. METHOD The current study used functional magnetic resonance imaging (fMRI) to examine the neuronal responses of female adolescents (n = 80; M age = 14.6 ± 0.9; M BMI = 21.9 ± 3.6; 41% with a biological parental history of eating pathology) during a food receipt paradigm. RESULTS Females with overweight/obesity showed a greater ventromedial prefrontal cortex (vmPFC), and ventral anterior cingulate (ACC) response to milkshake cues and a greater ventral striatum, subgenual ACC, and dorsomedial prefrontal cortex response to milkshake receipt than those with a healthy weight. Females with overweight/obesity plus a parental history of eating pathology showed a greater vmPFC/medial orbitofrontal cortex response to milkshake cues than those without a parental history of eating pathology and those with a healthy weight. Females with overweight/obesity and without a parental history of eating pathology showed a greater thalamus and striatum response to milkshake receipt. CONCLUSIONS Overweight/obesity is associated with an elevated reward region response to palatable food cues and food receipt. A risk for eating pathology enhances the reward region response to food cues in those with excess weight.
Collapse
Affiliation(s)
- Sonja Yokum
- Oregon Research Institute, Springfield, OR 97477, USA
| | - Eric Stice
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305, USA
| |
Collapse
|