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Jones G, Castro-Ramirez F, Al-Suwaidi M, McGuire T, Herrmann F. A Brief, Digital Music-Based Mindfulness Intervention for Black Americans With Elevated Race-Based Anxiety and Little-to-No Meditation Experience ("healing attempt"): Replication and Extension Study. JMIR Form Res 2023; 7:e53268. [PMID: 37999941 DOI: 10.2196/53268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 11/02/2023] [Accepted: 11/05/2023] [Indexed: 11/25/2023] Open
Abstract
BACKGROUND Race-based anxiety is a critical health issue within the Black community. Mindfulness interventions hold promise for treating race-based anxiety in Black Americans; however, there are many barriers that prevent Black Americans from using these treatments, such as low cultural relevance, significant time burdens, and excessive costs. OBJECTIVE This study is a replication and extension of findings that "healing attempt"-a brief (<60-minute), digital, music-based mindfulness intervention-is a feasible and acceptable intervention for race-based anxiety in Black Americans. In this study, we tested this research question among those with little-to-no meditation experience. METHODS The participants were 4 Black American adults with elevated race-based trait anxiety and little-to-no meditation experience. We used a series of multiple-baseline single-case experiments and conducted study visits on Zoom (Zoom Video Communications) to assess whether the intervention can decrease state anxiety and increase mindfulness and self-compassion in Black Americans. We also assessed feasibility and acceptability using quantitative and qualitative scales. RESULTS In line with our hypotheses, "healing attempt" increased mindfulness/self-compassion (Tau-U range: 0.57-0.86; P<.001) and decreased state anxiety (Tau-U range: -0.93 to -0.66; P<.001), with high feasibility and acceptability (the average likelihood of recommending "healing attempt" was 88 out of 100). CONCLUSIONS "healing attempt" may represent a feasible intervention for race-based anxiety in Black Americans with elevated race-based anxiety and little or no mindfulness experience. Future between-subjects randomized feasibility trials can assess whether the intervention can give rise to lasting improvements in race-based anxiety, mindfulness, and self-compassion. TRIAL REGISTRATION OSF Registries osf.io/k5m93; https://osf.io/k5m93.
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Affiliation(s)
- Grant Jones
- Department of Psychology, Harvard University, Cambridge, MA, United States
| | | | - Maha Al-Suwaidi
- Department of Psychology, University of California, Los Angeles, CA, United States
| | - Taylor McGuire
- Department of Psychology, Harvard University, Cambridge, MA, United States
| | - Felipe Herrmann
- Department of Psychology, Harvard University, Cambridge, MA, United States
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Jones G, Castro-Ramirez F, McGuire T, Al-Suwaidi M, Herrmann F. A Digital Music-Based Mindfulness Intervention ("healing attempt") for Race-Based Anxiety in Black Americans. J Med Internet Res 2023; 25:e51320. [PMID: 37824179 PMCID: PMC10603556 DOI: 10.2196/51320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 09/26/2023] [Accepted: 09/29/2023] [Indexed: 10/13/2023] Open
Abstract
This study replicates and extends findings that "healing attempt"-a brief digital music-based mindfulness intervention-represents a feasible and potentially effective intervention for race-based anxiety in the Black community.
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Affiliation(s)
- Grant Jones
- Department of Psychology, Harvard University, Cambridge, MA, United States
| | | | - Taylor McGuire
- Department of Psychology, Harvard University, Cambridge, MA, United States
| | - Maha Al-Suwaidi
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, United States
| | - Felipe Herrmann
- Department of Psychology, Harvard University, Cambridge, MA, United States
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Jones G, Al-Suwaidi M, Castro-Ramirez F, McGuire TC, Mair P, Nock MK. Race and ethnicity moderate the associations between lifetime psilocybin use and crime arrests. Front Psychiatry 2023; 14:1169692. [PMID: 37692301 PMCID: PMC10484513 DOI: 10.3389/fpsyt.2023.1169692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 08/07/2023] [Indexed: 09/12/2023] Open
Abstract
Introduction Psilocybin use has been linked to lowered odds of crime-related outcomes across a host of observational studies. No studies have investigated how these associations may differ among those of different races and ethnicities. Methods Using a nationally-representative sample of 734,061 adults from the National Survey on Drug Use and Health (2002-2020), we investigated whether race and ethnicity moderate the associations between lifetime psilocybin use and four measures of crime arrests (property crime, assault, serious violence, and miscellaneous crimes). Results First, we replicated prior findings and demonstrated that psilocybin confers lowered odds of crime arrests for all four outcomes in question. Second, we demonstrated that race and ethnicity moderate the associations between lifetime psilocybin use and crime arrests for three of our four outcomes. Third, we examined the associations between psilocybin and crime arrests across different races and ethnicities (White, Black, Indigenous, Asian, Multiracial, and Hispanic participants). Psilocybin conferred lowered odds of at least one crime arrest outcome for all racial and ethnic groups except for Black and Hispanic participants. Discussion Future investigations should take an intersectional approach to studying the interrelationship of sociodemographic factors, psychedelic use, and crime, examine the structural factors (i.e., systemic racism) that may underlie these results, and investigate whether psychedelics can alleviate mental health disorders that contribute to cycles of recriminalization for communities of color.
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Affiliation(s)
- Grant Jones
- Department of Psychology, Harvard University, Cambridge, MA, United States
| | - Maha Al-Suwaidi
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, United States
| | | | - Taylor C. McGuire
- Department of Psychology, Harvard University, Cambridge, MA, United States
| | - Patrick Mair
- Department of Psychology, Harvard University, Cambridge, MA, United States
| | - Matthew K. Nock
- Department of Psychology, Harvard University, Cambridge, MA, United States
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Nock MK, Millner AJ, Ross EL, Kennedy CJ, Al-Suwaidi M, Barak-Corren Y, Castro VM, Castro-Ramirez F, Lauricella T, Murman N, Petukhova M, Bird SA, Reis B, Smoller JW, Kessler RC. Prediction of Suicide Attempts Using Clinician Assessment, Patient Self-report, and Electronic Health Records. JAMA Netw Open 2022; 5:e2144373. [PMID: 35084483 PMCID: PMC8796020 DOI: 10.1001/jamanetworkopen.2021.44373] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
IMPORTANCE Half of the people who die by suicide make a health care visit within 1 month of their death. However, clinicians lack the tools to identify these patients. OBJECTIVE To predict suicide attempts within 1 and 6 months of presentation at an emergency department (ED) for psychiatric problems. DESIGN, SETTING, AND PARTICIPANTS This prognostic study assessed the 1-month and 6-month risk of suicide attempts among 1818 patients presenting to an ED between February 4, 2015, and March 13, 2017, with psychiatric problems. Data analysis was performed from May 1, 2020, to November 19, 2021. MAIN OUTCOMES AND MEASURES Suicide attempts 1 and 6 months after presentation to the ED were defined by combining data from electronic health records (EHRs) with patient 1-month (n = 1102) and 6-month (n = 1220) follow-up surveys. Ensemble machine learning was used to develop predictive models and a risk score for suicide. RESULTS A total of 1818 patients participated in this study (1016 men [55.9%]; median age, 33 years [IQR, 24-46 years]; 266 Hispanic patients [14.6%]; 1221 non-Hispanic White patients [67.2%], 142 non-Hispanic Black patients [7.8%], 64 non-Hispanic Asian patients [3.5%], and 125 non-Hispanic patients of other race and ethnicity [6.9%]). A total of 137 of 1102 patients (12.9%; weighted prevalence) attempted suicide within 1 month, and a total of 268 of 1220 patients (22.0%; weighted prevalence) attempted suicide within 6 months. Clinicians' assessment alone was little better than chance at predicting suicide attempts, with externally validated area under the receiver operating characteristic curve (AUC) of 0.67 for the 1-month model and 0.60 for the 6-month model. Prediction accuracy was slightly higher for models based on EHR data (1-month model: AUC, 0.71; 6 month model: AUC, 0.65) and was best using patient self-reports (1-month model: AUC, 0.76; 6-month model: AUC, 0.77), especially when patient self-reports were combined with EHR and/or clinician data (1-month model: AUC, 0.77; and 6 month model: AUC, 0.79). A model that used only 20 patient self-report questions and an EHR-based risk score performed similarly well (1-month model: AUC, 0.77; 6 month model: AUC, 0.78). In the best 1-month model, 30.7% (positive predicted value) of the patients classified as having highest risk (top 25% of the sample) made a suicide attempt within 1 month of their ED visit, accounting for 64.8% (sensitivity) of all 1-month attempts. In the best 6-month model, 46.0% (positive predicted value) of the patients classified at highest risk made a suicide attempt within 6 months of their ED visit, accounting for 50.2% (sensitivity) of all 6-month attempts. CONCLUSIONS AND RELEVANCE This prognostic study suggests that the ability to identify patients at high risk of suicide attempt after an ED visit for psychiatric problems improved using a combination of patient self-reports and EHR data.
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Affiliation(s)
- Matthew K. Nock
- Department of Psychology, Harvard University, Cambridge, Massachusetts
- Mental Health Research Program, Franciscan Children’s, Brighton, Massachusetts
- Department of Psychiatry, Massachusetts General Hospital, Boston
| | - Alexander J. Millner
- Department of Psychology, Harvard University, Cambridge, Massachusetts
- Mental Health Research Program, Franciscan Children’s, Brighton, Massachusetts
| | - Eric L. Ross
- Department of Psychiatry, Massachusetts General Hospital, Boston
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Chris J. Kennedy
- Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts
| | - Maha Al-Suwaidi
- Department of Psychology, Harvard University, Cambridge, Massachusetts
| | - Yuval Barak-Corren
- Department of Bioinformatics, Boston Children’s Hospital, Boston, Massachusetts
| | - Victor M. Castro
- Department of Psychiatry, Massachusetts General Hospital, Boston
| | | | - Tess Lauricella
- Department of Psychology, Harvard University, Cambridge, Massachusetts
| | - Nicole Murman
- Department of Psychology, Harvard University, Cambridge, Massachusetts
| | - Maria Petukhova
- Department of Healthcare Policy, Harvard Medical School, Boston, Massachusetts
| | - Suzanne A. Bird
- Department of Psychiatry, Massachusetts General Hospital, Boston
| | - Ben Reis
- Department of Bioinformatics, Boston Children’s Hospital, Boston, Massachusetts
| | - Jordan W. Smoller
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
- Center for Precision Psychiatry, Department of Psychiatry, Massachusetts General Hospital, Boston
| | - Ronald C. Kessler
- Department of Healthcare Policy, Harvard Medical School, Boston, Massachusetts
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Castro-Ramirez F, Al-Suwaidi M, Garcia P, Rankin O, Ricard JR, Nock MK. Racism and Poverty are Barriers to the Treatment of Youth Mental Health Concerns. J Clin Child Adolesc Psychol 2021; 50:534-546. [PMID: 34339320 DOI: 10.1080/15374416.2021.1941058] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Traditional studies of treatment moderators have focused largely on psychological factors such as clinical severity. Racial and economic inequity exert large effects on youth mental health, on treatment efficacy, and on the likelihood of receiving treatment altogether. Yet, these factors are studied less often by clinical psychological scientists. METHOD We conducted a narrative review of literature on racial and economic inequities and their impact on youth mental health. RESULTS First, systemic problems such as racism and poverty increase the risk of developing complex health issues and decrease the likelihood of benefiting from treatment. Second, attitudinal barriers, such as mistrust associated with treatments provided by researchers and government agencies, decrease the likelihood that minoritized groups will engage with or benefit from evidence-based treatments. Third, minoritized and underserved communities are especially unlikely to receive evidence-based treatment. CONCLUSION Clinical psychological science has unique insights that can help address systemic inequities that can decrease treatment efficacy for youth mental health treatment. Psychological scientists can help eliminate disparities in accessing evidence-based treatment and help end violent policies in underserved minoritized communities by at the very least (1) building and supporting scalable community-based treatments as well as (2) publicly advocating for an end to violent policies that impose negative social costs.
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Affiliation(s)
| | | | | | | | | | - Matthew K Nock
- Department of Psychology, Harvard University.,Department of Psychiatry, Massachusetts General Hospital.,Mental Health Research Program, Franciscan Children's
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Fortgang RG, Wang SB, Millner AJ, Reid-Russell A, Beukenhorst AL, Kleiman EM, Bentley KH, Zuromski KL, Al-Suwaidi M, Bird SA, Buonopane R, DeMarco D, Haim A, Joyce VW, Kastman EK, Kilbury E, Lee HIS, Mair P, Nash CC, Onnela JP, Smoller JW, Nock MK. Increase in Suicidal Thinking During COVID-19. Clin Psychol Sci 2021; 9:482-488. [PMID: 38602997 PMCID: PMC7967020 DOI: 10.1177/2167702621993857] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Accepted: 12/19/2020] [Indexed: 11/15/2022]
Abstract
There is concern that the COVID-19 pandemic may cause increased risk of suicide. In the current study, we tested whether suicidal thinking has increased during the COVID-19 pandemic and whether such thinking was predicted by increased feelings of social isolation. In a sample of 55 individuals recently hospitalized for suicidal thinking or behaviors and participating in a 6-month intensive longitudinal smartphone monitoring study, we examined suicidal thinking and isolation before and after the COVID-19 pandemic was declared a national emergency in the United States. We found that suicidal thinking increased significantly among adults (odds ratio [OR] = 4.01, 95% confidence interval [CI] = [3.28, 4.90], p < .001) but not adolescents (OR = 0.84, 95% CI = [0.69, 1.01], p = .07) during the onset of the COVID-19 pandemic. Increased feelings of isolation predicted suicidal thinking during the pandemic phase. Given the importance of social distancing policies, these findings support the need for digital outreach and treatment.
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Affiliation(s)
- Rebecca G. Fortgang
- Department of Psychology, Harvard
University
- Department of Psychiatry, Massachusetts
General Hospital, Boston, Massachusetts
| | | | - Alexander J. Millner
- Department of Psychology, Harvard
University
- Franciscan Children’s, Brighton,
Massachusetts
| | | | | | | | - Kate H. Bentley
- Department of Psychology, Harvard
University
- Department of Psychiatry, Massachusetts
General Hospital, Boston, Massachusetts
| | - Kelly L. Zuromski
- Department of Psychology, Harvard
University
- Franciscan Children’s, Brighton,
Massachusetts
| | | | - Suzanne A. Bird
- Department of Psychiatry, Massachusetts
General Hospital, Boston, Massachusetts
| | | | | | - Adam Haim
- National Institute of Mental Health,
Bethesda, Maryland
| | | | | | - Erin Kilbury
- Department of Psychology, Harvard
University
- Department of Psychiatry, Massachusetts
General Hospital, Boston, Massachusetts
| | | | | | | | | | - Jordan W. Smoller
- Department of Psychiatry, Massachusetts
General Hospital, Boston, Massachusetts
| | - Matthew K. Nock
- Department of Psychology, Harvard
University
- Department of Psychiatry, Massachusetts
General Hospital, Boston, Massachusetts
- Franciscan Children’s, Brighton,
Massachusetts
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