Ethnoracialized group differences in attitudes and knowledge about schizophrenia and willingness to engage in biomarker research: The UBIGR Study

Although there is renewed optimism in biomarker research in schizophrenia, there is also need for greater inclusion of historically underrepresented groups in the research. In the present study, we surveyed 599 African American, 352 American Indian/Alaska Native, and 725 NonHispanic White participants about their attitudes toward research, knowledge and attitudes about schizophrenia, and willingness to engage in biomarker testing. Attitudes toward research were examined using the standardized 7-item Research Attitudes Questionnaire (RAQ) measure. Using structural equation modeling (SEM), we tested our predictive model of the likelihood of willingness to engage in biomarker testing for schizophrenia risk. Members of historically underrepresented groups were less willing to engage in biomarker testing. Overall, attitudes toward research, particularly trust, influenced biomarker testing willingness. These findings suggest that factors influencing willingness to engage in schizophrenia biomarker testing may be modifiable by outreach engagement and education.

Employment and emotional well-being in veterans with mental illness

The purpose of this study is to examine group differences between employed and unemployed Veterans with mental illnesses utilizing the National Institutes of Health (NIH) emotion toolbox factors including negative affect, psychological well-being, stress, and social relationships. Data was collected from three samples from 2018 to 2020. The first sample (Sample 1) is 156 Veterans with mental illness from Amazon MTurk; the second sample (Sample 2), recruited from a higher education institution, is 232 veterans with posttraumatic stress disorder (PTSD) symptoms; and the final sample (Sample 3), recruited from a higher education institution, is 129 Veterans with disabilities, including psychiatric disabilities. Independent-samples t-tests were carried out to test our objectives. Sample 1 results revealed that employed Veterans with mental illnesses had lower levels of depression and stress and higher levels of positive emotion, life satisfaction, meaning in life, and social relationships compared to unemployed Veterans. Sample 2 results revealed that employed Veterans with PTDS symptoms had lower levels of stress and higher levels of positive emotion and lower levels of stress compared to unemployed Veterans with PTSD symptoms. Sample 3 results revealed that employed Veterans with disabilities including psychiatric disabilities had lower levels of depression and higher levels of positive emotion and social relationships. Our findings are consistent with the previous research documenting that employment plays a central role in optimal psychological and physical health in both civilians and veterans.

Validation of the Chinese version of the Perceived Stress Scale-10 integrating exploratory graph analysis and confirmatory factor analysis

OBJECTIVE

The study aimed to initially assess the measurement properties of the 10-item simplified Chinese version of the Perceived Stress Scale (PSS-C-10) and as a first, assess a longitudinal measurement invariance (LMI).

METHODS

A longitudinal survey was conducted with a convenient sample of healthcare students using the PSS-C-10. We assessed the PSS-C-10 mainly using composite analytical approaches, including exploratory graph analysis (EGA) and confirmatory factor analysis (CFA) to suggest the best-fit factor structure and assess measurement invariance.

RESULTS

The EGA identified a two-factor structural solution with an accuracy of 98.6% at baseline and 100% at a 7-day follow-up. The CFA subsequently confirmed this structure, with a comparative fit index of 0.963 at baseline and 0.987 at follow-up, Tucker-Lewis index of 0.951 at baseline and 0.982 at follow-up, and root mean square error of approximation of 0.111 at baseline and 0.089 at follow-up. The LMI was supported by the goodness-of-fit indices, and their changes fell within the recommended cut-off range. Additionally, Cronbach's alpha (0.885 at baseline and 0.904 at follow-up), McDonald's omega (0.885 at baseline and 0.902 at follow-up), and an ICC value of 0.816 for 7 days demonstrated the robust reliability of the PSS-C-10.

CONCLUSION

The PSS-C-10 exhibited a stable two-factor structure with promising LMI and measurement properties.

Exploring the trajectory and correlates of social isolation for veterans across a 6-month period during COVID-19

Social isolation is a relevant problem for veterans who are at risk for disengaging from others as a function of transition stress from military life to civilian life, and given high rates of exposure to trauma and psychological distress. Few researchers have examined social isolation in veterans over time, particularly during COVID-19 that led to significant barriers and restrictions on social interactions. The purpose of this longitudinal study was to assess veterans' experience of social isolation and its mental health and social functioning correlates during a 6-month period of the COVID-19 pandemic. Participants were 188 United States veterans of the Iraq and Afghanistan wars. A total of four assessments were administered: one every two months for a total duration of six months. The average number of completed assessments across all participants was 3.70 (SD = 0.75) with 159 participants (84.13%) completing all four timepoints. Surveys included measures of global mental health and social functioning as indicated by perceived emotional support, quality of marriage, and couple satisfaction. Multilevel modeling was used to assess 1) growth models to determine whether social isolation changed over time and the trajectory of that change (i.e., linear or quadratic); and 2) whether social isolation was related to both concurrent and prospective indicators of mental health and social functioning. All analyses included person mean centered and grand mean centered isolation to assess for within-and between-person effects. Veterans reported a quadratic trajectory in social isolation that decreased slightly and stabilized over time. Findings indicate that higher social isolation, at both the within- and between-person level, was negatively associated with concurrent emotional support, mental health, quality of marriage, and couple satisfaction. However, all prospective effects were nonsignificant at the within-person level. Results suggest although isolation may decrease over time, veterans report worse mental health and social functioning during times when they report higher levels of social isolation compared to themselves and others. Future work is needed to determine if interventions can be applied during those times to prevent or target those negative associations.

Job Automation and Concerns During the COVID-19 Pandemic Among Middle and Low-Income US Adults

OBJECTIVE

This study examined job automation and concerns about job automation during the COVID-19 pandemic.

METHODS

Data from a national sample of 6607 middle- and low-income US adults in May to June 2020 were analyzed.

RESULTS

Among recently employed participants, 19.1% reported partial or complete job automation during the pandemic. Male sex, racial/ethnic minorities, students, higher education, full-time employment, and any history of psychiatric disorder were associated with job automation. In the total sample, 57.5% had concerns about job automation, which were associated with younger age, male, racial/ethnic minorities, students, veterans, more minors in the household, Northeast residence, any history of psychiatric diagnosis, COVID-19 infection, and any recent job changes.

CONCLUSIONS

Job automation is impacting the lives of middle- and low-income US adults, and particular groups are vulnerable to ongoing changes in the nature of work.

Differences in Americans with Disabilities Act Title I discrimination allegations filed by people with learning disabilities and other disabilities

BACKGROUND: Workers with learning disabilities (LD) report many barriers to employment, including discrimination on the part of employers. OBJECTIVE: To compare the workplace discrimination experiences of workers with LD to those of people with other disabilities. METHOD: The comparison of the two groups, people with LD and people with other disabilities, concerned three factors: Characteristics of Charging Parties, Prominent Issues involving the nature of the discrimination allegation, and the outcomes of EEOC investigations at the time of case closure. An ex post facto, causal-comparative quantitative design was used to examine allegations closed following the ADA Amendments Act of 2008 (ADAA). RESULTS: Results revealed statistically significant differences in characteristics of the Charging Parties in the two groups. The LD group was significantly younger, more Caucasian, and more male than general population disabilities (GENDIS). The LD group was less African American, Latina/o, or Asian than GENDIS. Regarding the nature of allegations, the substance of allegations made by the LD group was more likely to involve matters of disability harassment, discipline, hiring, constructive discharge, training, and promotion. The LD group was less likely to file allegations involving reasonable accommodation, assignment, and layoff. CONCLUSION: Workers with learning disabilities experience high rates of employment discrimination, and the types of discrimination they experience are different than those experienced by people with other disabilities.

Drug Use Difficulties and Academic Adjustment in Student Veterans With Disabilities: A Parallel Mediation Study

The attainment of postsecondary education is critical to leading a successful life. Substance abuse is one area that may negatively impact academic and, ultimately, employment outcomes in the student veteran population. We conducted a parallel mediation analysis to examine the relationship between substance use and academic outcomes in a sample of 129 college veterans with disabilities. We explored interpersonal problems, physical health problems, depression, and anxiety as possible mediators. Our results concluded that only interpersonal problems and anxiety mediated the relationship. Implications for practice and research are provided.

Wisconsin Healthcare Utilization Cost Among American Indians/Alaska Natives with and without Alzheimer's Disease and Related Dementias

Individuals with Alzheimer's disease and related dementias (ADRD) accrue higher healthcare utilization costs than peers without ADRD, but incremental costs of ADRD among American Indians/Alaska Natives (AI/AN) is unknown. State-wide paid electronic health record data were retrospectively analyzed using percentile-based bootstrapped 95% confidence intervals of the weighted mean difference of total 5-year billed costs to compare total accrued for non-Tribal and Indian Health Service utilization costs among Medicaid and state program eligible AI/AN, ≥40 years, based on the presence/absence of ADRD (matching by demographic and medical factors). AI/AN individuals with ADRD accrued double the costs compared to those without ADRD, costing an additional $880.45 million to $1.91 billion/year.

Service-Connected Disability and Happiness in Student Veterans: A Parallel Mediation Study of PERMA

The student veteran population has been growing in higher education, along with the attention to their happiness and well-being. Seligman developed the positive emotion, engagement, relationships, meaning, and accomplishment (PERMA) model to help understand an individual’s happiness, including five pillars: Positive emotion, Engagement, Relationship, Meaning, and Accomplishment. In this study, we aim at evaluating the role of the PERMA model’s five pillars in explaining the relationship between service-connected disability and happiness. Data were collected from 205 student veterans. The result demonstrated that positive emotion and accomplishment mediated the relationship between service-connected disability and happiness. The findings of this study suggest utilizing positive psychology to help student veterans improve happiness, as well as engage in more activities that could potentially increase an individual’s positive emotion and accomplishment, and eventually increase the level of happiness.

Doctoral Dissertation Research in Rehabilitation Counseling: 2013

Our team recently examined the 2012 doctoral dissertation research in our field. This article continues a series of annual reviews of rehabilitation doctoral dissertation research. In 2013, there were a total of 22 doctoral dissertations completed from identified doctoral programs in rehabilitation counseling. Dissertations were organized by research topic, methodology used, model, and statistical analysis, and an annotated bibliography was provided. The analysis also included institutional productivity and trends in employment outcomes for doctoral graduates. Findings of the current analysis demonstrated that majority of the studies consisted of quantitative descriptive research designs. Compared to analyses from previous years, in 2013, advanced statistics were used at the highest rate since 2005. The proportion of dissertations focusing on professional issues topics was greater than any of the prior reporting periods. Implications for the practice of rehabilitation counseling, education, and future research are discussed.

Creating a college adjustment index score for student veterans with and without disabilities

Higher education is a critical public health tool to achieve economic success, upward mobility, and improved quality of life. Yet, certain groups of students, including student veterans with and without disabilities (SVDs), are at high risk for course failure and dropout, partially due to challenges related to college adjustment. The purpose of this study is to develop a new college adjustment index score for SVDs. We had a total of 4 different research studies to examine the psychometric properties of our college adjustment index score. After conducting a series of psychometric analyses, we selected a total of 18-items. This 18-item tool may help clinicians and researchers conceptualize college adjustment among students through the lens of integrative Tinto's model and positive psychology approaches. Our psychometric analyses revealed that this index tool is brief, reliable, and valid tool to capture college adjustment in SVDs.

Evaluating Optimism, Hope, Resilience, Coping Flexibility, Secure Attachment, and PERMA as a Well-Being Model for College Life Adjustment of Student Veterans: A Hierarchical Regression Analysis

The purpose of this study is to examine (a) to what extent demographic covariates, foundational and emerging positive psychology traits (FEPPTs), and PERMA uniquely predict college life adjustment, health-related quality of life (HRQOL), and life satisfaction of student military veterans; (b) PERMA as a happiness and well-being model for college life adjustment, HRQOL, and life satisfaction among student veterans; and (c) FEPPTs as predictors of PERMA. In addition, we tested whether total PERMA scores mediate the relationship between service-connected disability and college adjustment. A total of 205 student veterans responded to an online survey. Results revealed that demographic covariates (e.g., service-connected disability), FEPPTs (e.g., optimism), and PERMA (e.g., positive emotion) significantly accounted for college life adjustment, HRQOL, and life satisfaction of student veterans. In addition, a mediation analysis revealed that PERMA partially mediated the relationship between service-connected disability and college life adjustment of student veterans. The results of this study provide empirical supports for the use of PERMA as a comprehensive well-being model of college life adjustment for student veterans.

COVID-19 stress, resilience, and job loss concerns in people with chronic conditions and disabilities

BACKGROUND: People experience higher levels of psychological distress during times of crisis, such as the current COVID-19 pandemic. Resilience is a psychological resource that helps people to recover from adverse events. OBJECTIVE: The purpose of this study was to determine the effects of resilience on COVID-19-related stress and worry about job loss in people with chronic conditions and disabilities (PwCID). METHODS: The Perceived Stress Questionnaire -8 (PSQ-8) and the Brief Resilience Scale were used to measure COVID-19-related stress and resilience, respectively. Demographics were also assessed. A two-step hierarchical regression and binary regression analyses were conducted. RESULTS: A moderate amount of perceived stress and resilience with mean scores of 2.45 (SD = 0.69; range 1-4) and 3.17 (SD = 0.98; range 1-5), respectively, were found among the 269 participants. Resilience (β=-0.44, p <  0.001) was significantly associated withCOVID-19-related stress after controlling for demographic variables. Results also revealed that those with higher resilience scores had lower probability to worry about job loss. CONCLUSION: PwCID who have higher scores on resilience reported lower levels of COVID-19-related stress. Resilience can be cultivated among PwCID for better psychological outcomes during times of crisis. Vocational rehabilitation counselors can implement strategies to improve resilience in PwCID.

Cardiology clinic patient attitudes toward and potential personal utility of genetic testing: Findings from a unique multiracial clinical sample

As more is understood about the hereditary nature of disease risk, the utility of genetic testing within cardiovascular medicine is increasingly being explored. Although testing may afford more personalized risk stratification, there is a paucity of information regarding patient knowledge, attitudes, and beliefs toward genetic testing among cardiology patients. Participants (n = 530) recruited primarily from a cardiology clinic filled out a 41-item written questionnaire assessing knowledge, beliefs, and attitudes toward genetic testing, motivators and detractors for considering genetic testing, and perceived likelihood for behavior change after hypothetical genetic testing risk stratification. Path analysis was used to test the hypothetical models predicting the likelihood of getting a genetic test and making behavior changes following genetic testing. The patient population was late-middle-aged (59.0 ± 14.5 years), majority women (61.5%), and about half reported having a bachelor's degree. 58.1% of participants self-identified as White, 25.7% as African American or Black, 6.8% as Spanish, Latino, or Hispanic, 3.0% as Asian or Pacific Islander, and 0.5% as Native American. Gender (being a woman) and more years of education were related to greater knowledge about genetic testing. Racial identity and years of education were related to beliefs about genetic testing. Beliefs, but not knowledge, were related to more positive attitudes and a higher likelihood of pursuing genetic testing. Positive attitudes were related to greater perceived personal control (PPC). Furthermore, attitudes and PPC were related to higher likelihood of lifestyle change after genetic testing. These results highlight the need to integrate the experiences of racialized communities into education/counseling efforts. Most educational counseling efforts lack a nuanced discussion of social determinants of health or beliefs. In addition to factual information, educational counseling must also address people's beliefs, concerns, and the intersecting experiences and identities, which shape patients' relationships with the evolving landscape of healthcare and personalized medicine.

Psychological well-being and cognitive aging in Black, Native American, and White Alzheimer's Disease Research Center participants

Psychological well-being is associated with cognition in later life but has not been examined across diverse populations-including minoritized communities at disproportionately high risk of dementia. Further, most previous work has not been able to examine links between specific facets of psychological well-being and performance within distinct cognitive domains that can capture subclinical impairment. Using a well-characterized sample followed through enrollment in an NIH-funded Alzheimer's Disease Center, we sought to test these associations within three racial groups at baseline. Participants were N = 529 cognitively unimpaired Black, American Indian/Alaska Native (AI/AN), and white middle-aged and older adults (mean age = 63.6, SD = 8.1, range = 45-88 years) enrolled in the Wisconsin Alzheimer's Disease Research Center's Clinical Core. Predictors included validated NIH Toolbox Emotion Battery scales assessing positive affect, general life satisfaction, and meaning and purpose. Outcomes included performance on widely used tests of executive functioning and episodic memory. We conducted race-stratified regression models to assess within-group relationships. Black and AI/AN participants reported lower life satisfaction than white participants. Racial disparities were not observed for positive affect or meaning and purpose scores. Across groups, life satisfaction predicted better executive functioning. Similar associations were observed for positive affect in Black and AI/AN samples but not among whites. In general, well-being measures were not related to performance on tests of episodic memory. Our results highlight well-being as a potentially important determinant of late-life cognitive health, particularly executive functioning, that is modifiable if older adults are connected with appropriate resources and supports. Further, psychological well-being may represent a potent target for brain health interventions tailored for Black and Native communities.

Relations among gratitude, adaptation to disability, and flourishing among adults with disabilities: A longitudinal mediation model

PURPOSE/OBJECTIVE

Flourishing, a primary outcome of rehabilitation psychology, is understudied among adults with disabilities. Gratitude has emerged as an individual strength that is both malleable and robust in predicting flourishing and adaptation to disability. The purpose of this study was to assess the influence of gratitude on flourishing over time and to analyze the potential mediating role of adaptation to disability on this relationship for a group of adults with disabilities.

RESEARCH METHOD/DESIGN

Data were collected at 3 time points over 21 months (N = 429). A single mediator model with external demographic variables was tested to determine the relationship of gratitude (Time 1) with adaptation to disability (Time 2) and flourishing (Time 3). Approximately 40% of the initial sample was retained across all time points.

RESULTS

Gratitude predicted later flourishing and adaptation to disability accounted for a significant portion of this relationship, accounting for 27% of the total effect.

CONCLUSIONS/IMPLICATIONS

Results of this single mediator model indicate that adaptation to disability serves as a partial mediator of the relationship between gratitude and flourishing, with both gratitude and adaptation to disability having a significantly positive influence on flourishing. Understanding gratitude's influence on later adaptation and flourishing provides data to inform rehabilitation psychology interventions. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Measuring COVID-19 vaccine hesitancy among college students with disabilities: Sociodemographic and psychological correlates of COVID-19 vaccine hesitancy

Objective: The purpose of the study was to explore characteristics of vaccine hesitancy and behaviors among college students with disabilities. Participants and Methods: Participants consisted of 105 college students with disabilities (Mage=26.82, SD = 8.42), and a majority of participants were female (69.5%) and Hispanic (85%). Results: No demographic differences were observed in vaccine hesitancy scores in this sample. Those who do not know where to get reliable information about COVID-19 vaccination had higher scores on vaccine hesitancy than those who know how to obtain reliable information; and participants who had a negative experience with a previous vaccination also had higher scores of vaccine hesitancy. Additionally, findings demonstrated COVID-19 vaccine hesitancy scores were negatively associated with openness to experience personality trait and COVID-19-related perceived stress. Conclusions: Implications provide additional insight into factors associated with vaccine hesitancy among college students with disabilities.

Mental Health Among College Students During the COVID-19 Pandemic at a Hispanic-Serving Institution

This study examines the prevalence and severity of stress, anxiety, depression, and substance use among college students during the COVID-19 pandemic at a Hispanic-serving institution. The aim of the study is to increase knowledge about student mental health during a public health emergency in order to help develop strategies that promote student success. Using the Perceived Stress Scale-4 (PSS-4) and the Patient Health Questionnaire for Depression and Anxiety-4 (PHQ-4), we found high levels of stress, depression, and anxiety in the sample. Based on these findings, we propose a greater investment of time and resources to promote mental health and positive coping strategies among college students through culturally competent mental health and supportive programs.

Racial Differences in Associations of Cognitive Health Status With Happiness, Helplessness, and Hopelessness Among Older Adults: An Exploratory Study

Background

The relationship between healthy and positive aging and dementia and cognitive impairment has received limited attention in the field of aging. Affect impacts cognitive changes and processes, and cognitive impairment is associated with affective comorbidities. The purpose of the study was to examine (a) whether happiness, helplessness, and hopelessness are linked to cognitive health status, and (b) whether these associations differ by race.

Methods

Participants were enrollees in the Wisconsin Alzheimer's Disease Research Center's Clinical Core (ADRC). Average age at baseline was 60.85 (SD = 8.65), 73.70 (SD = 8.02), and 73.80 (SD = 9.59) years for cognitively normal individuals, individuals with MCI, and individuals with dementia, respectively.

Results

In the full sample, chi-square test results revealed associations between Cognitive Health Status (CHS) and (a) happiness, χ2(2) = 6.06, p < 0.05, (b) helplessness, χ2(2) = 6.44, p < 0.05, and (c) hopelessness, χ2(2) = 14.11, p < 0.01.

Conclusion

This study provides support for the association of both positive and negative affect with cognitive health status in middle- to older-aged adults.

Associations between mental health and job loss among middle‐ and low‐income veterans and civilians during the COVID‐19 pandemic: An exploratory study

This study examined the relationship between job loss and mental health during the pandemic among a nationally representative sample of middle- and low-income military veterans and civilians. Participants were recruited from Amazon Mechanical Turk in May-June 2020. Our sample was comparable to the U.S. population with respect to key demographics (i.e., sex, race, ethnicity, and geographic region). More veterans were male (36.9% civilians vs. 74.1% veterans), and on average they were older than civilians (M_civilians  = 47.86 vs. M_veterans  = 52.64). After controlling for sociodemographic factors, probable anxiety (adjusted odds ratio for veterans = 1.96, 95% [1.22-3.15]) was significantly associated with job loss among veterans, whereas among civilians, probable anxiety (adjusted odds ratio for civilians [AOR_c ] = 1.48, 95% [1.21-1.81]), probable COVID-19 era-related stress (AOR_c  = 1.73, 95% [1.45-2.07]), and loneliness (AOR_c  = 1.09, 95% [1.04-1.13]) were associated with job loss. Results demonstrated that veteran sample's effect sizes were larger than civilian sample's effect sizes; however, our moderation analyses results revealed that veteran status did not moderate the relationships between mental health and job loss. The findings in this study support a relationship between job loss and poorer mental health, suggesting that increased mental health services may be important to address ongoing effects of the COVID-19 pandemic.

An Evaluation of the PERMA Model as a Framework for Reducing Psychiatric Comorbidity in Individuals With Alopecia Areata

Abstract. Background: Alopecia areata (AA) is among the most common immunological conditions. Although AA is considered to be a medically benign condition, those living with AA often report comorbid psychiatric conditions, high levels of functional impairment, and diminished quality of life. These consequences are largely due to the unique psychological turmoil associated with the condition. Unfortunately, little research has considered how to improve quality of life outcomes for this group. Aims: The purpose of this study was to evaluate how the PERMA framework of well-being is associated with the individual subjective experience of AA. A greater understanding of how PERMA applies to this group holds promise for assisting clinicians with devising psychosocial coping strategies for this population. Method: 274 individuals were recruited for participation. Hierarchical regression analyses were used to evaluate associations between the PERMA variables and AA-related (a) subjective symptoms (e.g., self-consciousness, sadness) and (b) relationship impact (e.g., perceived attractiveness). Each analysis controlled for demographic and condition-specific variables. Results: Demographic and PERMA variables were found to be significantly associated with positive experiences of each quality of life outcome. Limitations: The male to female ratio of participants was biased toward females. Furthermore, the nature of cross-sectional survey research has inherent limitations. Conclusion: The findings provide support for a relationship between PERMA variables and quality of life outcomes among people with AA. Clinical implications and future research directions are discussed.

Functional Limitations, Post-Traumatic Stress Disorder, and College Adjustment in Student Veterans: A Mediation Analysis Study

Purpose

The purpose of this study was to examine whether functional limitations mediate the relation between PTSD symptoms and college life adjustment in student veterans with PTSD symptoms.

Methods

A total of 232 student veterans with PTSD symptoms were recruited for this study. Participants were predominantly male (84.5%; females = 15.5%). Participants’ ages ranged from 18 to 54 years (M = 28.43, SD = 5.42). Correlational analyses were conducted to calculate the relationships among study variables. We also conducted a mediation analysis to examine whether functional limitations mediate the relationship between PTSD symptoms and college life adjustment.

Results

The mediation analysis indicated that the effect of PTSD symptoms on college adjustment can be partially explained by functional limitations.

Conclusion

Our results have potentially important implications for rehabilitation counseling researchers and clinicians in the COVID-19 era.

Social isolation and well-being in veterans with mental illness

BACKGROUND

Veterans with mental illness are a growing population in the United States (US). For some veterans, their military service has a negative effect on well-being. Social isolation is problematic for veterans' mental health by increasing incidence of depression, suicidal ideation or attempts, and readmittance to psychiatric hospitals. Social support is a protective factor for individuals with mental illness and is key to a successful military-to-civilian transition.

AIM

Thus, we examine the relationship of social isolation on well-being among veterans with any mental illness.

METHODS

This cross-sectional correlational study consisted of a sample of 146 US veterans with any mental illness. A three-step hierarchical regression analysis was used to determine if social isolation is a predictor of well-being after controlling for demographics, functional limitations and depression.

RESULTS

Findings revealed social isolation was positively correlated with functional limitations (r = 0.48, p < 0.001), depression (r = 0.66, p < 0.001) and negatively correlated with well-being (r = -.64, p < 0.001). Hierarchical regression analysis revealed social isolation was negatively correlated (β = -.44, p < 0.001) with well-being. Overall, our three-step model accounted a total of 50% of variance in well-being, a large effect size.

CONCLUSION

The findings underscore the importance of assessing the relationship of social isolation on well-being in veterans with mental illness. The findings also highlight promising targets to improve prevention and psychosocial interventions to improve well-being among veterans with mental illness.

The Influence of State-Level Contextual Factors on State/Federal System Vocational Rehabilitation Employment Outcomes for Persons With Traumatic Brain Injury

The purpose of this exploratory study was to develop a preliminary understanding of the influence of state-level contextual factors predictive of employment outcomes for State/Federal Vocational Rehabilitation System (State VR) participants with traumatic brain injury (TBI). Participants were 5,213 individuals with TBI with Individualized Plans for Employment closed during Federal Fiscal Year 2016. A four-step hierarchical logistic regression model (5.6% explained variance) containing five demographic, three state-level economic, six state TBI service climate, and nine State VR service variable expenditures correctly classified 57.0% of cases as attaining or not attaining an employment outcome at closure. Significant predictors associated with an employment closure were (a) education, veteran status, and presence of a secondary area of disability impairment; (b) state-level per-capita income; (c) State VR specialized acquired brain injury (ABI)/TBI service and state TBI Implementation Partnership grant funding; and (d) State VR service expenditures on diagnosis and treatment, occupational or vocational training, on-the-job training, job readiness training, transportation, maintenance support, and benefits counseling. The practice, policy, and research implications of these findings are presented.

Character Strengths Across Disabilities: An International Exploratory Study and Implications for Positive Psychiatry and Psychology

The purpose of this study was to examine the differences in character strengths for people with disabilities by using an international dataset by the VIA Institiute on Character. Specifically, we aimed to explore (a) the top and bottom five character strengths reported by different disability groups and all people with disabilities more broadly, and (b) group differences in each character strength and total character strengths. The investigator contacted the VIA Institute on Character (http://www.viacharacter.org/) for obtaining the dataset for the current study. After data cleaning, our sample size resulted in 11,699 people with disabilities. Among most people with disabilities, the top five character strengths scores were love of learning, honesty, appreciation of beauty and excellence, kindness, and fairness. The bottom five character strengths scores were self-regulation, perseverance, zest, spirituality, and prudence. Knowing that there is heterogeneity in character strengths across groups gives us a better understanding of the areas that people with different disabilities and conditions might thrive and provides clinicians and practitioners with a more nuanced understanding for how to possibly intervene with their clients. Positive psychiatry and psychology implications are discussed.

Is Gratitude Associated With Suicidal Ideation in Veterans With Mental Illness and Student Veterans With PTSD Symptoms?

ABSTRACT

The present study is aimed to identify the effect of gratitude as an adaptive regulating mechanism from suicidal ideation (SI) for veterans with mental illness (study 1) and student veterans with posttraumatic stress disorder (PTSD) symptoms (study 2) in the United States. Descriptive statistics and regression analyses were used to examine sociodemographic characteristics and relationships between gratitude and SI. Our study 1 consisted of 156 veterans with mental illness. The mean age for study 1 was 37.85. Our study 2 consisted of 232 student veterans with PTSD symptoms. The mean age for study 2 was 28.43. Higher gratitude scores in study 1 and study 2 were significantly associated with lower SI scores after adjusting for demographics and depression. This study partially supports the association between gratitude and SI in veterans with mental illness. Based on the results from this study, gratitude interventions may be effective in reducing SI when working with veterans with mental illness.

Prevalence of lifetime nonmedical opioid use among U.S. Health Center Patients aged 45 years and older with psychiatric disorders

OBJECTIVE

Despite recent concerns over the increase in opioid misuse among aging adults, little is known about the prevalence of lifetime nonmedical opioid use in underserved, vulnerable middle-aged and older patients with psychiatric disorders. This study aims to determine the lifetime prevalence of nonmedical opioid use among underserved, vulnerable U.S. adults aged ≥45 years with psychiatric disorders.

METHOD

A nationally representative sample (n = 3,294) was obtained from the 2014 Health Center Patient Survey which collects data on psychiatric disorders, opioid use, and other health information from underserved, vulnerable U.S. primary care populations. Predictor variables included self-reported panic disorder, generalized anxiety disorder, schizophrenia, or bipolar disorder. The outcome variable was self-reported lifetime nonmedical opioid use. Frequencies, counts, and unadjusted and adjusted logistic regression models were conducted with the cross-sectional survey dataset.

RESULTS

Patients with bipolar disorder had the highest lifetime nonmedical opioid use rate (20.8%), followed by schizophrenia (19.3%), panic disorder (16.5%), and generalized anxiety disorder (14.5%). Nonmedical opioid use was significantly associated with bipolar disorder (OR 3.46, 95% CI [1.33, 8.99]) and generalized anxiety disorder (OR 2.03 95% CI [1.08, 3.83]).

CONCLUSION

Our findings demonstrate a high prevalence of lifetime nonmedical opioid use in underserved, vulnerable middle-aged and older health center patients with psychiatric disorders. Given the prevalence, health center professionals should monitor, prevent, and treat new or reoccurring signs and symptoms of nonmedical opioid use in this high-risk group of aging patients with psychiatric disorders.

Peer and Non-Peer Academic Scientists and Peer Support Specialist Community of Practice: Stakeholder Engagement to Advance the Science of Peer Support

Community of Practice, a community-engagement method that encourages a group of people to interact regularly towards a common goal, may promote satisfying experiences in patient-outcomes research among marginalized populations. Peer support specialists are increasingly being involved in peer-informed mental health research due to their lived experiences of mental illness and are an asset in co-designing healthcare programs along with researchers. In 2015, ten scientists and ten mental health service users joined as a Community of Practice that trained to engage in patient-centered outcomes research. The group has so far has presented at 20 conferences, published three book chapters and 30 peer-reviewed publications, and developed two smartphone applications. Of note are the co-production of a smartphone application, a digital peer support certification program, an app decision support tool, and an instrument to assess the value of patient-research partnerships. Future research will assess the feasibility of incorporating more stakeholders to enhance research outcomes.

A National Study to Assess Validity and Psychometrics of the Short Kessler Psychological Distress Scale (K6)

This study aimed to test the validity and reliability of the Kessler Psychological Distress Scale-6 (K6) with a nationally representative clinical sample with various mental health disorders. The cross-sectional, nationally representative, and publicly available data were extracted from the 2014 Health Center Patient Survey (HCPS), which was sponsored by the Health Resources and Services Administration (HRSA). After excluding certain individuals for the purpose of this study, we had a total of 1,863 participants. The highest and lowest psychological distress weighted scores were reported by individuals with bipolar disorder ( M = 17.16) and individuals with schizophrenia ( M = 16.09), respectively, although psychological distress interference was highest in individuals with schizophrenia ( M = 2.44). Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) results yielded a unidimensional factor solution for K6 scale in all subgroups. The K6 is a brief, reliable, and valid measure of psychological distress in adults with panic disorder, generalized anxiety disorder, bipolar disorder, and schizophrenia.

Key components of recovery predict occupational performance and health in peer support specialists

Objective: The primary purpose of the study was to explore and identify how components of recovery are associated with occupational performance and health among peer support specialists. Methods: One hundred and twenty-one peer support specialists were recruited from statewide peer certification training programs and the International Association of Peer Supporters. Study respondents completed a survey package including demographic questions and psychometrically sound self-report measures. Two hierarchical multivariable linear regression models were conducted to evaluate whether the recovery components of the process of recovery, social support for recovery, and work self-determination (i.e., work autonomy, work competence, and work relatedness) were associated with indicators of occupational performance (i.e., work engagement) and health (i.e., job satisfaction). Results: Work autonomy was associated with the occupational performance indicator, while the process of recovery and social support for recovery were the only recovery components associated with the indicator for occupational health. Conclusions and Implications for Practice: Findings support the importance of work self-determination and social support and recovery for occupational performance and health among peer support specialists. Mental health and rehabilitation professionals should address these key components of recovery when working with and supporting the work well-being of peer support specialists. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Psychometric Validation of the PERMA-Profiler as a Well-Being Measure for Young Adult Survivors of Pediatric Central Nervous System Tumor

This study aims to validate a measure of well-being, the PERMA-Profiler, among a sample of young adult survivors of pediatric central nervous system (CNS) tumor. Measurement structure of the PERMA-Profiler was evaluated using exploratory factor analysis and confirmatory factor analysis using pretest–posttest data. Reliability and concurrent validity of the PERMA-Profiler were examined. This study included 127 young adult survivors of pediatric CNS tumor between the ages of 18 and 30 ( M = 23.83, SD = 3.00) years. The results of factor analyses yielded a single-factor solution for well-being. Significant relationships between well-being and happiness, life satisfaction, perceived stress, and physical health were observed, providing support for the concurrent validity of the PERMA-Profiler. The PERMA-Profiler displayed good internal consistency and test–retest reliability. The PERMA-Profiler can help rehabilitation researchers and counselors better evaluate well-being in young adult survivors of pediatric CNS tumor, which provides opportunity for more targeted psychosocial interventions.

Preliminary Outcomes of an Older Peer and Clinician co-Facilitated Pain Rehabilitation Intervention among Adults Aged 50 Years and Older with Comorbid Chronic Pain and Mental Health Conditions

The present study aimed to examine the acceptability, feasibility, and preliminary effectiveness of an older peer and clinician co-facilitated Behavioral Activation for Pain Rehabilitation (BA-PR) intervention among adults aged 50 years and older with comorbid chronic pain and mental health conditions. This was a mixed-methods research design with eight participants aged 55 to 62 years old with mental health conditions including schizophrenia spectrum disorder, bipolar disorder, major depressive disorder, personality disorder, and adjustment disorder. The quantitative data were assessed from observational methods, a pain rating scale and related measures. We used semi-structured interviews for qualitative feedback on experiences with the BA-PR intervention after participation. Overall, the participants had positive experiences following receipt of the BA-PR intervention. The recruitment and adherence rates for participants were 72.7% and 100%, respectively. Approximately 75% of the participants remained enrolled in the study. Findings from a paired t-test showed the BA-PR intervention was linked to significantly reduced prescription opioid misuse risk, t (7) = 2.42, p < 0.05. There were also non-significant reductions in pain intensity and depression severity, in addition to improvements in active and passive pain coping strategies and behavioral activation.The BA-PR intervention is the first pain rehabilitation intervention specifically designed for middle-aged and older adults with comorbid chronic pain and mental health conditions. Our findings indicate promise for the BA-PR intervention to potentially reduce prescription opioid misuse risk, pain, and depressive symptoms. However, a quasi-experimental study is needed before rigorous effectiveness testing.

Differences in Psychosocial Factors and Experimental Pain Sensitivity between Hispanics and non-Hispanic Whites from the U.S.-Mexico Border

PURPOSE

Research suggests that ethnicity is a predictor of pain-related outcomes; however, studies comparing the differences in experimental pain sensitivity between Hispanics and non-Hispanic Whites (NHW) are scarce. This study investigated these differences between Hispanics and NHW from the U.S- Mexico border.

METHODS

Fifty-eight healthy subjects completed the survey packet, which included a demographic and a psychosocial factors questionnaire. Participants underwent quantitative sensory testing which included heat pain threshold, heat pain tolerance, Suprathreshold Heat Pain Response (SHPR), and Conditioned Pain Modulation (CPM). SHPR was induced by repeated thermal stimuli in both thenar eminences. CPM was assessed using SHPR as the experimental stimulus, and cold pressor task as the conditioning stimulus.

RESULTS

Analyses showed significant differences in experimental pain measures believed to be representative of facilitatory pain processing including SHPR, and heat pain threshold, where Hispanics reported significantly higher pain ratings than NHW. Hispanics also reported higher levels of ethnic identity and acculturation. However, these factors were not significantly associated with experimental pain sensitivity.

CONCLUSION

The experimental pain sensitivity and psychosocial factors included in this study differed by ethnic group, where Hispanics reported significantly higher pain ratings, when compared to NHW. However, ethnic identity and acculturation were not associated with these pain-related outcomes. Overall, enhanced understanding by clinicians of pain sensitivity and disparities in the pain experience between ethnic groups allows for increased cultural sensitivity and can be used to optimize pain treatment on an individual-by-individual basis.

Measuring grit in veterans with mental illnesses: Examining the model structure of grit

Objective: The purpose of this study was to examine the model structure, reliability, and validity of the Grit-S for veterans with mental illnesses. Method: A total of 156 veterans with mental illnesses (M_age = 37.85, SD = 10.74) were recruited from Amazon MTurk to complete an online survey consisting of the Short Grit Scale (Grit-S), the Brief Resilience Scale, the PERMA-Profiler, the Patient Health Questionnaire-9, and the World Health Organization Disability Assessment Schedule II. Results: Results revealed that grit is a multidimensional construct in veterans with mental illnesses. The Grit-S was found to have acceptable reliability and concurrent validity. Grit was found to be negatively associated with functional disability in veterans with mental illnesses after controlling for demographic variables. Conclusions and Implications: The Grit-S is a multidimensional, reliable, and valid scale for measuring grit in veterans with mental illnesses. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Functional limitations and worrying to lose employment among individuals with chronic conditions and disabilities during COVID-19: A hierarchical logistic regression model

BACKGROUND: As an unexpected environmental factor causing significant economic, financial, and health challenges for everyone, it is no wonder that COVID-19 presents significant employment-related worries for people with chronic health conditions and disabilities. OBJECTIVE: The purpose of this study was to explore whether higher levels of functional limitations are associated with worry about job loss for individuals with disabilities and chronic conditions. METHODS: Data for this study were collected to understand the effects of COVID-19 on individuals with disabilities and chronic conditions. A total of 219 employed participants were extracted from a total of 269 individuals with disabilities and chronic conditions. The mean age among participants was 37.83 (SD = 10.97). RESULTS: Our hierarchical logistic regression analysis revealed that (a) demographic variables were not associated with worry about job loss in the first block, (b) perceived COVID-19 stress (AOR = 2.90, p < 0.001) was correlated with worry about job loss in the second block, and (c) functional limitations (AOR = 1.06, p < 0.001) were positively correlated with worry about job loss in the third block. Overall, the entire model containing all predictor variables in three blocks explained 23% (Nagelkerke R2) of the variance in worry about job loss. CONCLUSIONS: This study contributes to the disability and vocational rehabilitation literature by examining the relationship between functional limitations and worry to lose jobs in people with disabilities.

Association of Demographic and Disability Characteristics With Total PROMISE Expenditure: Wisconsin PROMISE Findings—Brief Report

The purpose of this exploratory study was to examine whether demographic and disability variables predict total health care expenditure of Wisconsin PROMISE. The findings are intended to assist in promoting cost-effectiveness for future similar initiates. This study data were extracted from Wisconsin PROMISE data set. This study had a total of 1,443 youth with disabilities ( Mage = 14.89). The majority of participants were male (69%). Our results indicated that some demographic and disability–related characteristics are associated with total health care expenditure in control with VR case during PROMISE, control without VR case during PROMISE, and treatment group. Overall, findings of the current study suggest demographic and disability variables do assist in predicting total health care expenditure of Wisconsin PROMISE.

Perspectives of Veterans Affairs mental health providers on working with older adults with dementia and their caregivers

Continuing education directed at building providers' skills and knowledge in geriatrics represents a practical approach to addressing the geriatric mental health (MH) care workforce shortage. To inform the development of professional training curricula, we surveyed MH providers (N = 65) at a Veterans Affairs medical center on working with older persons with dementia (PwD) and informal caregivers. Providers rated service provision to PwD and caregivers as highly important but endorsed modest self-efficacy. Half of respondents were minimally confident in managing risk of harm to self or others in a PwD. Respondents believed PwD can benefit from MH treatments, yet identified several barriers to providing care, including inadequate time and staffing resources. Interest in geriatric training topics was high. Findings demonstrate that MH providers at this site value care provision to PwD and caregivers, and desire additional training to serve this population. System-level barriers to MH care for PwD should also be identified and addressed.

The Protective Role of Character Strengths in COVID-19 Stress and Well-Being in Individuals With Chronic Conditions and Disabilities: An Exploratory Study

Individuals with chronic conditions and disabilities, in response to stress associated with COVID-19, may experience a decrease in their overall well-being beyond that experienced by otherwise healthy individuals. Therefore, it is imperative to identify internal resources (e.g., character strengths) that can help them better manage COVID-19-related stress and enhance well-being in spite of COVID-19. This study explored the potential protective role of character strengths and virtues in moderating the negative effects of COVID-19 on stress and well-being. A cross-sectional study design was implemented. Participants included 269 individuals with self-reported chronic conditions and disabilities. After controlling for demographic and clinical characteristics, we examined whether character strengths and virtues acted as independent moderators between COVID-19-related stress and well-being. A higher degree of multiple character strengths significantly and independently moderated the relationship between COVID-19-related stress and well-being. Findings suggested the importance of promoting more character strengths overall in people with chronic conditions and disabilities to help them better manage COVID-19-related stress and enhance well-being.

Psychometric Validation of a Measure Assessing Functional Limitations of Students With Disabilities: An Adaptation of the World Health Organization Disability Assessment Schedule 2.0

The 12-item World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) has been used to assess functional impairments in various disability populations and has been shown to be applicable to the youth population. The purpose of the study was to evaluate the psychometric properties of the World Health Organization Disability Assessment Schedule II–Youth Version (WHODAS-Y). Results of the study revealed a two-factor solution, including the socio-cognitive index and self-care index. The WHODAS-Y measurement appears to be a reliable and valid measure of function impairment in transition-age youth with disabilities in a community setting. This assessment tool can be integrated in vocational rehabilitation practices and guide rehabilitation counselors in identifying needs and facilitators related to education and employment-related services, as well as understanding health care needs in youth with disabilities.