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Wells SY, Patel TA, Halverson TF, LoSavio ST, Morland L, Wachsman T, Ponzini GT, Kelton K, Mackintosh MA, Powell A, Kaplan S, Dillon KH. The impact of trauma-focused psychotherapies on anger: A systematic review and meta-analysis. Psychol Trauma 2024:2024-69054-001. [PMID: 38546592 DOI: 10.1037/tra0001697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2024]
Abstract
OBJECTIVE Anger is one of the most prevalent concerns among individuals with posttraumatic stress disorder (PTSD) and is often a residual symptom following PTSD treatment. The purpose of this systematic review and meta-analysis was to determine how effective trauma-focused PTSD psychotherapies are in reducing anger. METHOD The study was reported according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. This study conducted a systematic review of studies that reported the effect of trauma-focused treatments on anger outcomes. Additionally, a meta-analysis was conducted with a subset of studies that used randomized controlled trials (RCTs) methodologies to compare trauma-focused PTSD treatments to nontrauma-focused and control conditions. RESULTS The systematic review included 16 studies with a total of 1,846 participants. In 11 of the studies, there was a significant decrease in an anger dimension following treatment. Eight studies with 417 total participants met inclusion criteria for the meta-analysis. The meta-analysis yielded a pooled effect size of PTSD treatment on anger of Hedges's g = 0.33. CONCLUSION Overall, trauma-focused treatments for PTSD significantly improve anger, but the magnitude of change is small-to-medium. Additional research is needed to determine how best to maximize anger outcomes following trauma-focused treatment or determine if and when targeted anger treatment is needed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
- Stephanie Y Wells
- Durham Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham VA Health Care System
| | | | - Tate F Halverson
- VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center
| | | | - Leslie Morland
- National Center for PTSD, Women's Health Science Division
| | | | - Gabriella T Ponzini
- Durham Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham VA Health Care System
| | | | | | | | - Samantha Kaplan
- Duke University Medical Center Library & Archives, Duke University School of Medicine
| | - Kirsten H Dillon
- VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center
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Tsai J, Kelton K, Blonigen DM, Keith Mcinnes D, Sean Clark, Blue-Howells J, Hooshyar D. A Research Agenda for Criminal Justice Involvement Among U.S. Veterans. Mil Med 2024; 189:e481-e485. [PMID: 37283229 DOI: 10.1093/milmed/usad201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 05/15/2023] [Indexed: 06/08/2023] Open
Abstract
INTRODUCTION A substantial proportion of adults in the U.S. criminal justice system are military veterans. Justice-involved veterans are of particular public concern given their service to the country and the high rates of health and social problems in the general veteran population. This article describes the development of a national research agenda for justice-involved veterans. MATERIALS AND METHODS In the summer of 2022, the VA National Center on Homelessness among Veterans in partnership with the VA Veterans Justice Programs Office convened a national group of subject matter experts and stakeholders across three listening sessions that included 40-63 attendees per session. These sessions were recorded, and transcriptions of all sessions and chats were synthesized to generate a preliminary list of 41 agenda items. The Delphi method involving two rounds of ratings from subject matter experts was used to develop consensus. RESULTS The final research agenda consists of 22 items covering five domains: Epidemiology and knowledge of the population, treatment and services, systems and systems interface, methodology and research resources, and policies. CONCLUSIONS The intent of sharing this research agenda is to spur stakeholders to conduct, collaborate, and support further study in these areas.
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Affiliation(s)
- Jack Tsai
- U.S. Department of Veterans Affairs (VA) Homeless Programs Office, National Center on Homelessness among Veterans, Washington, DC 20420, USA
- School of Public Health, University of Texas Health Science Center at Houston, Houston, TX 77030, USA
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06511, USA
| | - Katherine Kelton
- U.S. Department of Veterans Affairs (VA) Homeless Programs Office, National Center on Homelessness among Veterans, Washington, DC 20420, USA
| | - Daniel M Blonigen
- U.S. Department of Veterans Affairs Palo Alto Health Care System, Center for Innovation to Implementation, Palo Alto, CA 94025, USA
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 01730, USA
| | - D Keith Mcinnes
- U.S. Department of Veterans Affairs , Bedford Health Care System, Bedford, MA 02118, USA
- School of Public Health, Boston University, Boston, MA 20420, USA
| | - Sean Clark
- U.S. Department of Veterans Affairs (VA) Homeless Programs Office, Veterans Justice Programs, Washington, DC 75390, USA
| | - Jessica Blue-Howells
- U.S. Department of Veterans Affairs (VA) Homeless Programs Office, Veterans Justice Programs, Washington, DC 75390, USA
| | - Dina Hooshyar
- U.S. Department of Veterans Affairs (VA) Homeless Programs Office, National Center on Homelessness among Veterans, Washington, DC 20420, USA
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
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Ishaq J, Eyman K, Goncy E, Williams L, Kelton K, Knickerbocker N. A Pilot Study of Yoga with Incarcerated Youth Using the Prison Yoga Project Approach. Int J Yoga Therap 2023; 33:Article 16. [PMID: 38155602 DOI: 10.17761/2023-d-23-00012] [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] [Indexed: 12/30/2023]
Abstract
In recent decades, there has been more significant implementation and research of yoga programs in prisons and correctional facilities. Existing literature suggests that adult and juvenile prison-based yoga programs may improve stress-management and self-regulation skills; reduce depression, anxiety, aggression, and addictive behaviors; and increase prosocial behaviors. However, yoga in juvenile correctional facilities is still understudied compared to adult populations. The Prison Yoga Project (PYP) and Yoga FLAME (Focus, Letting go, Anger management, Mindfulness, and Exhaling negativity) are two frameworks used to structure the implementation of prison-based yoga programs among incarcerated adolescents. The present study aimed to describe trauma-related stress and self-regulation levels in a sample of incarcerated youth and to explore yoga's effects on developing stress-reduction skills. The study collected measures on overall and in-session stress reduction and baseline self-regulation. Because of the COVID-19 pandemic and public-safety restrictions, the present study was prematurely terminated after 5 months. Only pre-assessment measures were collected. Across time, participants reported a 38% mean stress reduction from the beginning to the end of a yoga session. Incarcerated youth with higher initial self-regulation levels showed higher pre- to post-session improvements in stress. The present findings provide valuable evidence that yoga practice using the combined PYP and FLAME framework can deliver practical benefits to juvenile correctional facilities. Furthermore, yoga may be used to foster rehabilitation, enhance skill development, and facilitate greater success in youth transitioning back into the community.
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Affiliation(s)
- Jennifer Ishaq
- Department of Psychology, Cleveland State University, Ohio
| | - Kyle Eyman
- Doctoral student, School of Psychology, University of Indianapolis, Indiana
| | - Elizabeth Goncy
- Associate Professor of Psychology, Department of Psychology, Cleveland State University, Ohio
| | - Lynn Williams
- Psychologist, Cuyahoga County Common Pleas Court, Juvenile Division, Ohio
| | - Katherine Kelton
- Staff Psychologist, VA Boston Healthcare System, Department of Veterans Affairs, Massachusetts
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Han BH, Bronson J, Washington L, Yu M, Kelton K, Tsai J, Finlay AK. Co-occurring Medical Multimorbidity, Mental Illness, and Substance Use Disorders Among Older Criminal Legal System-Involved Veterans. Med Care 2023; 61:477-483. [PMID: 37204150 PMCID: PMC10330246 DOI: 10.1097/mlr.0000000000001864] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
BACKGROUND Older veterans involved in the criminal legal system (CLS) may have patterns of multimorbidity that place them at risk for poor health outcomes. OBJECTIVES To estimate the prevalence of medical multimorbidity (≥2 chronic medical diseases), substance use disorders (SUDs), and mental illness among CLS-involved veterans aged 50 and older. RESEARCH DESIGN Using Veterans Health Administration health records, we estimated the prevalence of mental illness, SUD, medical multimorbidity, and the co-occurrence of these conditions among veterans by CLS involvement as indicated by Veterans Justice Programs encounters. Multivariable logistic regression models assessed the association between CLS involvement, the odds for each condition, and the co-occurrence of conditions. SUBJECTS Veterans aged 50 and older who received services at Veterans Health Administration facilities in 2019 (n=4,669,447). METHODS Mental illness, SUD, medical multimorbidity. RESULTS An estimated 0.5% (n=24,973) of veterans aged 50 and older had CLS involvement. For individual conditions, veterans with CLS involvement had a lower prevalence of medical multimorbidity compared with veterans without but had a higher prevalence of all mental illnesses and SUDs. After adjusting for demographic factors, CLS involvement remained associated with concurrent mental illness and SUD (adjusted odds ratio [aOR] 5.52, 95% CI=5.35-5.69), SUD and medical multimorbidity (aOR=2.09, 95% CI=2.04-2.15), mental illness and medical multimorbidity (aOR=1.04, 95% CI=1.01-1.06), and having all 3 simultaneously (aOR=2.42, 95% CI=2.35-2.49). CONCLUSIONS Older veterans involved in the CLS are at high risk for co-occurring mental illness, SUDs, and medical multimorbidity, all of which require appropriate care and treatment. Integrated care rather than disease-specific care is imperative for this population.
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Affiliation(s)
- Benjamin H. Han
- University of California San Diego Department of Medicine, Division of Geriatrics, Gerontology, and Palliative Care, San Diego, CA
- Veterans Affairs San Diego Healthcare System, Jennifer Moreno Department of Veterans Affairs Medical Center, San Diego, CA
| | - Jennifer Bronson
- National Association of State Mental Health Program Directors Research Institute (NRI), Falls Church, VA
| | - Lance Washington
- National Association of State Mental Health Program Directors Research Institute (NRI), Falls Church, VA
| | - Mengfei Yu
- Center for Innovation to Implementation, VA Palo Alto Healthcare System, Menlo Park, CA
| | - Katherine Kelton
- South Texas Veteran Health Care System, Audie L. Murphy Veteran Hospital San Antonio, TX
| | - Jack Tsai
- School of Public Health, University of Texas Health Science Center at Houston, Houston, TX
| | - Andrea K. Finlay
- Center for Innovation to Implementation, VA Palo Alto Healthcare System, Menlo Park, CA
- National Center on Homelessness Among Veterans, Department of Veterans Affairs
- Schar School of Policy and Government, George Mason University
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Van Voorhees EE, Dillon KH, Crombach A, Beaver T, Kelton K, Wortmann JH, Visn-Mid-Atlantic Mirecc Workgroup, Nieuwsma J. Enjoying the violence of war: Association with posttraumatic symptomatology in U.S. combat veterans. Psychol Trauma 2023:2023-84472-001. [PMID: 37384480 PMCID: PMC10755059 DOI: 10.1037/tra0001530] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/01/2023]
Abstract
OBJECTIVE Engaging in war-related violence can have a devastating impact on military personnel, with research suggesting that injuring or killing others can contribute to posttraumatic stress disorder (PTSD), depression, and moral injury. However, there is also evidence that perpetrating violence in war can become pleasurable to a substantial number of combatants and that developing this "appetitive" form of aggression can diminish PTSD severity. Secondary analyses were conducted on data from a study of moral injury in U.S., Iraq, and Afghanistan combat veterans, to examine the impact of recognizing that one enjoyed war-related violence on outcomes of PTSD, depression, and trauma-related guilt. METHOD Three multiple regression models evaluated the impact of endorsing the item, "I came to realize during the war that I enjoyed violence" on PTSD, depression, and trauma-related guilt, after controlling for age, gender, and combat exposure. RESULTS Results indicated that enjoying violence was positively associated with PTSD, β (SE) = 15.86 (3.02), p < .001, depression, β (SE) = 5.41 (0.98), p < .001, and guilt, β (SE) = 0.20 (0.08), p < .05. Enjoying violence moderated the relationship between combat exposure and PTSD symptoms, β (SE) = -0.28 (0.15), p < .05, such that there was a decrease in the strength of the relationship between combat exposure and PTSD in the presence of endorsing having enjoyed violence. CONCLUSIONS Implications for understanding the impact of combat experiences on postdeployment adjustment, and for applying this understanding to effectively treating posttraumatic symptomatology, are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
| | | | | | | | | | - Jennifer H Wortmann
- Mid-Atlantic Mental Illness Research, Education and Clinical Center (MIRECC)
| | | | - Jason Nieuwsma
- Mid-Atlantic Mental Illness Research, Education and Clinical Center (MIRECC)
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Tsai J, Kelton K. Service use and barriers to care among homeless veterans: Results from the National Veteran Homeless and Other Poverty Experiences (NV-HOPE) study. J Community Psychol 2023; 51:507-515. [PMID: 35748189 DOI: 10.1002/jcop.22912] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 05/22/2022] [Accepted: 06/09/2022] [Indexed: 06/15/2023]
Abstract
The objective of this study was to examine type of services U.S. veterans seek when they experience homelessness, characteristics associated with service use, and reasons for not using services. Data from a 2021 nationally representative survey of 1004 low-income U.S. veterans were analyzed with descriptive and multivariable analyses. One-quarter of low-income U.S. veterans with experiences of homelessness reported using homeless services while they were homeless and about 27% reported using U.S. Department of Veterans Affairs (VA) healthcare or benefits while homeless. Black and Hispanic veterans were more likely to use both homeless services and VA services while homeless than veterans of other race/ethnic groups. The most common barriers to services were: veterans felt they did not need help, they did not have information about services, there was stigma and shame, and transportation barriers were encountered. These findings suggest veterans use various VA and community-based homeless and healthcare services, but they do experience barriers that may be improved with better public information and care coordination to improve service uptake among homeless veterans.
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Affiliation(s)
- Jack Tsai
- U.S. Department of Veterans Affairs, National Center on Homelessness among Veterans, Tampa, Florida, USA
- Department of Management, Policy, and Community Health, School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Katherine Kelton
- U.S. Department of Veterans Affairs, National Center on Homelessness among Veterans, Tampa, Florida, USA
- Department of Management, Policy, and Community Health, School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas, USA
- South Central Mental Illness Research Education and Clinical Center (MIRECC), Houston, TX, USA
- South Texas Veterans Health Care System, San Antonio Geriatric Research Education and Clinical Center (GRECC), San Antonio, TX, USA
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Kelton K, Van Voorhees EE, Elbogen EB, Workgroup VAMAMIRECC, Dillon KH. Correlates of Incarceration History Among Military Veterans. Mil Psychol 2022; 2022:577-589. [PMID: 36712896 PMCID: PMC9881233 DOI: 10.1080/08995605.2022.2141049] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 10/25/2022] [Indexed: 11/23/2022]
Abstract
Veterans with histories of incarceration are at greater risk for poor physical and mental health outcomes, yet prior research in this population has focused on specific subsets of veterans or a narrow range of predictors. We utilized the Bronfenbrenner Socioecological Model as the framework to evaluate correlates of incarceration history in a large sample of Iraq and Afghanistan-era veterans at four levels: demographic, historical, clinical, and contextual. Participants were 2,904 veterans (76.9% male; 49.5% White and 46.5% Black; mean age 38.08, SD = 10.33), 700 of whom reported a history of incarceration. Four logistic regression models predicting history of incarceration were tested, adding demographic, historical, clinical, and contextual variables hierarchically. In the final model, younger age (OR=0.99, 95% CI=0.98-1.00), male gender (OR of being female =0.28, 95% CI=0.21-0.38), belonging to a historically marginalized group (OR of being White =0.69, 95% CI=0.56-0.84), family history of incarceration (OR=1.47, 95% CI=1.10-1.94), adult interpersonal trauma (OR=1.39, 95% CI=1.28-1.51), problematic alcohol use (OR=1.03, 95% CI=1.02-1.05), drug abuse (OR=1.15, 95% CI=1.11-1.19), and unemployment (OR for being employed=0.76, 95% CI=0.62-0.92) were significantly associated with a history of incarceration. Implications of these findings for developing interventions and supporting systems to effectively target this high-risk population of veterans are discussed.
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Affiliation(s)
- Katherine Kelton
- Research & Development, Durham VA Health Care System, Durham, North Carolina, USA
| | - Elizabeth E. Van Voorhees
- Research & Development, Durham VA Health Care System, Durham, North Carolina, USA
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, USA
- VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, North Carolina, USA
| | - Eric B. Elbogen
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, USA
- VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, North Carolina, USA
- National Center on Homelessness among Veterans, Washington, District of Columbia, USA
| | | | - Kirsten H. Dillon
- Research & Development, Durham VA Health Care System, Durham, North Carolina, USA
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, USA
- VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, North Carolina, USA
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Kelton K, Young JR, Evans MK, Eshera YM, Blakey SM, Mann AJD, Pugh MJ, Calhoun PS, Beckham JC, Kimbrel NA. Complementary/integrative healthcare utilization in US Gulf-War era veterans: Descriptive analyses based on deployment history, combat exposure, and Gulf War Illness. Complement Ther Clin Pract 2022; 49:101644. [PMID: 35947938 PMCID: PMC9669216 DOI: 10.1016/j.ctcp.2022.101644] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 06/20/2022] [Accepted: 07/23/2022] [Indexed: 11/20/2022]
Abstract
Complementary and integrative health (CIH) approaches have gained empirical support and are increasingly being utilized among veterans to treat a myriad of conditions. A cluster of medically unexplained chronic symptoms including fatigue, headaches, joint pain, indigestion, insomnia, dizziness, respiratory disorders, and memory problems, often referred to as Gulf War Illness (GWI) prominently affect US Gulf War era (GWE) veterans, yet little is known about CIH use within this population. Using data collected as part of a larger study (n = 1153), we examined the influence of demographic characteristics, military experiences, and symptom severity on CIH utilization, and utilization differences between GWE veterans with and without GWI. Over half of the sample (58.5%) used at least one CIH modality in the past six months. Women veterans, white veterans, and veterans with higher levels of education were more likely to use CIH. GWE veterans with a GWI diagnosis and higher GWI symptom severity were more likely to use at least one CIH treatment in the past six months. Over three quarters (82.7%) of veterans who endorsed using CIH to treat GWI symptoms reported that it was helpful for their symptoms. Almost three quarters (71.5%) of veterans indicated that they would use at least one CIH approach if it was available at VA. Results provide a deeper understanding of the likelihood and characteristics of veterans utilizing CIH to treat health and GWI symptoms and may inform expansion of CIH modalities for GWE veterans, particularly those with GWI.
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Affiliation(s)
- Katherine Kelton
- South Texas Veteran Health Care System, Audie L. Murphy Veteran Hospital San Antonio, TX, USA; National Center for Homelessness Among Veterans, USA.
| | - Jonathan R Young
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA; Durham Veterans Affairs Health Care System, Durham, NC, USA; Mid-Atlantic Mental Illness Research, Education, And Clinical Center (MIRECC), Durham, NC, USA
| | - Mariah K Evans
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA; Durham Veterans Affairs Health Care System, Durham, NC, USA
| | - Yasmine M Eshera
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA; Durham Veterans Affairs Health Care System, Durham, NC, USA
| | - Shannon M Blakey
- Durham Veterans Affairs Health Care System, Durham, NC, USA; Mid-Atlantic Mental Illness Research, Education, And Clinical Center (MIRECC), Durham, NC, USA
| | - Adam J D Mann
- Department of Psychology, University of Toledo, Toledo, OH, USA
| | - Mary Jo Pugh
- VA Salt Lake City Health Care System and IDEAS Center of Innovation, Salt Lake City UT, USA; University of Utah School of Medicine, Department of Medicine, Salt Lake City UT, USA
| | - Patrick S Calhoun
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA; Durham Veterans Affairs Health Care System, Durham, NC, USA; Mid-Atlantic Mental Illness Research, Education, And Clinical Center (MIRECC), Durham, NC, USA; Durham HSRD Center (ADAPT), USA
| | - Jean C Beckham
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA; Durham Veterans Affairs Health Care System, Durham, NC, USA; Mid-Atlantic Mental Illness Research, Education, And Clinical Center (MIRECC), Durham, NC, USA
| | - Nathan A Kimbrel
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA; Durham Veterans Affairs Health Care System, Durham, NC, USA; Mid-Atlantic Mental Illness Research, Education, And Clinical Center (MIRECC), Durham, NC, USA; Durham HSRD Center (ADAPT), USA
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Tsai J, Kelton K, Gluff J, Elbogen E. Terms That Refer to Homeless Populations: National Surveys of Several Stakeholder Groups. Psychiatr Serv 2022; 74:415-418. [PMID: 35895838 DOI: 10.1176/appi.ps.202100708] [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] [Indexed: 11/30/2022]
Abstract
OBJECTIVE This study examined the descriptive terms used in referring to homeless populations. METHODS Data were from a 2020 national survey of 6,607 middle- and low-income U.S. adults with or without lived experiences of homelessness and a 2021 survey of a convenience sample of 354 U.S. researchers, homelessness service providers, and policy makers. RESULTS Among the middle- and low-income adults, 70%-73% reported using the term "homeless person," although adults with histories of homelessness were more likely to use "person experiencing homelessness" than those with no such histories. Among the providers, researchers, and policy makers, ≥39% reported using "person experiencing homelessness" in both writing and speaking, and they also had consensus around using "person at risk of homelessness" and "person in shelter." CONCLUSIONS Most stakeholders agreed that "homeless person" or "person experiencing homelessness" are acceptable terms. Because usage may vary by social background, profession, and individual, best practice may be to ask individuals with experiences of homelessness what terms they prefer to use.
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Affiliation(s)
- Jack Tsai
- National Center on Homelessness Among Veterans, U.S. Department of Veterans Affairs, Tampa, Florida (all authors); School of Public Health, University of Texas Health Science Center at Houston, Houston (Tsai); Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina (Elbogen)
| | - Katherine Kelton
- National Center on Homelessness Among Veterans, U.S. Department of Veterans Affairs, Tampa, Florida (all authors); School of Public Health, University of Texas Health Science Center at Houston, Houston (Tsai); Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina (Elbogen)
| | - Jeffrey Gluff
- National Center on Homelessness Among Veterans, U.S. Department of Veterans Affairs, Tampa, Florida (all authors); School of Public Health, University of Texas Health Science Center at Houston, Houston (Tsai); Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina (Elbogen)
| | - Eric Elbogen
- National Center on Homelessness Among Veterans, U.S. Department of Veterans Affairs, Tampa, Florida (all authors); School of Public Health, University of Texas Health Science Center at Houston, Houston (Tsai); Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina (Elbogen)
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Termos M, Holzer KJ, Vaughn MG, Kelton K. Gender Differences in Prescription Medications Among Transitioning Justice-Involved Individuals. J Correct Health Care 2022; 28:198-202. [PMID: 35475658 DOI: 10.1089/jchc.20.10.0088] [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] [Indexed: 11/12/2022]
Abstract
Little is known-especially with regard to gender differences-about the prescription trends among justice-involved individuals with health conditions after release from correctional facilities. This article presents initial findings from a large outreach program designed to provide prescription support during the turbulent prison-to-community transition period. We analyzed data derived from a prescription outreach program during the years 2018-2019. Multivariate logistic regression was employed to examine the association between gender and therapeutic areas, controlling for age and race. Compared with men, women were at higher odds of receiving prescriptions for psychiatric conditions followed by neurological conditions, but lower odds of receiving prescriptions for cardiovascular conditions. Further research is necessary to unpack the causal pathways that underlie the associational trends observed in our current analysis.
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Affiliation(s)
- Mirvat Termos
- School of Social Work, College for Public Health and Social Justice, Saint Louis University, St. Louis, Missouri, USA
| | - Katherine J Holzer
- Division of Clinical and Translational Research, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Michael G Vaughn
- College for Public Health and Social Justice, Saint Louis University, St. Louis, Missouri, USA.,Graduate School of Social Welfare, Yonsei University, Seoul, Republic of Korea
| | - Katherine Kelton
- Department of Psychology, Saint Louis University, St. Louis, Missouri, USA
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Kelton K, Greif TR, Meinerding M, Elrod N, Harvey RD. Discrimination and financial, occupational, and emotional well-being in strip club dancers during the COVID-19 pandemic: A call for policy reform. Stigma and Health 2022. [DOI: 10.1037/sah0000368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Kelton K, Weaver TL, Willoughby L, Kaufman D, Santowski A. The Efficacy of Binaural Beats as a Stress-buffering Technique. Altern Ther Health Med 2021; 27:28-33. [PMID: 32619206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
CONTEXT Distress has deleterious effects on health. While complementary and alternative medicine (CAM) is a growing system of practices in the treatment of health and mental-health conditions, many individuals have limited access to mind-body interventions. Creating accessible stress-inoculation strategies may augment traditional mental-health interventions and services. OBJECTIVE This pilot study intended to assess the effectiveness of a theta binaural beat (TBB) auditory stimulus on heart rate and self-reported stress, which was experimentally induced by the Trier Social Stress Test (TSST). DESIGN The repeated measures study compared the stress levels after a stimulus and stressor for two groups, within an experimentally induced psychological stress paradigm, the Trier Social Stress Test (TSST). SETTING The study occurred at a private Midwestern university. PARTICIPANTS Participants were 64 US adults recruited from undergraduate classes at the university, with a mean age of 19 years and a range from 18 to 30. INTERVENTION Participants were randomly assigned to the intervention or the control group. The intervention group listened to pink sound, carrier tones, and embedded TBB, while the control group listened to pink sound and carrier tones without embedded TBB. OUTCOME MEASURES Participants completed self-report assessments about the auditory stimulus, perceived stress, and mindfulness and then engaged in the Trier Social Stress Test (TSST). Subsequently, they completed measures on perceived stress using a visual analogue scale (VAS), and heart rate variability (HRV) was recorded throughout the study. RESULTS With respect to the evaluation of subjective stress using the VAS, psychological stress increased significantly between the exposure to the stimuli and the TSST-F(1.28, 53) = 42.76, P = .01, partial η2 = 0.44. The change in stress levels for the intervention group, however, was not significantly different from that of the control group at any time point F(1.28, 53) = 1.03, P = .33, partial η2 = 0.02. With respect to the evaluation of physiological response to stress using the HRV, the changes in HF HRV between the 4, five-minute segments during stimulus exposure were not significantly different between the groups F(3, 55) = 0.90, P = .44, partial η2 = 0.02. A significantly greater change-F(1, 55) = 4.84, P = .03 partial η2 = 0.08-in the HF HRV occurred over the TSST period for the intervention group compared to the control group suggesting that on average across the TSST stress tasks, those in the intervention group demonstrated higher HF signals. CONCLUSIONS The current study found that the intervention group, who listened to TBBs, had greater parasympathetic dominance during TSST than the control group. This suggests that TBB exposure may dampen subsequent stress responses to an acute, psychological stressor. This finding, however, should be interpreted with caution, because further research and independent replication are warranted.
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Weaver TL, Kelton K, Riebel J. The Relationship between Women's Resources and Health-Related Quality of Life in a Sample of Female Victims of Intimate Partner Violence. J Soc Serv Res 2021; 47:565-578. [PMID: 35694202 PMCID: PMC9187049 DOI: 10.1080/01488376.2020.1859433] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
While it is known that resource inadequacy increases the risk of exposure to intimate partner violence (IPV) and that women's health is significantly impacted by IPV, scant research has documented diminished resources as a primary determinant of women's health. Fifty female victims of moderate to severe IPV completed assessments of their physical, sexual and psychological experiences of IPV, resource profile, symptoms of posttraumatic stress disorder (PTSD) and depression and mental and physical health-related quality of life (HRQoL). Women's resources, controlling for age, income, psychological abuse and sexual coercion, were unique predictors of symptoms of PTSD, symptoms of depression; and mental HRQoL. The public health implications of the adequacy of women's resources are discussed in the context of IPV prevention and intervention. Future studies should evaluate the efficacy of economic empowerment programs regarding the impact on IPV survivors' mental and physical health and safety.
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Weaver TL, Elrod NM, Kelton K. Intimate Partner Violence and Body Shame: An Examination of the Associations Between Abuse Components and Body-Focused Processes. Violence Against Women 2019; 26:1538-1554. [PMID: 31543074 DOI: 10.1177/1077801219873434] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Intimate partner violence (IPV) is a stigmatizing, interpersonal violation with elements that confer risk for body shame. This study examined the role of body-focused processes (i.e., self-objectification and body surveillance) in the development of body shame within a sample of 61 primarily African American women, exposed to moderate to severe IPV. Severity of sexual coercion, physical assault, and psychological abuse were significantly associated with increased body shame and self-objectification. Mediation analyses revealed that self-objectification was a unique mediator of the relationship between psychological abuse, physical assault, sexual coercion, and body shame. Implications for women's health care experiences are discussed.
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McLaughlin EA, Campos-Melady M, Smith JE, Serier KN, Belon KE, Simmons JD, Kelton K. The role of familism in weight loss treatment for Mexican American women. J Health Psychol 2016; 22:1510-1523. [DOI: 10.1177/1359105316630134] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Mexican American women are disproportionately affected by overweight/obesity and the health complications accompanying them, but weight loss treatments are less successful in this ethnic group. High levels of familism, a value reflecting obligation to family that supersedes attention to oneself, interfere with weight loss for Mexican American women. This mixed methods study investigated overweight Mexican American women’s beliefs about how familism, and Mexican American culture, might hinder weight loss success, and how treatments might be culturally adapted. Results suggest a need to support women in their commitment to family while also helping them make changes. Recommendations for culturally adapted treatments are made.
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Corley MC, Zimmerman P, Kelton K, Veazey M. Coronary care documentation: incentives for improvement. Nurs Manag (Harrow) 1986; 17:34A-34F. [PMID: 3638563 DOI: 10.1097/00006247-198609000-00013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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