Medication treatment perceptions, concerns and expectations among depressed individuals with Type I Bipolar Disorder

BACKGROUND: Subjective experience of illness affects outcomes among populations with bipolar disorder (BD). This cross-sectional study combined qualitative and quantitative approaches to evaluate perceived treatment effects, concerns and expectations among 90 individuals with BD. METHODS: Adults with type I BD, mean age 36.6 years, 51% women, completed a semi-structured interview that was audio taped, transcribed, coded and analyzed along emergent themes. Quantitative scales measured depressive symptoms (Hamilton Depression Scale/HAMD), psychopathology (Clinical Global Impression/CGI), and insight and treatment attitudes (Insight and Treatment Attitudes Questionnaire/ITAQ). RESULTS: Individuals had moderate depression and psychopathology with good insight into need for treatment. Drug treatment was perceived as beneficial, by “stabilizing” or “balancing” mood (42%, N=38), decreasing anxiety/depressive symptoms (19%, N=17) and improving sleep (10%, N=9). While 39%, (N=35) of individuals denied medication concerns, nearly 29%, (N=26) feared possible long-term effects, particularly diabetes or liver/kidney damage. Media stories and advertisements contributed to medication fears. Hopes and expectations for treatment ranged from those that were symptom or functional status-based, such as desiring mood stabilization and elimination of specific symptoms (23%, N=21), to more global hopes such as “being normal” (20%, N=18) or “cured” (18%, N=16). LIMITATIONS: Limitations include relatively small sample, lack of a comparator, inclusion of only depressed individuals and those willing to discuss their illness experience. CONCLUSIONS: While individuals with BD appreciate the effects of medications, concerns regarding adverse effects and discrepancy between actual and hoped-for outcomes can be substantial. Subjective experience with medications using qualitative and quantitative methods should be explored in order to optimize treatment collaboration and outcomes

Differences in Relationship and Sexual Satisfaction and Social Support Between Only Lesbian, Mostly Lesbian, and Bisexual Women

Research suggests relationship and sexual satisfaction and social support are correlated with components of well-being such as anxiety, depression, and physical health. Differences in relationship and sexual satisfaction and social support have been identified between sexual minority women (SMW; i.e., lesbian and bisexual) and heterosexual women. However, classifying SMW into a single group may mask important differences. Further research is needed to better understand the differences in relationship and sexual satisfaction and social support between subgroups of SMW. Thus, the purpose of the present study was to examine differences in these constructs between women who identify as only lesbian, mostly lesbian, and bisexual. Participants were 427 partnered sexual minority women (Mage = 24.66; 84.8% White; 46.8% only lesbian; 34.2% mostly lesbian; 19% bisexual) recruited from social media to complete an online survey consisting of measures of relationship, health, and related factors as part of a larger study. A one-way ANOVA revealed statistically significant differences between only lesbian, mostly lesbian, and bisexual women in relationship satisfaction (p=.021), sexual satisfaction (p=.049), and social support (p=.034). Post-hoc pairwise comparisons revealed women who identified as only lesbian reported better relationship satisfaction (p=.007), sexual satisfaction (p=.015), and social support (p=.010) than women who identified as mostly lesbian. There were no differences between bisexual women and women who identified as either only lesbian or mostly lesbian. These findings identified important differences between subgroups of SMW, with women who identify as mostly lesbian reporting the lowest relationship and sexual satisfaction and social support. This study provides further evidence that collapsing across identities within the broad category of SMW may mask meaningful subgroup differences. Additional research is needed to further explore disparities in well-being among subsections of SMW. Findings may help identify important protective factors for mental and physical health and well-being specific to SMW of different identities.https://digitalcommons.odu.edu/gradposters2023_sciences/1007/thumbnail.jp

Recruiting and Retaining Individuals with Serious Mental Illness and Diabetes in Clinical Research: Lessons Learned from a Randomized, Controlled Trial.

Abstract: Recruitment and retention of individuals with serious mental illness (SMI) and comorbid diabetes mellitus (DM) in research studies can be challenging with major impediments being difficulties reaching participants via telephone contact, logistic difficulties due to lack of transportation, ongoing psychiatric symptoms, and significant medical complications. Research staff directly involved in recruitment and retention processes of this study reviewed their experiences. The largest barriers at the macro, mediator, and micro levels identified in this study were inclement weather, transportation difficulties, and intermittent and inaccessible telephone contact. Barrier work-around practices included using the health system’s EHR to obtain current phone numbers, providing transportation assistance (bus passes or parking reimbursement), and flexible scheduling of appointments. Suggestions are intended to assist in planning for recruitment and retention strategies

Understanding Etiologies of Road Traffiffic Crashes, Injuries, and Death for Patients at National Hospital Abuja: A Qualitative Content Analysis Using Haddon\u27s Matrix

Road traffic crashes and sequelae are reaching pandemic proportions globally and have currently achieved disproportionately high levels in Nigeria. Quantitative studies are accumulating in the peer-reviewed literature, but there is a paucity of qualitative research in Nigeria. Data for this study of structural and behavioral factors of road traffic crashes and injuries in Federal Capital Territory were collected in semi-structured interviews with crash survivors at National Hospital Abuja. Interviews were analyzed via qualitative content analysis, revealing crash location and participant beliefs about crash etiologies. Units of analysis were developed from participant statements and were structured within four a priori etiologic categories using Haddon\u27s (1980) matrix: human-, vehicle-, physical environment-, and socioeconomic environment-related. Subcategories were generated. Human-related subcategories included reckless behavior and drivers, limited technical knowledge and skill. Vehicle-related subcategories included vehicular disrepair and lack of safety equipment. Physical environment-related subcategories included road disrepair, infrastructural inadequacy, and weather. Socioeconomic environment-related subcategories included government, prehospital care, money, and prayer. Subcategories were organized temporally by pre-event, event, and post-event phases, with most units of analysis allocated in the preevent phase. These qualitative results can be utilized to guide future research along community-aligned priorities, and to structure community-engaged preventative and interventional efforts

Understanding Etiologies of Road Traffic Crashes, Injuries, and Death for Patients at National Hospital Abuja: A Qualitative Content Analysis Using Haddon’s Matrix

Road traffic crashes and sequelae are reaching pandemic proportions globally and have currently achieved disproportionately high levels in Nigeria. Quantitative studies are accumulating in the peer-reviewed literature, but there is a paucity of qualitative research in Nigeria. Data for this study of structural and behavioral factors of road traffic crashes and injuries in Federal Capital Territory were collected in semi-structured interviews with crash survivors at National Hospital Abuja. Interviews were analyzed via qualitative content analysis, revealing crash location and participant beliefs about crash etiologies. Units of analysis were developed from participant statements and were structured within four a priori etiologic categories using Haddon’s (1980) matrix: human-, vehicle-, physical environment-, and socioeconomic environment-related. Subcategories were generated. Human-related subcategories included reckless behavior and drivers, limited technical knowledge and skill. Vehicle-related subcategories included vehicular disrepair and lack of safety equipment. Physical environment-related subcategories included road disrepair, infrastructural inadequacy, and weather. Socioeconomic environment-related subcategories included government, prehospital care, money, and prayer. Subcategories were organized temporally by pre-event, event, and post-event phases, with most units of analysis allocated in the pre-event phase. These qualitative results can be utilized to guide future research along community-aligned priorities, and to structure community-engaged preventative and interventional efforts

Refining an Ecological Momentary Assessment Study of Binge Eating Among Sexual Minority and Heterosexual Young Women: A Mixed Methods Pilot Study

Background: Ecological momentary assessment (EMA) is used to capture daily lived experiences, states, and environments. Although EMA is commonly used in behavioral health research, there remains a dearth of literature on how researchers account for design considerations of EMA techniques when designing studies. The goal of this formative mixed methods study was to elicit feedback on EMA study procedures and materials from the target populations for a larger study about binge eating among sexual minority and heterosexual young women, in which data are collected entirely remotely. Methods: Sexual minority (n=12) and heterosexual (n=9) women ages 18–30 who binge ate took part in a pilot EMA study and exit interview and survey. As part of the consent and orientation process, participants reviewed video and written materials describing the study purpose and procedures. Using a smartphone app, for seven consecutive days they completed a survey each morning, 5 random surveys per day, and self-initiated a survey each time they binge ate. Participants then provided feedback on the study via a 1-hour virtual interview and online survey. Interviews were transcribed and reviewed by two coders to identify themes on the acceptability and feasibility of the EMA procedures with a focus on: (I) the training and study description materials; (II) general smartphone app and survey preferences; and (III) specific EMA survey question content and wording. Results: The qualitative and quantitative data converged to suggest participants were able to easily download and use the app to complete surveys and report on binge eating events. Participants provided feedback that was incorporated into revisions on general study procedures, the training video content, and EMA question content for binge eating, identity-related stressors, and appearance-related pressures. No systematic themes in the quantitative or qualitative data emerged to suggest questions were perceived differently by sexual minority and heterosexual young women. Conclusions: These findings provide evidence for the feasibility of conducting a remote EMA study to assess young women’s experiences around binge eating. This formative study provides an example of how a mixed methods approach can be used to refine EMA study methods and questions to improve study design

Rationale and Design of an Ecological Momentary Assessment Study Examining Predictors of Binge Eating Among Sexual Minority and Heterosexual Young Women: Protocol for the Health and Experiences in Real Life (HER Life) Study

Background: Previous research has identified health disparities between sexual minority and heterosexual women, including increased rates of obesity and binge eating in sexual minority women. Established predictors of binge eating behavior include negative emotions and sociocultural processes; however, these studies are generally conducted in samples of young women where sexual identity is not known or reported. There is a dearth of research evaluating how sexual minority–specific factors (eg, minority stress and connectedness to the lesbian, gay, bisexual, transgender, and queer community) may affect binge eating in sexual minority women. In addition, no studies have examined these processes in racially diverse samples or considered how intersecting minority identities (eg, Black and sexual minority) may affect eating behaviors. Objective: The Health and Experiences in Real Life (HER Life) Project aims to clarify real-world predictors of binge eating in young heterosexual and sexual minority women using ecological momentary assessment. The role of affective, social, and health behavior factors in binge eating will be examined for all women (aim 1), and sexual minority–specific predictors will also be considered for sexual minority women participants (aim 2). Person-level moderators of race, body- and eating-related factors, and sexual minority–specific factors will also be examined to better understand how real-world binge eating predictors may differ for various demographic groups (aim 3). Methods: Researchers aim to recruit 150 sexual minority and 150 heterosexual women from across the United States, including at least 50 Black women for each group, using web-based recruitment methods. The eligibility criteria include identifying as a woman, being aged between 18 and 30 years, and having had at least two binge eating episodes in the last 2 weeks. Participants must endorse being only or mostly attracted to men (considered heterosexual) or only or mostly attracted to women or having a current or most recent female partner (considered sexual minority). Eligible participants complete an initial web-based baseline survey and then 14 days of ecological momentary assessment involving the completion of a morning and before-bed survey and 5 prompted surveys per day as well as a user-initiated survey after binge eating episodes. The data will be analyzed using a series of multilevel models. Results: Data collection started in February 2021. We have currently enrolled 129 sexual minority women and 146 heterosexual women. Data collection is expected to conclude in fall 2022. Conclusions: The Health and Experiences in Real Life Project aims to elucidate potential differences between sexual minority and heterosexual women in within-person factors predicting binge eating and inform eating disorder interventions for sexual minority women. The challenges in recruiting sexual minority women, including the determination of eligibility criteria and considerations for remote data collection, are discussed. International Registered Report Identifier (IRRID): DERR1-10.2196/4119

Self‐management for adults with epilepsy: Aggregate Managing Epilepsy Well Network findings on depressive symptoms

ObjectiveTo assess depressive symptom outcomes in a pooled sample of epilepsy self‐management randomized controlled trials (RCTs) from the Managing Epilepsy Well (MEW) Network integrated research database (MEW DB).MethodsFive prospective RCTs involving 453 adults with epilepsy compared self‐management intervention (n = 232) versus treatment as usual or wait‐list control outcomes (n = 221). Depression was assessed with the nine‐item Patient Health Questionnaire. Other variables included age, gender, race, ethnicity, education, income, marital status, seizure frequency, and quality of life. Follow‐up assessments were collapsed into a visit 2 and a visit 3; these were conducted postbaseline.ResultsMean age was 43.5 years (SD = 12.6), nearly two‐thirds were women, and nearly one‐third were African American. Baseline sample characteristics were mostly similar in the self‐management intervention group versus controls. At follow‐up, the self‐management group had a significantly greater reduction in depression compared to controls at visit 2 (P < .0001) and visit 3 (P = .0002). Quality of life also significantly improved in the self‐management group at visit 2 (P = .001) and visit 3 (P = .005).SignificanceAggregate MEW DB analysis of five RCTs found depressive symptom severity and quality of life significantly improved in individuals randomized to self‐management intervention versus controls. Evidence‐based epilepsy self‐management programs should be made more broadly available in neurology practices.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/151320/1/epi16322_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/151320/2/epi16322.pd

The ENIGMA Stroke Recovery Working Group: Big data neuroimaging to study brain–behavior relationships after stroke

The goal of the Enhancing Neuroimaging Genetics through Meta‐Analysis (ENIGMA) Stroke Recovery working group is to understand brain and behavior relationships using well‐powered meta‐ and mega‐analytic approaches. ENIGMA Stroke Recovery has data from over 2,100 stroke patients collected across 39 research studies and 10 countries around the world, comprising the largest multisite retrospective stroke data collaboration to date. This article outlines the efforts taken by the ENIGMA Stroke Recovery working group to develop neuroinformatics protocols and methods to manage multisite stroke brain magnetic resonance imaging, behavioral and demographics data. Specifically, the processes for scalable data intake and preprocessing, multisite data harmonization, and large‐scale stroke lesion analysis are described, and challenges unique to this type of big data collaboration in stroke research are discussed. Finally, future directions and limitations, as well as recommendations for improved data harmonization through prospective data collection and data management, are provided

Using the Mystery Motivator to Improve Child Bedtime Compliance

Child bedtime problems are commonly reported by parents. A number of behavioral techniques, including extinction of tantrum behaviors, reinforcement of compliant bedtime, and implementation of consistent bedtime routines have been successful in improving bedtime compliance. The present study examined the effects of the Mystery Motivator (MM), a behavioral contract designed to remediate bedtime problems by delivering random reinforcement. Emphasis was placed on the optimal use of clinical intervention by enlisting parents as primary change agents in the home setting. Three adults and their four children, aged 3-5 years, participated. Three of the four children showed substantial changes in both time out of bed and bedtime noncompliance between baseline and treatment phases. A fourth child showed less improvement. Parent participants demonstrated understanding of the materials and successfully implemented the home program. Both parent and child participants rated the Mystery Motivator reinforcement system as an acceptable intervention