Pain interference, gambling problem severity, and psychiatric disorders among a nationally representative sample of adults

Background and aims: A paucity of studies has examined the association between gambling and pain interference. We examined differences in the associations of gambling problem severity and psychiatric disorders among a nationally representative sample of adults with varying levels of pain interference. Methods: Chi-square tests and logistic regression analyses were performed on National Epidemiologic Survey on Alcohol and Related Conditions data from 41,987 adult respondents (48% men; 52% women), who were categorized according to two levels of pain interference (i.e., no or low pain interference [NLPI] or moderate or severe pain interference [MSPI]) and three levels of gambling problem severity (i.e., non-gamblers or low-frequency gamblers [NG], low-risk or at-risk gamblers [LRG], and problem or pathological gamblers [PPG]). Results: MSPI respondents exhibited higher rates of PPG than NLPI respondents. Categories of Axis I disorders and clusters of mood, anxiety and substance-use disorders showed similarly strong associations with problem-gambling severity in MSPI and NLPI groups. Similarly strong associations between Axis II disorders (and each cluster — A, B and C) and problem-gambling severity were also observed in MSPI and NLPI groups. Exploratory analyses suggested potentially stronger relationships between PPG and dysthymia, panic disorder, and dependent personality disorder and LRG and specific phobia in NLPI compared to MSPI respondents. Discussion and conclusions: While MSPI is associated with PPG, largely similar patterns of associations across pain-interference levels were observed between problem-gambling severity and Axis I and Axis II psychiatric disorders

The relationship between tooth size discrepancy and archform classification in orthodontic patients

Background: To determine the relationship between clinically significant tooth size discrepancies (TSD) and archform classification in orthodontic patients. Material and Methods: Two hundred and forty consecutive sets of pre-treatment orthodontic study models were scanned and landmarked. All models had permanent teeth erupted from first molar to first molar in both arches. Sixty sets of images were classified into two groups of 30 according to the presence (group 1) or absence (group 2) of a clinically significant overall or anterior TSD (>2 SD from Bolton’s original means). Mean upper and lower archforms were created for each group using a fourth degree polynomial curve. Upper and lower archforms in each group were classified as square, tapering or ovoid; their distribution was analysed using the Fisher test with a 5% level of significance. To evaluate the intra-operator error when determining archform type, the 60 archforms were re-classified by the same operator two weeks later. The unweighted Kappa statistic at 95% confidence intervals was used to determine the similarity of the classification on the two occasions. Results: Reproducibility of the classification of archform was very good (unweighted Kappa statistic of 0.83 with a 95% confidence interval of 0.73, 0.93). There was no statistically significant difference in the distribution of archform type between group 1 and group 2 for the upper ( p =0.3305) or lower ( p =0.6310) arches. Conclusions: The presence of a clinically significant TSD and archform classification do not appear to be related

Alexithymia and Emotional Ambivalence as Predictors of College Adjustment

The current study evaluated the constructs alexithymia and emotional ambivalence, regarding their impact on adjustment to college. Alexithymia is an emotional processing concept which is defined as difficulty identifying and describing feelings, externally oriented thought, and limited imaginal ability. Emotional ambivalence is the ongoing internal conflict about the desire to hide emotions, despite external circumstances that demand disclosure, and/or regret over decisions to disclose feelings. These were both looked at as predictors of college adjustment, with the inclusion of chronic pain and psychiatric distress as physical and mental health components of the transition

The Relationship Between Tooth Size Discrepancy and Archform Classification in Orthodontic Patients

Background To determine the relationship between clinically significant tooth size discrepancies (TSD) and archform classification in orthodontic patients. Material and Methods Eighty teeth with artificial white spot lesions were randomly divided into four groups: (A) distilled and deionized water, (B) Nd:YAG laser, (C) CPP-ACP crème, & (D) CPP-ACP plus laser. SMH was measured using Vickers diamond indenter in Vickers Hardness Number (VHN). Two samples of each group were analyzed using scanning electron microscope (SEM). The results were analyzed with the SPSS 17/win. Results Reproducibility of the classification of archform was very good (unweighted Kappa statistic of 0.83 with a 95% confidence interval of 0.73, 0.93). There was no statistically significant difference in the distribution of archform type between group 1 and group 2 for the upper (p=0.3305) or lower (p=0.6310) arches. Conclusions The presence of a clinically significant TSD and archform classification do not appear to be related

The Impact of Body Image Preoccupation on College Adjustment

Faculty Research Day 2018: Graduate Student Poster Honorable MentionThe physical and psychological adjustment to college is a often a disorienting time for students. Upon entering college, students are met with a new set of societal, personal, and academic expectations that decide the degree to which they are able to adapt to their new lives (Tinto, 1993). Given the taxing mental demands associated with the college transition, as well as the increasing prevalence of mental illnesses among college students (Duarte, Ferreira, Trindade, & Pinto-Gouveia, 2015; Hunt & Eisenberg, 2010), extensive research has examined the many psychological components that can effect students’ college experiences. Yet, despite the extensive literatures centering around body image preoccupation and college students’ psychological health/adjustment to college, there have been no studies that assess body image alongside college adjustment. The present study aims to fill this gap in the literature by examining the association of body image preoccupation and students’ adjustment to college

Expectations and Preferences for Counseling and Psychotherapy in Native Americans

We provide a broad overview of the research on expectations and preferences for counseling and psychotherapy with Native Americans and identify a critical lack of research in this area. We conclude that increased research could improve the effectiveness of counseling and psychotherapy for Native peoples. For example, understanding and engaging patients’ expectations and preferences would likely lead to increased retention and satisfaction. Finally, we suggest that a Native American clinical practice network might be one way to generate clinical and research knowledge in the area of expectations and preferences for psychotherapy and counseling

Reply to Ruan et al. (2017): Non-medical use of prescription opioids is associated with heroin initiation among US veterans.

We thank Ruan and colleagues for their letter and appreciate their comments regarding our recent study, which demonstrated an independent association between non-medical use of prescription opioids (NMUPO) and heroin initiation among US veterans

Non-medical use of prescription opioids is associated with heroin initiation among US veterans: a prospective cohort study

Aims: To estimate the influence of non-medical use of prescription opioids (NMUPO) on heroin initiation among US veterans receiving medical care. Design: Using a multivariable Cox regression model, we analyzed data from a prospective, multi-site, observational study of HIV-infected and an age/race/site-matched control group of HIV-uninfected veterans in care in the United States. Approximately annual behavioral assessments were conducted and contained self-reported measures of NMUPO and heroin use. Setting: Veterans Health Administration (VHA) infectious disease and primary care clinics in Atlanta, Baltimore, New York, Houston, Los Angeles, Pittsburgh and Washington, DC. Participants: A total of 3396 HIV-infected and uninfected patients enrolled into the Veterans Aging Cohort Study who reported no life-time NMUPO or heroin use, had no opioid use disorder diagnoses at baseline and who were followed between 2002 and 2012. Measurements: The primary outcome measure was self-reported incident heroin use and the primary exposure of interest was new-onset NMUPO. Our final model was adjusted for socio-demographics, pain interference, prior diagnoses of post-traumatic stress disorder and/or depression and self-reported other substance use. Findings: Using a multivariable Cox regression model, we found that non-medical use of prescription opioids NMUPO was associated positively and independently with heroin initiation [adjusted hazard ratio (AHR) = 5.43, 95% confidence interval (CI) = 4.01, 7.35]. Conclusions: New-onset non-medical use of prescription opioids (NMUPO) is a strong risk factor for heroin initiation among HIV-infected and uninfected veterans in the United States who reported no previous history of NMUPO or illicit opioid use

Long-term Patterns of Self-reported Opioid Use, VACS Index, and Mortality Among People with HIV Engaged in Care.

Longitudinal analyses of opioid use and overall disease severity among people with HIV (PWH) are lacking. We used joint-trajectory and Cox proportional hazard modeling to examine the relationship between self-reported opioid use and the Veterans Aging Cohort Study (VACS) Index 2.0, a validated measure of disease severity and mortality, among PWH engaged in care. Using data from 2002 and 2018, trajectory modeling classified 20% of 3658 PWH in low (i.e., lower risk of mortality), 40% in moderate, 28% in high, and 12% in extremely high VACS Index trajectories. Compared to those with moderate VACS Index trajectory, PWH with an extremely high trajectory were more likely to have high, then de-escalating opioid use (adjusted odds ratio [AOR], 95% confidence interval [CI] 5·17 [3·19-8·37]) versus stable, infrequent use. PWH who report high frequency opioid use have increased disease severity and mortality risk over time, even when frequency of opioid use de-escalates

Patient Satisfaction with Primary Care Office-Based Buprenorphine/Naloxone Treatment

BACKGROUND: Factors associated with satisfaction among patients receiving primary care–based buprenorphine/naloxone are unknown. OBJECTIVE: To identify factors related to patient satisfaction in patients receiving primary care–based buprenorphine/naloxone that varied in counseling intensity (20 vs 45 minutes) and office visit frequency (weekly vs thrice weekly). DESIGN AND PARTICIPANTS: One hundred and forty-two opioid-dependent subjects. MEASUREMENTS: Demographics, drug treatment history, and substance use status at baseline and during treatment were collected. The primary outcome was patient satisfaction at 12 weeks. RESULTS: Patients’ mean overall satisfaction score was 4.4 (out of 5). Patients were most satisfied with the medication and ancillary services and indicated strong willingness to refer a substance-abusing friend for the same treatment. Patients were least satisfied with their interactions with other opioid-dependent patients, referrals to Narcotics Anonymous, and the inconvenience of the treatment location. Female gender (β = .17, P = .04) and non-White ethnicity/race (β = .17, P = .04) independently predicted patient satisfaction. Patients who received briefer counseling and buprenorphine/naloxone dispensed weekly had greater satisfaction than those whose medication was dispensed thrice weekly (mean difference 4.9, 95% confidence interval 0.08 to 9.80, P = .03). CONCLUSIONS: Patients are satisfied with primary care office-based buprenorphine/naloxone. Providers should consider the identified barriers to patient satisfaction