The Association Between Trauma History and Body Image, Depression, Posttraumatic Stress, and Relationship Satisfaction in Postpartum Women

The postpartum period can be a time of significant change and transition. Little is known regarding how a history of trauma may impact functioning during this critical time. The literature is consistent regarding the relationship between trauma and body image-related issues, but this has not been investigated with this population. While posttraumatic stress symptoms are considered a significant public health concern, the association between depression and interpersonal concerns has not been thoroughly explored. The purpose of this observational, cross-sectional study is to explore the relationship between trauma and body image, mood, and relationship satisfaction in postpartum women. Proposed Methods: English speaking adult women (age ≥ 18 years, N = 200) who gave birth in the past year and are currently in an intimate relationship will be eligible to participate in the study. Participants will be recruited through social media and online forums that focus on topics related to pregnancy and the postpartum period. Screened and eligible participants will be asked to complete surveys including a demographic and trauma history questionnaire, PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (PCL-5), Body Attitude Questionnaire (BAQ), Edinburgh Postnatal Depression Scale (EPDS), and The Couples Satisfaction Index (CSI). Survey data will be captured using REDCap. Proposed Hypotheses: Postpartum women who endorse a history of trauma will report significantly greater body image concerns and depressions levels, as well as lower relationship satisfaction compared to postpartum women who do not endorse a history of trauma. In postpartum women with a history of trauma, higher posttraumatic stress symptoms will be associated with greater body image concerns and depression levels, and lower relationship satisfaction. We will descriptively explore levels of body image concerns, depression levels, and relationship satisfaction in postpartum women who endorse a history of sexual trauma. Proposed Analyses: Descriptive statistics will be used to characterize the sample. Correlations will evaluate the relationship between demographic variables and outcome measures. Regression or independent samples t-tests will be utilized to evaluate the hypotheses. Implications: This research has important implications for postpartum women for both their therapeutic and medical care. Findings may clarify conceptualizations of trauma and, therefore, inform treatment strategies and trauma-informed postpartum care. Additionally, results may provide further support for universal screenings during postpartum to identify women at-risk of various perinatal psychosocial concerns

Weight stability in adults with obesity initiating medical marijuana treatment for other medical conditions

Few studies have evaluated weight change in patients who initiate medical marijuana treatment to address diagnosed health concerns. The objective of this study was to examine whether patients initiating medical marijuana use for a qualifying health condition experienced changes in health and biopsychosocial functioning over time, including weight gain or loss. Specifically, this observational, longitudinal study evaluated changes in the body mass index (BMI) of adults with co-morbid obesity (body mass index [BMI] ≥ 30 kg/m2) and severe obesity (BMI ≥ 40 kg/m2) who were starting medical marijuana treatment for any of the 23 qualifying medical conditions at one of three dispensaries in Pennsylvania. Height and weight measurements were collected at baseline (prior to medical marijuana use) and then 90 days (± 14 days) later. Participants included in analyses (n = 52, M = 55.0 ± 13.6 years, 59.6% female) had a mean baseline BMI of 36.2 ± 5.4 kg/m2 and the majority sought medical marijuana for chronic pain (73.1%). No significant change in BMI was observed from baseline to month three (p \u3e 0.05) in the sample. Additionally, no significant change in BMI was observed in the subset of patients with severe obesity (n = 12, p \u3e 0.05). Our findings are limited by low follow-up rates and convenience sampling methodology but may help to mitigate weight gain concerns in the context of medical marijuana use

Anxiety severity and prescription medication utilization in first-time medical marijuana users

Background Anxiety and post-traumatic stress disorder (PTSD) are qualifying psychiatric conditions for medical marijuana (MM) treatment in Pennsylvania. This study examined baseline prevalence and changes in prescription anxiety medication use three months following MM treatment initiation among individuals with these qualifying conditions. Methods The study sample was comprised of 108 adults with anxiety or PTSD as a referring condition; they were enrolled in a longitudinal study evaluating biopsychosocial outcomes in new MM patients. Consenting participants completed an assessment battery at baseline and Month 3 (n = 94, 87 % follow-up rate) that included a measure of anxiety severity and questions about current anxiety medication prescription and desired (baseline) and actual (Month 3) reductions in medication use. Results Findings indicated that 59 % of participants reported prescription medications for anxiety, with 70 % reporting at least a moderate desire to reduce medication use. Overall and within the medication sub-sample, participants displayed significant reductions in anxiety severity from baseline to Month 3 (p’s \u3c0.0001). Furthermore, 32 % reported actual reductions in medication use at Month 3, and reductions were more likely among patients prescribed benzodiazepines than other drug classes. Conclusions Results suggest that a significant number of MM patients with anxiety and/or PTSD diagnoses are currently being prescribed antianxiety medications and that MM may help to reduce their use of these medications. Limitations Limitations include the observational study design and the lack of a PTSD-specific measure. More controlled longitudinal studies are necessary to better understand the role of MM in the treatment of anxiety and PTSD

Recovery Capital, Mental Health and Substance Use among Individuals Initiating Office-Based Buprenorphine Treatment for Opioid Use Disorder

Recovery capital refers to the internal and external resources available to support an individual in their recovery from substance use disorders. Using data from an ongoing trial, the current study examined recovery capital among 225 individuals initiating office-based buprenorphine treatment for opioid use disorder (OUD) at Federally Qualified Health Centers in the mid-Atlantic region. At baseline, participants completed the Brief Assessment of Recovery Capital-10 (BARC-10), a validated measure assessing the 4 major domains of recovery capital and completed a urine toxicology screening. Participants reported BARC-10 scores of 49.22 on average (SD = 8.14). Average scores were highest for the item “I take full responsibility for my actions,” (M = 5.77, SD = .52), and lowest for “I am proud of the community I live in and feel a part of it” (M = 4.07, SD = 1.73). Lower recovery capital scores were associated with providing a urine screen suggestive of substance use, r(224) = -.16, p \u3c .05 and reporting depression (B = -.06, p = .001) or anxiety (B = -.05, p \u3c .05) in the past 30 days. By screening for recovery capital in individuals with OUD, providers may be able to more effectively tailor individuals’ behavioral treatment plans to positively impact their treatment outcomes

Attitudes about Future Genetic Testing for Posttraumatic Stress Disorder and Addiction among Community-Based Veterans.

This study explored attitudes toward hypothetical genetic testing for posttraumatic stress disorder (PTSD) and addiction among veterans. We surveyed a random sample of community-based veterans (n = 700) by telephone. One year later, we asked the veterans to provide a DNA sample for analysis and 41.9% of them returned the DNA samples. Overall, most veterans were not interested in genetic testing neither for PTSD (61.7%) nor for addiction (68.7%). However, bivariate analyses suggested there was an association between having the condition of interest and the likelihood of genetic testing on a 5-point scale (p \u3c 0.001 for PTSD; p = 0.001 for alcohol dependence). While ordinal regressions confirmed these associations, the models with the best statistical fit were bivariate models of whether the veteran would likely test or not. Using logistic regressions, significant predictors for PTSD testing were receiving recent mental health treatment, history of a concussion, younger age, having PTSD, having alcohol dependence, currently taking opioids for pain, and returning the DNA sample during the follow-up. For addiction testing, significant predictors were history of concussion, younger age, psychotropic medication use, having alcohol dependence, and currently taking opioids for pain. Altogether, 25.9% of veterans reported that they would have liked to have known their genetic results before deployment, 15.6% reported after deployment, and 58.6% reported they did not want to know neither before nor after deployment. As advancements in genetic testing continue to evolve, our study suggests that consumer attitudes toward genetic testing for mental disorders are complex and better understanding of these attitudes and beliefs will be crucial to successfully promote utilization

Demographic, Clinical, and Behavioral Determinants of 7-Year Weight Change Trajectories in Roux-en-Y Gastric Bypass Patients.

BACKGROUND: Weight change trajectories after weight-loss surgery may vary significantly. OBJECTIVES: This study evaluated the weight trajectories of Roux-en-Y gastric bypass (RYGB) patients and identified the distinct clinical, behavioral, and demographic features of patients by trajectory. SETTING: Data from 2918 RYGB patients from a comprehensive medical center between January 2004 and November 2016 were included. METHODS: This retrospective, observational study used data for RYGB patients up to year 7 postsurgery. Group-based trajectory models were fitted for percentage weight change. Variables evaluated by trajectory included age, sex, diagnoses, medications, smoking, presurgical body mass index, preoperative weight loss, and early postoperative weight loss. RESULTS: Of 3215 possible patients, 2918 (90.8%) were included (mean age = 46.2 ± 11.2 yr, body mass index = 46.9 ± 7.9 kg/m CONCLUSION: Select clinical, demographic, and behavioral factors may increase or decrease the chance for better weight loss after RYGB

Prevalence and predictors of suicidality among adults initiating office-based buprenorphine.

BACKGROUND: Individuals who have substance use disorders may have an elevated risk of suicidality. This study sought to examine the prevalence of, and identify factors associated with, suicidality in adults with opioid use disorder (OUD) initiating office-based buprenorphine treatment. METHODS: Individuals were eligible to participate if they had OUD and had initiated treatment in the past month. Participants (n = 244) completed a semi-structured interview using the Addiction Severity Index-Lite. RESULTS: At baseline, 37.70% of participants reported significant thoughts of suicide over their lifetime and 27.46% reported suicidal attempts over their lifetime. Logistic regression analyses were used to identify predictors of lifetime suicidal thoughts and attempts. A history of physical abuse (OR = 4.31, p \u3c .001), having chronic pain-related conditions (OR = 3.28, p \u3c .001), a history of depression (OR = 3.30, p = .001) or anxiety (OR = 7.47, p = .001), and Latino/a/x ethnicity (OR = 2.66, p = .01) were associated with an increased risk of lifetime suicidal thoughts. A history of sexual abuse (OR = 2.89, p = .01), Latino/a/x ethnicity (OR = 4.01, p \u3c .001), a history of depression (OR = 4.03, p = .001) or anxiety (OR = 15.65, p = .007) and having a chronic pain-related condition (OR = 2.43, p = .01), were associated with an increased risk of lifetime suicide attempts. CONCLUSIONS: Results demonstrate the high prevalence of suicidal thoughts and attempts among patients initiating buprenorphine. Findings may help to better identify at-risk patients and to inform screening, prevention, and mental health treatment efforts. TRIAL REGISTRATION: ClinicalTrials.gov, NCT04650386 (registered 12 December 2020, https://clinicaltrials.gov/ct2/show/NCT04650386 ) and NCT04257214 (registered 5 February 2020, https://clinicaltrials.gov/ct2/show/NCT04257214 )

Clinical Characteristics and Quality of Life in Adults Initiating Medical Marijuana Treatment

Introduction: Despite the rising availability and use of medical marijuana (MM) in the USA, little is known about the demographics, clinical characteristics, or quality of life of MM patients. This study describes the demographic characteristics and health-related quality of life (HRQoL) of MM patients who are initiating treatment in Pennsylvania. Methods: Two-hundred adults naive to MM and referred for any of the 23 state-approved qualifying conditions were recruited at three MM dispensaries in Pennsylvania between September 2020 and March 2021. All participants consented to the study; completed semi-structured interviews that included demographic questionnaires, the Short Form-36 (SF-36), and Generalized Anxiety Disorder-7 (GAD-7); provided height and weight measurements; and allowed access their dispensary medical records. Results: Participants had a mean age of 48.5 ± 15.6 years, predominantly identified as female (67.5%), and were most commonly referred for chronic pain (63.5%) and/or anxiety (58.5%). Additionally, 46.0% were living with obesity as determined by BMI. Relative to a normative sample, participants reported diminished HRQoL in several domains, most notably in role limitations due to physical health (M = 46.0 ± 42.0), role limitations due to emotional problems (M = 52.5 ± 42.3), energy and fatigue (M = 39.8 ± 20.2), and pain (M = 49.4 ± 26.0). Discussion/Conclusion: Patients initiating MM treatment experienced low HRQoL in multiple domains. Future studies could evaluate the relationship between HRQoL and patients’ decisions to pursue MM treatment, as well as changes in HRQoL with MM use over time

The development, implementation and early learnings of a training program to advance interest in behavioral research careers among undergraduate BIPOC students majoring in psychology.

OBJECTIVES: Black, indigenous and people of color (BIPOC) remain underrepresented in research occupations. This report discusses a collaboration to train undergraduate BIPOC students in clinical research between a public health institute, two medical schools, and a historically Black College or University (HBCU). This nine-month program trained BIPOC undergraduates in research methodology, psychology, and addiction science, and immersed trainees in real-world research. The program included didactic seminars, experiential activities, and a mentored research project culminating in a poster and oral presentation. METHODS: Key learnings, program satisfaction survey results, and preliminary outcomes from the first three program cohorts (N = 6 students) are presented. This program addressed several barriers hypothesized to contribute to the limited number of BIPOC students pursuing research careers, including mentorship from BIPOC faculty and financial concerns. RESULTS: Students reported moderate to high satisfaction with the program and endorsed gaining new research skills. Limitations and future directions are discussed. CONCLUSION: The expansion of the BIPOC health and research workforce is an urgent priority given the importance of BIPOC professionals to the health of our nation. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04650386

Nonalcoholic fatty liver disease, liver fibrosis, and structural brain imaging: The Cross-Cohort Collaboration

Background and purpose Prior studies reported conflicting findings regarding the association of nonalcoholic fatty liver disease (NAFLD) and liver fibrosis with measures of brain health. We examined whether NAFLD and liver fibrosis are associated with structural brain imaging measures in middle- and old-age adults. Methods In this cross-sectional study among dementia- and stroke-free individuals, data were pooled from the Offspring and Third Generation cohorts of the Framingham Heart Study (FHS), the Rotterdam Study (RS), and the Study of Health in Pomerania. NAFLD was assessed through abdominal imaging. Transient hepatic elastography (FibroScan) was used to assess liver fibrosis in FHS and RS. Linear regression models were used to explore the relation of NAFLD and liver fibrosis with brain volumes, including total brain, gray matter, hippocampus, and white matter hyperintensities, adjusting for potential confounders. Results were combined using fixed effects meta-analysis. Results In total, 5660 and 3022 individuals were included for NAFLD and liver fibrosis analyses, respectively. NAFLD was associated with smaller volumes of total brain (β = −3.5, 95% confidence interval [CI] = −5.4 to −1.7), total gray matter (β = −1.9, 95% CI = −3.4 to −0.3), and total cortical gray matter (β = −1.9, 95% CI = −3.7 to −0.01). In addition, liver fibrosis (defined as liver stiffness measure ≥8.2 kPa) was related to smaller total brain volumes (β = −7.3, 95% CI = −11.1 to −3.5). Heterogeneity between studies was low. Conclusions NAFLD and liver fibrosis may be directly related to brain aging. Larger and prospective studies are warranted to validate these findings and identify liver-related preventive strategies for neurodegeneration