Recounting Trauma: Adjusting for Differences in Extreme Responding on PTSD Measures Between Pan-Ethnic Groups in the United States and Mexico

Background: Psychological measurements often ask respondents to select their answer choice from several ranked options. Scale usage is affected by many factors, including culturally socialized response styles, such as extreme responding. If unaccounted for, systematic extreme responding could skew scores, affecting both research and clinical assessment. Method: Extreme responding was operationalized by tallying endpoint responses on two measures related to but distinct from the target construct, Posttraumatic Stress Disorder (PTSD) symptom severity. Extreme responding was assessed among a gender-balanced sample of 1,820 participants: 936 in the U.S. (n = 312 Black; n = 312 Latinx; n = 304 White) and 884 in Mexico (n = 607 mestizo/a; n = 277 Indígeno/a). Results: Contrary to expectations, Mexican participants demonstrated less extreme responding than U.S. participants, driven by high levels of this response style among Black participants in the U.S. Extreme responding predicted PTSD scores beyond the contributions of environmental and sociodemographic factors. Two methods to account for the effects of extreme responding were attempted. Following ipsatization, intergroup differences remained significant; truncating scoring removed national differences in PCL-5 scores, but not all pan-ethnic differences. Discussion: Culturally influenced response styles, including extreme responding, represent an important source of potential measurement error. However, methods to assess and account for this form of bias have not yet been standardized, and questions remain as to the proportion of valid interpersonal variance that may be lost to standardization procedures. Future work is required to incorporate cultural response style into assessments in both research and clinical contexts

COVID-19 protective behaviors at NYC universities

A survey assessing COVID-19 protective behaviors and predictors of behavior among undergraduates in NYC

Aging and older people who use illicit opioids, cocaine, or methamphetamine: a scoping review and literature map.

AIMS: To provide an overview of research literature on aging and older people who use illicit opioids and stimulants by documenting the conceptual frameworks used and content areas that have been investigated. METHODS: We conducted a scoping review of literature relating to aging and older people who use illicit stimulants and opioids, defining "older" as 40 years and above. Primary studies, secondary studies, and editorials were included. Searches were conducted in PubMed and Embase in July 2020 and March 2021; the Cochrane library was searched in November 2021. Charted data included methodological details, any conceptual frameworks explicitly applied by authors, and the content areas that were the focus of the publication. We developed a hierarchy of content areas and mapped this to provide a visual guide to the research area. RESULTS: Of the 164 publications included in this review, only 16 explicitly applied a conceptual framework. Seven core content areas were identified, with most publications contributing to multiple content areas: acknowledgement of drug use among older people (n = 64), health status (n = 129), health services (n = 109), drug use practices and patterns (n = 84), social environments (n = 74), the criminal legal system (n = 28), and quality of life (n = 15). CONCLUSIONS: The literature regarding older people who use illicit drugs remains under-theorized. Conceptual frameworks are rarely applied and few have been purposely adapted to this population. Health status and health services access and use are among the most frequently researched topics in this area

A rapid review of the impacts of "Big Events" on risks, harms, and service delivery among people who use drugs: implications for responding to COVID-19.

BACKGROUND "Big Events" are major disruptions to physical, political, and economic environments that can influence vulnerability to drug-related harms. We reviewed the impacts of Big Events with relevance to the COVID-19 pandemic on drug-related risk and harms and access to drug treatment and harm reduction services. METHODS We conducted a rapid review of quantitative, qualitative, and mixed methods literature relating to the following Big Events: respiratory infection pandemics, natural disasters, financial crises, and heroin shortages. Included studies reported data on changes to risks, harms, and/or service provisioning for people who use illicit drugs (other than cannabis) in the context of these Big Events. Searches were conducted in PubMed in May 2020, and two reviewers screened studies for inclusion. Peer-reviewed studies published in English or French were included. We used a narrative synthesis approach and mapped risk pathways identified in the literature. RESULTS No studies reporting on respiratory infection pandemics were identified. Twelve studies reporting on natural disaster outcomes noted marked disruption to drug markets, increased violence and risk of drug-related harm, and significant barriers to service provision caused by infrastructure damage. Five studies of the 2008 global financial crisis indicated increases in the frequency of drug use and associated harms as incomes and service funding declined. Finally, 17 studies of heroin shortages noted increases in heroin price and adulteration, potentiating drug substitutions and risk behaviors, as well as growing demand for drug treatment. CONCLUSION Current evidence reveals numerous risk pathways and service impacts emanating from Big Events. Risk pathway maps derived from this literature provide groundwork for future research and policy analyses, including in the context of the COVID-19 pandemic. In light of the findings, we recommend responding to the pandemic with legislative and financial support for the flexible delivery of harm reduction services, opioid agonist treatment, and mental health care

Sex and gender differences in hepatitis C virus risk, prevention, and cascade of care in people who inject drugs:systematic review and meta-analysis

Background: People who inject drugs (PWID) are a priority population in HCV elimination programming. Overcoming sex and gender disparities in HCV risk, prevention, and the cascade of care is likely to be important to achieving this goal, but these have not yet been comprehensively reviewed.Methods:Systematic review and meta-analysis. We searched Pubmed, EMBASE and the Cochrane Database of Systematic Reviews 1 January 2012-3 August 2022 for studies of any design reporting sex or gender differences among PWID in at least one of: sharing of needles and/or syringes, incarceration history, injection while incarcerated, participation in opioid agonist treatment or needle and syringe programs, HCV testing, spontaneous HCV clearance, direct-acting antiviral (DAA) treatment initiation or completion, and sustained virological response (SVR). Assessment of study quality was based on selected aspects of study design. Additional data were requested from study authors. Data were extracted in duplicate and meta-analysed using random effects models. PROSPERO registration CRD42022342806.Findings:9,533 studies were identified and 92 studies were included. Compared to men, women were at greater risk for receptive needle and syringe sharing (past 6-12 months: risk ratio (RR) 1.12; 95% confidence interval (CI) 1.01-1.23; < 6 months: RR 1.38; 95% CI 1.09-1.76), less likely to be incarcerated (lifetime RR 0.64; 95% CI 0.57-0.73) more likely to be tested for HCV infection (lifetime RR 1.07; 95% CI 1.01, 1.14), more likely to spontaneously clear infection (RR1.58; 95% CI 1.40-1.79), less likely to initiate DAA treatment (0.84; 95% CI 0.78-0.90), and more likely to attain SVR after completing DAA treatment (RR 1.02; 95% CI 1.01-1.04).Interpretation:There are important differences in HCV risk and cascade of care indicators among people who inject drugs that may impact the effectiveness of prevention and treatment programming. Developing and assessing the effectiveness of gender-specific and gender-responsive HCV interventions should be a priority in elimination programming