Adam Gonzalez

BackgroundPost-traumatic stress disorder (PTSD) is a major risk factor for increased asthma morbidity among World Trade Center (WTC) workers.ObjectiveTo investigate whether differences in perception of airflow limitation mediate the association of PTSD with worse asthma control in WTC workers.MethodsWe collected data from WTC workers on asthma control (Asthma Control Questionnaire and Asthma Quality of Life Questionnaire) and daily peak expiratory flow (PEF) measures over 6 weeks. Perception of airway limitation was assessed by comparing guessed vs actual PEF values. Post-traumatic stress disorder was diagnosed using the Structured Clinical Interview. We used unadjusted and adjusted models to compare PEF and perception measures in WTC workers with PTSD with those of workers without PTSD.ResultsOverall, 25% of 224 participants had PTSD. Post-traumatic stress disorder was …

Introduction Responding to the need for innovative, multi-modal, non-pharmacological strategies in chronic low back pain (cLBP) care, this article presents the development and a mixed methods feasibility trial of a manualized Mindfulness-based Dance/Movement Therapy (M-DMT) program for cLBP. The 12-week program is designed as a group therapy, integrating mindfulness principles, creative/expressive dance and movement, and psychoeducational content focused on cLBP management. This holistic program seeks to cultivate nonjudgmental awareness of pain experiences, challenge maladaptive pain-related beliefs, enhance emotional well-being, foster social support, and promote effective coping strategies for the daily challenges associated with cLBP. Methods The 12-week M-DMT intervention was administered to individuals with non-specific cLBP (N = 18, aged 51.7 ± 13.9 years, 72% female, 55% Black and 39% White). We assessed feasibility and acceptability through monitoring enrollment and retention rates, attendance, and adverse events. Moreover, we measured the intervention's credibility/expectancy, participants' perception of changes, and overall satisfaction. Additionally, we collected qualitative data, capturing participants' perspectives on the intervention's usefulness and perceived benefits. Specific benchmarks were established to gauge the successful feasibility and acceptability of the program. Results The adherence rate stood at 80%, with a perfect retention rate of 100%. The study successfully met the benchmarks for treatment acceptability and satisfaction criteria, with 61% of participants reporting “feeling better …

Background Post-traumatic stress disorders (PTSD) is associated with worse asthma outcomes in individuals exposed to the World Trade Center (WTC) site. Research question Do WTC workers with coexisting PTSD and asthma have a specific inflammatory pattern that underlies the relationship with increased asthma morbidity? Study design and methods We collected data on a cohort of WTC workers with asthma recruited from the WTC Health Program. Diagnosis of PTSD was ascertained with a Structured Clinical Interview for DSM-5 (Diagnostic and Statistical Manuel of Mental Disorders) and the severity of PTSD symptoms was assessed with the PTSD Checklist 5. We obtained blood and sputum samples to measure cytokines levels in study participants. Results Of the 232 WTC workers with diagnosis of asthma in the study, 75 (32%) had PTSD. PTSD was significantly associated with worse asthma control (p = 0.002) and increased resource utilization (p = 0.0002). There was no significant association (p>0.05) between most blood or sputum cytokines with PTSD diagnosis or PCL-5 scores both in unadjusted and adjusted analyses. Interpretation Our results suggest that PTSD is not associated with blood and sputum inflammatory markers in WTC workers with asthma. These findings suggest that other mechanisms likely explain the association between PTSD and asthma control in WTC exposed individuals.

LGBTQ+ individuals experience health care disparities and difficulty accessing affirming care. Little is known regarding the health and experiences among subpopulations of specific sexual orientations and gender identities (SOGI). We implemented the first LGBTQ + health needs assessment survey in Nassau and Suffolk Counties, New York, to assess individuals’ health care experiences, behaviors, access to care, and health care needs. The sample (N = 1150) consisted of many SOGI subgroups. Greater than 60% of respondents reported symptoms of chronic depression; over one third reported disrespectful health care experiences; and two thirds experienced verbal harassment. Bisexual/bicurious, pansexual, queer, gender nonconforming and transgender individuals experienced highest rates of mental health concerns and difficulty accessing care. Behavioral health concerns were also high among Black …

Introduction and objective The significant impact of bladder cancer and treatment on patient health related quality of life (HRQoL) and emotional wellbeing has been documented. Increasing evidence from cancer research emphasizes the importance of examining patients supportive care needs and received social support as factors that could influence their emotional adjustment. The purpose of the study was to assess the demographic and clinical predictors of depression and anxiety among bladder cancer patients and its associations with patient reported supportive care needs and perceived availability of social support. Methods A cross-sectional design was used to investigate the study questions. Bladder cancer patients were recruited from the Bladder Cancer Advocacy Network (BCAN) to complete a questionnaire that included the Hospital Anxiety and Depression Scale (HADS), bladder cancer patient need …

ObjectiveResearch indicates that greater exposure to Hurricane Sandy is associated with increased mental health difficulties. This study examined whether Project Restoration, a program that linked adults into mental health care (L2C), was effective in reducing post-Sandy mental health difficulties as compared to a cohort of adults matched on mental health difficulties that were not linked into post-Sandy mental health care.MethodsProject Restoration participants (n = 52) with elevated self-reported mental health difficulties had the option to enroll into L2C. Project LIGHT (n = 63) used similar methodologies but did not have a L2C component and served as the matched control group.ResultsMultivariable modeling showed significant decreases in all mental health difficulties except for depression in the Project Restoration group, whereas there were no significant decreases in LIGHT. The decrease in anxiety from …

A research initiative was launched during the initial coronavirus disease (COVID-19) outbreak by 3 New York metropolitan area institutions. Collaborators recruited community members and patients from previous research studies to examine COVID-19 experiences and mental health symptoms through self-report surveys. The current report descriptively presents findings from the initial survey characterized by both community and clinical cohorts, and discusses challenges encountered with rapid implementation. The clinical cohort exhibited higher rates of symptoms of mental health difficulties (depression, anxiety, and posttraumatic stress disorder [PTSD]) as compared to the community cohort. COVID-19 positivity rates were similar among both groups and lower than the national average. While both groups reported low rates of job loss, community members reported higher rates of financial difficulty resulting from …

First responders include police officers, firefighters, and emergency medical technicians. Given occupational demands, first responders are chronically exposed to stress and potentially traumatic events in the line-of-duty. An emergent literature has documented the mental health sequelae of first responding. The goal of this article is to provide an overview of mental health among first responders, including a review of prevalent mental health conditions, discussion of risk and protective factors related to mental health and well-being, and discussion of the efficacy of evidence-based mental health treatments. This article will also discuss clinical applications and research recommendations regarding first responder mental health.

Objective Posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) frequently co-occur, with elevated rates of both disorders in lesbian, gay, or bisexual (LGB) samples. Few studies have compared the strength of PTSD-AUD associations between LGB and heterosexual individuals or evaluated the role of nontraumatic LGB discrimination in these relationships among sexual minorities. Method The current study utilized nationally representative epidemiological data (N= 29,646) to (a) examine whether associations between lifetime trauma endorsement/PTSD and lifetime alcohol dependence (AD) differ as a function of sexual minority status and (b) evaluate the role of LGB-specific discrimination in trauma/PTSD and AD associations among LGB individuals. Results Logistic regression analyses showed the association between lifetime trauma endorsement and lifetime AD was significantly greater in …

Background: Childbirth is among the most significant and pleasant events in a woman’s life. This event can be a traumatic event and a threat to the mother’s mental health. This study recognizes the relationship between Post-Traumatic Stress Disorder (PTSD) after childbirth and social support and marital satisfaction.Methods: This Cross-sectional analytical study was performed on a sample of 400 mothers who had delivered at Shohadaye-15-Khordad Hospital in Varamin (in two groups with & without PTSD). The research instruments include the Demographic, Midwifery, Neonatal Factors checklist, Enrich Marital Satisfaction, Weinfeld and Tigman Social Support, and the PTSD Symptoms Scale. We used SPSS to analyze the descriptive and Pearson correlation and logistic regression data. A P< 0.05 was considered significant.Results: The prevalence of PTDS in this study was equal to 16.8%. There was no significant correlation between the mean of the total score of PTSD in all dimensions with social support (P> 0.05). Marital satisfaction significantly affected the probability of PTSD after childbirth (P= 0.001). There was a significant correlation between PTSD total score and dimension of avoidance symptoms and infant gender (P= 0.038). There was also a significant correlation between gestational age and avoidance symptoms (P= 0.001) and type of nutrition feeding and motivational symptoms (P= 0.041) of PTSD dimensions.Conclusion: According to the relationship between marital satisfaction and PTSD, it is recommended to design suitable interventions to improve the marital status and promptly diagnose the susceptible mothers to prevent …

Background: The role of working alliance remains unclear for many forms of internet-based interventions (IBIs), a set of effective psychotherapy alternatives that do not require synchronous interactions between patients and therapists.Objective: This study examined the conceptual invariance, trajectories, and outcome associations of working alliance across an unguided IBI and guided IBIs that incorporated clinician support through asynchronous text messaging or video messaging.Methods: Adults with high education attainment (n= 145) with subclinical levels of anxiety, stress, or depressive symptoms were randomized to 1 of 3 treatment conditions for 7 weeks. All participants received treatments from MyCompass, an unguided IBI using cognitive behavior therapy. Participants in condition 2 and 3 received supplemental, asynchronous clinician support through text and video, respectively. Working alliance with the IBIs was measured weekly using select items from the 12-item version of the Agnew Relationship Measure. Symptom and functional outcomes were assessed at baseline, at the end of treatment, and 1-month follow-up.Results: Working alliance with the IBIs was conceptually invariant across the 3 conditions. Working alliance followed a quadratic pattern of change over time for all conditions and declined significantly only in the text-support condition. After controlling for baseline symptoms, higher baseline levels of working alliance predicted less depression and less functional impairment at follow-up, whereas faster increases in working alliance predicted less worry at the end of treatment and at follow-up, all of which only occurred in the …

Background Prenatal maternal stress (PNMS) is common among childbearing women, and there is substantial evidence that persistent high levels of stress during pregnancy are associated with adverse birth outcomes and poorer postpartum mental health. Therefore, the purpose of this study was to examine the idiographic experiences of women who experienced elevated PNMS during their current or most recent pregnancy. Methods Six focus groups were conducted, and data were collected from 26 women (n = 16 pregnant and n = 10 postpartum) at a large medical center in the United States (US). Data from the semi‐structured focus group prompts were analyzed by two independent raters using conventional content analysis21. Results Three key themes emerged from the data: (1) Navigating Changing Circumstances, (2) Being a “Good” Mother, and (3) Loss of Control and Autonomy. Discussion The …

Objectives Despite the significant mental health challenges and unique treatment needs of transgender and gender diverse (TGD) youth, research on the acceptability of evidence‐based treatments for these youth is limited. To address this gap, the current study explored the perceived relevance of dialectical behaviour therapy (DBT) for high‐risk TGD youth. Methods Qualitative data were collected from six focus group discussions with a purposive sample of 21 TGD youth aged 18–25 years old who endorsed a history of depression, suicidality or self‐harm and individual interviews with 10 mental health treatment providers with prior DBT and TGD client experience. The data were analysed inductively using thematic content analysis. Results The results highlighted the perceived relevance of DBT in targeting chronic and acute stressors, some of which are unique to TGD youth such as issues related to gender …

Corrigendum to “Examining the effects of stress and psychological distress on smoking abstinence in cancer patients” [Prev. Med. Rep. 23 (2021) 101402] - PMC Back to Top Skip to main content NIH NLM Logo Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation Search PMC Full-Text Archive Search in PMC Advanced Search User Guide Journal List Prev Med Rep v.25; 2022 Feb PMC8800054 Other Formats PubReader PDF (221K) Actions Cite Collections Share Permalink Copy RESOURCES Similar articles Cited by other articles Links to NCBI Databases Journal List Prev Med Rep v.25; 2022 Feb PMC8800054 As a library, NLM provides access to scientific literature. Inclusion in an NLM database does not imply endorsement of, or agreement with, the contents by NLM or the National Institutes of Health. Learn more: PMC Disclaimer | PMC Copyright Notice Logo of pmedr Prev Med …

BackgroundWorld Trade Center (WTC) rescue and recovery workers have a high burden of asthma, comorbid posttraumatic stress disorder (PTSD), and major depressive disorder (MDD). PTSD is associated with worse asthma outcomes.ObjectiveIn this study, we evaluated whether the relationship between PTSD and asthma morbidity is modified by the presence of MDD.MethodsWe used data from a cohort of WTC workers with asthma. Asthma control (asthma control questionnaire), resource utilization, and quality of life (asthma quality of life questionnaire) were evaluated. We used regression analyses to evaluate the adjusted association of PTSD and MDD with asthma control, resource utilization, and quality of life.ResultsOf the study cohort of 293 WTC workers with asthma, 19% had PTSD alone, 2% had MDD alone, and 12% had PTSD and MDD. Adjusted mean differences (95% confidence interval) in asthma …

Background. The demand for psychological services outpaces the number of available providers. Waitlists at mental health clinics range from weeks to months in length, and longer wait-times predict less favorable outcomes once treatment begins. There is a need for efficient, sustainable service models that provide faster access to care. Offering interim, low-intensity supports to treatment-seekers may both strengthen clinically-relevant proximal outcomes and prevent clinical deterioration while waiting for longer-term treatment. Thus, we tested the acceptability and short-term effects of a solution-focused single-session consultation (SSC), offered to individuals waiting for therapy at two outpatient mental health clinics. Method. Clients wait-listed for outpatient therapy at either clinic were offered an SSC. Participants self-reported overall psychological distress at baseline and two-week follow-up, along with levels of hopelessness and perceived agency at baseline and post-intervention. Participants also rated the SSC’s acceptability. Results. Of 90 treatment-seeking individuals offered an SSC, 46 (51.11%) scheduled an appointment, and 30 (65.21%) attended the session (M age= 31.2, 72.67% female). SSC recipients reported significant pre-to post-intervention improvements in perceived agency (d_z= 1.11, p<. 001) and hopelessness (d_z= 1.43, p<. 001). Psychological distress significantly decreased from baseline to follow-up (d_z=. 73, p=. 002). Participants rated SSC sessions as highly acceptable, useful, and worth recommending to others. Conclusions. A solution-focused single-session consultation was associated with improvements in …

The aim of this article was to systematically review the quality and efficacy of the current evidence for mindfulness-based interventions (MBIs) in patients with mild cognitive impairment (MCI), patients with dementia (PwD), and their caregivers. We identified 20 randomized controlled trials (RCTs) (11 for patients, 9 for caregivers) published in the last 15 years. Evidence suggested that MBIs are highly acceptable and credible treatments for patients with MCI, PwD and caregivers. Specifically, for PwD, the results indicated that the magnitude of post-treatment effects of MBIs are in the medium to large range for psychosocial outcomes, and in the small to medium range for cognitive functioning; however, treatment effects on dementia biomarkers were mixed, ranging from small to large, depending on the outcome measure. Findings also evidenced salutary effects of MBIs for caregivers of PwD, with post-treatment effects …

Objectives Disaster workers are at elevated risk for mental health problems as a result of trauma exposures during response efforts. One possible way to prevent mental health problems is to build-up coping resources that promote resilience to the effects of disaster work. The primary aim of this study was to evaluate the efficacy of a resilience building workshop, the Disaster Worker Resiliency Training Program (DWRT), in disaster workers previously exposed to Hurricane Sandy. Methods Disaster workers (N = 167) were randomly assigned to the DWRT workshop (n = 78) or a waitlist (n = 89). Workers completed self-report measures on healthy lifestyle behaviors, perceived stress, depression, and Posttraumatic Stress Disorder (PTSD) symptoms at baseline and 3-month follow-up. They also completed a measure assessing subsequent trauma …

Methods:We conducted a national survey study of graduating fellows (3 rd and 4 th year) and program directors (PDs). An initial trainee and a PD survey were administered in 5/2020; a 6-month follow-up trainee survey was administered in 11/2020. The surveys aimed to determine the impact of COVID-19 on:(1) employment;(2) CME;(3) telehealth;(4) clinical practice; and (6) confidence/competency. Initial and follow-up trainee surveys and trainee and PD surveys were compared. Bivariate analyses were performed using either Chi-square or Fisher exact tests.Results:105 and 43 graduating GI fellows completed the initial and follow-up surveys. 107 PDs were surveyed. 15.2% of trainees had a change in their employment due to the pandemic. Popular educational resources used were ACG Education Universe (39.1%) and ACG Virtual Grand Rounds (55.4%). A large proportion of fellows were not likely to attend an …

Assessment of posttraumatic stress disorder (PTSD) has relied almost exclusively on retrospective memory of symptoms, sometimes over long intervals. This approach creates potential for recall bias and obscures the extent to which symptoms fluctuate. The aim of the present study was to examine the discrepancy between retrospective self-reporting of PTSD symptoms and ecological momentary assessment (EMA), which captures symptoms closer to when they occur. The study also sought to estimate the degree to which PTSD symptoms vary or are stable in the short-term. World Trade Center responders (N = 202) oversampled for current PTSD (19.3% met criteria in past month) were assessed three times a day for 7 consecutive days. Retrospective assessment of past week symptoms at the end of the reporting period were compared with daily EMA reports. There was correspondence between two approaches …