New Research Findings
Can religiosity impact attitudes towards professional mental health services among Latina/o communities?
Latinas/os tend to underutilize mental health services. This is interesting given that approximately 90% of Latinas/os identify as religious. However, little is known about whether religiosity and religious coping impact attitudes towards mental health help-seeking behaviors among these communities. Can religiosity impact attitudes towards professional mental health services among Latinas/os?
Oswaldo Moreno, Ph.D., assistant professor of counseling psychology and director of the La Esperanza Research Program, and his collaborator Esteban Cardemil, Ph.D., with the Mental Health, Culture and Community Research Program at Clark University, have been studying religiosity, help-seeking behaviors and overall well-being among Latinas/os in the U.S.
One quantitative study with 100 Latinas/os in the southwest U.S. recently found religiosity had negative attitudes towards mental health services. This study also noted that religiosity impacted external religious coping (e.g., seeking support from religious-oriented individuals such as religious counseling) and internal religious coping (e.g., engaging in more internal/private practices). Results also showed a nonsignificant association with both religious coping and negative attitudes towards mental health services. However, external religious coping (e.g., seeking support from religious oriented individuals such as religious counseling) and internal religious coping (e.g., engaging in more internal/private practices) mediated the relationship between religiosity and negative attitudes towards mental health services for men but not for women.
Moreno, O., Nelson, T., & Cardemil, E. V. (2017). Religiosity and attitudes towards professional mental health services: An initial examination of mediation. Journal of Mental Health, Religion, and Culture. doi: 10.1080/13674676.2017.1372735
Doctor-patient communication: We know it's important, but how do we study it?
Much research in health psychology has found the quality of communication between doctors and patients is a significant predictor of health outcomes across a number of domains. For instance, Epstein and Street (1984) found that medical interactions in which physicians displayed greater patient-centered behaviors (i.e., physicians listening to, informing and involving patients in their care) were associated with significantly higher reported treatment adherence in patients with both acute and chronic illnesses. In a more recent study, Young and his colleagues (2017) demonstrated positive patient-physician communication was associated with medication adherence in adults with asthma and that such relationships were mediated by increased trust and motivation.
Though a strong body of evidence supports the importance of the quality of doctor-patient communication, researchers have encountered difficulties when it comes to the question of measurement. Specifically, the current tools are either time-consuming to use or are subject to rating bias by having doctors and patients self-report the quality of their communication.
A new paper in Social Science & Medicine by researchers at VCU, Carnegie Mellon University and Wayne State University proposes the measure of semantic similarity between the doctor's and patient's language via latent semantic analysis (LSA) as a possible solution to this problem. LSA may represent an objective, fast and low-cost way to evaluate the communication quality in medical interactions.
Scott Vrana, Ph.D., a professor in the clinical psychology program, collaborated with Nao Hagiwara, Ph.D., an assistant professor in the health psychology program, and her colleagues at Wayne State University. Dylan Vrana, a Carnegie Mellon University researcher in computational biology, is second author on the paper and conducted the latent semantic analysis.
LSA is a mathematical way of deriving meaning from a conversation by using principal components analysis to reduce transcribed texts to a number of dimensions. By comparing the dimensions for the words said by the doctor with those said by the patient in a clinical encounter, the quality of the communication can be measured. In this study the authors found LSA yielded reliable differences in the communication quality of physicians. Further, they found gender is related to semantic similarity between physicians and patients: semantic similarity in the doctor-patient conversation was greater for both female doctors and female patients than it was for male physicians and patients.
Other exploratory findings suggested physician-patient communication similarity is related to patient expectations about how the interaction will go.
"Trust seems to be the key factor here," explains Vrana. "When patients reported generally trusting doctors ahead of the interaction, we found less similarity in the subsequent communication, maybe because they were less assertive with their physician. Conversely, a high-quality interaction resulted in patients reporting greater trust in their individual doctor following an interaction."
Vrana, S. R., Vrana, D., Penner, L. A., Eggly, S., Slatcher, R. B., & Hagiwara, N. (2018). Latent semantic analysis: A new measure of patient-physician communication. Social Science & Medicine, 198, 22-26. doi:10.1016/j.socscimed.2017.12.021
What helps us to express compassion toward people for whom we may not otherwise feel concern?
People receiving brief instruction in mindfulness exhibited more kindness to strangers who had been ostracized or socially excluded by their peers, according to a new study by researchers in the Department of Psychology.
“This is one of the first series of studies that’s directly addressed the question of whether mindfulness training can promote more prosocial behavior toward victims of social exclusion or rejection,” said Kirk Warren Brown, Ph.D., associate professor of social psychology. “What it suggests is that even very brief instruction in mindfulness can promote more kindness toward people who have been victimized in social ways.”
The article in which the studies are described, “Mindfulness Increases Prosocial Responses Toward Ostracized Strangers Through Empathic Concern,” will appear in a forthcoming issue of the Journal of Experimental Psychology: General and was led by Daniel R. Berry, Ph.D., left, a VCU doctoral graduate ('17) working with Brown and now at California State University, San Marcos.
- Read VCU News' feature on this research finding.
- Read Time magazine's feature on this research finding.
Berry, D. R., Cairo, A. H., Goodman, R. J., Quaglia, J. T., Green, J. D., & Brown, K. W. (2018). Mindfulness increases prosocial responses toward ostracized strangers through empathic concern. Journal of Experimental Psychology: General, 147, 93-112.
Improving homework and organization problems in students with ADHD
Most children diagnosed with ADHD experience significant difficulties completing homework. They frequently forget to complete assignments, lose papers, procrastinate and have difficulty focusing while completing work. These problems prevent students with ADHD from reaching their full academic potential. In a new article published in the Journal of Consulting and Clinical Psychology, Joshua Langberg, Ph.D., associate professor of clinical psychology, presented the results of a school-based intervention study focused on improving the homework, organization and planning problems of middle students with ADHD.
Importantly, the interventions tested in the study were brief and feasible for school counselors to implement during the school day. The study evaluated the impact of the Homework, Organization and Planning Skills (HOPS) intervention as compared to the Completing Homework by Improving Efficiency and Focus (CHIEF) intervention. The interventions were delivered to 280 middle school students with ADHD and both led to significant and meaningful improvements in homework problems according to parents. The HOPS intervention was more effective than CHIEF according to teacher ratings of organizational skills and was more effective than CHIEF on all outcomes for students with severe behavioral problems.
The study is important because frequently research-developed interventions are too time intensive and complex to be feasible to implement in typical school settings. Both HOPS and CHIEF require only 16 meetings, each lasting 20 minutes. In the study, the interventions were delivered as intended by school counselors, with more than 90% of students receiving all 16 intervention meetings. These findings increase the likelihood that schools will be able to use and sustain these types of services.
- Read VCU News' full feature on this research finding.
- Listen to Langberg's radio interview with local public radio.
Langberg, J. M., Dvorsky, M. R., Molitor, S. J., Bourchtein, E., Eddy, L. E., Smith, Z. R., Oddo, L. E., & Eadeh, H. M. (2017). Overcoming the research-to-practice gap: A randomized trial with two brief homework and organization interventions for students with ADHD as implemented by school mental health providers. Journal of Consulting and Clinical Psychology. Advance online publication. doi:10.1037/ccp0000265
How can feeling good lead to doing bad?
Aggressive behavior has a lot of causes. Conventional approaches to explaining aggression have focused on negative emotions, such as anger and fear. In a new article in Current Directions in Psychological Science, David Chester, Ph.D., assistant professor in the social psychology program, reviews the current research literature to argue that positive feelings such as pleasure and reward also play a significant role in motivating human violence.
From linguistic descriptions of "sweet revenge" to brain imaging research demonstrating that aggression is associated with activity in the brain's reward circuitry, there is a wealth of evidence to indicate that aggressive acts are often experienced as pleasant and that this pleasure motivates violent acts. Further, people appear to harness the positive feelings of aggression to regulate their negative moods, combating life's pains with aggressive pleasures. Chester propose that this well-established role of positive affect in aggression should represent a paradigm shift in research into and treatment of violent behaviors, focusing on how feeling good may lead to doing bad.
Chester, D. S. (2017). The role of positive affect in aggression. Current Directions in Psychological Science, 26, 366-370.
Are symptoms of ADHD associated with functional impairment in pregnant women?
Current research suggests up to 75% of children with ADHD continue to experience significant symptoms and associated impairment into adulthood. Compared to adults without significant ADHD symptoms, adults with significant ADHD symptoms have difficulty holding steady employment, experience greater relationship difficulties, are cited for more reckless driving tickets and report higher rates of comorbid psychopathology. Given that adult ADHD has only recently become a focus for researchers, there is a lack of empirical data on pregnant women with ADHD symptomatology even though pregnant women and their fetuses represent a vulnerable and important population.
Researchers in the Department of Psychology at VCU, including Laura Eddy, clinical psychology doctoral student, Heather Jones, Ph.D., assistant professor of clinical psychology, and Dace Svikis, Ph.D., professor of psychology, psychiatry and obstetrics/gynecology, have been investigating how symptoms of ADHD may relate to impairment, prenatal health and quality of life during pregnancy. The first publication from their study of pregnancy and ADHD, which was published in the Journal of Attention Disorders, documents the functional impairment related to different ADHD symptom clusters in pregnant women. The researchers found inattentive symptoms predicted impairment across the three major areas of life functioning, including home life, professional (work) life and relationships with others. Impulsivity, however, only predicted impairment at work and in relationships with others. Hyperactivity did not predict functional impairment at all. These findings speak to the roles inattention and impulsivity play in the everyday lives of pregnant women and highlight the need for further research in this population.
Eddy, L. D., Jones, H. A., Snipes, D., Karjane, N., & Svikis, D. (2017). Associations between ADHD symptoms and occupational, interpersonal, and daily life impairments among pregnant women. Journal of Attention Disorders. Advance online publication. doi: 10.1177/1087054716685839
E-cigarette and cigarette use patterns among undergraduates
Cigarette smoking remains the leading preventable cause of death in the U.S., claiming the lives of more than 480,000 Americans annually. In recent years, the use of novel tobacco products such as e-cigarettes has been steadily increasing, especially among young people. Importantly, some evidence suggests adolescents who use e-cigarettes are more likely to go on to smoke cigarettes. Previous research has determined that many people start smoking cigarettes due to internalizing factors such as depression and anxiety and/or externalizing factors such as impulsivity. However, until now, no study had examined whether these factors are also predictive of trying e-cigarettes or whether these products make college students more likely to try cigarettes.
A team of researchers at VCU, including doctoral students Tory Spindle (pictured), Megan Cooke and Marzena Hiler, along with faculty member Danielle Dick, Ph.D., explored tobacco use patterns among undergraduates who participated in the Spit for Science study. The study, published recently in Addictive Behaviors, found that students who started as non-smokers had a greater chance of later trying cigarettes if they were an e-cigarette user, suggesting e-cigarette use served as a catalyst to initiating cigarette smoking. The researchers also found that many internalizing and externalizing factors that typically predict who starts cigarette smoking were not predictive of e-cigarette use. This means that the reasons people decide to start using e-cigarettes remains a bit unknown. These findings highlight the need to explore whether individuals begin using e-cigarettes through alternative pathways such as increased exposure to advertising and could suggest that future laws may consider limiting young adults’ access to e-cigarettes.
Spindle, T. R., Hiler, M. M., Cooke, M. E., Eissenberg, T., Kendler, K. S., & Dick, D. M. (2017). Electronic cigarette use and uptake of cigarette smoking: A longitudinal examination of US college students. Addictive Behaviors, 67, 66-72. doi: https://doi.org/10.1016/j.addbeh.2016.12.009
Genetic and environmental factors in alcohol use disorder and divorce
Excerpt: "Previous research has shown that alcohol use disorder and divorce are closely tied. The researchers in this study sought to understand why, and in what ways.
“In this study, we were asking the simple question, ‘Why are AUD and divorce related to one another?’” said lead author Jessica Salvatore, Ph.D. "What we find is that genetic factors account for a substantial proportion (about 50 percent) of this association, and then nonshared environmental factors account for the rest.”
The researchers identified twin and sibling pairs with alcohol use disorder and divorce information from national population registries in Sweden, totaling 670,836 individuals born between 1940 and 1965. “What we were able to do in this genetically informative sample was look at the sources of covariation between alcohol use disorder and divorce,” Salvatore said. “What that means in layman’s terms is we were able to disentangle the degree to which genetic and environmental influences contribute to the correlation between alcohol use disorder and divorce.”
The researchers wanted to build on previous studies that asked, “Does an alcohol use disorder predict divorce later on?” and, “Does getting divorced increase someone’s risk for later developing an alcohol use disorder?” “What we’re able to show here is that genetic confounding may contribute to both alcohol use disorder and divorce,” Salvatore said. “Which means that an underlying set of genes that are common to both alcohol use disorder and divorce may increase people’s risks for both of those outcomes.”
The full manuscript of this study is available online at: http://onlinelibrary.wiley.com/doi/10.1111/add.13719/abstract.
Profiles of family functioning in pediatric asthma
Asthma is the most prevalent pediatric chronic illness, affecting over six million children in the United States. Each year, asthma causes nearly five million pediatrician visits and over 200,000 hospitalizations for children. Even when asthma symptoms are not severe, they interfere with a child’s ability to sleep, play and function well; compared to children without asthma, children with asthma are at risk for poorer physical and mental health outcomes.
Although effective treatment options can ameliorate asthma symptoms and decrease asthma-related problems, many children continue to experience poor asthma control. The family, as the primary context of development for children, is where the majority of asthma management takes place. As such, linking aspects of family functioning to child mental and physical health outcomes in pediatric asthma has been of central interest to researchers for decades.
In this study, which will appear in an upcoming issue of the Journal of Pediatric Psychology, graduate student Nour Al Ghriwati, M.S., and Drs. Marcia Winter and Robin Everhart examined profiles of family functioning in pediatric asthma. Primary caregivers and children (N = 1,030) from the Childhood Asthma Management Program completed questionnaires assessing family functioning and child adaptation across four years. Asthma severity was assessed via spirometry test of lung function.
Latent profile analyses identified four patterns of family functioning: cohesive, permissive, controlling/disengaged and controlling/enmeshed. Children from families that were more cohesive had fewer internalizing and externalizing symptoms at all time points. Family profiles did not differ with regards to child asthma severity. Results highlight the utility of looking beyond the effects of individual aspects of family functioning and instead using pattern-based approaches to examine family effects on children’s adjustment to and management of asthma symptoms.
Al Ghriwati, N., Winter, M. A., & Everhart, R. S. (2016). Examining profiles of family functioning in pediatric asthma: Longitudinal associations with child adjustment and asthma severity. Journal of Pediatric Psychology. Advance online publication. doi: 10.1093/jpepsy/jsw089
How do Mexican mothers impact their adolescent daughters’ ethnic-racial identity?
Ethnic–racial identity is a normative aspect of development that is linked with adolescents’ psychological, academic, and health outcomes. Despite this impact on well-being, less is known about the processes that underlie adolescents’ ethnic-racial identity. In this study, Dr. Chelsea Derlan and colleagues at Arizona State University explored how Mexican-origin mothers’ cultural characteristics and efforts to teach their adolescent daughters about their culture (i.e., cultural socialization) informed youths’ ethnic-racial identity across 3 years. Results showed that mothers’ familism values and ethnic-racial identity exploration predicted mothers’ greater cultural socialization a year later with adolescents; however, cultural socialization did not predict adolescents’ ethnic-racial identity. Instead, mothers’ own ethnic-racial identity affirmation (i.e., positive attitudes toward being Mexican) predicted adolescents’ greater ethnic-racial identity affirmation two years later. These findings suggest that because teaching cultural traditions or history may not always include positive messages, it may be necessary for family members to model positive attitudes about their ethnic-racial group to adolescents in order to inform adolescents’ ethnic-racial identity.
Derlan, C. L., Umaña-Taylor, A. J., Updegraff, K. A., & Jahromi, L. B. (2016). Mothers’ characteristics as predictors of adolescents’ ethnic-racial identity: An examination of Mexican-origin teen mothers. Cultural Diversity and Ethnic Minority Psychology, 22, 453-459. doi:10.1037/cdp0000072
Why do kids respond differently to intervention? Could it be in their genes?
Early interventions are a preferred method for addressing behavior problems in high-risk children, but often have only modest effects. Why do some children benefit from intervention, while others do not? One potential source of variation may lie in the genome. VCU researchers, including Dr. Danielle Dick, worked with investigators from Duke University to conduct a genetic analysis of the Fast Track randomized control trial, a 10-year-long intervention to prevent high-risk kindergarteners from developing adult externalizing problems including substance abuse and antisocial behavior. The researchers tested whether variants in a gene associated with stress physiology (glucocorticoid receptor gene NR3C1) were associated with differences in response to the Fast Track intervention. Kids who carried a particular version of the gene were especially likely to develop externalizing problems when they did not receive intervention, and especially likely to benefit in terms of reduced likelihood of externalizing problems when they did receive the intervention.
In the post-genomic era, we know that genetic predispositions play a role in the likelihood that an individual will develop a behavioral or emotional disorder; these findings demonstrate that this predisposition is also susceptible to preventive intervention. The kids who are most at risk also appear to be the ones most likely to benefit from intervention. These analyses underscore the importance of early intervention for at-risk children.
Albert, D., Crowley, D. W., Latendresse, S. J., Aliev, F., Riley, B., Sun, C., Conduct Problems Prevention Research Group, Dick, D. M., & Dodge, K. A. (2015). Can genetics predict response to complex behavioral interventions? Evidence from a genetic analysis of the Fast Track randomized control trial. Journal of Policy Analysis and Management, 1-22.