2021 - Virtual Poster Symposium

One of the most pervasive public health challenges for Veterans is suicide. Finding ways to prevent this devastating phenomenon is a paramount concern for our country as well as the primary aim of this study. Common risk factors for suicidal ideation include male gender, older age, depression, psychosis, substance use, and social isolation, but predictors of suicidality-related hospitalization for PTSD residential treatment post-discharge are unknown. This study utilized archival data provided by 837 Veterans from residential PTSD treatment programs across five VA sites in the United States to examine the factors that predict Veteran hospitalization due to suicide risk (as the result of either a serious concern or an attempt) within four months from discharge. The study utilized multivariate logistic regression analysis to examine the predictors of hospitalizations due to suicide risk. The variables hypothesized to be predictors included age, gender, period of war service, having a military sexual trauma, taking medications for PTSD, depression, PTSD, aggression, alcohol use problems, drug use problems, quality of life, and history of hospitalizations due to suicide risk. Follow-up assessment at four-month post-discharge regarding whether Veterans were hospitalized due to suicide risk since discharge at least one time (Yes/No) was used as the outcome measure. Out of a total of 837 participants at residential PTSD treatment initiation, 516 Veterans completed a follow-up post-survey and 58 (11.2%) indicated that they were hospitalized at least once due to suicide risk in the four-months post-discharge. Bivariate correlation analyses showed that hospitalization due to suicide risk within 4 months from discharge were associated with depression, trauma, and poor quality of life assessed at residential treatment initiation. Multivariate logistic regression analyses showed history of suicidality and poor quality of life assessed at residential PTSD treatment initiation predicted hospitalizations due to suicidality within four-months post-discharge. The findings highlight the importance to consider quality of life concerns for Veterans who are receiving residential PTSD treatment; Veterans with poor quality of life at the time of treatment initiation may be at risk to be hospitalized for suicidality after discharge. If the current findings are confirmed by future studies, residential PTSD program providers should thoroughly assess for quality of life in Veterans prior to discharge. In addition, Veterans with poor quality of life should be monitored closely and receive early intervention if necessary to prevent suicide risk.

BACKGROUND: Traumatic Brain Injury (TBI) is a catastrophic injury that physically and mentally affects the individual as well as his or her loved ones. There is limited research focusing on the impact of ambiguous loss on a couple with a partner who sustained a TBI.

OBJECTIVE: The purpose of this review is to evaluate and summarize the current literature of ambiguous loss, specifically within a couple with one partner affected by a TBI.

METHOD: A comprehensive literature search was conducted utilizing PsychInfo, Google Scholar, and PubMed using the search terms ambiguous loss, traumatic brain injury, couples, spouses, caregivers, loss, and grief.

RESULTS: Seven qualitative studies were reviewed. Each study provided direct experiences of the individual with a TBI and/or his or her partner. The themes found in couples experiencing ambiguous loss with a partner affected by a TBI included roles in marital relationships, self-identity and partner identity, ambivalence and psychological distress, and future planning.

CONCLUSION: The current literature revealed common themes in qualitative data that can help inform TBI rehabilitation for individuals and couples. By increasing research in ambiguous loss and TBI, resources can be developed to effectively transition a couple and individuals after a TBI.

Beliefs about the self are an integral component across multiple psychological applications. Comprehensive depictions of personality, etiology of psychopathology, and treatment of many common psychological concerns incorporate or are informed by these self-schemata. Despite the evident importance of this construct, modern measurement of self-schemata evaluate a monolithic self—abstracted and without the nuance of relational contexts. Modern conceptualization of self-schemata depicts the self as highly context-dependent and consisting of numerous selves that fluctuate in activation. The Relational Self-Schema Measure (RSSM) was developed with the goal of bridging this gap between prior measurement and modern conceptualization of self-schemata. The current study was designed to evaluate the psychometric properties of the RSSM and investigate potential clinical applications for this measure. 78 respondents, primarily female college freshmen from a large northwestern university in the United States, completed the RSSM and multiple measures of positive and negative psychological outcomes at two timepoints (separated by approximately eight weeks). As part of the RSMM, respondents were asked to select multiple interpersonal relationships they commonly reflected on and rated their psychological need satisfactions and frustrations within the contexts of each of these relationships. Positive and negative psychological outcomes assessed included measures of psychological wellbeing, anxiety, depression, objective stressors, and perceived stress. The longitudinal data was analyzed using correlation and multiple hierarchical regressions to evaluate the RSSM’s test-retest reliability, convergent and discriminant validity, and general ability to predict changes in psychological outcomes across the two timepoints. Strong support was found for the RSSM’s test-retest reliability and other positive psychometric properties, but few significant results were found regarding the RSSM’s ability to predict changes in psychological outcomes between the two timepoints. In conclusion, the RSSM demonstrated excellent psychometric properties and shows promise as a new method of assessing multiple self-schemata that is consistent with modern research. However, further research is required regarding the measure’s clinical applications.

Sexual assault is a pervasive public health issue in the United States. Every 73 seconds, an American experiences sexual assault (RAINN, 2020). It is estimated that 1 in 6 women and 1 in 33 men will be victims of sexual assault during their lifetime (RAINN, 2020). Though sexual assault can happen to anyone regardless of age, gender, race, or religion, college students are at a higher risk of sexual assault than people in other age cohorts. It is estimated that 1 in 4 college women and 1 in 16 college men will be sexually assaulted during their time in college (National Sexual Violence Resource Center, 2015). Sexual assault, specifically rape, is the most frequent violent crime occurring on college campuses (Munro-Kramer, Dulin, & Gaither, 2017).

Though sexual assault has been prevalent throughout history, the United States of America is currently in the middle of a cultural movement around sexual assault- the ‘me too.’ movement. This movement began in 2006 with Tarana Burke but became part of popular culture in the United States until almost 10 years later when Ashley Judd accused director Harvey Weinstein of sexual harassment. The goal of the ‘me too.’ movement, both in Burke’s inception and in its current form, was to build a community of survivors and advocates and better support survivors on their journey to healing (me too., 2018).

This study sought to understand the experience of college survivors of sexual assault during the ‘me too.’ movement through the use of phenomenological qualitative interviews. Sixteen women between the ages of 18 and 21 were interviewed using a constructivist approach with a critical-ideological framework. Participants’ experiences were organized along the following major themes: (a) drawn to advocacy work and directly supporting survivors, (b) feelings of resilience and empowerment post assault, (c)‘me too.’ encourages reporting because of community, (d) ‘me too.’ brings awareness and conversations about sexual assault, (e) ‘me too.’ increases empathy for other survivors, (f) ‘me too.’ decreases stigma and helps name assault, (g) ‘me too.’ makes participants feel part of something bigger, and (h) trauma-related symptoms as a result of assault. Implications of these findings for practice include recommendations for how mental health providers can better support sexual assault survivors, such as specific trainings in sexual assault, creating a safe space in therapy for disclosure, appropriately responding to disclosure, and not naming the experience as assault until patients are ready. In addition, recommendations for university policy, such as a comprehensive list of resources for survivors, a centralized location for survivors to find relevant information, and specific support for survivors on campus such as a support group or hotline, are discussed.

Depression is prevalent in patients with heart failure (HF) and is associated with poor outcomes. Poor and/or worsening health is a predictor of depression in HF. Self-care behavior is important for the prevention of worsening health and therefore might protect against depression. Given the potential impact of self-care confidence on effective self-care behavior, it was hypothesized that self-care confidence would be inversely related to depression. Further, because self-care confidence involves belief in one's ability to manage symptoms, it was hypothesized that self-care confidence would moderate the relationship between symptom burden and depression in HF. Specifically, it was expected that symptom burden would be less strongly associated with depression among patients with greater self-care confidence. It was further hypothesized that greater HF knowledge, as well as accurate personal beliefs about HF, would be associated with greater self-care confidence. Data were obtained from the Heart ABC study. Participants were 324 individuals diagnosed with HF, recruited from cardiology departments. Measures included the Patient Health Questionnaire–9, the Kansas City Cardiomyopathy Questionnaire, the Self-care in Heart Failure Index, the Dutch Heart Failure Knowledge Scale, and the Survey of Illness Beliefs in Heart Failure. Greater self-care confidence predicted less depression (p = .009) and lower functioning due to higher HF symptom burden predicted greater depression (p < .001). However, a moderation analysis did not find an interaction effect (p = .250). A trend was found for a positive relationship between HF knowledge and self-care confidence (p = .08). The accuracy of HF beliefs did not predict self-care confidence (p = .199). Findings of the present study suggest that HF symptom burden is positively associated with depression, whereas self-care confidence appears to be inversely associated with depression in HF. Further research is needed to explore potential mechanisms for the influence of self-care confidence on depression as well as predictors and mechanisms of increasing self-care confidence. It could be clinically beneficial for healthcare professionals to monitor for self-care confidence in those with a diagnosis of HF and to provide self-care education where needed. (Funding: Supported by 1 R01 HL096710-01A1to Drs. Hughes and Dolansky.)

Parents and teachers encourage preschool-aged children to share with their peers. Sharing resources equally – egalitarianism – is beneficial to humans and shapes their interactions (Boehm et al., 1993; Dawes et al., 2007). But is a generosity motive—a tendency to share more than expected—synonymous with an egalitarian motive? Psychology research concerned with children’s social values orientation (SVO) has traditionally conflated the two as cooperative SVO, the preference to maximize the combined group total. Individualist SVO, the preference to maximize personal total, independent of the effect their choice has on others, and competitive SVO, the preference to maximize personal total in relation to others (i.e., have more), have also been widely studied using simple resource allocation games (Knight, 1981; Van Lange et al., 1997). SVO is thought to develop during early childhood and remain stable through adulthood (Fehr et al., 2008; Knight et al., 1995). Cooperative SVO is associated with positive social interactions and higher levels of altruism, empathy, and helpfulness (Balliet et al., 2009; Declerck & Bogaert, 2008; McClintock & Allison, 1989). Recent work in behavioral economics allows us to better understand cooperative SVO by distinguishing the egalitarian and generous motives that drive cooperation (Fehr et al., 2008).

Because SVO is known to relate closely to cultural values, we were interested in evaluating how culture relates to these distinct cooperative motives (e.g., House et al, 2013). The present study was concerned with whether cultural collectivism, long associated with cooperation, is animated more so by generosity or egalitarianism. Similarly, we investigated whether SVO of collectivists differed from two other culture groups—cultural individualists and a mixed cultural background group. We hypothesized that collectivist preschoolers would be more cooperative than the other groups, consistent with the literature. Further, we predicted that generosity would animate cooperative behavior for collectivists, more so than for other culture groups.

We tested these hypotheses by utilizing the methodology of Fehr and colleagues (2008) with a multicultural sample of preschoolers attending Head Start. Participants (n = 175) played three games in which they split resources (stickers) between themselves and a hypothetical classmate. Choices across games resulted in SVO classification as egalitarian, generous, or competitive. Finally, we examined whether SVO and culture related to behavioral adjustment in the classroom, measured by the teacher-reported Strengths and Difficulties Questionnaire (Goodman, 1994). Data were analyzed using a series of chi-square tests of significance and independent samples t-tests to assess for group differences in SVO. We conducted an ANOVA and MANCOVA to test for a relationship between SVO and behavioral adjustment, and whether that relationship depended upon culture. Results indicated that frequency of generous, egalitarian, and competitive SVO types differed significantly by culture, x2 (4, N = 175) = 11.52, p = .025. Collectivists were more generous than egalitarian, consistent with our predictions. These findings suggest that cooperative behavior in collectivists is motivated by generosity, not egalitarianism. By better understanding the social values of collectivist preschoolers, we can encourage educators to nurture these values and ultimately create a more inclusive learning environment.

Background: Nearly one third of Americans have a substance use disorder (SUD) at some point in their lifetimes and more than 70% of them never receive SUD care (Grant et al., 2015; Grant et al., 2016). Previous studies on treatment patterns among those with SUD have largely focused on SUD specialty settings. Other studies examining treatment receipt in SUD and mental health (MH) settings are typically restricted to those with a SUD and co-occurring MH conditions. Both types of studies preclude insight into treatment patterns across the broader SUD population. Knowledge of where people with SUD receive care (if at all) and what factors influence type of care receipt are needed to improve delivery of adequate SUD care across treatment setting types.

Objective: The goal of the study is to better understand where people with SUD receive care and identify factors related to type of treatment receipt.

Method: Participants with a lifetime SUD from the 2012/3 National Epidemiological Survey on Alcohol and Related Conditions-III were included (N=10,930). A latent class analysis of lifetime types of SUD and MH treatment receipt was conducted to identify treatment classes. A Wald test compared classes on a series of demographics, psychiatric factors, and psychosocial factors. The Benjamini-Hochberg procedure was applied to control the false discovery rate for multiple comparisons.

Results: The best-fitting model was a 5-class solution with the following classes: no treatment (53.3%), MH outpatient (25.2%), SUD self-help/rehabilitation (9.8%), MH outpatient/inpatient (6.2%), and all types of MH/SUD care (5.4%). All of the treatment classes generally had greater psychopathology and poorer psychosocial functioning than the no treatment class but the degree of impairment increased as SUD and/or inpatient care are added. Nearly one-third of the sample (~31%) received only some form of MH care while approximately 15% received some form of SUD care, with or without additional MH care. Those who exclusively received MH care had significantly lower SUD severity and substance-related legal problems than those who received SUD care. Those who received MH outpatient/inpatient and all types of MH/SUD had higher rates of most mental disorders and childhood instability/abuse, as well as poorer social support relative to the other classes.

Conclusion: Findings suggest that distress from other mental health disorders and psychosocial stressors may be particular drivers of decisions to seek care for those with SUD, with an apparent preference for MH care receipt. Future research needs to determine whether individuals with SUD who seek care in MH settings receive adequate care for their substance related issues. Consistent with previous studies, most people with SUD received no treatment; this group likely includes those with untreated chronic SUD, individuals with recent SUD onset, and people who naturally recover from SUD. Future research is needed to typify individuals who never receive treatment to identify potential unmet needs of this group.

There is little known about parenting knowledge in pre-parents, as most studies focus on those that are already a parent. Additionally, evidence suggests there may be ethnic/racial disparities in age of diagnosis for children with autism spectrum disorder (ASD) due to caregivers’ lack of awareness of early signs of neurodevelopmental delay (Mandell et al., 2009). The present study aimed to evaluate how prior experience with children, undergraduate education, and family SES may relate to pre-parents’ actual and perceived ASD knowledge and how ethnicity may moderate those relations.

Participants were 221 undergraduate students who identified as pre-parents (i.e., have no children but plan to have children in the future). They completed questionnaires via Qualtrics including A Survey of Knowledge of Autism Spectrum Disorder (ASK-ASD), assessing perceived (ranging from 1 to 3) and actual (ranging from 0 to 1) ASD knowledge, and a demographic questionnaire, which included ethnicity (coded 0 = White, 1 = Non-White), experience with children in five roles (e.g., daycare worker; coded 0 = no, 1= yes), and previous enrollment in specific Psychology undergraduate classes (coded 0 = no, 1 = yes). An experience composite (ranging from 0 to 5) and a classes composite (ranging from 0 to 16) were created by summing the items for the respective constructs.

Zero-order correlations indicated that ethnicity related to actual and perceived knowledge of ASD and family SES, with White participants having significantly more perceived and actual knowledge and higher family SES. Both experience and family SES were significantly positively correlated with ASD knowledge.

Six moderated multiple regressions examined whether ethnicity interacted with experience, classes, or family SES (considered separately) in predicting both actual and perceived ASD knowledge. At Step 1, the significant main effects found in the zero-order correlations held, with no additional main effects emerging. That is, ethnicity, experience, and family SES were significant unique predictors in each of their respective analyses [although ethnicity and family SES only predicted a marginal amount (p = .05) of unique variance in perceived ASD knowledge]. At Step 2 (interaction effect), only the interaction between ethnicity and experience predicted unique variance in actual knowledge, b = -0.03, SE = 0.02, [95% CI (-0.06, -0.003)], and perceived knowledge, b = -0.09, SE = 0.04, [95% CI (-0.17, -0.001)]. Post-hoc plots showed that the positive relation between child experience and perceived or actual ASD knowledge only emerged for White participants. Levels of experience did not predict levels of actual or perceived knowledge for Non-White participants.

Ethnicity, family SES, and child experience contributed to participants’ ASD knowledge. The lack of finding of a contribution from classes suggests that Psychology curriculum may need to place a heavier emphasis on neurodevelopmental differences, and future research should evaluate if specific courses contribute to variability in ASD knowledge. The interaction between ethnicity and child experience indicated that Non-White participants may rely on other factors when acquiring ASD knowledge of ASD. The findings may provide clinical implications to how pre-parent knowledge of neurodevelopmental disabilities could enhance early diagnoses.