Color It Real: A Program to Increase Condom Use and Reduce Substance Abuse and Perceived Stress

Few interventions have targeted perceived stress as a co-occurring construct central to substance use and subsequent HIV/AIDS risk reduction among African American urban young adults. 

The Color It Real Program was a seven session, weekly administered age-specific and culturally-tailored intervention designed to provide substance abuse and HIV education and reduce perceived stress among African Americans ages 18 to 24 in Atlanta, GA. Effectiveness was assessed through a quasi-experimental study design that consisted of intervention (n = 122) and comparison (n = 70) groups completing a pre- and post-intervention survey. 

A series of Analysis of Variance (ANOVA) tests were used to assess pre- to post-intervention changes between study groups. For intervention participants, perceived stress levels were significantly reduced by the end of the intervention (t(70) = 2.38, p = 0.020), condom use at last sexual encounter significantly increased (F = 4.43, p = 0.0360), intervention participants were significantly less likely to drink five or more alcoholic drinks in one sitting (F = 5.10, p = 0.0245), and to use clean needles when injecting the drug (F = 36.99, p = 0.0001). 

This study is among the first of its kind to incorporate stress management as an integral approach to HIV/SA prevention. The program has implications for the design of other community-based, holistic approaches to addressing substance use and risky behaviors for young adults.

Below:  Perceived Stress Scale Composite Score for Intervention and Comparison Group

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By:  Tiffany Zellner,1,* Jennie Trotter,2 Shelia Lenoir,2 Kelvin Walston,2 L’dia Men-Na’a,2 Tabia Henry-Akintobi,1 and Assia Miller3

¹Department of Community Health and Preventive Medicine, Morehouse School of Medicine Prevention Research Center, 720 Westview Drive SW, Atlanta, GA 30310, USA; Email: ude.msm@ibotnikat

²Wholistic Stress Control Institute, Incorporated, 2545 Benjamin E Mays Drive, Atlanta, GA 30311, USA; Email: moc.1citsilohw@tj (J.T.); Email:moc.1citsilohw@lks (S.L.); Email: moc.liamtoh@notslawnivlek (K.W.); Email: moc.loa@aannemaidl (L.M.-N.)

³McKing Consulting Corporation, 2900 Chamblee Tucker Road, Building 10, Suite 100, Atlanta, GA 30341, USA; Email: ude.msm@rellima

^*Correspondence: Email: ude.msm@renllezt; Tel.: +1-404-756-8833; Fax: +1-404-752-1707

Int J Environ Res Public Health. 2016 Jan; 13(1): 51. Published online 2015 Dec 22. doi:  10.3390/ijerph13010051

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Among Inpatients, Posttraumatic Stress Disorder Symptom Severity Is Negatively Associated with Time Spent Walking

This study aimed to determine whether posttraumatic stress disorder (PTSD) symptom severity and psychological and functional variables were associated with physical activity (PA) upon admission to an inpatient facility. 

PTSD symptoms, depression, anxiety and stress, sleep quality, and PA participation were assessed among 76 participants (age, 47.6 ± 11.9 years; 83% male). Backward stepwise regression analyses identified variables independently associated with time spent walking and engaging in moderate-vigorous PA (MVPA). No significant correlations were found between any of the variables and MVPA. Total PTSD symptoms (r = -0.39, p < 0.001), combined symptoms of depression, anxiety, and stress (r = -0.31, p < 0.01), and sleep behavior (r = -0.24, p < 0.05) were significantly and negatively associated with total walking time. Total PTSD symptoms were the only significant predictor of walking time (B = -0.03, SE = 0.008, β = -0.4; t = -3.4; p < 0.001). 

Results indicate that increased PTSD symptoms are associated with lower levels of walking. Results highlight the importance of considering symptoms when designing PA programs for people with PTSD.

Purchase full article at:   http://goo.gl/bYvzkZ

By:  Rosenbaum S1, Vancampfort D, Tiedemann A, Stubbs B, Steel Z, Ward PB, Berle D, Sherrington C.

• 1*School of Psychiatry, University of New South Wales; †South Eastern Sydney Local Health District, Bondi Early Psychosis Programme, Sydney, NSW; ‡Musculoskeletal Division, The George Institute for Global Health and Sydney Medical School, The University of Sydney, Sydney, Australia; §UPC KU Leuven, campus Kortenberg, Department of Neurosciences, KU Leuven-University of Leuven, Kortenberg; ∥Department of Rehabilitation Sciences, KU Leuven-University of Leuven, Leuven, Belgium; ¶School of Health and Social Care, University of Greenwich, London, UK; #St John of God Health Care Richmond Hospital, North Richmond; **Black Dog Institute, NSW; and ††Schizophrenia Research Unit, South Western Sydney Local Health District, Sydney, Australia. 
• J Nerv Ment Dis. 2016 Jan;204(1):15-9. doi: 10.1097/NMD.0000000000000415.

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Drug Use among Street Children in Tehran, Iran

Introduction and objective

Globally, children who work and live on the streets are at higher risk of undesired behavioral health outcomes, including increased drug use and abuse. Considering the rapid growth of this population in Iran and the lack of program planning that is partly due to a scarcity of research-based information, this study was conducted in 2013 to investigate drug use among street children in Tehran.

Method

With a qualitative design, we conducted a Rapid Assessment and Response Survey of street children in Tehran, 2012–2013. Data were also obtained from 10 focus group discussions with street children using semi-structured questionnaires and 27 in-depth interviews with key informants in governmental, non-governmental, and international organizations.

Results

The variation in age at first use, type of drugs, and pattern of drug use were found based on ethnicity. Consuming of Alcohol was reported to be more among an ethnic group. Drug use problems were commonly described among families of street children. Children whose parents had drug-use problems described using drugs earlier than other children. Informants reported that families with drug-related problems used children for procurement of drugs. Children themselves described using drugs to cope with stress, and to reduce physical and psychological stressors and problems, such as fatigue, sadness, and pressure, resulting from frequent failures in life.

Conclusion

These results suggest that intervention and prevention programs dealing with drug use of street children in Iran should include family and peers when addressing drug use by street children.

Full article at:   http://goo.gl/snNXdP

By:  Masoumeh Dejman,1,2 Meroe Vameghi,3,* Payam Roshanfekr,2 Fatemeh Dejman,2 Hassan Rafiey,2 Ameneh Setareh Forouzan,2 Shervin Assari,4,5 Judith Bass,1 and Renee M. Johnson1

¹Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA

²Social Determinants of Health Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran

³Social Welfare Management Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran

⁴Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA

⁵Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA

Edited by: Pythia Nieuwkerk, Academic Medical Center, Netherlands

Reviewed by: Mary Odum, Texas A&M University, USA; Limin Mao, UNSW, Australia

*Correspondence: Meroe Vameghi, Email: moc.oohay@ihgemav_m

Specialty section: This article was submitted to HIV and AIDS, a section of the journal Frontiers in Public Health

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The Relation between Stress and Alcohol Use among Hispanic Adolescents

We explored the relation between eight domains of Hispanic stress and alcohol use and frequency of use in a sample of Hispanic adolescents between 11 and 19 years old (N = 901). Independent t-tests were used to compare means of domains of Hispanic stress between adolescents who reported alcohol use and those who reported no use. In addition, multinomial logistic regression was used to examine whether domains of Hispanic stress were related to alcohol use and whether the relation differed by gender and age. Multiple imputation was used to address missing data. 

In the analytic sample, 75.8% (n = 683) reported no use and 24.2% (n = 218) reported alcohol use during the previous 30 days. Higher mean Hispanic stress scores were observed among youths who reported alcohol use during the previous 30 days in five domains: acculturation gap, community and gang violence, family economic, discrimination, and family and drug-related stress. Increased community and gang violence, family and drug, and acculturative gap stress were found to be associated with some alcohol use categories beyond the effect of other domains. Few differences in the association between Hispanic stress and alcohol use by gender and age were observed. 

Study findings indicate that family and drug-related, community and gang violence, and acculturative gap stress domains are salient factors related to alcohol use among Hispanic adolescents, and their implications for prevention science are discussed.

Full article at:   http://goo.gl/dHkKeC

By:   Jeremy T. Goldbach, Ph.D., Jodi Berger Cardoso, Ph.D., Richard C. Cervantes, Ph.D., and Lei Duan, Ph.D.

Jeremy T. Goldbach, University of Southern California, School of Social Work;

Correspondence concerning this article should be addressed to Jeremy T. Goldbach, University of Southern California School of Social Work, 663 W. 34th St., Los Angeles CA 90089

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Introduction to Psychoactive Drugs

Via:  http://goo.gl/mqlmlj
By:  http://goo.gl/WUevak and http://goo.gl/kjharo

Stress and Coping with Racism and Their Role in Sexual Risk for HIV among African American, Asian/Pacific Islander, and Latino Men Who Have Sex with Men

The deleterious effects of racism on a wide range of health outcomes, including HIV risk, are well documented among racial/ethnic minority groups in the United States. However, little is known about how men of color who have sex with men (MSM) cope with stress from racism and whether the coping strategies they employ buffer against the impact of racism on sexual risk for HIV transmission. 

We examined associations of stress and coping with racism with unprotected anal intercourse (UAI) in a sample of African American (N = 403), Asian/Pacific Islander (N = 393), and Latino (N = 400) MSM recruited in Los Angeles County, CA during 2008-2009. Almost two-thirds (65 %) of the sample reported being stressed as a consequence of racism experienced within the gay community. 

Overall, 51 % of the sample reported having UAI in the prior 6 months. After controlling for race/ethnicity, age, nativity, marital status, sexual orientation, education, HIV serostatus, and lifetime history of incarceration, the multivariate analysis found statistically significant main effects of stress from racism and avoidance coping on UAI; no statistically significant main effects of dismissal, education/confrontation, and social-support seeking were observed. None of the interactions of stress with the four coping measures were statistically significant. Although stress from racism within the gay community increased the likelihood of engaging in UAI among MSM of color, we found little evidence that coping responses to racism buffered stress from racism. Instead, avoidance coping appears to suggest an increase in UAI. 

Below:  Stress from Racism Experienced in the Gay Community, by Race/Ethnicity (%)

Below:  Coping Strategies Employed to Deal with Racism, by Race/Ethnicity: Mean Scale Scores¹

1. Range: 1 = “strongly disagree” to 4 = “strongly agree”

Full article at:   http://goo.gl/78mRbc

By:   Han CS1, Ayala G, Paul JP, Boylan R, Gregorich SE, Choi KH.

• 1Department of Sociology and Anthropology, Middlebury College (http://www.middlebury.edu/academics/soan), Middlebury, VT, 05753, USA, chongsukhan@gmail.com.
• Arch Sex Behav. 2015 Feb;44(2):411-20. doi: 10.1007/s10508-014-0331-1. Epub 2014 Jul 25. 

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How Was the Weekend? How the Social Context Underlies Weekend Effects in Happiness and Other Emotions for US Workers

In this paper we estimate the size of weekend effects for seven emotions and then explore their main determinants for the working population in the United States, using the Gallup/Healthways US Daily Poll 2008–2012. We first find that weekend effects exist for all emotions, and that these effects are not explained by sample selection bias. Full-time workers have larger weekend effects than do part-time workers. We then explore the sources of weekend effects and find that workplace trust and workplace social relations, combined with differences in social time spent with family and friends, together almost fully explain the weekend effects for happiness, laughter, enjoyment and sadness, for both full-time and part-time workers, with significant but smaller proportions explained for the remaining three emotions—worry, anger and stress. Finally, we show that workplace trust and social relations significantly improve emotions and life evaluations on both weekends and weekdays for all workers.

Below:  Propensity Score. Notes: The upper panel of Fig 1 shows the distribution of propensity scores for people who were actually interviewed on weekends and weekdays, and the lower panel shows the distribution of propensity scores for people who report emotions for weekends (who were interviewed on Sunday and Monday) and weekdays (who were interviewed on Tuesday to Saturday).

Below:  Impacts of Workplace Environment on Positive Emotions and Life Evaluations on Weekends and Weekdays—Full-time Workers.  Notes: The vertical bars indicated by “trust” show the difference in positive emotions or life evaluations between those reporting “trusting workplace” and those reporting “non-trusting workplace”. The bars indicated by “partner” show the difference between those reporting “partner-like supervisor” and those reporting “boss-like supervisor”. The bars indicated by “both” show the difference between those reporting both “trusting workplace” and “partner-like supervisor” and those reporting “non-trusting workplace” and “boss-like supervisor”. 95% confidence interval is also shown for each bar.

Below:  Impacts of Workplace Environment on Negative Emotions on Weekends and Weekdays—Full-time Workers. Notes: The vertical bars indicated by “trust” show the difference in negative emotions between those reporting “trusting workplace” and those reporting “non-trusting workplace”. The bars indicated by “partner” show the difference between those reporting “partner-like supervisor” and those reporting “boss-like supervisor”. The bars indicated by “both” show the difference between those reporting both “trusting workplace” and “partner-like supervisor” and those reporting “non-trusting workplace” and “boss-like supervisor”. 95% confidence interval is also shown for each bar.

Full article at:   http://goo.gl/46zQXW

By:   

John F. Helliwell

Vancouver School of Economics, University of British Columbia, Vancouver, British Columbia, Canada

John F. Helliwell

Canadian Institute for Advanced Research (CIFAR), Toronto, Ontario, Canada

Shun Wang

Korea Development Institute (KDI) School of Public Policy and Management, Sejong, Korea

  

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Affective Self-Regulation Trajectories During Secondary School Predict Substance Use among Urban Minority Young Adults

This study explored the relationship between trajectories of affective self-regulation skills during secondary school and young adult substance use in a large multi-ethnic, urban sample (N = 995). During secondary school, participants completed a measure of cognitive and behavioral skills used to control negative, unpleasant emotions or perceived stress. As young adults, participants reported on the frequency and quantity of their alcohol, cigarette, and marijuana use in a telephone interview. Controlling for demographic variables, self-regulation did not significantly change over adolescence, although there was significant variation in participants' rates of growth and decline. Lower seventh grade self-regulation and less steep increases in self-regulation were predictive of higher young adult substance use. Male participants had significantly lower initial self-regulation and higher young adult substance use. The results suggest that interventions that build affective self-regulation skills in adolescence may decrease the risk of young adult substance use.

Alcohol, tobacco, and marijuana use have been associated with a host of negative social and health risk behaviors in adolescence and emerging adulthood, including poor academic and vocational performance, relationship difficulties, risky sexual behavior, aggressive and violent behavior, the abuse of illicit and prescription drugs, and other physical and mental health problems (e.g., Dogan et al., 2010; Griffin et al., 2010; Hermos et al., 2008; Newcomb et al., 1993; Perkins, 2002; Schulenberg et al., 2005). These findings have broad implications for young people and suggest that substance use and abuse may decrease the likelihood of a healthy and successful developmental transition into young adulthood. In order to develop effective prevention and intervention programs that promote healthy development, it is important for researchers to identify key psychosocial risk and protective factors during adolescence that are associated with substance use and related problem outcomes during emerging adulthood.

One of the most popular conceptual models of substance use etiology, both from a scientific and lay perspective, is that individuals use or abuse alcohol, tobacco, or other drugs in order to regulate negative affective responses (e.g., distress, stress, or anxiety) that they experience due to exposure to unpleasant or threatening stimuli. This notion has been operationalized in models that emphasize substance use as a way to cope with or reduce anxiety or stress (Kushnera et al., 2000; Vaccaro & Wills, 1998; Wagner et al., 1999) or a way to self-medicate a variety of negative affective states (e.g., Khantzian, 1997; Weiss & Mirin, 1987). There has been significant support for these conceptual models in numerous studies and multiple populations. Studies have shown that youth who struggle with psychological distress, anxiety, perceived powerlessness, meaninglessness or other negative emotions engage in more licit and illicit drug use (Crutchfield & Gove, 1984; Labouvie, 1986; Labouvie et al., 1990; Mainous et al., 1996). In a study of adolescents aged 12 to 17 who participated in the National Household Survey on Drug Abuse, findings indicated that adolescents with serious emotional problems were twice as likely to use marijuana and four times as likely to use other illicit drugs compared to youth with low levels of emotional problems (Department of Health & Human Services, 1999).

Given the existing empirical support for the self-medication and coping models of substance use and abuse, a corollary hypothesis is that individuals who are able to regulate their affective responses in adaptive ways will be less likely to use alcohol, tobacco, or illicit drugs. Of particular interest is whether such affective self-regulation skills during adolescence serve as a protective factor for substance use during the early twenties – the years when the use of alcohol, tobacco, and other drugs typically peak in prevalence (Griffin, 2010). Scholars have focused increasingly on protective factors during the years of emerging adulthood (between ages 18 and 25). This period of life is characterized as a period of instability, exploration, and increasing responsibility (Arnett, 2000). Research has demonstrated that among college undergraduates, poor emotional self-regulation was associated with greater participation in risky behaviors such as cigarette smoking and alcohol-induced verbal and physical aggression (Magar et al., 2008). However, no study to our knowledge has assessed whether trajectories of affective self-regulation over the course of the secondary school years prospectively predict young adult substance use...

Below:  Affective Self-Regulation Skills During Adolescence and Young Adult Substance Use

Full article at:  http://goo.gl/BEpwrN

By:  Griffin KW1, Lowe SR2, Acevedo BP1, Botvin GJ1.

• 1Weill Cornell Medical College, Department of Public Health, New York, NY, USA.
• 2Columbia University, Mailman School of Public Health, Department of Epidemiology, New York, NY, USA. 

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Perceived Stress, Alexithymia, and Psychological Health as Predictors of Sedative Abuse - Iran

The harmful effects of sedative medications and substances in conjunction with limited research regarding predictive psychological constructs of drug abuse necessitate further investigation of associated factors. Therefore, the present study aimed to elucidate the roles of perceived stress, alexithymia, and psychological health as predictors of sedative abuse in medical students.

In this cross-sectional study, 548 students at Kermanshah University of Medical Sciences, Iran, were selected using stratified random sampling. The data were obtained using the Perceived Stress Scale, an alexithymia scale (Farsi version of the Toronto Alexithymia Scale-20), and a General Health Questionnaire to assess psychological health. Data were analyzed using discriminant analyses.

The results demonstrated that the user and non-user of sedative substances groups had significantly different predictive variables (except for social function disorder) (P>0.05). Physical complaints, alexithymia, and perceived stress, which had standard coefficients of 0.80, 0.60, and -0.27, respectively, predicted sedative drug use.

The results of the present study indicate that perceived stress, alexithymia, physical complaints, anxiety, and depression are associated with sedative drug abuse.

Full article at: http://goo.gl/t0SWQa

By: Nader Rajabi Gilan,1 Ali Zakiei,1 Sohyla Reshadat,1 Saeid Komasi,2 and Seyed Ramin Ghasemi1

²

1Social Development and Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.

2Cardiac Rehabilitation Center, Imam Ali Hospital, Kermanshah University of Medical Sciences. Kermanshah, Iran.

1Social Development and Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.

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Stress, Needs, and Quality of Life of People Living with Human Immunodeficiency Virus/AIDS in Taiwan

Human immunodeficiency virus (HIV)/AIDS is a manageable infectious disease by the effectiveness of highly active antiretroviral therapy. AIDS-related stigma and conflict may create distress and deteriorate quality of life (QoL) of people living with HIV/AIDS (PLWHA). This cross-sectional, descriptive, correlational study using structural questionnaires aimed to explore the stress, needs, QoL, and associated factors of PLWHA in Taiwan. 

A total of 200 PLWHA participating in this study needed most on treatment of HIV and prevention of AIDS, and health maintenance. They had worse QoL in physical, psychological, and social domains than the general population. Stress was the most significant predictor for all four domains of QoL. Needs was not significantly associated with QoL. 

The QoL of PLWHA can be explained by demographics, self-perception on health, needs, and stress for 25.3-40.7% of variances. No association existed between CD4(+) counts and QoL in Taiwanese PLWHA. It is important to recognize the perception of PLWHA on their health status, which is significantly associated with their QoL, besides monitoring their physical indicators of health (CD4(+) counts). 

To recognize the stress and needs that PLWHA experience and to develop intervention programs targeting strategies on HIV disclosure, prevention and health maintenance are crucial for PLWHA's QoL.

Via:  http://ht.ly/SBu7A  Full article at: http://ht.ly/SBua8

By: Feng MC1, Feng JY2, Yu CT1, Chen LH1, Yang PH2, Shih CC3, Lu PL4.

• 1Department of Nursing, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
• 2Department of Nursing, College of Medicine, National Cheng Kung University and Hospital, Tainan, Taiwan.
• 3Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan.
• 4Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.

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Negative Life Events and Depression in Adolescents with HIV: A Stress and Coping Analysis

The prevalence of negative life events (NLE) and daily hassles, and their direct and moderated associations with depression, were examined among HIV-infected adolescents. Specifically, we examined whether the negative association with depression of NLE, daily hassles, and/or passive coping were moderated by social support or active coping strategies. 

Demographic characteristics, depression, coping, social support, NLE, and daily hassles were collected at baseline as part of the Adolescent Impact intervention via face-to-face and computer-assisted interviews. Of 166 HIV-infected adolescents, 53% were female, 72.9% black, 59.6% with perinatally acquired HIV (PIY), the most commonly reported NLE were death in family (81%), violence exposure (68%), school relocation (67%), and hospitalization (61%); and for daily hassles "not having enough money (65%)". 

Behaviorally infected youth (BIY - acquired HIV later in life) were significantly more likely to experience extensive (14-21) lifetime NLE (38.8% vs. 16.3%) than PIY. In multiple stepwise regression analysis, the model accounting for the greatest variability in depression scores (32%) included (in order of entry): daily hassles, low social support, behaviorally acquired HIV, minority sexual orientation, and passive coping. A significant passive coping-by-social support interaction revealed that the association between passive coping and depression was exacerbated when social support was low. Social support moderated the effect of NLE, such that NLE were associated with greater depression when social support was low, although the effect did not remain statistically significant when main effects of other variables were accounted for. 

Daily hassles, poor coping, and limited social support can adversely affect the psychological well-being of HIV-infected adolescents, particularly sexual minority youth with behaviorally acquired HIV. Multimodal interventions that enhance social support and teach adaptive coping skills may help youth cope with environmental stresses and improve mental health outcomes.

Via: http://ht.ly/Sa4dh 

By: V Lewis J1, Abramowitz S, J Koenig L, Chandwani S, Orban L.
1a Department of Pediatric Infectious Diseases , NYU Langone Medical Center , New York , NY , USA