What Gets Measured in Reentry Research? A Scoping Review on Community Reentry From Jail and Prison for Persons With Mental Illnesses
Research on reentry for individuals with mental illnesses leaving jails and prisons lacks outcome specificity and standardization needed to advance knowledge about the efficacy and effectiveness of interventions. This scoping review aims to provide clarity about reentry outcomes by: (a) ascertaining what outcomes are a focus in reentry research, (b) explicating how outcomes are defined, and (c) identifying commonalities or gaps in outcomes reported. A search of multiple databases yielded 415 articles for potential inclusion. After independent document review by two of the authors, 61 articles were included in the review. Recidivism was the most used construct, accounting for 58% of total outcomes and 95% of criminal legal outcomes. Behavioral health indicators were reported the second most frequently and other outcomes were rarely reported. Increasing the specificity of commonly used concepts while also expanding the breadth of outcomes considered is needed to build an evidence base this area of research.
Parents’ Cannabis-Related Attitudes and Emerging Adult Offspring Cannabis Use: Testing the Mediating Effect of Perceived Parental Approval
Background: Contrary to parental alcohol use and expectancies work, little is known about how parent’s cannabis use (CU) and expectancies influence offspring CU. This is a notable gap in the literature given increasing acceptability and use of cannabis, especially among emerging adults (EA). Moreover, limited work has tested mechanisms of transmission of risk from these parent factors. This study addresses these gaps by testing prospective associations of parental CU and expectancies with offspring CU and CU problems, and perceived parental approval of offspring CU as a potential mediator. Method: A community sample of 314 EA and caregiver dyads completed three annual assessments (mean age = 19.13). The sample was 54% female and majority White/non-Hispanic (76%). Caregivers reported on their cannabis expectancies and use, and EA reported on their CU, CU-related problems, and perceived parental approval of CU. Results: Longitudinal structural equation modeling supported a mediated pathway such that high parental positive cannabis expectancies were associated with perceived parental approval of CU, which in turn, predicted increases in EA CU and CU problems. Parental negative expectancies had a significant indirect effect but in the opposite direction. Indirect effects were found above and beyond parental CU, which was not associated with offspring CU. Conclusions: This is the first study to test prospective indirect effects of parental cannabis expectancies on offspring CU. Findings suggest parents’ attitudes, even in the absence of parental use, confer risk for offspring use by shaping perceived acceptance of CU, suggesting parental expectancies as targets for parent-based CU interventions.
Diverse Spirituality Revisited: Lessons Learned
Chapters included in this volume highlight the vibrancy of research into diverse spiritualities. As shown by many of the book’s chapters, culturally specific measures enhance our ability to explain and understand the complexities of spiritual phenomena and help us appreciate religious traditions other than our own and humanize “the other.” The book includes chapters describing measures of Eastern forms of meditation, spiritual Jihad, afterlife beliefs associated with the three main religious worldviews, spirituality among Latin American youth, and Muslim religiousness. The case for particularism is not in conflict with that for universalism as some of the measures have been used cross-culturally. The challenge is to productively fuse these two research traditions. A second set of chapters explores the complex spiritual terrain of the Western world in the post-1960s era. These chapters illuminate a common theme of spirituality decoupled from traditional religiousness—all measures reflect a belief in interconnectedness between the person and the world at large—and articulate differences dependent on socio-cultural and historic contexts (e.g., the U.S. versus Western Europe) and field of inquiry (e.g., the psychology of religion versus transpersonal psychology). Other chapters demonstrate the empirical utility of assessing spirituality related concepts including spiritual support, modeling, struggle, well-being, as well as, prayer coping, faith, and meaning making. The new tools described in this book expand the understanding of the role played by spirituality in our rapidly changing and interconnected world while, at the same time, highlighting the aspects of spirituality common among all peoples and cultures.
The Interpersonal and Psychological Impacts of COVID-19 on Risk for Late-Life Suicide
Older adults experience increased risk for suicide compared to the general population, and the circumstances surrounding the Coronavirus Disease 2019 (COVID-19) may potentiate this risk. We discuss how current COVID-19 pandemic-related policies are likely to harm older adults disproportionately. COVID-19 pandemic social distancing policies and ethical guidelines for COVID-19 treatment may exacerbate experiences of social isolation, perceived expendability, and exposure to suffering, which are related to the 3 main components of the Interpersonal Theory of Suicide (i.e., thwarted belongingness, perceived burdensomeness to society, and capability for suicide). The COVID-19 pandemic poses a drain on services and has drawn ethical debates about policies around treating younger adults first. These experiences may lead older adults to have reduced access to needed medical and psychiatric services and may convey damaging messages of expendability. Furthermore, the potential prolonged stress associated with the COVID-19 pandemic may affect neurological, immunological, and health functioning—exacerbating suicide risk. Potential venues to increase treatment options and decrease social isolation are discussed. We acknowledge optimistic effects as well, such as “pulling together” as a society and the many valuable ways older adults may contribute during this crisis.
The Perceived Spiritual Support Scale (PSSS): Measuring Support from the Deep Connection with Diverse Sacred Entities
The concept of perceived spiritual support (PSS) centers on an internalized resource derived from perception of an intimate relationship with a higher power, be it God, Jesus, a cosmic force, ancestral spirits, or a psychologically functional equivalent. The literature has indicated the increasing importance of spiritual support in crises and medical care, but previous assessments tended to focus on mainstream religions with inadequate validation. To meet the gap and based on related scientific theories, three crises-based studies were conducted to develop and validate a 12-item scale of perceived spiritual support (the PSSS) for assessing the spiritual resource of individuals with diverse belief systems. This endeavor was also a response to a long-standing call for measuring consciousness-related faith experience and to an assessment problem—the use of simple frequency measures in large-scale epidemiological or sociological surveys. Participants in the three studies reflect varied makeups of age, gender, generation, race, belief systems, and cultural backgrounds. The findings provide the adequate psychometric information for the PSSS and its predictive value for various outcomes. Multivariate analyses demonstrated the indirect mediating or pathway effect of the PSSS, simultaneously evaluated the effects of other established factors, and tested an explanatory mechanism underlying its predictive value. The results suggest that the PSSS, as a short and easy to use tool, can be used to predict important outcomes in crises and across different populations. More cross-cultural studies are warranted for further validation.
“It really presents a struggle for females, especially my little girl”: Exploring father’s experiences discussing body image with their young daughters
Body dissatisfaction in children, particularly young girls, is a growing concern around the world. The home environment can have a strong influence on children’s well-being, and parents may contribute to their children’s positive or negative body image development. Nearly all research on parent influence on body image has focused on mothers, leaving fathers’ attitudes and experiences poorly-understood. To address this gap in the literature, we interviewed 30 fathers (Mage = 40.30; SD = 7.48) of girls between the ages of 5 and 10 about the conversations they have with their daughters regarding body image. Through thematic analysis, we identified three primary themes: barriers to effective communication, combatting negative influences, and strategies for discussing body image. Fathers recognized the importance of talking about body image with their daughters, yet many did not feel confident or competent to do so effectively. They engaged in a variety of strategies to combat adverse cultural influences and encourage self-expression, character development, and mental and physical health in their daughters. However, messages about health were sometimes conflated with messages about thinness or food restriction. Implications for families and future research are discussed.
Methods of visual assessment in children with cortical visual impairment
Purpose of review: Cortical visual impairment (CVI) is the leading cause of pediatric visual impairment in developed countries. Currently, there is no standardized method of visual assessment in these children, who usually cannot participate in tests designed for typically developing children. A reproducible method of visual assessment that accurately reflects the multitude of visual deficits in CVI is critical to evaluate proposed therapies for this disorder. This review analyzes current research on methods of visual assessment in children with CVI. Recent findings: Earlier studies focused on measuring visual acuity in children with CVI. More recent studies have emphasized other aspects of visual function, such as contrast sensitivity, motion detection, and visual search. Current research topics include questionnaires, functional vision assessment (CVI Range), neuropsychological tests of visual perception, and eye tracking. Eye tracking shows promise for visual assessment in both clinical and research settings because it is objective and quantitative, with the ability to assess diverse visual parameters. Summary: Current research on visual assessment in children with CVI focuses on measuring deficits of visual function beyond visual acuity. This research represents an important step toward designing clinical trials to identify effective therapeutics for this increasingly prevalent disorder with heterogeneous manifestations.
The impact of a diversity intervention on White college students’ colour-blind racial attitudes
This research explored the impact a 3-day pre-college diversity intervention had on incoming White college students’ (N = 63) colour-blind racial attitudes (COBRAS), or their unawareness of racial privilege, blatant racial issues, and institutional discrimination. Repeated measures analysis of variance tests indicated that students reported a greater awareness of racial privilege and blatant racial issues immediately after the programme. Students’ awareness of institutional discrimination – a potentially more abstract and complex understanding of racism – did not change after the program. To isolate the effects of the intervention, independent sample t-tests between White college students who did not undergo the intervention and intervention participants were conducted. Results indicated that both samples did not have significantly different COBRAS before the intervention, providing evidence that the intervention likely contributed to changes in intervention participants’ COBRAS. These results suggest that the pre-college diversity intervention impacted forms of COBRAS differently. Implications for diversity interventions on predominantly White college campuses are discussed.
Teaching Social Work Practice in the Shared Trauma of a Global Pandemic
Unique clinical dynamics occur when both clinician and client are exposed to the same community traumatic event or reality. This reflection explores the applicability of the concept of shared trauma for social work educators in the context of the COVID-19 pandemic. The author describes her experiences shifting suddenly to teaching social work direct practice courses online, against the backdrop of a rapidly escalating coronavirus pandemic. Several parallels to the clinical concept of shared trauma are described, including a stronger emphasis on the mutuality of the teaching relationship, heightened emotional identification with students, and blurred professional boundaries in the student-teacher relationship. The author also describes significant differences between her own experiences and those of her students, recognizing that shared trauma is not always shared proportionately in environments of persistent racial and economic inequality. The chapter concludes with implications for educators working in shared trauma contexts, including the importance of self-care and administrative support. Teaching in a shared traumatic reality requires social work educators to stay cognizant of our connections to our students, as well as the disproportionate tolls of this pandemic.
“Don’t Know where to Go for Help”: Safety and Economic Needs among Violence Survivors during the COVID-19 Pandemic
The COVID—19 pandemic and related quarantine has created additional problems for survivors of interpersonal violence. The purpose of this study is to gain a preliminary understanding of the health, safety, and economic impacts of the COVID-19 pandemic on people that are experiencing or have previously experienced violence, stalking, threats, and/or abuse. An online survey, open from April to June 2020, was taken by people with safety concerns from interpersonal violence. Participants were recruited from IPV and sexual assault-focused agencies, state coalitions, and social media. Quantitative data were summarized using descriptive methods in SPSS and coding methods from thematic and content analysis was used to analyze qualitative data from open-ended questions. A total of 53 participants were recruited for the survey. Individuals with safety concerns have experienced increased challenges with health and work concerns, stress from economic instability, difficulties staying safe, and access resources and support. Over 40% of participants reported safety had decreased. Use of social media and avoidance strategies were the most common safety approaches used. Participants reported mixed experiences with virtual services. The COVID-19 pandemic has exacerbated existing structural concerns for survivors of violence like IPV and sexual assault. Increased support and economic resource access, coupled with modified safety planning and improved virtual approaches, would better help meet survivor needs.
“We’re just two people in a relationship”: A qualitative exploration of emotional bond and fairness experiences between transgender women and their cisgender partners
Trans‐including couples experience systemic marginalization impacting their relationships, yet studies on these relationships or narratives of strength are few. The purpose of this qualitative study was to explore emotional bonding and perceptions of fairness between transgender women and their cisgender partners. Interpretative Phenomenological Analysis was utilized to answer the research question: What are the experiences of emotional bond and fairness between transgender women and their cisgender partners? This research was situated within frameworks of minority stress, romantic attachment, and contextual therapy. Seven couples of transgender women and cisgender partners were interviewed. Three themes emerged: Minority Stress Contexts and Relational Strengths; The Experience of Emotional Bond; and Negotiating Balance. Processes of boundary creation, attunement, affirmations, and balance of care were noted. Findings reframe partner relationships as opportunities to construct transphobia‐resistant and resilient narratives. Recommendations for clinicians include prioritizing the couple subsystem as an avenue for building resilience against minority stress.
“Gambling Can’t Be Positive, Can it?”: Gambling Beliefs and Behaviors Among Older Korean Immigrants
After migrating to the United States, older Korean immigrants may increase their gambling participation and be at higher risk for problem gambling. However, not much is known about their experiences and beliefs on gambling. The purpose of the present study was to explore gambling behaviors and shared beliefs about gambling among older Korean immigrants residing in New York City. A total of 20 semi-structured in-depth interviews (10 men and 10 women) were conducted in Korean. Interviews were transcribed verbatim and analyzed using a thematic analysis approach. The findings revealed three major categories among older Korean immigrants. The first category, cultural beliefs, has three subcategories (i.e., gambling is unethical, fear of addiction, and losing everything) and refers to negative beliefs about gambling. The second category, adaptation, refers to positive attitudes they acquired as they adjusted to the new gambling environment (i.e., harmless leisure, coping strategies, and excitement in life). Last, they revealed ambivalence about gambling (i.e., changes in gambling environment, ‘my gambling’ is different, and gambling in secrecy). Overall, older Korean immigrants have retained their cultural beliefs about gambling, even as they have embraced the legalized gambling environment and changed social norms of the U.S. However, they have trouble reconciling the differences between their beliefs, behaviors, values, and newly acquired norms. Findings point to a need for healthy and affordable leisure pursuits, and for culturally appropriate intervention programs to help problem gamblers.
Male service members’ and civilian wives’ perceptions of partner connection regarding deployment and PTSD symptoms
In general, a sense of understanding and connection is an important aspect of marital relationships. In the context of military couples in which a service member may have symptoms of posttraumatic stress disorder (PTSD), spouses’ understanding of the nature and causes of service member PTSD symptoms may be protective for both partners’ marital satisfaction. However, partners may vary in the degree to which they understand and connect around (a) historical experiences of combat and deployment versus understanding and connecting around (b) any ongoing manifestation of PTSD symptoms post deployment. In a sample of 58 male Army service members and their civilian wives drawn from a larger study of military couple functioning, we found that a measure of “Combat/Deployment connection” and a measure of “PTSD connection” were strongly correlated with each other yet not isomorphic. Both Combat/Deployment connection and PTSD connection had unique predictive effects for marital satisfaction. Both husbands and wives reported higher levels of PTSD connection relative to Combat/Deployment connection. At low or average levels of Combat/Deployment connection, higher levels of PTSD symptoms were associated with lower levels of marital satisfaction, whereas at high levels of Combat/Deployment connection, this association was no longer signiﬁcant. No such moderation effects were found for PTSD connection. The utility of distinguishing these two domains of potential connection for military couples is discussed.
Perceived Discrimination as a Mediator of ACEs and Psychological Distress
The authors investigated the role of perceived discrimination in the association between adverse childhood experiences and psychological distress in adulthood in a sample of individuals (n = 125) at a university-based couple and family therapy clinic. Results showed that a majority had experienced four or more adverse experiences, indicating a high risk of negative health outcomes. A significant indirect effect of adverse experiences through perceived discrimination on psychological distress, even with gender, race/ethnicity, and household income as covariates, was noted. Findings underscore the importance of incorporating assessment of perceived discrimination in therapy with clients presenting with childhood adversity and psychological distress.
The role of maternal psychosocial perceptions in parent-training programs: a preliminary randomized controlled trial
Parent-child interaction is critical for early language and literacy development. Parent training programs have proliferated to support early interactions. However, many environmental and psychosocial factors can impact the quality of parent-child language and literacy interactions as well as training program outcomes. This preliminary randomized controlled trial examined maternal perceived self-efficacy and locus of control during a language and literacy parent training program. Thirty mother-child dyads (mother age 21-40; children 2;6-4;0) were assigned in parallel to the training or control group. The training was efficacious for mothers and children – training-group dyads made significantly greater gains in maternal strategy use, responsivity, and child print awareness than the control group. Gains were maintained one month post-training. Children whose mothers had more external baseline control perceptions identified significantly fewer print targets at baseline and made greater gains than those with more internal control perceptions. Future directions and implications are discussed.
Inequality in Isolation:: Educating Students with Disabilities during COVID-19
Effects of homophobic name‐calling and verbal sexual harassment on substance use among young adults
Verbal aggression victimization, such as homophobic name‐calling, has been linked to heavier substance use among young people, but little longitudinal research has examined how different types of victimization may affect substance use or whether certain psychosocial factors moderate these risks. In a diverse cohort (N = 2,663), latent transition analysis was used to model heterogeneity in victimization (age 19) and substance use (age 20). Four victimization (high victimization, homophobic name‐calling only, verbal sexual harassment only, and low victimization) and three substance use (poly‐substance use, alcohol, and cannabis only, low all) classes were identified. The high victimization and homophobic name‐calling only classes had the highest probabilities of transitioning into the poly‐substance use class, and the high victimization class had the highest probability of transitioning into the alcohol and cannabis only class. The probability of transitioning into the low all substance use class was highest in the low victimization class and lowest in the high victimization class. For the high victimization class, greater depressive symptoms increased the odds, and better peer relationship quality decreased the odds, of transitioning into the poly‐substance use and alcohol and cannabis only classes. For the homophobic name‐calling only class, greater depressive symptoms increased the odds of transitioning into the poly‐substance use class. Homophobic name‐calling, alone or in combination with verbal sexual harassment, is a risk factor for escalating substance use in young adulthood, especially among victims with depressive symptoms.
Defining Patient Engagement in Research: Results of a Systematic Review and Analysis: Report of the ISPOR Patient-Centered Special Interest Group
Objectives: Lack of clarity on the definition of “patient engagement” has been highlighted as a barrier to fully implementing patient engagement in research. This study identified themes within existing definitions related to patient engagement and proposes a consensus definition of “patient engagement in research.” Methods: A systematic review was conducted to identify definitions of patient engagement and related terms in published literature (2006-2018). Definitions were extracted and qualitatively analyzed to identify themes and characteristics. A multistakeholder approach, including academia, industry, and patient representation, was taken at all stages. A proposed definition is offered based on a synthesis of the findings. Results: Of 1821 abstracts identified and screened for eligibility, 317 were selected for full-text review. Of these, 169 articles met inclusion criteria, from which 244 distinct definitions were extracted for analysis. The most frequently defined terms were: “patient-centered” (30.5%), “patient engagement” (15.5%), and “patient participation” (13.4%). The majority of definitions were specific to the healthcare delivery setting (70.5%); 11.9% were specific to research. Among the definitions of “patient engagement,” the most common themes were “active process,” “patient involvement,” and “patient as participant.” In the research setting, the top themes were “patient as partner,” “patient involvement,” and “active process”; these did not appear in the top 3 themes of nonresearch definitions. Conclusion: Distinct themes are associated with the term “patient engagement” and with engagement in the “research” setting. Based on an analysis of existing literature and review by patient, industry, and academic stakeholders, we propose a scalable consensus definition of “patient engagement in research.”
Psychometric properties of a measure to assess beliefs about modifiable behavior and emotional distress
Assessing beliefs about the helpfulness of modifiable behaviors related to mental health could inform public health efforts to prevent emotional distress. This study examined the psychometric properties of a measure to assess beliefs about the helpfulness of modifiable behaviors involved in the development of anxiety and depression. The relationship between beliefs about modifiable behaviors and actual engagement in modifiable behaviors was also examined. Item pool generation was based on a review of the literature. Experts (N = 10) and participants (N = 50) reviewed the items for content validity. An exploratory factor analysis was conducted on the resultant Beliefs about Behaviors and Emotional Distress Scale (BBEDS) for item reduction in a sample of MTurk participants (Study 1, N = 371). A confirmatory factor analysis was completed in a second MTurk sample (Study 2, N = 373). Construct validity was then examined in a sample of college students (Study 3, N = 215). The questionnaire included 16 items across four domains: health behavior (0.77 ≤ α ≤ 0.84), social support (0.72 ≤ α ≤ 0.76), substance use (0.75 ≤ α ≤ 0.76), and avoidance (0.81 ≤ α ≤ 0.83). The BBEDS had adequate psychometric properties supporting its use to assess beliefs about the helpfulness of modifiable behaviors related to the development of emotional distress. BBEDS scores were associated with engaging in some but not all modifiable behaviors. The BBEDS may be a useful instrument to assess beliefs about the helpfulness of modifiable behaviors implicated in the development of anxiety and depression.
Dignity at the end of life