Publications by authors named "Michael J McDermott"

21 Publications

  • Page 1 of 1

Borderline Personality Disorder Symptoms and Pain in College Students: The Role of Emotional Suppression.

J Pers Disord 2018 Apr 12;32(2):277-288. Epub 2017 Jun 12.

Department of Psychology, University of Louisiana, Lafayette, Lafayette, Louisiana.

Borderline personality disorder (BPD) is associated with higher rates of pain conditions and greater pain impairment. Past research implicates emotional suppression in acute pain tolerance; thus, emotional suppression may contribute to pain interference among those with high BPD features. Participants were 89 university students who completed measures of BPD features, and complied with 2-week daily diary procedures assessing suppression of emotional thoughts associated with social and nonsocial stressors, distress, pain severity, and interference. Multilevel models revealed a BPD × Suppression × Distress interaction, such that suppression in response to social (but not nonsocial) stressors in the context of high distress was related to pain interference when controlling for pain severity among those with high, but not low, BPD features. These findings suggest. that suppression of emotionally relevant thoughts in response to high distress may contribute to the functional impairment from pain among those with high BPD symptoms.
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http://dx.doi.org/10.1521/pedi_2017_31_300DOI Listing
April 2018

Emotion Dysregulation Mediates the Relation Between Borderline Personality Disorder Symptoms and Later Physical Health Symptoms.

J Pers Disord 2017 08 20;31(4):433-448. Epub 2016 Jun 20.

Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, Mississippi.

Despite evidence of a relation between borderline personality disorder (BPD) pathology and physical health problems, the mechanisms underlying this relation remain unclear. Given evidence that emotion dysregulation may affect physical health by altering physiological functioning, one mechanism that warrants examination is emotion dysregulation. This study examined BPD symptoms as a prospective predictor of physical health symptoms 8 months later and the mediating role of emotion dysregulation in this relation. Participants completed three assessments over an 8-month period, including a BPD diagnostic interview. Results of analyses examining baseline predictors of later physical health symptoms revealed a significant unique association between baseline BPD symptom severity and physical health symptoms 8 months later, above and beyond baseline physical health symptoms, depression and anxiety symptoms, and emotion dysregulation. Moreover, structural equation modeling revealed a significant indirect relation of BPD symptoms at Wave 1 to physical health symptoms at Wave 3 through emotion dysregulation at Wave 2.
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http://dx.doi.org/10.1521/pedi_2016_30_252DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5472518PMC
August 2017

The Role of Emotion Regulation Difficulties in the Relation Between PTSD Symptoms and the Learned Association Between Trauma-Related and Cocaine Cues.

Subst Use Misuse 2016 08 25;51(10):1318-29. Epub 2016 May 25.

e Department of Psychology , University of Maryland , College Park , Maryland , USA.

Background: PTSD and cocaine dependence frequently co-occur. However, few studies have specifically examined the functional relation between trauma-related distress and cocaine use and none have examined the extent to which PTSD is associated with a learned association between trauma cues and cocaine or the underlying role of emotion regulation difficulties in this relation.

Objectives: Thus, this study used a novel version of the Implicit Association Test (IAT) to examine the relation of PTSD symptoms to the strength of the trauma-cocaine cue association and the role of specific emotion regulation difficulties in this relation.

Methods: A sample of 42 cocaine-dependent inpatients with a history of interpersonal traumatic exposure were recruited. Participants completed a series of questionnaires assessing PTSD symptom severity and emotion regulation difficulties. Participants then completed the IAT.

Results: Results revealed a significant indirect relation of PTSD symptom severity to the strength of the trauma-cocaine cue association through the specific emotion regulation dimension of difficulties controlling impulsive behaviors when distressed. Conclusion/Importance: Results build upon extant research suggesting that factors related to emotional responding and regulation may underlie the relation between trauma-cue exposure and responses to cocaine cues among cocaine dependent patients with PTSD. The finding that PTSD symptom severity is associated with the strength of the trauma-cocaine cue association through one particular dimension of emotion regulation difficulties, difficulties controlling impulsive behaviors when distressed, highlight the potential utility of interventions focused on improving emotion regulation and impulse control abilities among trauma-exposed cocaine dependent patients.
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http://dx.doi.org/10.3109/10826084.2016.1168445DOI Listing
August 2016

Marijuana dependence moderates the effect of posttraumatic stress disorder on trauma cue reactivity in substance dependent patients.

Drug Alcohol Depend 2016 Feb 29;159:219-26. Epub 2015 Dec 29.

University of Mississippi Medical Center, Jackson, MS, USA.

Background: Individuals with posttraumatic stress disorder (PTSD) are at heightened risk for marijuana use. Although extant studies speak to the importance of examining the co-occurrence of PTSD and marijuana use as it relates to a variety of clinically-relevant outcomes, no studies have explored the way in which marijuana use may affect in-the-moment emotional responding among individuals with PTSD. Thus, the purpose of this study was to explore the role of marijuana dependence in the relation between PTSD and subjective and biological emotional reactivity in response to a trauma cue.

Methods: Participants were 202 patients with and without current PTSD consecutively admitted to a residential SUD treatment facility. Patients were administered diagnostic interviews, and subjective (negative affect) and biological (cortisol) reactivity to a personalized trauma cue were assessed.

Results: Whereas current PTSD was associated with greater subjective emotional reactivity among participants without marijuana dependence, there were no significant differences in subjective emotional reactivity as a function of PTSD status among participants with marijuana dependence. Moreover, marijuana dependent participants (with and without PTSD) reported less subjective emotional reactivity than participants with PTSD and without marijuana dependence. No significant findings were obtained for cortisol reactivity.

Conclusions: Findings suggest that patients with co-occurring PTSD and marijuana dependence may experience alterations in their emotional processing in response to a trauma cue (i.e., dampening of arousal). Additional research is required to clarify the specific mechanisms through which marijuana use influences emotional reactivity and fear-related emotional processing, as well as how such effects may influence PTSD treatment.
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http://dx.doi.org/10.1016/j.drugalcdep.2015.12.014DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4881389PMC
February 2016

The relation of PTSD symptoms to migraine and headache-related disability among substance dependent inpatients.

J Behav Med 2016 Apr 26;39(2):300-9. Epub 2015 Nov 26.

University of Mississippi Medical Center, Jackson, MS, USA.

Despite emerging evidence for the comorbidity of posttraumatic stress disorder (PTSD) and migraine, few studies have examined the relation of PTSD and migraine, particularly among clinical populations at-risk for both conditions (e.g., substance-dependent patients). This study examined the role of PTSD symptoms in migraine and headache-related disability within a sample of 153 substance-dependent inpatients (37.25% female, Mean age 36.46). PTSD symptoms predicted both migraine and headache-related disability above and beyond gender, depression and anxiety symptoms, the experience of a Criterion A traumatic event, and current alcohol use disorder. Findings highlight the strong association between migraine and PTSD symptoms in a unique population at risk for both conditions.
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http://dx.doi.org/10.1007/s10865-015-9697-3DOI Listing
April 2016

The Moderating Role of Experiential Avoidance in the Relationship between Posttraumatic Stress Disorder Symptom Severity and Cannabis Dependence.

J Contextual Behav Sci 2014 Oct;3(4):273-278

University of Mississippi Medical Center.

The relationship between cannabis use and posttraumatic stress disorder (PTSD) has received increased scientific scrutiny in recent years. Consistent with this research, studies provide evidence that many individuals with PTSD use cannabis to reduce negative affect and other unpleasant internal experiences associated with PTSD. However, no research to date has explored factors that may be associated with an increased likelihood of cannabis misuse among individuals with PTSD. Consequently, this study explored the moderating role of experiential avoidance (EA; defined as the tendency to engage in strategies to reduce unpleasant private experiences) in the PTSD-cannabis dependence relationship among a sample of 123 Criterion A trauma-exposed patients in residential substance abuse treatment. Moderation analyses indicated an interactive effect of PTSD symptom severity and EA on current cannabis dependence. Specifically, results revealed a conditional effect of PTSD symptom severity on cannabis dependence only when EA was average or higher, with higher levels of PTSD symptom severity associated with a greater risk of cannabis dependence. These findings are consistent with evidence that cannabis use may serve an avoidant function among some individuals with PTSD and suggest that acceptance-based behavioral approaches might be effective in targeting both cannabis use and PTSD-related impairment.
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http://dx.doi.org/10.1016/j.jcbs.2014.08.005DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4249704PMC
October 2014

Full and home smoking ban adoption after a randomized controlled trial targeting secondhand smoke exposure reduction.

Nicotine Tob Res 2015 May 16;17(5):612-6. Epub 2014 Oct 16.

Department of Pediatrics, University of South Florida, Tampa, FL.

Introduction: The current study examined home and full (i.e., home plus car) smoking ban adoption as secondary outcomes to a randomized controlled trial targeting reduced secondhand smoke exposure (SHSe) for children under treatment for cancer.

Methods: Families with at least 1 adult smoker who reported SHSe for their children (n = 119) were randomized to control or intervention conditions and followed for 1 year with 5 assessments. Both groups were advised of the negative health outcomes associated with SHSe; the intervention group provided more in-depth counseling from baseline to 3 months. Parents reported on household and car smoking behavior, demographic, psychosocial, and medical/treatment-related information.

Results: Regardless of group assignment, there was an increase in home (odds ration [OR] = 1.16, p = .074) and full (OR = 1.37, p = .001) smoking ban adoption across time. Families in the intervention group were more likely to adopt a full ban by 3 months, but this difference was nonsignificant by 12 months. Married parents (OR = 2.33, p = .006) and those with higher self-efficacy for controlling children's SHSe (OR = 1.11, p = .023) were more likely to have a home smoking ban; parents who reported smoking fewer cigarettes were more likely to adopt a home (OR = 1.62, p < .0001) or full (OR = 7.32, p = .038) ban.

Conclusions: Smoking bans are in-line with Healthy People 2020's tobacco objectives and may be more feasible for parents with medically compromised children for immediate SHSe reduction. Furthermore, interventions targeting full smoking bans may be a more effective for comprehensive elimination of SHSe.
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http://dx.doi.org/10.1093/ntr/ntu201DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4481706PMC
May 2015

Tobacco use and exposure among youth undergoing cancer treatment.

J Pediatr Health Care 2015 Jan-Feb;29(1):80-7. Epub 2014 Sep 6.

Introduction: Adolescents with cancer are susceptible to the health consequences associated with secondhand smoke exposure (SHSE) and tobacco use. The present study compared tobacco use, exposure, and risk factors between patients and population peers.

Method: Self-reported data on tobacco use, SHSE, and tobacco-related risk factors were drawn from a pediatric oncology hospital and the National Youth Tobacco Survey. Conditional logistic regression was used to estimate odds ratios for patients and control subjects.

Results: Patients were as likely to have tried tobacco and report home SHSE as control subjects. Patients were more likely to report car SHSE, less likely to report that SHSE is harmful, and less likely to report home smoking bans.

Discussion: Patients experienced SHSE, tobacco use, and tobacco-related risk factors at rates greater than or equal to control subjects. These results provide support for consideration of intervention targets, health status, and delivery mechanisms, particularly by health care providers, when developing comprehensive tobacco control strategies.
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http://dx.doi.org/10.1016/j.pedhc.2014.07.004DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4268156PMC
November 2016

Fertility as a priority among at-risk adolescent males newly diagnosed with cancer and their parents.

Support Care Cancer 2015 Feb 2;23(2):333-41. Epub 2014 Aug 2.

Department of Psychology, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN, 38105-2794, USA,

Purpose: Infertility is a frequent consequence of cancer therapy and is often associated with psychological distress. Although adult survivors prioritize fertility and parenthood, this issue remains unexplored among adolescent males. This study examined future fertility as a priority (relative to other life goals) at time of diagnosis for at-risk adolescents and their parents.

Methods: Newly diagnosed adolescent males (n = 96; age = 13.0-21.9 years) at increased risk for infertility secondary to cancer treatment prioritized eight life goals: to have school/work success, children, friends, wealth, health, a nice home, faith, and a romantic relationship. Patients' parents (fathers, n = 30; mothers, n = 61) rank-ordered the same priorities for their children.

Results: "Having children" was ranked as a "top 3" life goal among 43.8 % of adolescents, 36.7 % of fathers, and 21.3 % of mothers. Fertility ranked third among adolescents, fourth among fathers, and fifth among mothers. Future health was ranked the top priority across groups, distinct from all other goals (ps < 0.001), and fertility ranked higher than home ownership and wealth for all groups (ps < 0.001). For adolescents, low/moderate fertility risk perception was associated with higher fertility rankings than no/high risk perceptions (p = 0.01).

Conclusions: Good health is the most important life goal among adolescents newly diagnosed with cancer and their parents. In this relatively small sample, adolescents prioritized fertility as a top goal, parents also rated fertility as being more important than home ownership and financial wealth. Health care providers should communicate fertility risk and preservation options at diagnosis and facilitate timely discussion among families, who may differ in prioritization of future fertility.
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http://dx.doi.org/10.1007/s00520-014-2366-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4289648PMC
February 2015

The role of executive attention in deliberate self-harm.

Psychiatry Res 2014 Aug 4;218(1-2):113-7. Epub 2014 Apr 4.

Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS 39216, USA. Electronic address:

Although a wealth of literature has examined the role of emotion-related factors in deliberate self-harm (DSH), less is known about neurocognitive factors and DSH. In particular, despite theoretical literature suggesting that deficits in executive attention may contribute to engagement in DSH, studies have not yet examined the functioning of this attentional network among individuals with DSH. The present study sought to address this gap in the literature by examining the functioning of the alerting, orienting, and executive attentional networks among participants with a recent history of DSH (n=15), a past history of DSH (n=18), and no history of DSH (n=21). Controlling for borderline personality pathology and depression symptoms, participants with a recent history of DSH exhibited deficits in executive attention functioning relative to participants without any history of DSH. No differences were found in terms of performance on the alerting or orienting attentional networks. These results provide preliminary support for the association between executive attention deficits and DSH.
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http://dx.doi.org/10.1016/j.psychres.2014.03.035DOI Listing
August 2014

Prevalence and sociodemographic correlates of lifetime substance use among a rural and diverse sample of adolescents.

Subst Abus 2013 ;34(4):371-80

a Department of Psychology , University of Mississippi , University , Mississippi , USA.

Background: Data are limited regarding the prevalence of substance use among adolescents in rural and ethnically diverse communities. This study examined rates and sociodemographic correlates of lifetime substance use among adolescents in Mississippi, a rural state that is the poorest in the country (21.3% poverty rate) and has the largest proportion of African Americans per capita (36.3%).

Methods: Participants in this cross-sectional study were 6349 adolescents (6th through 12th grade) who reported on lifetime tobacco, alcohol, marijuana, cocaine, inhalant, hallucinogen, and methamphetamine use.

Results: Lifetime smoking (10.2% to 44.5%), alcohol (23.2% to 72.0%), and marijuana use (7.9% to 39.2%) increased steadily when comparing students in 6th to 12th grade. Substances with more serious abuse potential (cocaine [6.7% to 11.1%], inhalants [12.2% to 17.9%], hallucinogens [4.4% to 12.1%], and methamphetamine [3.0% to 6.7%]) displayed more modest increases across grade. Adolescents who classified their race/ethnicity as "Other" (i.e., not white, black/African American, Asian, or Hispanic/Latino/Latina) demonstrated more than 2-fold increased likelihood of methamphetamine use (odds ratio [OR] = 2.42), and increased risk for use of any illicit substance (OR = 1.49). In general, males demonstrated an increased risk for use across substances (OR = 1.15-1.94), and higher income was associated with a decreased likelihood of illicit substance use (OR = 0.51-0.67). Living in a more populated area was associated with an increased likelihood of alcohol (OR = 1.43), marijuana (OR = 2.11), and cocaine use (OR = 2.06), and use of any illicit substance (OR = 1.54).

Conclusions: Mississippi adolescents reported higher rates of lifetime cocaine, inhalant, hallucinogen, and methamphetamine use across all grade levels compared with national surveys. Male gender, low income, and residence in more populated areas were associated with increased use of several substances. Findings demonstrate the need for prevention and intervention programs targeting impoverished rural and ethnically diverse communities.
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http://dx.doi.org/10.1080/08897077.2013.776000DOI Listing
September 2014

Accuracy and Concordance in Reporting for Secondhand Smoke Exposure among Adolescents Undergoing Treatment for Cancer and Their Parents.

J Adolesc Young Adult Oncol 2013 Sep;2(3):125-129

Department of Psychology, St. Jude Children's Research Hospital , Memphis, Tennessee. ; Department of Psychology, University of Mississippi , University, Mississippi.

Few studies have examined adolescent reporting accuracy for secondhand smoke exposure (SHSe), and never for youth with cancer. SHSe reporting from adolescents being treated for cancer (=14.92 years, SD=1.67) was examined against parent/guardian reports and urine cotinine among 42 adolescent-parent dyads. Number of days in hospital-based lodgings prior to assessment emerged as the strongest predictor of urine cotinine (=-0.46, =0.003) and adolescent SHSe reporting significantly predicted urine cotinine (=0.37, =0.011) beyond relevant demographic and contextual variables (overall =0.40, (6, 35)=3.90, =0.004). Findings support adolescents as accurate reporters of discrete SHSe occurrences.
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http://dx.doi.org/10.1089/jayao.2012.0026DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3778992PMC
September 2013

Comorbidity of migraine and psychiatric disorders among substance-dependent inpatients.

Headache 2014 Feb 12;54(2):290-302. Epub 2013 Jul 12.

Department of Psychology, University of Mississippi, Oxford, MS, USA.

Background: Limited and conflicting data exist regarding the prevalence of psychiatric disorders, particularly substance use disorders (SUDs), among migraineurs in inpatient clinical settings.

Methods: As part of a larger cross-sectional study, 181 substance-dependent inpatients completed a structured psychiatric interview and measures of psychiatric symptoms and migraine. Standardized mean differences were used to quantify differences between inpatients with and without migraine across 4 domains of predictors (demographic variables, non-SUD psychiatric diagnoses, specific SUDs, and self-reported psychiatric symptoms). The predictors within each domain that best discriminated between the migraine and no-migraine groups were identified using a classification tree approach with Bonferroni corrections. These candidate predictors were subsequently entered into a multivariate logistic regression to predict migraine status, which was then replicated using bootstrapping of 500 samples. Associations between migraine status and SUD treatment dropout were also examined.

Results: Forty-four of the 181 (24.3%) participants met criteria for migraine. Migraineurs were more likely to be female (34.8% vs. 18.3%) and reported higher levels of current anxiety symptoms (mean [standard deviation]: 19.7 [11.0] vs. 11.3 [10.3]). Having a lifetime diagnosis of generalized anxiety disorder (56.8% vs. 27%, odds ratio 3.47, 95% confidence interval [CI] 1.39-10.58) or a current diagnosis of alcohol dependence (45.5% vs. 24.1%, odds ratio 3.79, 95% CI 1.63-13.62) was associated with more than a 3-fold risk of migraine. These 4 variables in combination were forced into the final multivariate model, which differentiated well between those with and without migraine (area under the receiver operating characteristic curve = 0.81; 95% CI 0.73-0.88). Migraine was not differentially associated with increased risk for SUD treatment dropout (13.6% vs. 16.1% dropout among those without migraine).

Discussion: A history of generalized anxiety disorder, high levels of current anxiety symptoms, and current alcohol dependence are the strongest psychiatric predictors of migraine status among substance-dependent inpatients. However, migraine status is not associated with SUD treatment dropout.
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http://dx.doi.org/10.1111/head.12171DOI Listing
February 2014

Do episodic migraineurs selectively attend to headache-related visual stimuli?

Headache 2013 Feb 18;53(2):356-64. Epub 2012 Dec 18.

Department of Psychology, University of Mississippi, Oxford, MS 38677, USA.

Objective: To assess pain-related attentional biases among individuals with episodic migraine.

Background: Prior studies have examined whether chronic pain patients selectively attend to pain-related stimuli in the environment, but these studies have produced largely mixed findings and focused primarily on patients with chronic musculoskeletal pain. Limited research has implicated attentional biases among chronic headache patients, but no studies have been conducted among episodic migraineurs, who comprise the overwhelming majority of the migraine population.

Methods: This was a case-control, experimental study. Three hundred and eight participants (mean age = 19.2 years [standard deviation = 3.3]; 69.5% female; 36.4% minority), consisting of 84 episodic migraineurs, diagnosed in accordance with International Classification of Headache Disorders (2(nd) edition) criteria using a structured diagnostic interview, and 224 non-migraine controls completed a computerized dot probe task to assess attentional bias toward headache-related pictorial stimuli. The task consisted of 192 trials and utilized 2 emotional-neutral stimulus pairing conditions (headache-neutral and happy-neutral).

Results: No within-group differences for reaction time latencies to headache vs happy conditions were found among those with episodic migraine or among the non-migraine controls. Migraine status was unrelated to attentional bias indices for both headache (F [1,306] = 0.56, P = .45) and happy facial stimuli (F [1,306] = 0.37, P = .54), indicating a lack of between-group differences. Lack of within- and between-group differences was confirmed with repeated measures analysis of variance.

Conclusions: In light of the large sample size and prior pilot testing of presented images, results suggest that episodic migraineurs do not differentially attend to headache-related facial stimuli. Given modest evidence of attentional biases among chronic headache samples, these findings suggest potential differences in attentional processing between chronic and episodic headache subforms.
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http://dx.doi.org/10.1111/head.12011DOI Listing
February 2013

Examining the interactive effect of posttraumatic stress disorder, distress tolerance, and gender on residential substance use disorder treatment retention.

Psychol Addict Behav 2013 Sep 3;27(3):763-73. Epub 2012 Sep 3.

Department of Psychiatry and Human Behavior, University of Mississippi Medical Center.

An extensive body of research has demonstrated that patients with a co-occurring posttraumatic stress disorder (PTSD) and substance use disorder (SUD) diagnosis are at high risk for a wide range of negative clinical outcomes, including treatment noncompletion. However, no studies to date have explored the effect of a PTSD-SUD diagnosis on residential SUD treatment completion, as well as potential moderators of this effect. Consequently, the goal of this study was to examine the interactive effect of a PTSD diagnosis, distress tolerance (DT), and gender on residential SUD treatment retention. Participants were 214 substance-dependent patients consecutively admitted to a residential SUD treatment facility. Participants were administered diagnostic interviews, completed a laboratory-based measure of DT, and were followed throughout the course of treatment. Although no significant main effects were found, results did reveal a significant PTSD × gender × DT interaction. Post hoc analyses indicated that, among men, those with a current diagnosis of PTSD and low DT completed a significantly lower proportion of residential SUD treatment compared to all other groups. The implications of the study's findings for identifying ways to improve residential SUD treatment retention among patients with a PTSD-SUD diagnosis are discussed.
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http://dx.doi.org/10.1037/a0029911DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3647007PMC
September 2013

Human papillomavirus vaccination and the primary prevention of cancer: implications for survivors of childhood cancer.

Stud Health Technol Inform 2012 ;172:33-42

Department of Psychology, St. Jude Children's Research Hospital.

Effective vaccination is now available to prevent human papillomavirus (HPV), the most common sexually transmitted infection and the cause of cervical cancer, the second most common cancer among women worldwide. HPV vaccine uptake is particularly important for females surviving cancer, who are at high risk for HPV-related complication due to the direct and indirect effects of cancer therapy. Thus, Version 3.0 of the Children's Oncology Group Long-Term Follow-Up Guidelines for Survivors of Childhood, Adolescent and Young Adult Cancer recommends HPV vaccination for all eligible females surviving childhood cancer. Because this vaccine was only FDA approved in 2006, little is known about the complexity of vaccination uptake among those surviving childhood cancer. This chapter describes HPV vaccination and its usefulness in survivors of childhood cancer, provides a rationale for describing survivors as being at increased risk for HPV-related complication, identifies factors that are predictive of HPV vaccination, and discusses the utilization of these predictors in designing strategies to promote adherence to the HPV vaccination recommendations among survivors.
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February 2013

Cocaine-related attentional bias following trauma cue exposure among cocaine dependent in-patients with and without post-traumatic stress disorder.

Addiction 2011 Oct 27;106(10):1810-8. Epub 2011 Jul 27.

Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS 39216, USA.

Aims: Although the co-occurrence of post-traumatic stress disorder (PTSD) and cocaine dependence is associated with a wide range of negative clinical outcomes, little is known about the mechanisms that underlie this association. This study investigated one potential mechanism-attentional bias to cocaine imagery following trauma cue exposure.

Design: Male and female cocaine-dependent in-patients with and without PTSD were exposed to both a neutral and personalized trauma script on separate days, followed by a visual dot-probe task. A 2 (PTSD versus non-PTSD) × 2 (neutral versus trauma script) × 2 (male versus female) design was used to examine hypotheses.

Setting: Participants were recruited from a residential substance use disorder (SUD) treatment center.

Participants: Participants were 60 trauma-exposed cocaine dependent in-patients, 30 with current PTSD and 30 without a history of PTSD.

Measurements: Attentional bias was assessed using a visual dot-probe task depicting cocaine-related imagery following both a neutral script and personalized trauma script.

Findings: Following neutral script exposure, PTSD (versus non-PTSD) participants exhibited an attentional bias away from cocaine imagery. This effect was reversed following trauma script exposure, with PTSD participants exhibiting a greater attentional bias towards the location of cocaine imagery than non-PTSD participants. Severity of subjective distress following trauma script exposure predicted level of attentional bias among PTSD participants.

Conclusions: Cocaine appears to serve an emotion-regulating function among post-traumatic stress disorder patients and may be a potential target for brief post-traumatic stress disorder-substance use disorder interventions that can facilitate residential substance use disorder treatment retention.
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http://dx.doi.org/10.1111/j.1360-0443.2011.03508.xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3174347PMC
October 2011

Negative impact of episodic migraine on a university population: quality of life, functional impairment, and comorbid psychiatric symptoms.

Headache 2011 Apr;51(4):581-9

Department of Psychology, University of Mississippi, Oxford, MS, USA.

Background: Migraine is associated with significant negative impact, including reduced quality of life, impaired functioning, and comorbid psychiatric disorders. However, the impact of migraine on university students is understudied, despite their high prevalence of migraine and psychiatric disorders and their frequent use in research studies.

Objectives: The aim of this cross-sectional study was to evaluate the impact of migraine among college students on quality of life, functional impairment, and comorbid psychiatric symptoms.

Methods: Three hundred and ninety-one students (76.73% female, mean age = 19.43 ± 2.80 years) completed well-validated measures of migraine and migraine-related disability, quality of life, and comorbid psychiatric symptoms. They also quantified impairment in school attendance and home functioning and reported the number of medical visits during the preceding 3 months.

Results: One hundred and one (25.83%) met conservative screening criteria for episodic migraine; their mean score on the Migraine Disability Assessment Questionnaire was 9.98 ± 12.10. Compared to those not screening positive for migraine, the migraine-positive group reported reduced quality of life on 5 of 6 domains, as well as a higher frequency of missed school days (2.74 vs 1.36), impaired functioning at home (2.84 vs 1.21 days), and medical visits (1.86 vs 0.95). They also reported more symptoms of both depression and anxiety than controls, although differences in functional impairment remained after controlling for these comorbid psychiatric symptoms. These differences were highly statistically significant and corroborated by evidence of clinically significant impairment; the corresponding effect sizes were modest but non-trivial.

Conclusions: Episodic migraine is associated with negative impact in numerous domains among university students. These findings replicate and extend those of studies on other samples and have implications for future research studies with this population.
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http://dx.doi.org/10.1111/j.1526-4610.2011.01857.xDOI Listing
April 2011

PTSD symptom clusters in relationship to alcohol misuse among Iraq and Afghanistan war veterans seeking post-deployment VA health care.

Addict Behav 2010 Sep 14;35(9):840-3. Epub 2010 Apr 14.

Mental Illness Research, Education, and Clinical Center (MIRECC), VA Puget Sound Health Care System, Seattle, WA 98108, United States.

Demographic factors, characteristics of military service, PTSD, and depression were examined as predictors of alcohol misuse in Iraq and Afghanistan War Veterans (N=287) presenting for post-deployment Veteran Affairs (VA) health care. Results indicated that alcohol misuse was more common among younger male Veterans who served in the Army or Marine Corps. Accounting for demographic factors and characteristics of service, Veterans who screened positive for PTSD or depression were two times more likely to report alcohol misuse relative to Veterans who did not screen positive for these disorders. The examination of specific PTSD symptom clusters suggested that emotional numbing symptoms were most strongly associated with alcohol misuse. The implications for interventions for alcohol misuse in returning Veterans are discussed.
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http://dx.doi.org/10.1016/j.addbeh.2010.03.023DOI Listing
September 2010

The role of anxiety sensitivity and difficulties in emotion regulation in posttraumatic stress disorder among crack/cocaine dependent patients in residential substance abuse treatment.

J Anxiety Disord 2009 Jun 20;23(5):591-9. Epub 2009 Jan 20.

Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216, USA.

Current research suggests the importance of anxiety sensitivity (AS) in the risk for posttraumatic stress disorder (PTSD), and a growing body of research has demonstrated that difficulties in emotion regulation may also play a role. This study examined the unique relationships between AS dimensions, difficulties in emotion regulation, and a probable PTSD diagnosis among a sample of inner-city crack/cocaine dependent patients in residential substance abuse treatment. Probable PTSD participants exhibited higher levels of the AS dimension of social concerns and emotion regulation difficulties. Emotion regulation difficulties reliably distinguished probable PTSD participants from non-PTSD participants above and beyond both anxiety symptom severity and the AS dimension of social concerns. Further, social concerns did not account for unique variance when difficulties in emotion regulation was entered into the model. Results provide support for the central role of difficulties in emotion regulation relative to AS dimensions in the prediction of PTSD within a crack/cocaine dependent population.
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http://dx.doi.org/10.1016/j.janxdis.2009.01.006DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2698460PMC
June 2009

Tetrachloroethylene (PCE, Perc) levels in residential dry cleaner buildings in diverse communities in New York City.

Environ Health Perspect 2005 Oct;113(10):1336-43

Center for Environmental Health, New York State Department of Health, Troy, New York, USA.

Fugitive tetrachloroethylene (PCE, perc) emissions from dry cleaners operating in apartment buildings can contaminate residential indoor air. In 1997, New York State and New York City adopted regulations to reduce and contain perc emissions from dry cleaners located in residential and other buildings. As part of a New York State Department of Health (NYSDOH) study, indoor air perc levels were determined in 65 apartments located in 24 buildings in New York City where dry cleaners used perc on site. Sampling occurred during 2001-2003, and sampled buildings were dispersed across minority and nonminority as well as low-income and higher income neighborhoods. For the entire study area, the mean apartment perc level was 34 microg/m3, 10-fold lower than mean apartment levels of 340-360 microg/m3 documented before 1997. The maximum detected perc level was 5,000 microg/m3, 5-fold lower than the maximum of 25,000 microg/m3 documented before 1997. Despite these accomplishments, perc levels in 17 sampled apartments still exceeded the NYSDOH residential air guideline of 100 microg/m3, and perc levels in 4 sampled apartments exceeded 1,000 microg/m3. Moreover, mean indoor air perc levels in minority neighborhoods (75 microg/m3) were four times higher than in nonminority households (19 microg/m3) and were > 10 times higher in low-income neighborhoods (256 microg/m3) than in higher income neighborhoods (23 microg/m3). Logistic regression suitable for clustered data (apartments within buildings) indicated that perc levels on floors 1-4 were significantly more likely to exceed 100 microg/m3 in buildings located in minority neighborhoods (odds ratio = 6.7; 95% confidence interval, 1.5-30.5) than in nonminority neighborhoods. Factors that may be contributing to the elevated perc levels detected, especially in minority and low-income neighborhoods, are being explored.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1281276PMC
http://dx.doi.org/10.1289/ehp.7414DOI Listing
October 2005