Ana J. Bridges

Aggression and Sexual Behavior in Best-Selling Pornography Videos: A Content Analysis Update:

This current study analyzes the content of popular pornographic videos, with the objectives of updating depictions of aggression, degradation, and sexual practices and comparing the study’s results to previous content analysis studies. Findings indicate high levels of aggression in pornography in both verbal and physical forms. Of the 304 scenes analyzed, 88.2% contained physical aggression, principally spanking, gagging, and slapping, while 48.7% of scenes contained verbal aggression, primarily name-calling. Perpetrators of aggression were usually male, whereas targets of aggression were overwhelmingly female. Targets most often showed pleasure or responded neutrally to the aggression.

Mental health needs and service utilization by Hispanic immigrants residing in mid-southern United States

Purpose: This study assessed mental health needs and service utilization patterns in a convenience sample of Hispanic immigrants. Design and Method: A total of 84 adult Hispanic participants completed a structured diagnostic interview and a semistructured service utilization interview with trained bilingual research assistants. Results: In the sample, 36% met diagnostic criteria for at least one mental disorder. Although 42% of the sample saw a physician in the prior year, mental health services were being rendered primarily by religious leaders. The most common barriers to service utilization were cost (59%), lack of health insurance (35%), and language (31%). Although more women than men met criteria for a disorder, service utilization rates were comparable. Participants with a mental disorder were significantly more likely to have sought medical, but not psychiatric, services in the prior year and faced significantly more cost barriers than participants without a mental disorder. Conclusions: Findings suggest that Hispanic immigrants, particularly those with a mental illness, need to access services but face numerous systemic barriers. The authors recommend specific ways to make services more affordable and linguistically accessible.

Diagnoses, intervention strategies, and rates of functional improvement in integrated behavioral health care patients.

OBJECTIVE Compared with more traditional mental health care, integrated behavioral health care (IBHC) offers greater access to services and earlier identification and intervention of behavioral and mental health difficulties. The current study examined demographic, diagnostic, and intervention factors that predict positive changes for IBHC patients. METHOD Participants were 1,150 consecutive patients (mean age = 30.10 years, 66.6% female, 60.1% Hispanic, 47.9% uninsured) seen for IBHC services at 2 primary care clinics over a 34-month period. Patients presented with depressive (23.2%), anxiety (18.6%), adjustment (11.3%), and childhood externalizing (7.6%) disorders, with 25.7% of patients receiving no diagnosis. RESULTS The most commonly delivered interventions included behavioral activation (26.1%), behavioral medicine-specific consultation (14.6%), relaxation training (10.3%), and parent-management training (8.5%). There was high concordance between diagnoses and evidence-based intervention selection. We used latent growth curve modeling to explore predictors of baseline global assessment of functioning (GAF) and improvements in GAF across sessions, utilizing data from a subset of 117 patients who attended at least 3 behavioral health visits. Hispanic ethnicity and being insured predicted higher baseline GAF, while patients with an anxiety disorder had lower baseline GAF than patients with other diagnoses. Controlling for primary diagnosis, patients receiving behavioral activation or exposure therapy improved at faster rates than patients receiving other interventions. Demographic variables did not relate to rates of improvement. CONCLUSION Results suggest even brief IBHC interventions can be focused, targeting specific patient concerns with evidence-based treatment components. (PsycINFO Database Record

Contamination aversion and repeated exposure to disgusting stimuli

Abstract Recent research has highlighted the central role of disgust in the etiology and maintenance of contamination aversion (CA). Data would also suggest that, although amendable to the treatment of choice for CA (exposure and response prevention [ERP]), disgust is resistant to habituation. However, with regard to CA, it is not yet known if disgusts resistance to habituation is an artifact of the emotion or the disorder. Specifically, research has not yet indicated if severity of CA moderates the effect of ERP on disgust. Utilizing an undergraduate convenience sample (n=33), the present study compared emotional responding (disgust and fear) with repeated exposure to a disgusting contamination-relevant stimulus between participants who are high in contamination aversion (HCA; n=17) and low in contamination aversion (LCA; n=16). Results indicated that, habituation of disgust was slower than fear within the HCA group but not the LCA group. Contrasts revealed that the decay of fear across trials was faster for HCA participants when compared with LCA participants, although decay of disgust was similar between groups. These results indicate that habituation of disgust is slower than fear when elevated CA is present.

Unique Affective and Cognitive Processes in Contamination Appraisals: Implications for Contamination Fear

A large body of evidence suggests an important role of disgust in contamination fear (CF). A separate line of research implicates various cognitive mechanisms in contamination fear, including obsessive beliefs, memory biases, and delayed attentional disengagement from threat. This study is an initial attempt to integrate these two lines of research and examines whether disgust and delayed attention disengagement from threat explain unique or overlapping processes within CF. Non-clinical undergraduate students (N = 108) completed a spatial cueing task, which provided measures of delayed disengagement from frightening and disgusting cues, and a self-report measure of disgust propensity (DP). Participants also completed a chain of contagion task, in which they provided contamination appraisals of an object as a function of degrees of removal from an initial contaminant. Results demonstrated that DP predicted greater initial contamination appraisals, but a sharper decline in estimations across further degrees of removal from the contaminant. Delayed disengagement from disgust cues uniquely predicted sustained elevations in contamination estimations across further degrees of removal from the contaminant. These results suggest that DP and delayed disengagement from disgust cues explain unique and complimentary processes in contamination appraisals, which suggests the utility of incorporating the disparate affective and cognitive lines of research on CF.

Effects of language concordance and interpreter use on therapeutic alliance in Spanish-speaking integrated behavioral health care patients.

The discrepancy between the growing number of Spanish speakers in the U.S. and the availability of bilingual providers creates a barrier to accessing quality mental health care. Use of interpreters provides one strategy for overcoming this linguistic barrier; however, concerns about whether sessions with interpreters, versus bilingual providers, impede therapeutic alliance remain. The current study explored associations between the use of interpreters and therapeutic alliance in a sample of 458 Spanish-speaking patients seen for integrated behavioral health visits at primary care clinics. Patients completed a brief (4 item) therapeutic alliance scale at their behavioral health appointment. In addition, to supplement the quantitative study data, a pilot study of 30 qualitative interviews was conducted with a new sample of 10 Spanish-speaking patients, 10 behavioral health consultants (BHCs), and 10 trained interpreters. Quantitative results showed that interpreter use did not relate to therapeutic alliance, even when controlling for relevant demographic variables. However, qualitative interviews suggested major themes regarding the relative benefits and challenges of using interpreters for patients, interpreters, and BHCs. In interviews, patients expressed a strong preference for bilingual providers. Benefits included greater privacy, sense of trust, and accuracy of communication. However, in their absence, interpreters were seen as increasing access to services and facilitating communication with providers, thereby addressing the behavioral health needs of patients with limited English proficiency. BHCs and interpreters emphasized the importance of interpreter training and a good collaborative relationship with interpreters to minimize negative effects on the quality of care.

A Multi-Study Analysis of Conceptual and Measurement Issues Related to Health Research on Acculturation in Latinos

Purpose: The aims of the study were to evaluate the orthogonality of acculturation for Latinos. Design: Regression analyses were used to examine acculturation in two Latino samples (N = 77; N = 40). In a third study (N = 673), confirmatory factor analyses compared unidimensional and bidimensional models. Method: Acculturation was assessed with the ARSMA-II (Studies 1 and 2), and language proficiency items from the Children of Immigrants Longitudinal Study (Study 3). Results: In Studies 1 and 2, the bidimensional model accounted for slightly more variance (R2Study 1 = .11; R2Study 2 = .21) than the unidimensional model (R2Study 1 = .10; R2Study 2 = .19). In Study 3, the bidimensional model evidenced better fit (Akaike information criterion = 167.36) than the unidimensional model (Akaike information criterion = 1204.92). Discussion/Conclusions: Acculturation is multidimensional. Implications for Practice: Care providers should examine acculturation as a bidimensional construct.

The independent effects of child sexual abuse and impulsivity on lifetime suicide attempts among female patients

Child sexual abuse (CSA) is a causal agent in many negative adulthood outcomes, including the risk for life-threatening behaviors such as suicide ideation and suicide attempts. Traumatic events such as CSA may pose risk in the healthy development of cognitive and emotional functioning during childhood. In fact, high impulsivity, a risk factor for suicidal behavior, is characteristic of CSA victims. The current study aims to understand the relations among CSA, impulsivity, and frequency of lifetime suicide attempts among a female patient sample admitted for suicidal behavior. Participants included 177 female patients between the ages of 18 and 63 years admitted at two hospitals in Buenos Aires, Argentina. Number of previous suicide attempts and CSA were assessed via structured interviews, while impulsivity was assessed with the Barratt Impulsiveness Scale (BIS-11). A model of structural equations was employed to evaluate the role of impulsivity in the relation between CSA and suicide attempts. CSA (β=.18, p<.05) and impulsivity (β=.24, p<.05) were associated with the number of previous suicide attempts. However, impulsivity was not significantly associated with CSA (β=.09, p>.05). CSA and impulsivity are independently associated with lifetime suicide attempts among female patients with recent suicidal behavior.

Peritraumatic Dissociation and Peritraumatic Emotional Predictors of PTSD in Latino Youth: Results from the Hispanic Family Study

This is the 1st study to examine peritraumatic dissociation and peritraumatic emotions as they predict symptoms and diagnosis of posttraumatic stress disorder (PTSD) in Latino youth. Our aim was to test the hypothesis that the degree of peritraumatic dissociation would predict the number of PTSD symptoms and PTSD clinical diagnosis when the influences of other salient factors were statistically controlled. We also explored the possible contributions of peritraumatic emotional responses to PTSD symptomatology and PTSD diagnosis. We expected that peritraumatic dissociation would emerge as a significant predictor of PTSD. A total of 204 Latino youth (mean age = 12.37 years) completed semistructured individual clinical interviews with bilingual research assistants. These interviews assessed trauma exposure, peritraumatic responses, and current psychopathology. A linear regression analysis demonstrated significant relationships between lifetime number of traumatic events, peritraumatic dissociation, shame, and number of PTSD symptoms endorsed. Significant inverse (protective) relationships were demonstrated between anger and guilt and current PTSD symptomatology. Logistic regression analysis demonstrated significant relationships between peritraumatic dissociation, shame, lifetime number of traumatic events experienced, and PTSD diagnosis. The analyses examined both the number of PTSD symptoms as well as diagnosis of PTSD while simultaneously controlling for age, lifetime exposure to traumatic events, time residing in the United States, and gender. These results support an increasingly robust body of empirical literature suggesting that the peritraumatic dissociative and emotional responses to trauma are important predictors of future PTSD diagnosis. Possible cultural factors contributing to the dissociative responses in Latino youth and clinical implications are discussed.

Cognitive Appraisals of Specialty Mental Health Services and Their Relation to Mental Health Service Utilization in the Rural Population

PURPOSE Rural individuals utilize specialty mental health services (eg, psychiatrists, psychologists, counselors, and social workers) at lower rates than their urban counterparts. This study explores whether cognitive appraisals (ie, individual perceptions of need for services, outcome expectancies, and value of a positive therapeutic outcome) of help-seeking for depression symptoms are related to the utilization of specialty mental health services in a rural sample. METHODS Demographic and environmental characteristics, cultural barriers, cognitive appraisals, and depression symptoms were assessed in one model predicting specialty mental health service utilization (MHSU) in a rural sample. Three hypotheses were proposed: (1) a higher number of environmental barriers (eg, lack of insurance or transportation) would predict lower specialty mental health service utilization; (2) an increase in cultural barriers (stigma, stoicism, and lack of anonymity) would predict lower specialty mental health utilization; and (3) higher cognitive appraisals of mental health services would predict specialty mental health care utilization beyond the predictive capacities of psychiatric symptoms, demographic variables, environmental barriers, and cultural barriers. FINDINGS Current depression symptoms significantly predicted lifetime specialty mental health service utilization. Hypotheses 1 and 2 were not supported: more environmental barriers predicted higher levels of specialty MHSU while cultural barriers did not predict specialty mental health service utilization. Hypothesis 3 was supported: cognitive appraisals significantly predicted specialty mental health service utilization. CONCLUSIONS It will be important to target perceptions and attitudes about mental health services to reduce disparities in specialty MHSU for the rural population.