Dessa Bergen-Cico

Reductions in Cortisol Associated With Primary Care Brief Mindfulness Program for Veterans With PTSD

Background:Patients with posttraumatic stress disorder (PTSD) have significant medical morbidity, which may be mediated by hypothalamic pituitary axis (HPA) dysfunction and reflected in cortisol output. Many veterans with PTSD are hesitant to engage in trauma-focused exposure treatments; therefore briefer, non–exposure-based treatments are needed; one such promising approach is an abbreviated Primary Care brief Mindfulness Program (PCbMP). Objective:This study investigated the relationship between dose-response to participation in a veterans PCbMP program and diurnal cortisol. Cortisol reflects HPA function and PTSD is associated with HPA dysregulation. Research Design:Veterans with PTSD were identified in PC and randomly assigned to treatment as usual (TAU, n=21) or participation in brief 4-week Mindfulness Based Stress Reduction program (n=19). Subjects:Veterans (n=40) (mean age, 48±16 y; 90% men) with PTSD referred through their VA PC provider and randomly assigned to PCbMP or TAU. Measure:As an objective indicator of HPA function, salivary diurnal cortisol was measured from samples collected across 2 consecutive days at baseline and follow-up. Results:Analyses revealed that significant changes in cortisol were associated with PCbMP treatment engagement and dosing (number of mindfulness program sessions completed). Veterans completing 4 mindfulness-based meditation sessions significantly reduced their cortisol awakening response (P⩽0.05); and had significant changes in cortisol area under the curve increase compared with TAU participants (P⩽0.05). Results indicate that PCbMP has a beneficial physiological impact on veterans with PTSD with a minimum of 4 weeks of practice.

A Randomized Clinical Trial of Primary Care Brief Mindfulness Training for Veterans With PTSD

OBJECTIVES Primary care (PC) patients typically do not receive adequate posttraumatic stress disorder (PTSD) treatment. This study tested if a brief mindfulness training (BMT) offered in PC can decrease PTSD severity. METHOD VA PC patients with PTSD (N = 62) were recruited for a randomized clinical trial comparing PCBMT with PC treatment as usual. PCBMT is a 4-session program adapted from mindfulness-based stress reduction. RESULTS PTSD severity decreased in both conditions, although PCBMT completers reported significantly larger decreases in PTSD and depression from pre- to posttreatment and maintained gains at the 8-week follow-up compared with the control group. Exploratory analyses revealed that the describing, nonjudging, and acting with awareness facets of mindfulness may account for decreases in PTSD. CONCLUSION Our data support preliminary efficacy of BMT for Veterans with PTSD. Whether PCBMT facilitates engagement into, or improves outcomes of, full-length empirically supported treatment for PTSD remains to be evaluated.

Street addiction: A proposed theoretical model for understanding the draw of street life and gang activity

Through qualitative analysis of interviews conducted with men who have histories of gang affiliation and street crime, this article posits understanding these behaviors through the framework of addictions. The participants in this study describe themselves as being addicted to the action of the streets and their narratives fit with the evolving framework of a behavioral addiction. There is currently no formal diagnosis for understanding the draw of action to street crime and gang association as addiction. Through semi-structured interviews we examine the key constructs of cognition and behaviors relevant to understanding the cycle of gang involvement, crime, and violence under the rubric of behavioral addictions. Thematic elements of significance emerged which parallel the analytic framework of addictions and delineate ways that being addicted to the “action of the streets” is a substantive factor in recidivism with the criminal justice system. The construct of “street addiction” articulated by those who live it, makes important practical and theoretical contributions to the fields of addictions, criminal justice, public health, psychology, and sociology.

Exploring the Association between Campus Co-Curricular Involvement and Academic Achievement:

This research examines the relationship between college student attendance at co-curricular programs and GPA. Researchers tracked attendance of two cohorts totaling 3,000+ students through electromagnetic scanning at university-sponsored events. Analysis of GPA by attendance rate clusters revealed that students attending 5–14 events over the 4–year period had significantly higher (p < 0.001) GPAs than students attending fewer or more events. The findings from this study contribute to the scope of research on student engagement in higher education. Whereas research on student alcohol use, depression, and anxiety has addressed the risk factors for student success, this study complements existing research by examining the protective facets of student institutional engagement.

Age of First Use as a Predictor of Current Alcohol and Marijuana Use among College-Bound Emerging Adults.

Background: Alcohol and marijuana are the most commonly used psychoactive substances; however, the sequencing and relationship between age of first use and continued current problematic use among college-bound emerging adults is not well understood. Methods: This is a cross-sectional study of current and historical alcohol and marijuana use among college-bound recent high school graduates (N = 1,365; age ∼18 years). Results: Drinking was prevalent (78%, N = 1,055) and marijuana use was prevalent (46%, N = 622). Stepwise logistical regression revealed the lower the age of first use, the higher the prevalence of current problematic substance use. Those who initiate alcohol ≤ 12 are twice as likely to currently use marijuana frequently. A significant relationship was found between age of first use and non-social substance use (drinking, p = 0.0001; marijuana, p = 0.0025). The temporal ordering of substance use indicates that alcohol precedes marijuana use, and age of first alcohol use is relevant to rates of initiation and current marijuana use.

The Trauma Response Team: a Community Intervention for Gang Violence

While violent crime has decreased in many cities in the USA, gang-related violence remains a serious problem in impoverished inner city neighborhoods. In Syracuse, New York, gang-related murders and gun shots have topped other New York state cities. Residents of the high-murder neighborhoods suffer trauma similar to those living in civil conflict zones. The Trauma Response Team was established in 2010, in collaboration with the Police Department, health care institutions, and emergency response teams and with the research support of Syracuse University faculty. Since its inception, gang-related homicides and gun shots have decreased in the most severely affected census tracts.

Neighborhood trauma due to violence: a multilevel analysis

Abstract:In Syracuse, New York the social determinants of trauma from neighborhood violence are rooted in historical processes, including urban renewal, the Rockefeller drug laws, and de-industrialization. These contributed to destabilizing Syracuse communities of color, resulting in disproportionate incarceration, family disruption, and economic devastation. Community violence, clustering in densely populated neighborhoods, creates unmanageable stress for the families who live in them. A map of gunshots and gun fatalities (2009 to 2014) illustrates the continuing onslaught of bullets being fired, often in close proximity to elementary schools. A community survey indicated that over half of respondents personally knew more than 10 murder victims. Half the respondents scored positive on the Civilian PTSD Checklist; there thus is a great deal of unaddressed traumatic stress in the community. This analysis, conducted to prepare for planning future interventions to reduce the community trauma and violence, is part of an ongoing university-community collaboration.

Clients improve disease prevention behaviors through lifestyle-oriented nutrition counseling provided by dietetic students and interns

An 8-week treatment-control intervention with 6-month follow-up study determined the effectiveness of disease prevention lifestyle-oriented nutrition counseling provided by dietetic interns/students to a convenience sample of 38 executive military and 30 campus clients (52 control subjects). Repeated measures distinguished changes between and within groups on the 4 disease prevention variables: fruit intake, vegetable intake, low-fat eating, and exercise. The executive military clients significantly improved their vegetable intake and low-fat eating behaviors (P < .001). Campus clients made some changes through the counseling, however relapsed by the 6-month follow-up. Clients collaborated with their counselors to pursue a wide variety of individualized goals through this lifestyle-oriented nutrition counseling.

Civic Aspirations as a Protective Factor Against College Students' Abuse of Alcohol

This study examines the potential protective nature of aspirations that are civically oriented against alcohol abuse among college students. We examined the drinking behaviors and academic/professional aspirations of two incoming first-year student cohorts at a large private university. Chi-square analysis revealed significant and consistent findings across cohorts: students who selected their major because they “wanted to make a difference in the world and contribute to society” (intrinsic aspiration) reported lower alcohol use and higher abstinence than their peers. Students aspiring to “make a lot of money” (extrinsic aspiration) had relatively higher rates of alcohol use. Our findings support the potential benefits of civic engagement and its implications for substance abuse prevention in higher education.

Considerations for Research and Development of Culturally Relevant Mindfulness Interventions in American Minority Communities

As many health disparities in American minority communities (AMCs) are stress related, there has been an increased interest in the development of mindfulness programs as potential stress-reduction measures in these communities. However, the bulk of the extant literature on mindfulness research and mindfulness interventions is based upon experiences with the larger White community. The intent of this commentary is to share a framework that includes key cultural considerations for conducting research and developing culturally salient mindfulness programs with AMCs. We build on our experiences and the experiences of other researchers who have explored mindfulness in African- and Native American communities; in particular, we examine issues around community outreach with an emphatic gesture toward emphasizing protection of AMCs and their participants. Discussed are considerations with respect to attitudinal foundations in mindfulness-based research and program development with these communities. However, the overall message of this paper is not to provide a “to-do” list of research steps, but to rather, encourage researchers to turn inward and consider the development of skillful characteristics that will increase the likelihood of a successful research venture while also protecting the cultural traditions of the AMC of interest.