Jeffrey L. Kibler

Posttraumatic Stress and Cardiovascular Disease Risk

A growing literature indicates that posttraumatic stress is associated with cardiovascular risk and cardiovascular disease (CVD). Research on specific CVD risk factors and their prevalence in posttraumatic stress disorder (PTSD) may improve understanding of CVD development in this population. The primary purpose of the present article is to outline the evidence relating posttraumatic stress to CVD risk, with an emphasis on behavioral factors. The evidence concerning potential elevations in traditional cardiovascular risk factors with behavioral components in PTSD is reviewed. Brief discussions of autonomic nervous system hyperarousal and immune dysfunction as potential mechanisms for CVD risk are also presented. Together, the available evidence suggests that multiple related risk factors and physiological systems may impact health in PTSD. Based on the literature to date, it is suggested that additional studies are needed on the synergistic effects of multiple interacting CVD risk factors and interventions aimed at primary and secondary prevention of cardiovascular risk.

Metabolic, autonomic and immune markers for cardiovascular disease in posttraumatic stress disorder

Posttraumatic stress disorder (PTSD) has been associated with significantly greater incidence of heart disease. Numerous studies have indicated that health problems for individuals with PTSD occur earlier in life than in the general population. Multiple mechanistic pathways have been suggested to explain cardiovascular disese (CVD) risk in PTSD, including neurochemical, behavioral, and immunological changes. The present paper is a review of recent research that examines cardiovascular and immune risk profiles of individuals with PTSD. First, we address the relatively new evidence that the constellation of risk factors commonly experienced in PTSD fits the profile of metabolic syndrome. Next we examine the findings concerning hypertension/blood pressure in particular. The literature on sympathetic and parasympathetic responsivity in PTSD is reviewed. Last, we discuss recent findings concerning immune functioning in PTSD that may have a bearing on the high rates of CVD and other illnesses. Our primary goal is to synthesize the existing literature by examining factors that overlap mechanistically to increase the risk of developing CVD in PTSD.

Gratitude is associated with greater levels of protective factors and lower levels of risks in African American adolescents.

The literature suggests gratitude is associated with positive youth development. The current study examined the relationship between gratitude and protective/risk factors among African American youth. Adolescents (N = 389; 50.4% males) ages 12-14 completed measures of gratitude (moral affect and life-orientation), protective factors (e.g., academic and activity engagement, family relationship), and high-risk behaviors (e.g., sexual attitudes and behaviors, drug/alcohol use). Results indicated greater moral affect gratitude was the only variable significantly associated with greater academic interest, better academic performance, and more extra-curricular activity engagement. Greater moral affect and life-orientation gratitude both significantly correlated with positive family relationship. Greater life-orientation gratitude was the only variable significantly associated with abstinence from sexual intimacy, sexual intercourse, likelihood of engaging in sex during primary school, and abstinence from drug/alcohol use. The findings suggest that moral affect gratitude may enhance protective factors while life-orientation gratitude may buffer against high-risk behaviors among African American youth.

Hormones, menstrual distress, and migraine across the phases of the menstrual cycle

Objective.—The primary objectives of the present study were to (1) contrast reproductive hormone levels and ratings of menstrual distress of female migraineurs with those of a control group in each menstrual cycle phase, (2) examine correlations between hormone levels and migraine frequency, severity, and migraine‐related disability, and (3) examine correlations between menstrual distress and migraine frequency, severity, and migraine‐related disability. A secondary objective was to evaluate the validity of a migraine disability measure modified to reflect 7‐day recall.

The Relationship of Character Strengths to Sexual Behaviors and Related Risks among African American Adolescents

Background: Relatively few studies have examined positive character traits that are associated with lower HIV/STD risks.Purpose: In the present study, the relationships of character strengths with sexual behaviors and attitudes were assessed among 383 African-American adolescents.Method: Character strengths were measured using the Values in Action Inventory of Strengths. Because the strengths were highly inter-correlated, stepwise discriminant function analyses were utilized to assess their independent associations with sexual behaviors and attitudes.Results: Greater Love of Learning was related to self-reported abstinence from sexual intercourse for boys and self-reported abstinence from drug use for boys and girls. Greater Love of Learning and Curiosity were related to the belief in no premarital sex for boys, whereas only Curiosity was significant for girls. Prudence was related to reported abstinence from sexual intimacy (e.g., touching or kissing). Judgment was related to sexual initiation efficacy for girls and boys, whereas Leadership was only significant for girls.Conclusions: The findings suggest that character strengths may be associated with lower levels of sexual behaviors and sex-related beliefs among a sample of African-American adolescents.

Latino cultural values as protective factors against sexual risks among adolescents

The study objective was to examine the associations between cultural values and sexual risk factors among Latino youth. A sample of 226 Latino adolescents ages 13-16 completed a survey on cultural and sexual variables. Results indicate higher levels of Latino cultural orientation were related to greater sexual self-efficacy and fewer sexual partners for female adolescents and greater condom use self-efficacy for both males and females. Greater endorsement of simpatia (belief in interpersonal relationship harmony) was associated with sexual abstinence and greater sexual self-efficacy for all adolescents, and with being older at sexual debut for females. Stronger endorsement of respeto (respect towards parents and other authority figures) was correlated with a lower intention to have sex during secondary school and greater condom use self-efficacy. American cultural orientation was associated with less condom use. Our findings indicate Latino cultural values may serve as protective factors against sexual risk behaviors among Latino youth.

Predictors of Willingness of Participate in HIV Vaccine Trials among African Americans

African Americans in the United States (U.S.) are disproportionately affected by HIV. Developing an HIV vaccine is an important part of the HIV prevention and treatment toolkit and may help contribute to ending the HIV epidemic. To date, HIV vaccine trials have not engaged representative numbers of African Americans. We evaluated the willingness of African Americans to participate in HIV vaccine trials and identified correlates of willingness to participate (WTP) by surveying African Americans at low- and high-risk of HIV infection in a multi-site, cross-sectional study. We enrolled 1,452 participants; 59% heterosexual women; 21% heterosexual men; 20% men who have sex with men (MSM). Over half of participants (58%) expressed some level of WTP in HIV vaccine trials. Multivariable analyses revealed several variables were positively related to WTP: HIV risk behavior, knowing someone with HIV/AIDS, social support for trial participation, high perception of risk, perceived protection if in a trial, altruism, and greater tolerance for the ambiguous nature of trials (p<0.01). Emphasis on contextual factors related to personal HIV experiences, including knowledge of someone with HIV, and community support for research, may provide effective strategies for engaging African Americans in future HIV vaccine trials.

Brief Cognition-Focused Group Therapy for Depressive Symptoms in Chronic Posttraumatic Stress Disorder: A Pilot Study

ABSTRACT A growing literature supports the inclusion of cognitive therapy components in the treatment of posttraumatic stress disorder (PTSD) and, in many cases, concomitant depression. However, further research is needed to examine whether cognitive therapies may serve as an effective approach to emotional regulation in cases of chronic treatment-resistant PTSD (e.g., combat veterans who have been in treatment for 20 or more years). This article outlines a brief outpatient cognitive emotion-management group with a present focus. The intervention, based on cognitive appraisal theory, is designed to reduce negative cognitive appraisals and depressive symptoms among individuals with treatment-resistant PTSD. Participants were 21 men and women (4 male cohorts and 1 female cohort) in a VA treatment program for trauma-related distress who met screening criteria for high depressive symptoms and evidenced maladaptive cognitive appraisals of stress. For 14 participants with complete data, the treatment yielded partial improvement in cognitive appraisals and improvement in depressive symptoms. Although conclusions are tempered by the absence of a control group and the small sample, these findings provide preliminary support for the treatment protocol.

Cultural Assets and Substance Use Among Hispanic Adolescents

Research on cultural factors and substance use among Hispanic adolescents has focused primarily on acculturation, while specific core Hispanic values and attributes have received minimal attention. The objective of the current study was to examine the relationship between traditional Hispanic cultural assets and substance use among adolescents. A purposive sample of 225 Hispanic adolescents (47% male) aged 13 to 16 years were recruited from community venues (e.g., park, school, mall) in a predominately Hispanic neighborhood. Participants completed a survey to assess cultural factors (familism, simpatía, respeto, and ethnic pride) and substance use in the past 3 months (alcohol and drug). Point-biserial correlations revealed significant associations of alcohol and drug use with greater familism (family connectedness), simpatía (interpersonal relationship harmony), and respeto (respect). Two stepwise binary logistic regressions were performed to evaluate the independent association between the cultural factors and substance use. The interaction of gender with each cultural factor was examined in both analyses. Simpatía emerged as the only cultural factor independently associated with alcohol use. Greater simpatía was related to abstention from alcohol. Both simpatía and familism independently correlated with drug use. Stronger endorsements of simpatía and familism were associated with absence from drug use. Interactions between cultural factors and gender were not observed. Simpatía emerged as the strongest cultural asset that may confer protection against substance use. If replicated, our results suggest substance prevention programs targeting Hispanic adolescents may benefit from the inclusion of cultural assets in the intervention paradigm.

Prospective predictors of actual research participation among African-American adults

AimAlthough several variables appear to be associated with reluctance of African Americans to participate in research, most research on this topic has utilized hypothetical study scenarios, and there is a need for empirical studies of factors that predict actual study participation. The purpose of the present paper was to assess five potential predictors of participation in an actual study of psychological stress and health.Subjects and methodsAfrican American adults (n = 236) completed the Barriers to Research Participation Questionnaire (BRPQ), which assesses attitudes toward research participation, and indicated whether they were willing to be contacted for involvement in a study of psychological stress and health.ResultsRespondents who declined to be contacted for further involvement (n = 191) scored significantly lower (less willingness/greater barriers) on the overall BRPQ, and on the health beliefs/fears, role overload/time demands, and perceived benefits subscales than respondents who were enrolled in the study (n = 45).ConclusionInvestigators might enhance enrollment of African American adults by ameliorating health-related fears, increasing accessibility, or communicating benefits of the research.