MacKenzie R. Peltier

Do they see dead people? Cultural factors and sensitivity in screening for schizophrenia spectrum disorders

ABSTRACT Objective. Schizophrenia spectrum disorders (SSDs), are diagnosed more frequently among African-Americans (AAs) than Caucasians. It has been suggested that cultural differences in symptom presentation and endorsement (including reporting spiritual/religious experiences) may influence this disparity. The current study investigated the relationship between endorsement of spiritual auditory and visual hallucinations and subsequent diagnosis of SSD among AA patients. Design. Participants (N = 471 AAs) completed the Mini International Neuropsychiatric Interview-Plus (MINI-Plus) Screening Interview as part of their intake to a HIV outpatient clinic. Endorsement of auditory or visual (A/V) hallucinations was explored with the MINI-Plus Psychotic Disorder Module and questions regarding the content of the unusual experience. Results. Logistic regression indicated that endorsement of A/V hallucinations significantly predicted a SSD (OR = 41.6, 95% CI 13.7-126.0, p < .001). However, when hallucinations were spiritual in nature, odds of an SSD fell dramatically (OR = 0.22, 95% CI 0.07-0.64, p < .001). Conclusions. The current study indicates that not all visual and auditory hallucinations are symptomatic of a psychotic disorder in AA patients. Many of these experiences may be related to spirituality. Clinicians assessing AA patients need to query content of, meaning attributed to, and distress associated with A/V unusual experiences.

Examination of trait impulsivity on the response to a brief mindfulness intervention among college student drinkers

Mindfulness-based strategies show promise for targeting the construct of impulsivity and associated variables among problematic alcohol users. This study examined the moderating role of intervention (mindfulness vs relaxation vs control) on trait impulsivity and three outcomes examined post-intervention (negative affect, positive affect, and urge to drink) among 207 college students with levels of at-risk drinking. Moderation analyses revealed that the relationship between baseline impulsivity and the primary outcomes significantly differed for participants who underwent the mindfulness versus relaxation interventions. Notably, simple slope analyses revealed that negative urgency was positively associated with urge to drink following the mindfulness intervention. Among participants who underwent the relaxation intervention, analysis of simple slopes revealed that negative urgency was negatively associated with urge to drink, while positive urgency was positively associated with positive affect following the relaxation intervention. Findings suggest that level (low vs high) and subscale of impulsivity matter with regard to how a participant will respond to a mindfulness versus relaxation intervention.

Facets of Mindfulness Mediate the Relationship Between Depressive Symptoms and Smoking Behavior

The relationship between cigarette smoking and depressive symptoms is well established. Dispositional mindfulness has been associated with lower depressive symptoms, lower smoking dependence, and higher odds of smoking cessation. Given that mindfulness is multi-faceted, the current study examined which facets of mindfulness might mediate the relationship between depressive symptoms and smoking behavior. Participants (n = 72) completed the Smoking Consequences Questionnaire (SCQ), Center for Epidemiologic Studies Depression Scale (CESD), and Kentucky Inventory of Mindfulness Skills (KIMS; subscales-Observe, Describe, Acting with Awareness, Accepting without Judgment) and indicated number of cigarettes smoked per day (CPD). Simple mediation models (followed by multiple mediation when more than one facet was significant) tested whether mindfulness facets mediated the relationship between CESD and smoking behavior (CPD and SCQ subscales). Results indicated that (1) lower depressive symptoms were associated with higher Accepting without Judgment, which was related to lower Negative Reinforcement expectancies, (2) lower depressive symptoms were associated with increased Describe, which was associated with greater perceived Negative Consequences, (3) lower depressive symptoms were associated with higher Accepting without Judgment, which was associated with lower Negative Consequences expectancies, and (4) higher depressive symptoms were associated with higher scores on Observe, which related to both greater Positive Reinforcement and Negative Consequences expectancies. Greater Accepting without Judgment and Describe aspects of mindfulness may serve as protective factors in the relationship of depressive symptoms and smoking.

Problems screening for HAND among the educationally disadvantaged.

ABSTRACT Neurocognitive screeners are used to detect symptoms of HIV-Associated Neurocognitive Disorders (HAND). However, the degree to which education and socioeconomic status affect these screeners remains unclear. Neurocognitive screeners were administered to 187 socioeconomically disadvantaged HIV+ individuals upon entering treatment who had no other risk factors for HAND. The false positive rates were: 84% for the Montreal Cognitive Assessment, 59% for the International HIV Dementia Scale, and 28.3% for the Modified HIV Dementia Scale. Given these high false positive rates, the screeners may be more useful for establishing baseline functioning and sequential testing to detect deterioration.