Faculty Bibliography

OBJECTIVES/OBJECTIVE:Residential time in the United States appears to be a risk factor for mental health problems among Latinos, according to studies of the immigrant paradox, or a pattern of findings documenting better health for immigrants relative to U.S.-born Latinos. The present study used an acculturative stress model to examine the immigrant paradox with a sample of Mexican-origin mothers. METHOD/METHODS:Mothers [N = 175; age = 33.52 (10.75)], who were foreign- or U.S.-born, were categorized as more acculturated or less acculturated based on cluster analyses using demographic and language proficiency variables. The association between acculturative status and depressive symptoms approximately 9 months later was tested with two models: with both cultural stressors (i.e., perceived discrimination, acculturative stress) and cultural assets (i.e., familismo, ethnic identity) as mediators, and with the effects of cultural stressors moderated by cultural assets. RESULTS:Data provide some support for the validity of the mediation model. Less acculturated mothers reported (a) a stronger ethnic identity, which appears to have protected them from later depression, and (b) stronger familismo, which increased risk for later depression. In addition, discrimination was negatively related to later depression. CONCLUSIONS:We found support for the mediating role of cultural assets in the link between acculturation and depression, but some associations were in unexpected directions. These findings highlight the complexities of preserving core cultural characteristics among Mexican-origin mothers living in the United States, and the need to consider the context in which cultural processes unfold. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

OBJECTIVES/OBJECTIVE:Recognizing that immigrant parents socialize their children in specific ways, the current study examines Mexican-origin families' parental socialization profiles using both parental cultural socialization and general parenting dimensions. We seek to understand how these dimensions interact to form culturally grounded parental socialization profiles in a sample of Mexican-origin parents and adolescents. METHOD/METHODS:There were 604 adolescents, 595 mothers, and 293 fathers within Mexican-origin families self-reporting on 2 cultural socialization dimensions (respeto, independence) and 4 general parenting dimensions (warmth, hostility, monitoring, reasoning). Adolescent outcomes were assessed 1 year later. RESULTS:Latent profile analysis revealed eight parental socialization profiles representing distinct combinations of cultural socialization and parenting dimensions. Relative to other profiles, the Integrative-Authoritative profile (high on socialization toward respeto and independence; high on warmth, monitoring, and reasoning; and relatively low on hostility) was the most common parenting pattern and was also associated with more optimal adolescent outcomes. CONCLUSION/CONCLUSIONS:Examining cultural socialization alongside general parenting dimensions can better capture parental socialization strategies among Mexican-origin parents. The various parental socialization profiles that characterize Mexican-origin parents have important implications for adolescent outcomes. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

OBJECTIVE:Find genetic contributions to glaucoma in African Americans. DESIGN/METHODS:Cross-sectional, case-control study. PARTICIPANTS/METHODS:1875 POAG cases and 1709 controls, self-identified as African Descent (AD), from the African Descent and Glaucoma Evaluation Study (ADAGESIII) and Wake Forest School of Medicine. METHODS:MegaChip genotypes were imputed to Thousand Genomes data. Association of SNPs with POAG and advanced POAG was tested by linear mixed model correcting for relatedness and population stratification. Genetic risk scores were tested by Receiver Operator Characteristics (ROC-AUC). MAIN OUTCOME/RESULTS:POAG defined by visual field loss without other non-ocular conditions (N=1875). Advanced POAG was defined by age-based mean deviation of visual field (N=946). RESULTS:) was observed, not in LD with the previously reported ED SNP. Additional previously identified loci associated with POAG in AD were: 8q22, AFAP1, TMCO1. An AUC of 0.62 was observed with an unweighted genetic risk score composed of 11 SNPs in candidate genes. Two additional risk scores were studied by using a penalized matrix decomposition with cross-validation; risk scores of 50 and 400 SNPs were identified with ROC of AUC=0.74 and AUC=0.94, respectively. CONCLUSIONS:A novel association with advanced POAG in the ENO4 locus was putatively identified in subjects of African descent. In addition to this finding, this GWAS in AD POAG subjects contributes to POAG genetics by identification of novel signals in prior loci (9p21), as well as advancing the fine-mapping of regions due to shorter average linkage disequilibrium (FNDC3B). While not useful without confirmation and clinical trials, the use of genetic risk scores demonstrated that considerable AD-specific genetic information remains in these data.

BACKGROUND/OBJECTIVES/OBJECTIVE:Nonpharmacological interventions, such as biofeedback, cognitive behavioral therapy, and relaxation techniques are Level-A evidence-based treatments for headache. The impact of these interventions is often equivalent to or greater than pharmacological interventions, with fewer side effects. Despite such evidence, the rate of participation in nonpharmacological interventions for headache remains low. Once obstacles to optimizing use of behavioral interventions, such as local access to nonpharmacological treatment and primary headache providers are traversed, identification of barriers contributing to low adherence is imperative given the high levels of disability and cost associated with treating headache disorders. In this review of factors in adults associated with underuse of nonpharmacological interventions, we discuss psychological factors relevant to participation in nonpharmacological treatment, including attitudes and beliefs, motivation for change, awareness of triggers, locus of control, self-efficacy, acceptance, coping styles, personality traits, and psychiatric comorbidities associated with treatment adherence. Finally, future prospects and approaches to optimizing treatment matching and minimizing adherence issues are addressed. METHODS:An interdisciplinary team conducted this narrative review. Neuropsychologists conducted a literature search during the month of July 2017 using a combination of the keywords ("headache" or "migraine") and ("adherence" or "compliance") or "barriers to treatment" or various "psychological factors" discussed in this narrative review. Content experts, a psychiatrist, and a complementary and integrative health specialist provided additional commentary and input to this narrative review resulting in integration of additional noteworthy studies, book chapters and books. RESULTS:Various psychological factors, such as attitudes and beliefs, lack of motivation, poor awareness of triggers, external locus of control, poor self-efficacy, low levels of acceptance, and engagement in maladaptive coping styles can contribute to nonadherence. CONCLUSIONS:To maximize adherence, clinicians can assess and address an individual's level of treatment acceptance, beliefs that may present as barriers, readiness for change, locus of control, self-efficacy and psychiatric comorbidities. Identification of barriers to adherence as well as the application of relevant assessment and intervention techniques have the potential to facilitate adherence and ultimately improve treatment success.

BACKGROUND:Concussion leads to neurophysiologic changes that may result in visual symptoms and changes in ocular motor function. Vision-based testing is used increasingly to improve detection and assess head injury. This review will focus on the historical aspects and emerging data for vision tests, emphasizing rapid automatized naming (RAN) tasks and objective recording techniques, including video-oculography (VOG), as applied to the evaluation of mild traumatic brain injury. METHODS:Searches on PubMed were performed using combinations of the following key words: "concussion," "mild traumatic brain injury," "rapid automatized naming," "King-Devick," "mobile universal lexicon evaluation system," "video-oculography," and "eye-tracking." Additional information was referenced from web sites of vendors of commercial eye-tracking systems and services. RESULTS:Tests of rapid number, picture, or symbol naming, termed RAN tasks, have been used in neuropsychological studies since the early 20th century. The visual system contains widely distributed networks that are readily assessed by a variety of functionally distinct RAN tasks. The King-Devick test, a rapid number naming assessment, and several picture-naming tests, such as the Mobile Universal Lexicon Evaluation System (MULES) and the modified Snodgrass and Vanderwart image set, show capacity to identify athletes with concussion. VOG has gained widespread use in eye- and gaze-tracking studies of head trauma from which objective data have shown increased saccadic latencies, saccadic dysmetria, errors in predictive target tracking, and changes in vergence in concussed subjects. Performance impairments on RAN tasks and on tasks recorded with VOG are likely related to ocular motor dysfunction and to changes in cognition, specifically to attention, memory, and executive functioning. As research studies on ocular motor function after concussion have expanded, so too have commercialized eye-tracking systems and assessments. However, these commercial services are still investigational and all vision-based markers of concussion require further validation. CONCLUSIONS:RAN tasks and VOG assessments provide objective measures of ocular motor function. Changes in ocular motor performance after concussion reflect generalized neurophysiologic changes affecting a variety of cognitive processes. Although these tests are increasingly used in head injury assessments, further study is needed to validate them as adjunctive diagnostic aids and assessments of recovery.

INTRODUCTION AND AIMS/OBJECTIVE:Polysubstance users are a high-risk population for negative health-related consequences. Although some studies have described harm reduction strategies adopted by polysubstance users, studies have not examined their effectiveness in minimising health-related consequences. We aimed to identify dosing-related harm reduction strategies in a sample of polysubstance-using dance festival attendees, and explore the relationship between harm reduction strategies and self-reported adverse health consequences. DESIGN AND METHODS/METHODS:Data were examined for 1226 past-year dance festival attendees who self-identified as past-year multiple drug users. We conducted bivariable and multivariable analyses to explore relationships between six dosing-related harm reduction strategies and 13 self-reported adverse consequences. RESULTS:Self-reported use of dosing-related harm reduction strategies was prevalent, mainly avoidance of mixing depressants (69.2%) and setting limits on quantity (62.2%). Frequent users of harm reduction strategies reported experiencing fewer adverse health consequences (P values < 0.05). Those who reportedly set limits on quantity were at decreased odds of experiencing a bad mood after drug use, sexual difficulties while under drug influence, injuries or fractures while under drug influence, and involvement in fights or being attacked while under drug influence (P values < 0.05). Moreover, those who report frequently avoid mixing depressants were at decreased odds of experiencing headache, loss of consciousness, drop in blood pressure, injuries of fractures, and fights or attacks (P values < 0.05). DISCUSSION AND CONCLUSIONS/CONCLUSIONS:Adoption of dosing-related harm reduction strategies appears to be associated with less drug-related harm among polysubstance-using festival attendees. Findings may inform organisations and policymakers in the designing of harm reduction interventions with this population.

BACKGROUND:Insulin titration is typically done face-to-face with a clinician; however, this can be a burden for patients due to logistical issues associated with in-person clinical care. The Mobile Insulin Titration Intervention (MITI) used basic cell phone technology including text messages and phone calls to help patients with diabetes find their optimal basal insulin dose (OID). OBJECTIVE:To evaluate sociodemographic and clinical correlates of reaching OID, text message response rate, and days needed to reach OID. METHODS:Primary care providers referred patients to MITI and nurses delivered the program. Three multivariable regression models quantified relationships between various correlates and primary outcomes. RESULTS:The sample included 113 patients from 2 ambulatory clinics, with a mean age of 50 years (SD = 10), 45% female, 79% Hispanic, 43% unemployed, and 46% uninsured. In regression models, baseline fasting blood glucose (FBG) was negatively associated with odds of reaching OID and 100% text responses, and positively associated with days to reach OID, p < .05). CONCLUSIONS:Patients with higher baseline FBG levels were less successful across outcomes and may need additional supports in future mHealth diabetes programs. PRACTICAL IMPLICATIONS/CONCLUSIONS:Basic cell phone technology can be used to adjust patients' insulin remotely, thereby reducing logistical barriers to care.

OBJECTIVES/OBJECTIVE:The present study investigates the association between skin color and academic achievement in young Latino students. METHOD/METHODS:= 750) were 4 and 5 years old when they were enrolled (baseline) and were followed through the end of first grade. Structural equation models and bootstrapping mediation tests were conducted to examine the effects of skin color on academic achievement at the end of first grade, partially mediated by academic and social emotional domains of school readiness in prekindergarten or kindergarten. This study considered the intersectionality of ethnicity and gender in the models. RESULTS:The findings showed that for Dominican-origin boys, being "collectively black" was indirectly associated with lower academic achievement in first grade, mediated by lower teacher-rated adaptive behavior in prekindergarten or kindergarten. CONCLUSIONS:Discussion focuses on the need for educational policies and practices to be conscious of phenotypicality bias. (PsycINFO Database Record (c) 2018 APA, all rights reserved).