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Pachankis J.E.,Haven Behavioral | Hatzenbuehler M.L.,Columbia University | Rendina H.J.,Center for Educational Studies and Training CHEST | Safren S.A.,Harvard University | And 2 more authors.
Journal of Consulting and Clinical Psychology | Year: 2015

Objectives: We tested the preliminary efficacy of a transdiagnostic cognitive-behavioral treatment adapted to improve depression, anxiety, and co-occurring health risks (i.e., alcohol use, sexual compulsivity, condomless sex) among young adult gay and bisexual men. Treatment adaptations focused on reducing minority stress processes that underlie sexual orientation-related mental health disparities. Method: Young gay and bisexual men (n = 63; M age = 25.94) were randomized to immediate treatment or a 3-month waitlist. At baseline, 3-month, and 6-month assessments, participants completed self-reports of mental health and minority stress and an interview of past-90-day risk behavior. Results: Compared to waitlist, treatment significantly reduced depressive symptoms (b =-2.43, 95% CI:-4.90, 0.35, p <.001), alcohol use problems (b =-3.79, 95% CI:-5.94,-1.64, p <.001), sexual compulsivity (b =-5.09, 95% CI:-8.78,-1.40, p <.001), and past-90-day condomless sex with casual partners (b =-1.09, 95% CI:-1.80,-0.37, p <.001), and improved condom use self-efficacy (b = 10.08, 95% CI: 3.86, 16.30, p <.001). The treatment yielded moderate and marginally significant greater improvements than waitlist in anxiety symptoms (b =-2.14, 95% CI:-4.61, 0.34, p =.09) and past-90-day heavy drinking (b =-0.32, 95% CI:-0.71, 0.07, p =.09). Effects were generally maintained at follow-up. Minority stress processes showed small improvements in the expected direction. Conclusion: This study demonstrated preliminary support for the first intervention adapted to address gay and bisexual men's co-occurring health problems at their source in minority stress. If found to be efficacious compared to standard evidence-based treatments, the treatment will possess substantial potential for helping clinicians translate LGB-affirmative treatment guidelines into evidence-based practice. © 2015 American Psychological Association.

Levy B.R.,Haven Behavioral | Chung P.H.,University of California at Berkeley | Bedford T.,Johns Hopkins University | Navrazhina K.,York College
Gerontologist | Year: 2014

Ageism has been found to exist throughout a wide variety of societal institutions. Whether it also exists in social networking sites has not been previously considered. To explore this possibility, we conducted a content analysis of each publicly accessible Facebook group that concentrated on older individuals. The site "Descriptions" of the 84 groups, with a total of 25,489 members, were analyzed. The mean age category of the group creators was 20-29; all were younger than 60 years. Consistent with our hypothesis, the Descriptions of all but one of these groups focused on negative age stereotypes. Among these Descriptions, 74% excoriated older individuals, 27% infantilized them, and 37% advocated banning them from public activities, such as shopping. Facebook has the potential to break down barriers between generations; in practice, it may have erected new ones. © 2013 The Author.

Millar B.M.,City University of New York | Wang K.,Yale University | Pachankis J.E.,Haven Behavioral
Journal of Consulting and Clinical Psychology | Year: 2016

Objective: As empirical evidence for the effectiveness of LGB-affirmative psychotherapy emerges, the question of whether some clients may derive greater benefit than others becomes important. The current study investigated whether internalized homonegativity (IH), both explicit and implicit, moderated the efficacy of a cognitive-behavioral intervention designed to improve the mental and sexual health of young gay and bisexual men through facilitating minority stress coping. Method: At baseline, young gay and bisexual men (n = 54) experiencing symptoms of depression and anxiety completed measures of explicit and implicit IH. Participants also completed self-reports of mental health and an interviewer-based assessment of past-90-day risk behavior before and after treatment in a 10-session individual LGB-affirmative intervention. Results: Moderation analyses showed that participants higher in implicit IH experienced greater reductions in depression (b =-2.99, p =.031, 95% confidence interval [CI] [-5.69,-0.29]), anxiety (b =-3.56, p =.014, 95% CI [-6.35,-0.76]), and past-90-day condomless anal sex with casual partners (b =-1.29, p =.028, 95% CI [-2.44,-0.14]). Participants higher in explicit IH experienced greater reductions in past-90-day heavy drinking (b =-0.42, p =.003, 95% CI [-0.69,-0.15]). Conclusions: These findings indicate that greater gains from LGB-affirmative psychotherapy were observed in gay and bisexual men who were higher in IH, particularly when measured implicitly. As the first study that examines factors moderating the efficacy of LGB-affirmative psychotherapy, the present research has important implications for intervention development and highlights the value of incorporating implicit measures into clinical work. © 2016 American Psychological Association.

Ickovics J.R.,Haven Behavioral | Carroll-Scott A.,Drexel University | Peters S.M.,CARE Community Alliance for Research and Engagement | Schwartz M.,Yale University | And 2 more authors.
Journal of School Health | Year: 2014

BACKGROUND: The Institute of Medicine (2012) concluded that we must "strengthen schools as the heart of health." To intervene for better outcomes in both health and academic achievement, identifying factors that impact children is essential. Study objectives are to (1) document associations between health assets and academic achievement, and (2) examine cumulative effects of these assets on academic achievement. METHODS: Participants include 940 students (grades 5 and 6) from 12 schools randomly selected from an urban district. Data include physical assessments, fitness testing, surveys, and district records. Fourteen health indicators were gathered including physical health (eg, body mass index [BMI]), health behaviors (eg, meeting recommendations for fruit/vegetable consumption), family environment (eg, family meals), and psychological well-being (eg, sleep quality). Data were collected 3-6months prior to standardized testing. RESULTS: On average, students reported 7.1 health assets out of 14. Those with more health assets were more likely to be at goal for standardized tests (reading/writing/mathematics), and students with the most health assets were 2.2 times more likely to achieve goal compared with students with the fewest health assets (both p < .001). CONCLUSIONS: Schools that utilize nontraditional instructional strategies to improve student health may also improve academic achievement, closing equity gaps in both health and academic achievement. © 2013, American School Health Association.

Keene D.E.,Haven Behavioral | Cowan S.K.,New York University | Cowan S.K.,Columbia University | Baker A.C.,University of Wyoming
American Journal of Public Health | Year: 2015

Objectives: We analyzed experiences of stigmatization, concealment, and isolation among African American homeowners who were experiencing mortgage strain. Methods: We conducted semistructured interviews between March 2012 and May 2013 with 28 African American homeowners in a northeastern US city who were experiencing mortgage strain. We coded all of the transcripts and reviewed data for codes relating to stigma, sharing information, social support, social isolation, and the meaning of homeownership. Results: Our data showed that mortgage strain can be a concealable stigma. Participants internalized this stigma, expressing shame about their mortgage situation. Additionally, some participants anticipated that others would view them as less worthy given their mortgage trouble. In an effort to avoid stigmatization, many concealed their mortgage trouble, which often led to isolation. This stigmatization, concealment, and isolation seemed to contribute to participants' depression, anxiety, and emotional distress. Conclusions: Stigma may exacerbate stress associated with mortgage strain and contribute to poor mental health, particularly among upwardly mobile African Americans who have overcome significant structural barriers to home ownership. Reducing stigma associated with mortgage strain may help to reduce the health consequences of this stressful life event.

Levy B.R.,Haven Behavioral | Pilver C.E.,0 College Street | Pietrzak R.H.,Yale University
Social Science and Medicine | Year: 2014

Older military veterans are at greater risk for psychiatric disorders than same-aged non-veterans. However, little is known about factors that may protect older veterans from developing these disorders. We considered whether an association exists between the potentially stress-reducing factor of resistance to negative age stereotypes and lower prevalence of the following outcomes among older veterans: suicidal ideation, anxiety, and posttraumatic stress disorder (PTSD). Participants consisted of 2031 veterans, aged 55 or older, who were drawn from the National Health and Resilience in Veterans Study, a nationally representative survey of American veterans. The prevalence of all three outcomes was found to be significantly lower among participants who fully resisted negative age stereotypes, compared to those who fully accepted them: suicidal ideation, 5.0% vs. 30.1%; anxiety, 3.6% vs. 34.9%; and PTSD, 2.0% vs. 18.5%, respectively. The associations followed a graded linear pattern and persisted after adjustment for relevant covariates, including age, combat experience, personality, and physical health. These findings suggest that developing resistance to negative age stereotypes could provide older individuals with a path to greater mental health. © 2014.

Axelrod S.R.,Yale University | Perepletchikova F.,Yale University | Holtzman K.,Haven Behavioral | Sinha R.,Yale University
American Journal of Drug and Alcohol Abuse | Year: 2011

Background: Dialectical behavior therapy (DBT) identifies emotion dysregulation as central to the dangerous impulsivity of borderline personality disorder (BPD) including substance use disorders, and DBT targets improved emotion regulation as a primary mechanism of change. However, improved emotion regulation with DBT and associations between such improvement and behavioral outcomes such as substance use has not been previously reported. Objective: Thus, the goal of this study was to assess for improvement in emotion regulation and to examine the relationship between improvements in the emotion regulation and substance use problems following DBT treatment. Method: Emotion regulation as assessed by the Difficulties in Emotion Regulation Scale, depressed mood as assessed by the Beck Depression Inventory, and their associations with substance use frequency were investigated in 27 women with substance dependence and BPD receiving 20 weeks of DBT in an academic community outpatient substance abuse treatment program. Results: Results indicated improved emotion regulation, improved mood, and decreased substance use frequency. Further, emotion regulation improvement, but not improved mood, explained the variance of decreased substance use frequency. Conclusion and Scientific Significance: This is the first study to demonstrate improved emotion regulation in BPD patients treated with DBT and to show that improved emotion regulation can account for increased behavioral control in BPD patients. Significance and future research: Emotion regulation assessment is recommended for future studies to further clarify the etiology and maintenance of disorders associated with emotional dysregulation such as BPD and substance dependence and to further explore emotion regulation as a potential mechanism of change for clinical interventions. © 2011 Informa Healthcare USA, Inc.

Levy B.R.,Haven Behavioral | Slade M.D.,Yale University | Chung P.H.,University of California at Berkeley | Gill T.M.,Yale University
Journals of Gerontology - Series B Psychological Sciences and Social Sciences | Year: 2015

Objective. To examine whether the age stereotypes of older individuals would become more negative or else show resiliency following stressful events and to examine whether age-stereotype negativity would increase the likelihood of experiencing a stressful event (i.e., hospitalization). Method. Age stereotypes of 231 participants, 70 years and older, were assessed across 10 years, before and after the occurrence of hospitalizations and bereavements. Results. Age-stereotype negativity was resilient despite encountering stressful events. In contrast, more negative age stereotypes were associated with a 50% greater likelihood of experiencing a hospitalization. Discussion. The robustness of negative age stereotypes was expressed in their capacity to resist change as well as generate it. © 2014 The Author.

The last two decades have witnessed widespread demolition of public housing and a large-scale relocation of public housing residents. Much of the current literature has examined the impact of demolition on relocated residents, focusing primarily on individual outcomes such as employment, housing quality, and health. This article examines the potential collective consequences of relocation by using data from 40 in-depth interviews conducted with relocated public housing residents in Atlanta, Georgia, to examine experiences of civic engagement and tenant activism before and after relocation. Participants describe frequent experiences of civic engagement and tenant activism in their public housing communities prior to demolition and also discuss how these collective actions often translated into meaningful gains for their communities. Participants also describe challenges associated with reestablishing these sources of collective agency in their new, post demolition, private-market rental communities where opportunities for civic engagement and tenant activism were perceived to be limited, where stigma was a barrier to social interaction, and where they experienced significant residential instability. © 2015 Virginia Polytechnic Institute and State University

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