All Articles

Faith Carini-Graves

Hillside Children's Center: Youth ACT, USA

Youth Assertive Community Treatment (Youth ACT) is a rising novel community based care model for youth with pervasive psychiatric illness. This type of intensive treatment follows specific principles which include an interdisciplinary team, small caseloads, 24/7 access to the team, and treatment given in the patient’s home or community. A variety of studies have reviewed outcomes and generally report that patients have statistically significant improvements in symptoms. However, much is still not well understood about how this model works, how it is applied, or about the clinical significance of the models. There have been relatively few case studies written outlining how patients respond to the Youth ACT interventions. To better understand Youth ACT, how it works, and what patients may benefit from this level of treatment, a clinical scenario is discussed. This clinical scenario involves a 15-year-old male youth with bipolar 1 disorder, psychosis and ongoing substance use. This case is indicative of the severe psychiatric symptoms that the Youth ACT teams address in the community. After case presentation, outcomes are discussed and significant clinical improvement is reflected upon.

Scott M. Barrera^*, Kristin Perrone, Stephanie Simon-Dack

Ball State University, IN, USA

Introduction: The purpose of this study was to examine the effect of cultural affirmations on the neural activity of Latinx individuals. Latinx participants viewed threatening stimuli after completing a cultural affirmation intervention. We also examined the impact of identity salience on the effectiveness of cultural affirmations.

Method: To understand relationships between these variables, 28 Latinx participants (19 female) viewed photos of angry and neutral white, non-Latinx, faces while event-related potentials (ERPs) were recorded before and after engaging in a cultural affirmation writing task.

Results: Scalp map assessment showed large effects for N2 in the frontal region. Repeated measures ANOVA indicated average N2 amplitudes were higher following the cultural affirmation, specifically in the right hemisphere. As predicted, the relationship was no longer significant when identity salience was controlled.

Discussion: After engaging in cultural affirmations, Latinx participants’ N2 amplitudes increased, indicating the affirmation increased the availability of preconscious social categorization resources to allocate to the angry and neutral white, non-Latinx, faces. However, when identify salience was controlled, there were no changes in available neural resources.

Conclusion: Theoretical and clinical implications are discussed as well as future directions for researchers on how cultural affirmations may be utilized among Latinx individuals with consideration to identity salience.

Momoh Lawal Hussaini^1*, Madueke Akachukwu²

¹General Education Department, School of Arts and Sciences, American university of Nigeria, Yola, Nigeria

²Communication and Multimedia Design Department, School of Arts and Sciences, American University of Nigeria, Yola, Nigeria

This study examined the influence of internet addiction on the psychological well-being of students in the American University of Nigeria (AUN), Yola, Adamawa State, Nigeria in the post Covid era. University students are particularly vulnerable to internet addiction due to the pressures of academic life, social expectations, and the widespread availability of digital technology. The study employs a quantitative cross-sectional survey design, which allows for the collection of data at a single point in time. The study administered 100 questionnaires due to the regulatory admission of students in line with the American styled education. A combination of convenience sampling and snowball sampling was employed to recruit participants for the study. Data analysis included descriptive statistics (means, percentages) and inferential statistics (Pearson’s r, regression, t-tests/ANOVA) performed using SPSS, with a significance level of p < 0.05. The results indicate that internet addiction negatively impacts all six dimensions of psychological well-being, with environmental mastery and self-acceptance showing the strongest correlations. A multiple regression analysis was conducted to determine whether internet addiction predicts psychological well-being dimensions. The regression model was statistically significant (F (6, 93) = 7.85, p < 0.001), with an R² of 0.45, indicating that internet addiction accounts for 45% of the variance in psychological well-being. Early intervention and support are essential for addressing internet addiction and promoting psychological well-being among university students. Essentially, the research demonstrates a clear link between internet addiction and compromised psychological well-being in university students. This therefore highlights the need for awareness, prevention strategies, and support systems to help students maintain a healthy balance between their online and offline activities.

Manu S Bala^2*, Nisha Dhanabalsamy^2,3, Bill Lucia¹

¹OptMyCare Inc, Texas, USA

²Texas Research Institute, Texas, USA

³PPG Healthcare PA, Texas, USA

Background: Value-based care systems are increasingly replacing fee-for-service models, as the latter has proven unsustainable. Mental health and their implications on patients are starting to get significant attention in the past decade. Unrecognized mental illness (MI) and their impact on chronic diseases could have a significant impact on disease progression and cumulative cost to the health system.

Study design: We have analyzed a large cohort of patients using OptMyCare’s risk stratification system. Predictive analytics using proprietary algorithms were implemented to estimate cost and disease progression in high-risk patients with and without MHD across the cohort. Cost modeling and outputs are resulted as cost per member across chronic conditions with & without MIs. The members with & without MIs were propensity matched for demographics, disease severity and SDOH.

Key Results: Members with MI in 8 of the 9 chronic conditions demonstrated a significant increase in cumulative cost. There was a 64% mean increase in claims cost per member with MIs.

Conclusion: Utilizing validated algorithms to identify high-risk MI members and implementing disease mitigation strategies targeted at chronic conditions in addition their MI could result in improved clinical outcomes and bend the cost curve.

Bakwanamaha Maha Alain^1*, Muhindo Vunyatsi Faustin², Kataka Asifiwe Olga¹

¹Faculty of Medicine, Catholic University of Graben, Butembo, Democratic Republic of the Congo

²Department of Gynecology & Obstetrics, Oicha General Referral Hospital, Oicha, Democratic Republic of the Congo

In the limited resources settings of sub-Saharan Africa generally and specifically in a region affected by armed conflict, diagnosis and management of congenital malformations pose significant challenges. This commentary on “Septate uterus discovery during an emergency cesarean section in the North Eastern of the Democratic Republic of Congo: A case report and review of the literature”, examines the diagnostic challenges, the impact of armed conflict on maternal health and the management strategies. In addition, it highlights the importance of accurate diagnosis and effective management in obstetric care and calls for building of research networking to improve the detection and treatment of congenital malformation in rural armed conflict zones with limited healthcare resources.

John Tawa, Milena E. Insalaco^*, Nancy Jiang^*, Alejandra Lorenzo^*

Department of Psychology and Education, Mount Holyoke College, South Hadley, MA, USA

^*Denotes Equal Authorship and Contribution

We developed a post-pandemic wellness scale (PPWS) to help understand some of the specific reasons why the pandemic may have differentially impacted the mental health of people from various sociodemographic groups. With an initial sample of 404 adults (74.3% White) collected in 2021 and in close proximity to the pandemic, we established adequate fit for a four-factor model of post-pandemic experiences including financial stress, social stress, and existential stress, and positive reframing experiences, which each predicted depression in the expected directions. In this initial sample, we found some evidence of race-based differences in post-pandemic experience as they related to mental health. In the interest of replicating these findings with more robust samples of non-White racial and ethnic groups, we collected a second sample of 462 adults (26% White) in 2024. Although we failed to replicate our race-based findings, we were able to verify the fit of the four-factor model. Moreover, some exploratory findings related to participant demographics were consistent across sample cohorts, including the influences of age and gender on post-pandemic experiences. In addition, all four PPWS subscales continued to predict depression in the expected directions. Thus, in two samples assessed in proximity to and more distally from the fallout of the coronavirus pandemic, we find evidence for the psychometric stability and predictive validity of our scale for mental health. We expect this scale to be useful to future researchers and clinicians attending to the pervasive impact of the pandemic on mental health and wellbeing.

Loyiso Kosana¹, Hermanus B. Grobler^1,2*, Mpho Maotoana³

¹North-West University, South Africa

²KIMEP University, Republic of Kazakhstan

³University of Limpopo, South Africa

Objective: This study aimed to determine whether there was a significant relationship between premature ejaculation (PE) and anxiety symptoms amongst South African males. In addition, the study conducted a preliminary analysis to examine whether ethnicity and age acted as moderating variables.

Method: A quantitative, correlational design was used with 175 men between the ages of 18 and 70 years of age who had joined the Men’s Clinic International private Facebook group.

Results: Regarding hypothesis one, the results indicate a significant correlation between PE and anxiety symptoms. The second hypothesis was also accepted, namely that that the correlation between anxiety and PE is stronger in white and mixed compared to black ethnicity groups. The third hypothesis, namely that age was a moderating variable between premature ejaculation and anxiety symptoms, did not change the direction of the relationship, and was therefore rejected.

Conclusion: The study provides new information to professionals when it comes to understanding men who experience PE and present with anxiety symptoms.

Contribution of the study: When treating individuals with anxiety-related premature ejaculation, the importance of cultural appropriateness and sensitivity should be emphasized. Understanding how ethnicity and age contribute to the presentation and interpretation of the disorder can be used to explain and offer treatment methods that would not perpetuate negative connotations regarding psychotherapy. Psychotherapy will become a conducive space for males where there will be respect, decreased experience of shame, and enabling vulnerability. With this approach, the male experience and perspective to therapy may become positive. Once the anxiety-related premature ejaculation is successfully treated, men will be able to confidently refer others for further assistance.

In addition, this approach will further yield effective collaborations between mental health practitioners and medical clinics such as Men’s Clinic International. It will enable further research studies pioneered by physicians and psychologists with the aim to explore sexual dysfunctions at length. The vision will be to ensure updated definitions of sexual dysfunctions, in different contexts by considering age, ethnicity and possibly medical conditions.

Katelynd Campo

MSc, Canada.

An abundant amount of research on mental health and more specifically the social barriers faced by Individuals with Mental Health Disabilities (IMHD) exists regarding access to adequate housing/community and employment. What research lacks in precision concerns incidents of criminality amongst IMHD. Research has concluded decades over that IMHD are more at-risk of finding themselves in situations of inadequate employment and inadequate housing/community. To which, research has also found most often leads to increased chances of addiction, welfare dependency, negative peer associations/influences, lack of positive role models; situations of which in general lend greater opportunities for criminal involvement. This paper will in a literature review, seek to understand and analyze why IMHDs make-up an overrepresented population within the criminal justice system, and whether or not there is a correlation between criminality perpetuated by IMHD in relation to situations of inadequate housing/community and inadequate employment amongst said population.

Sana Vora^1*, Christopher M. King¹, Rachel Bomysoad¹, Jill Del Pozzo²

¹Department of Psychology, Montclair State University, Montclair, NJ, USA

²Icahn School of Medicine at Mount Sinai, New York, NY, USA

Higher education students have experienced increased stressors and behavioral health problems during the COVID-19 pandemic. The current study further investigated such phenomena in a sample of university students collected between June 2020 to December 2021. Students (N = 1,441) from a Mid-Atlantic public university were recruited via email lists and a psychology department research participant pool. The participants completed an online survey with items pertaining to demographic factors, biopsychosocial stressors, and measures of behavioral health functioning. All variables were examined descriptively, and regression analyses were used to examine hypothesized cross-sectional relationships between demographic factors and biopsychosocial stressors, on the one hand, and behavioral health functioning, on the other. Experiencing notable levels of biopsychosocial stressors was common, though a linear trend across semesters was not observed with respect to behavioral health functioning. Gender was the most consistent demographic predictor of behavioral health functioning, whereas the most common biopsychosocial stressor predictors for behavioral health functioning were stress/worry, social isolation, discrimination, and prior mental health services. Results corroborate and extend prior research evidencing notable levels of biopsychosocial stressors and behavioral health problems reported by higher education students during the COVID-19 pandemic. Implications for campus administrators and behavioral health providers concern vulnerabilities for a range of pandemic-time challenges being experienced by their constituents to which to attend.

Kathryn Burrows

National Coalition of Independent Scholars, Portland, Oregon, USA

Henrique M. Lapo¹, Mara Patrícia T. Chacon-Mikahil^1,2, Amanda V. Sardeli^1,2,3*

¹Laboratory of Exercise Physiology, Scholl of Physical Education, University of Campinas SP, Brazil

²Gerontology Program – Scholl of Medical Sciences, University of Campinas, SP, Brazil

³Department of Inflammation and Ageing, University of Birmingham, Birmingham, UK

Objective: Although heart rate variability (HRV) has been a useful and accessible tool to monitor recovery from athletes’ training, it is not clear if it reflects changes in psychophysiological factors. The aim of these study is to identify, through a systematic review and meta-analyses, whether the psychophysiological factors are associated with alteration in heart rate variability (HRV) in sports.

Methods: We searched in four databases (PubMed; Scopus; Cochrane; Web of Science) for studies assessing the association of root mean square of successive differences between normal heartbeats (RMSSD) with a variety of psychophysiological outcomes in athletes of any modality.

Results: After initial search, we selected 12 studies with 27 study arms for analysis. First, we combined 19 study arms in a meta-analysis testing the correlation between HRV and the psychophysiological factors at baseline (Meta 1). Second, we combined 9 study arms in a meta-analysis testing the correlation between HRV and changes in psychophysiological factors within a training period (Meta 2). We analyzed the following psychophysiological factors: stress, sleep deprivation, fatigue, muscular soreness, mood, and hormonal changes (cortisol). summary, there was no significant association between the HRV and the psychophysiological factors in both meta-analyses (Meta 1: r = 0.084, P = 0.167; I² = 20%, P-value for heterogeneity = 0.215; and Meta 2: r = 0.268, P = 0.131, I² = 65.2%, P-value for heterogeneity = 0.003).

Conclusion: We were not able to confirm the association between HRV and any psychophysiological factors by meta-analysis, but it could be due to inherent limitations of this type of analyses. To test whether this associations truly exist, future meta-analysis will need to include studies with much larger sample size and standardize the methods between studies to reduce heterogeneity. Longitudinal studies will be fundamental to understand the causal relationship between these factors to ultimately improve training monitoring tools for better recovery in athletes.

Marcelo Nvo-Fernández^1*, Valentina Miño-Reyes¹, Gastón González-Cabeza², Sofia Gálvez-Cienfuegos¹, Martina Ignacia C.C²

¹Laboratory of Methodology, Behavioural Sciences and Neuroscience, Faculty of Psychology, Universidad de Talca, Talca, Chile

²Universidad Autónoma de Chile, Talca, Chile

Sexual abuse, especially when it occurs during childhood, is an experience that causes deep and lasting harm. Currently, its study as a risk factor for the development of trauma-related pathologies is of great relevance. In 2018, Complex Post-Traumatic Stress Disorder (CPTSD) was officially recognized as a distinct syndrome in the 11th Revision of the International Classification of Diseases (ICD-11), with the aim of distinguishing it from neurotic disorders secondary to stressful situations, somatoform disorders, and those specifically associated with stress. The inclusion of CPTSD in the ICD-11 marked the culmination of two decades of research dedicated to understanding its symptoms, treatments, and risk factors. This article aims to conduct a meta-analysis that explores the relationship between sexual abuse and the development of CPTSD. Fifteen studies were selected for analysis, and the results revealed several key risk factors associated with the development of CPTSD, with the primary one being childhood sexual abuse (k = 15; OR = 3.007).

Helene Vossos^1*, Ozioma Nwosu-Izevbekhai²

¹Associate Professor of Nursing, PMHNP Program Coordinator, University of St. Augustine for Health Sciences, St. Augustine, Florida, USA

²Assistant Professor in Residence, University of Nevada, Las Vegas, USA

Objective: The purpose of this manuscript is for readers to understand the differences between bipolar and unipolar mood disorders. Readers will be able to apply evidence-based screening tools to differentiate in the diagnosis of bipolar versus unipolar depressive disorders. The goal is to increase diagnostic accuracy of mood disorders with the opportunity to provide treatment that will lead to improved patient outcomes.

Method: Review of literature discovered 13 articles that were pertinent with three major themes. One theme showed up to 62% of bipolar disorder cases were missed or undiagnosed upon the first evaluation, second theme showed 7% to 70% of individuals were misdiagnosed with adverse outcomes and third theme discovered the importance of specialty psychiatric training, education and the use of evidence-based screening tools combined with clinical judgement improved the accuracy of the correct mood disorder diagnosis.

Findings: In mood disorders, if left untreated or misdiagnosis occurs, the risk of suicide is higher (29.2%) in bipolar affective disorder, versus unipolar major depressive disorder (17.3%).

Implications for clinical practice: Recommendation for the use of evidence-based screening tools are clinical best practices for screening and diagnosing bipolar affective disorders with a statistical significance of 95%. Misdiagnosis is common up to 70% and the implications of timely rapid assessments allow for prompt interventions that has shown to halt and/or prevent mental health conditions to worsen, reducing risk of emergency situations.

Anthony Ezerioha¹, Masoud Mohammadnezhad^2*

¹School of Allied Health and Social Care, Faculty of Health, Medicine and Social Care, Angelia Ruskin University, Cambridge, UK

²Faculty of Health, Education and Life Sciences, School of Nursing and Midwifery, Birmingham City University, Birmingham, UK

Introduction: Adolescents recovering from substance use problems face significant psycho-social challenges. These challenges can affect their recovery progress, overall well-being, and integration into the society. Due to paucity studies, this study aimed to identify the perceptions and attitude towards recovery among adolescents participating in drug addiction interventions.

Methods: This systematic review study applied a complete search of relevant databases, including Scopus, Embase, Cinahl, and PubMed/Medline using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The search was limited to articles published in English language, between 2013 and 2023, and focused on adolescents drug addiction. Twelve articles were critically appraised using Critical Appraisal Skills Programme (CASP) for qualitative studies and Joanna Briggs Institute (JBI) tools. The results were synthesised using a thematic analysis.

Results: The findings identify that adolescents in addiction recovery face several challenges, including stigmatisation, social isolation, self-doubt, and difficulties accessing and maintaining treatment. The findings also point out that supportive relationships, culturally sensitive treatment approaches and interventions to combat self-stigma can play a critical role in promoting resilience and recovery for adolescents in recovery.

Conclusion: The comprehensive review brings us up to speed on the challenging experiences young people recovering from addiction in different addiction intervention go through, it underscores the importance of supportive relationships and encourages strengthening of interventions that mitigate against stigmatization.

Sarah C. Haynes^1,2*, James P. Marcin^1,2, Peter Yellowlees³, Stephanie Yang¹, Jeffrey S. Hoch^4,5

¹Department of Pediatrics, University of California Davis, Sacramento, California, USA

²Center for Health and Technology, University of California Davis, Sacramento, California, USA

³Department of Psychiatry, University of California Davis, Sacramento, California, USA

⁴Department of Public Health Sciences, University of California Davis, Sacramento, California, USA

⁵Center for Healthcare Policy and Research, University of California Davis, Sacramento, California, USA

Background: People living in rural communities experience significant barriers accessing mental health care, including a shortage of psychiatrists and other behavioral health specialists. Telemedicine has the ability to improve access for these populations by allowing psychiatrists in urban settings to treat rural patients over video. However, start-up costs may hinder implementation of new tele-psychiatry programs.

Materials and Methods: We created a model to estimate the point at which tele-psychiatry would financially break even based on estimates of improved access to outpatient care for people with schizophrenia and bipolar disorder. We demonstrate how our model can be used with an example of a tele-psychiatry program serving five rural Indian Health Services clinics in California.

Results: When reimbursement for psychiatric services provided over telemedicine is relatively low compared to reimbursement for hospitalization visits, changes in the ratio of hospitalizations to telemedicine visits have very little impact on required hospitalization improvement.

Conclusions: Tele-psychiatry programs are likely to break even within the first three years when providing psychiatry services to a rural community with a scarcity of mental health services. Our findings are important because they indicate that the cost of improving access to tele-psychiatry services is likely low compared to the potential cost savings associated with reduced hospitalizations for people with severe persistent mental illness.

Elizabeth Levin^1*, Husam Aburub²

¹Department of Psychology, Laurentian University, Sudbury, Ontario, Canada

²Health Sciences North, Sudbury, Ontario, Canada

Hospital emergency departments in Ontario, have become a common place for patients with mental health problems to seek treatment. Studies report healthcare providers have limited knowledge and competency to provide optimal care for patients with mental health problems. As a result, these patients are at risk of poor hospital experiences and treatment outcomes. In addition, emergency staff report considering patients with mental health problems lower priority to other patients. This paper reviews the existing literature and examines the challenges surrounding patients with mental health problems seeking treatment in emergency rooms and how it leads to sub-optimal care. Strategies are then shared to overcome these challenges by changing emergency department experiences for mental health patients seeking treatment.

Sehrish Arshad^1*, Muhammad Afzal², Hajra Sarwar³

¹Doctors Hospital College of Nursing and Allied Health Sciences, Lahore, Pakistan

²Director Academics Faculty of Allied Health Sciences, University of Lahore, Pakistan

³University of Lahore, Pakistan

Introduction: Postpartum depression (PPD) is a major public health issue among females after giving birth to the baby, characterized by low mood, feeling of guilt and suicide. When left untreated, it has the potential for a profound negative impact on mothers, children and families. The efficacy of interpersonal psychotherapy (IPT) in addressing depression has been well-documented. However, the impact of IPT on PPD remains inadequately substantiated, particularly within the context of Pakistan, where data pertaining to its effectiveness remains limited.

Objective: The aim of study was to assess the level of depression in postpartum females and evaluate the effects of IPT on PPD among females at tertiary care hospital Lahore.

Methods: A Randomized controlled trial (RCT) was conducted at the Services Hospital Lahore from September 2021 to the same month in 2023. Subjects (n=110) were screened using the hamilton depression rating scale (HDRS) and divided equally in intervention group and control group to get eight sessions of individual based IPT versus routine care. Data was analyzed using SPSS version 21, intergroup comparison was done by Mann Whitney U test for intra group comparison Wilcoxon Signed Rank test was used, with 95% Confidence Interval (CI) and 5% level of significance. Significance of result showed with p value <0.05.

Results: Prevalence of PPD among female was observed 82%. Upon receiving IPT, females exhibited a statistically significant reduction (p<0.001) in scores indicative of mild depression, from 48 (87.3%) to 5(9.1%), as well as for moderate depression, from 7(12.7%) to 1(1.8%). Furthermore, following the IPT sessions, marked improvements were noted within the intervention group across various domains including depressed mood p<0.001, CI (0.000, 0.027), feelings of guilt p<0.001, CI (0.000, 0.027), early night insomnia p<0.008, CI (0.000, 0.043), impaired work and activities p<0.05, CI (0.072, 0.200), and insight p<0.001, CI (0.000, 0.027). Conversely, the control group did not exhibit any significant alterations in these parameters.

Conclusion: The results indicate a concerning prevalence rate of PPD among the study sample with many cases remaining undiagnosed and untreated. More positively, the study demonstrates the potential of IPT as an effective method to mitigate mild to moderate PPD. This research suggests the incorporation of IPT into therapeutic models could result in timely, potentially preventive interventions and lessen the occurrence of severe complications.

Shervin Assari^1,2,3*, Payam Sheikhattari^4,5,6

¹Department of Internal Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA

²Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA

³Department of Urban Public Health, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA

⁴Center for Urban Health Disparities Research and Innovation, Morgan State University, Baltimore, MD, USA

⁵The Prevention Sciences Research Center, School of Community Health and Policy, Morgan State University, Baltimore, MD, USA

⁶Department of Public and Allied Health Sciences, School of Community Health and Policy, Morgan State University, Baltimore, MD, USA

Background: Exposure to stressful life events (SLEs) can upset balance and affect the healthy brain development of children and youths. These events may influence substance use by altering brain reward systems, especially the nucleus accumbens (NAc), which plays a key role in motivated behaviors and reward processing. The interaction between sensitization to SLEs, depression, and substance use might vary between male and female youths, potentially due to differences in how each sex responds to SLEs.

Aims: This study aims to examine the effect of sex on the relationship between SLEs, Nucleus Accumbens activity, and substance use in a nationwide sample of young individuals.

Methods: We utilized data from the Adolescent Brain Cognitive Development study (ABCD), a longitudinal study of pre-adolescents aged 9–10 years, comprising 11,795 participants tracked over 36 months. Structured interviews measuring SLEs were conducted using the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS). Initial linear regression analyses explored if SLEs could predict volumes of the right and left NAc. Subsequently, Cox regression models were used to investigate how SLEs and NAc volume might predict the initiation of tobacco and marijuana use, with the analysis stratified by sex to address potential sex differences.

Results: Our findings reveal that SLEs significantly predicted marijuana use in males but not in females, and tobacco use was influenced by SLEs in both sexes. A higher number of SLEs was linked with decreased left NAc volume in males, a trend not seen in females. The right NAc volume did not predict substance use in either sex. However, volumes of both the right and left NAc were significant predictors of future tobacco use, with varying relationships across sexes. In females, an inverse relationship was observed between both NAc volumes and the risk of tobacco use. In contrast, a positive correlation existed between the left NAc volume and tobacco and marijuana use in males, with no such relationship for females.

Conclusion: This study underscores that the associations between SLEs, NAc volume, and subsequent substance use are influenced by a nuanced interplay of sex, brain hemisphere, and substance type.

Shervin Assari^1,2*, Babak Najand³, Payam Sheikhattari^4,5,6

¹Department of Internal Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA, USA

²Department of Urban Public Health, Charles R Drew University of Medicine and Science, Los Angeles, CA, USA

³Marginalization-related Diminished Returns Center, Los Angeles, CA, USA

⁴Center for Urban Health Disparities Research and Innovation, Morgan State University, Baltimore, MD, USA

⁵The Prevention Sciences Research Center, School of Community Health and Policy, Morgan State University, Baltimore, MD, USA

⁶Department of Behavioral Health Science, School of Community Health and Policy, Morgan State University, Baltimore, MD, USA

Background: While adversities across domains of finance, race, family, and life may operate as risk factors for initiation of substance use in adolescents, the influence of these factors may vary across racial groups of youth. Unfortunately, the existing knowledge is minimal about racial differences in the types of adversities that may increase the risk of subsequent substance use initiation during the transition into adolescence.

Aim: To compare racial groups for the effects of adversities across domains of finance, race, family, and life on subsequent substance use initiation among pre-adolescents transitioning into adolescence.

Methods: In this longitudinal study, we analyzed data from 6003 non-Latino White and 1562 non-Latino African American 9-10-year-old children transitioning into adolescence. Data came from the Adolescent Brain Cognitive Development (ABCD) study. Participants were followed for up to thirty-six months as they transitioned to adolescence. The independent variables were adversities related to the domains of finance, race, family, and life. The primary outcomes were time to first tobacco or marijuana use. Age, puberty, and gender were confounders. Cox regression models were used for data analysis.

Results: For White youth, tobacco use was under influence of having two parents in the household (HR = .611; 95% CI = .419-.891), parental education (HR = .900; 95% CI = .833-.972), household income (HR = .899; 95% CI = .817-.990), racial stress (HR = 1.569; 95% CI = 1.206-2.039), and life stress (HR =1.098 ; 95% CI = 1.024-1.178) and marijuana use was under influence of neighborhood income (HR = .576; 95% CI = .332-.999) and financial stress (HR =4.273; 95% CI = 1.280-17.422). No adverse condition predicted tobacco or marijuana use of African American youth.

Conclusion: The effects of adversities on substance use depend on race. While various types of adversities tend to increase subsequent initiation of tobacco and marijuana, such factors may be less influential for African American adolescents, who experience more of such adversities. What is common may become normal.

Sheldon X. Zhang¹, Rumi Kato Price^2*

¹School of Criminology and Criminal Justice Studies, University of Massachusetts at Lowell, Lowell, Massachusetts, USA

²Department of Psychiatry, School of Medicine, Washington University in St. Louis, St. Louis, Missouri, USA

The global campaign against human trafficking, also known as trafficking in persons, has gained much momentum in the past two decades. Although psychiatric and physical illness sequela of human trafficking are well documented, the research community continues to struggle over such foundational questions as what specific activities or experiences count as trafficking-in-persons victimization and how best to obtain representable and generalizable data on experiences of people who are trafficked. We provide a brief review of major efforts to define trafficking in persons to establish prevalence estimates to date. We argue for consensus on key clinical and public health indicators, resembling the Diagnostic and Statistical Manual (DSM) approach to enable common and systematic knowledge building and comparability across studies.

Rifath Ara Alam Barsha¹, Babak Najand², Hossein Zare^3,4, Shervin Assari^5,6,7*

¹School of Community Health & Policy, Morgan State University, Baltimore, MD, USA

²Marginalization Related Diminished returns, Los Angeles, CA, USA

³Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA

⁴University of Maryland Global Campus, Health Services Management, Adelphi, Maryland, USA

⁵Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA, USA

⁶Department of Internal Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA, USA

⁷Department of Urban Public Health, Charles R Drew University of Medicine and Science, Los Angeles, CA, USA

Objectives: Although educational attainment is a major social determinant of health, according to Marginalization-related Diminished Returns (MDRs), the effect of education tends to be weaker for marginalized groups compared to the privileged groups. While we know more about marginalization due to race and ethnicity, limited information is available on MDRs of educational attainment among US immigrant individuals.

Aims: This study compared immigrant and non-immigrant US adults aged 18 and over for the effects of educational attainment on subjective health (self-rated health; SRH).

Methods: Data came from General Social Survey (GSS) that recruited a nationally representative sample of US adults from 1972 to 2022. Overall, GSS has enrolled 45,043 individuals who were either immigrant (4,247; 9.4%) and non-immigrant (40,796; 90.6%). The independent variable was educational attainment, the dependent variable was SRH (measured with a single item), confounders were age, gender, race, employment and marital status, and moderator was immigration (nativity) status.

Results: Higher educational attainment was associated with higher odds of good SRH (odds ratio OR = 2.08 for 12 years of education, OR = 2.81 for 13-15 years of education, OR = 4.38 for college graduation, and OR = 4.83 for graduate studies). However, we found significant statistical interaction between immigration status and college graduation on SRH, which was indicative of smaller association between college graduation and SRH for immigrant than non-immigrant US adults.

Conclusions: In line with MDRs, the association between educational attainment and SRH was weaker for immigrant than non-immigrant. It is essential to implement two sets of policies to achieve health inequalities among immigrant populations: policies that increase educational attainment of immigrants and those that increase the health returns of educational attainment for immigrants.

Loren Henderson^1*, Ruby Mendenhall², Meggan J Lee³

¹The School of Public Policy, University of Maryland, Baltimore County, Baltimore, MD, USA

²Department of Sociology, Department of African American Studies, Carle Illinois College of Medicine, IL, USA

³Carle Illinois College of Medicine, Urbana, IL, USA

Shervin Assari^1,2,3*, Babak Najand⁴, Alexandra Donovan¹

¹Department of Internal Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA, USA

²Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA, USA

³Department of Urban Public Health, Charles R Drew University of Medicine and Science, Los Angeles, CA, USA

⁴Marginalization related Diminished Returns Center, Los Angeles, CA, USA

Background: Racism is shown to diminish the protective effects of family socioeconomic position (SEP) resources for racial minorities compared to the majority groups, a pattern called minorities’ diminished returns. Our existing knowledge is minimal about diminished returns of family SEP indicators on reducing exposure to adverse life events among children transitioning into adolescence. Aim: To compare diverse racial groups for the effects of family income and family structure on exposure to adverse life events of pre-adolescents transitioning to adolescence.

Methods: In this longitudinal study, we analyzed data from 22,538 observations belonging to racially diverse groups of American 9–10-year-old children (n = 11,878) who were followed while transitioning to adolescence. The independent variables were family income and family structure. The primary outcome was the number of stressful life events with impact on adolescents, measured by the Life History semi-structured interview. Mixed-effects regression models were used for data analysis to adjust for data nested to individuals, families, and centers.

Results: Family income and married family structure had an overall inverse association with children’s exposure to adverse life events during transition to adolescence. However, race showed significant interactions with family income and family structure on exposure to adverse life events. The protective effects of family income and married family structure were weaker for African American than White adolescents. The protective effect of family income was also weaker for mixed/other race than White adolescents.

Conclusion: While family SEP is protective against children’s exposure to adverse life events, this effect is weaker for African American and mixed/other race compared to White youth.

Kaishi Imatani¹, Takeshi Inoue^2*, Yuji Oto¹, Tasuku Kitajima², Ryoko Otani², Satoshi F Nakashima³, So Kanazawa⁴, Masami K. Yamaguchi⁵, Ryoichi Sakuta², Tomoyo Matsubara¹

¹Department of Pediatrics, Dokkyo Medical University Saitama Medical Center, Koshigaya, Saitama, Japan

²Child Development and Psychosomatic Medicine Center, Dokkyo Medical University Saitama Medical Center, Koshigaya, Saitama, Japan

³Department of Psychological Sciences, University of Human Environments, Okazaki, Aichi, Japan

⁴Department of Psychology, Japan Women’s University, Kawasaki, Kanagawa, Japan

⁵Department of Psychology, Chuo University, Hachioji, Tokyo, Japan

Developmental prosopagnosia is a disorder of facial recognition that begins during early childhood in the absence of acquired central nervous system disease. We report the case of a 15-year-old female with developmental prosopagnosia as measured by the 20-item Prosopagnosia Index and Cambridge Face Memory Test who ultimately developed generalized anxiety disorder and depression despite relatively normal social and psychological function during early childhood. In elementary school, the case patient adapted by learning alternative ways to identify others, such as by clothing and hairstyle, but this became more difficult in junior high school due to the requirement for school uniforms and regulations on hairstyle. This difficulty in turn led to interpersonal problems that ultimately resulted in symptoms of generalized anxiety disorder and depression, such as headache and sleep dysfunction. People with developmental prosopagnosia are generally prone to having depressed and anxious feelings. However, to the best of our knowledge, this is the first case report of anxiety disorder or depression related to developmental prosopagnosia. This comorbidity may be relatively common, especially in ethnically homogeneous countries with strict school regulations on personal appearance such as Japan.

Seth Davin Norrholm^1,2*, Jessica L. Maples-Keller³, Barbara O. Rothbaum³, Chad C. Tossell²

¹Neuroscience Center for Anxiety, Stress, and Trauma, Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, Michigan, USA

²Department of Behavioral Sciences and Leadership, United States Air Force Academy, Colorado Springs, Colorado, USA

³Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia, USA

The use of remote piloted aircraft (RPAs) has been a part of military operations for decades and this type of service can present its own unique constellation of combat experiences and psychological consequences. The RPA crewmember experience has typically involved surveillance, targeting, striking, and after-battle assessments of individuals of interest to a host country or agency from a distance that can span several thousand miles. These operators are engaged in physically remote activities that carry a significant degree of intimacy due to the live, high-resolution, high-fidelity images and sounds that are available to the combatants in real-time. The potential psychological consequences of this type of military occupational specialty can include the symptoms of depression, anxiety, and posttraumatic stress disorder (PTSD) as well as moral injury, mental exhaustion or burnout, and disturbed sleep. The following narrative review examines the current state of RPA warfare from a psychological trauma perspective with an emphasis on the evolution of the inherent technology, the operator force, the psychological experiences and consequences of this type of service, and potential preventative interventions for servicemembers. A key objective of this narrative review is to integrate the available peer-reviewed empirical data, experiential military perspectives and analyses, clinician observations from this unique population, and exemplar reports from those with lived experience on an RPA crew regarding psychological consequences of this military occupational specialty.