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Context: Depression in primary care remains challenging; patients with depression often do not seek help. Interventions to increase help-seeking (HS) behavior have been ineffective or decreased HS. Mental Contrasting and Implementation Intentions (MCII) is a behavioral intervention to create action plan in advance. It has been effective among patients seeking to increase exercise, reduce smoking, and other health behaviors. However, it has not been used for initiating help- seeking for depression. Objective: To assess whether an online MCII training program increases HS or the intention to seek help at 2 weeks post-intervention among those with elevated depressive symptoms, compared to information-only controls (C). Study Design and Analysis: RCT comparing HS and C at 2 weeks using pre-post survey. Analysis using t-test and ANOVA; intention to treat. Setting: MTurk online cloud research toolkit (Feb-March 2020). Population Studied: Adults with Beck Depression Inventory (BDI-II) score of 14 (mild depressive symptoms) or above and who were not seeking professional help at baseline. Intervention: Published online MCII intervention. Outcome Measures: Primary: Self-reported help seeking success (single-item). Secondary: Strength of Implementation Intentions Scale (SIIS), depressive symptoms (BDI-II), current perceived depression (single item). Results: Of the 2134 participants prescreened for depression and HS, 228 met eligibility criteria (37.2 [+ or -] 12.1 yrs, 65% F, 67% white). Demographics and disease severity were similar between groups at baseline. The HS group (n=105) reported greater HS success (p = .013) as well as intention to seek help (p = .001) 2 weeks post intervention compared to C (n=124). Further, perceived HS success was more likely for those who received the HS intervention and either did not perceive themselves as currently depressed at Time 2 (OR = 3.7) or individuals whose actual BDI-II score at follow up was below 14 points (OR = 10.6). Conclusions: Among participants with elevated depression symptoms, an online training in MCII effectively increased help-seeking behavior and intention to seek help compared to information-only control participants 2 weeks after delivery. The intervention is relatively brief and potentially scalable. Further research is warranted to determine clinical utility., Presenters Amanda Keeler, MA, Liesl Nydegger, PhD, [...]

People who are incarcerated are at heightened risk of overdose upon community reentry. Virtual reality (VR) may provide an innovative tool for overdose prevention intervention in corrections facilities. This mixed methods study sought to understand incarcerated individuals' perspectives on VR for overdose prevention and explore physiological arousal associated with use of VR equipment. Study participants were 20 individuals, stratified by gender, with an opioid use disorder at a county jail. Qualitative interviews assessed acceptability and perceived utility of VR in the jail setting. Thematic analysis indicated high levels of acceptability and potential utility in the following areas: (a) mental health and substance use interventions, (b) community reentry skills training, and (c) communication and conflict resolution skills. Heart rate variability (HRV) data were collected continuously during the interview and during VR exposure to explore whether exposure to the VR environment provoked arousal. Physiological data analyses showed a significant decrease in heart rate (HR) [b = −3.14, t(18) = −3.85, p < .01] and no arousal as measured by root mean square of successive RR interval differences (RMSSD) [b = −0.06, t(18) = −1.06, p = .30] and high frequency-HRV (HF-HRV) [b = −0.21, t(18) = −1.71, p = .10]. This study demonstrated high acceptability and decreased HR response of VR among incarcerated people who use drugs. [ABSTRACT FROM AUTHOR]

Physical and sexual intimate partner violence (IPV) among adolescents leads to adverse health behaviors, particularly suicidal ideation and attempts. Studies demonstrated the link between IPV and suicidal ideation and attempts among adolescents, yet there is conflicting evidence regarding differences between adolescent males and females; research evaluating the interaction of gender and the association between IPV and suicidal ideation and attempts is limited. The present study used a nationally representative sample from the Youth Behavioral Risk Surveillance questionnaire to determine whether there is an interaction of gender on the relationship between physical IPV, sexual IPV, and suicidal ideation and suicidal attempts. Weighted logistic regressions were fit using Stata 15.1 and multiple imputations were used to account for missing data. There is a significant gender by sexual IPV interaction (AOR = 0.66, CI = 0.51–0.84, p = 0.002) such that at low levels of sexual IPV there were no differences between genders in reported suicide attempts (t[33] = 1.19, p = 0.242). However, at moderate and high instances of sexual IPV, adolescent females were significantly less likely than males to report attempting suicide in the past year (t[33] = −2.71, p = 0.011; t[33] = −3.17, p = 0.003, respectively). The present study demonstrates the vital need for IPV and suicidal ideation and attempt screening, tailored multi-level interventions, and advocacy for adolescents. Policies are essential to increase screening among medical providers, and increase school- and community-based interventions and IPV and suicide awareness to decrease rates among adolescents. Female students were more likely than males to report suicidal ideation. Significant interaction between sex and sexual IPV on suicide attempts. Gender differences at medium and high levels of sexual IPV on suicide attempts. [ABSTRACT FROM AUTHOR]

Background: There are many reasons why individuals with depression may not seek help. Among those with elevated depressive symptomatology, some previous interventions aimed at increasing help-seeking have unintentionally decreased help-seeking intentions. Beck's cognitive theory of depression posits that individuals with elevated depressive symptomatology process information differently from those without depression (i.e., increased cognitive errors, negative bias); potentially explaining the iatrogenic results of previous interventions. Mental contrasting and implementation intentions (MCII; a self-regulatory strategy) interventions have successfully influenced physical and mental health behaviors. However, MCII has not been used specifically for initiating help-seeking for depression. The goal of this research was to ascertain whether an online MCII intervention could increase actual help-seeking or the intention to seek help for depression. Method: Two online randomized pre-post experiments were conducted to measure the primary outcome measures 2 weeks post-intervention (Study 1 collected Summer 2019: information-only control ["C"], help-seeking MCII intervention ["HS"], and comparison MCII intervention ["E"]; Study 2 collected Winter 2020: "C" and "HS"). At Time 1, adults recruited from MTurk had a minimum Beck Depression Inventory (BDI-II) score of 14 (mild depressive symptoms) and were not seeking professional help. Results: Study 1 (N =74) indicated that the intervention was feasible, provided preliminary support, and clarified intervention components for Study 2. Study 2 (N=224) indicated that the HS group reported greater intentions to seek help and actual help-seeking than the C group. Proportionally, actual help-seeking was more likely among individuals who received the HS intervention and either did not perceive themselves as depressed at Time 2 or had BDI-II scores indicating that their depressive symptomatology decreased from Time 1. Limitations: Participation was limited to US residents who self-reported data. Discussion: These studies indicate that a brief online MCII intervention to encourage help-seeking is feasible and preliminarily successful. Future studies should consider using ecological momentary assessment measurements to establish the temporal precedence of intervention effects and whether MCII is effective for encouraging help-seeking among individuals prone to experiencing cognitive errors who may not be experiencing negative bias (e.g., bipolar disorder or anxiety). Clinicians may find this method successful in encouraging ongoing treatment engagement. [ABSTRACT FROM AUTHOR]