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AimDrug overdose related-deaths in the US are increasing, with over 100,000 deaths occurring in 2020, an increase of 30% from the previous year and the highest number recorded in a single year. It is widely known that experiences of trauma and substance use very often co-occur, but little is known about the role of trauma in the context of drug overdose-related deaths. Latent class analysis (LCA) was used to classify drug overdose-related deaths based on type of traumatic experiences and individual, social, and substance use characteristics.MethodsPsychological autopsy data were obtained from the University of Texas Health Science Center at Houston (UTHealth) Brain Collection. A total of 31 drug overdose-related deaths collected from January 2016 through March 2022 were included in this study. LCA was used to identify latent factors via experience of four trauma categories (illness/accidents, sexual/interpersonal violence, death/trauma to another, other situations where life was in danger). Generalized linear modeling (GLM) was used to explore differences on demographic, social, substance use, and psychiatric variables between the latent classes in separate models.ResultsLCA identified 2 classes: C1 (n=12; 39%) was characterized by higher incidence of overall trauma exposure as well as variation in trauma type; C2 (n=19; 61%) had lower levels of overall trauma exposure with sexual/interpersonal violence as the most frequent. GLMs indicated that C1 membership was associated with higher incidence of polysubstance use, being married, and having suicidal ideation compared to C2 membership (psConclusionAmong individuals who died by drug overdose, the exploratory LCA identified two distinct subgroups that differed in type of trauma experienced and substance use pattern, the first group having more “typical” characteristics of drug overdoses cases, the other group less typical. This suggests that those at risk of drug overdose may not always exhibit high-risk characteristics.

Background: Although exposure to potentially traumatic events (PTEs) for Black and Latinx may be comparable or lower than their White counterparts, type of trauma experiences differ such as more interpersonal trauma and violence reported by Black people, who also experience higher rates of PTSD. In this retrospective study, we examined the association between use of particular substances and various PTEs and the race/ethnicity-group differences for this association. Methods: One-hundred seventy-nine participants recruited from an outpatient substance use disorder program from February 2018 to October 2020 completed measures on lifetime trauma history and current/past cocaine, cannabis, and alcohol misuse. Bayesian generalized linear modeling with horseshoe prior was used to predict substance misuse using 17 PTEs, then PTEs were ranked and examined by racial/ethnic group. Results: No PTEs were associated with substance misuse across all four r/e groups. Transportation accident, natural disaster, war exposure, and other stressful events were associated with substance misuse across two or three r/e groups. Notably, the three PTEs involving interpersonal violence in our study (weapon assault, physical assault, and sexual assault) were only associated with substance misuse (posterior probability ≥70%) for Latinx participants. Conclusion: The relational nature of interpersonal/violent traumas may make them particularly salient for Latinx people where interpersonal relationships are prioritized. These types of traumas may also be viewed as an extension of discrimination and exclusion, two longstanding, intractable issues for people of color in the US, making them even more damaging. Furthermore, lack of resources may limit options for coping, resulting in substance use problems.

INTRODUCTION: Exchange sex places individuals with cocaine use disorder (CUD) at particularly high risk for deleterious safety and health outcomes. A substance use treatment provider who is aware of a patient’s exchange sex behavior is better able to provide appropriate screening, care, and/or referral to risk reduction services. However, little is known about exchange sex, especially purchasing, among treatment-seeking adults with CUD. METHOD: The current study examined the prevalence and correlates of sex selling and sex purchasing among treatment-seeking men and women with CUD (n = 109; ClinicalTrials.gov #NCT02896712). Separate binary logistic regressions via backward elimination were used to identify best fitting models for sex selling and sex purchasing. RESULTS: Over 41% of participants endorsed exchange sex within the last 30 days; 20.2% reported selling sex and 30.3% reported purchasing sex. Sex selling and sex purchasing rates differed by gender and race. Number of sexual partners (OR = 5.83, 95% CI = 2.07-16.43), concern about contracting HIV/AIDS (OR = 2.01, 95% CI = 1.31-3.44), cumulative interpersonal trauma exposure (OR = 1.82, 95% CI = 1.20-2.77), years using cocaine (OR = 1.11, 95% CI = 1.03-1.20), drug-related problem days (OR = 1.07, 95% CI = 1.00-1.14), and sexual preference (OR = 9.50, 95% CI = .69-130.35) were retained in the final model estimating sex selling (Nagelkerke R(2) = .56). In the final sex purchasing model (Nagelkerke R(2) = .46), gender (OR = 36.17, 95% CI = 2.96-441.75), number of sexual partners (OR = 6.28, 95% CI = 2.69-14.66), number of convictions (OR = 1.13, 95% CI = 1.02-1.25), and drug-related problem days (OR = 0.96, 95% CI = .92 – 1.01) were retained. CONCLUSION: Predictive models in this study identified distinct sets of variables related to sex selling and purchasing. Findings may be used to improve identification of exchange sex in the substance use treatment setting and referral to targeted interventions to reduce associated risk.

OBJECTIVES Perceived racial discrimination is associated with depressive symptoms for African American adults; however, insight to protective factors for racism and depression in African Americans is limited. While current research suggests that dispositional forgiveness is an important factor in how people perceive and cope with interpersonal transgressions, few studies have examined its role in the context of racial discrimination. The purpose of this study was to examine the moderating effect of forgiveness (beyond broader internalized religiosity) on the association between perceived racial discrimination and depressive symptoms in African American adults. METHOD Sample included 101 African American adults (60.2% female; Mage = 21.90 years, SD = 4.93 years) who endorsed experiences of racial discrimination. Participants completed a questionnaire battery consisting of self-report measures of perceived experiences of racial discrimination, depression, dispositional forgiveness, and intrinsic religiosity. RESULTS Regression analyses showed dispositional forgiveness moderated the association between perceived racial discrimination and symptoms of depression above and beyond intrinsic religiosity (β = -.05, 95% CI [-.10, -.05], p < .05), such that the racial discrimination-depression association was significant for participants who reported low levels of dispositional forgiveness, but not for individuals who reported higher levels of dispositional forgiveness. CONCLUSIONS These findings provide insight into the role of dispositional forgiveness in experiences of racial discrimination and suggest that cognitive flexibility serves as an adaptive coping strategy to experiencing discrimination. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Introduction While suicide attempts and deaths increase, research and assessment methods have stagnated in terms of increasing predictive power. Lexical analysis has been a useful method in descriptive suicide research, but may have utility for assessment and prediction. Objective The present study used lexical analysis to examine language differences across a spectrum of psychological distress, with death by suicide as the most extreme indicator. Methods Suicide writings were collected for 38 persons who died by suicide in two southern U.S. cities. Blog writings were collected from the "Depression" and "Suicide" categories of an online mental health discussion community and from food blogging communities (n = 38 each). Linguistic Inquiry and Word Count was used to calculate proportions of words that fell into lexical categories indicative of distress. Results One-way ANOVA revealed significant differences in first-person singular pronouns and words related to positive emotions, negative emotions, religion, and death. Suicide notes were found to use less frequent lexical markers of distress than depression and suicide ideation blogs, and more frequent positive emotion language than all comparison groups. Conclusion The present findings suggest that deciding to take one's life may be associated with a decrease in distress, and possibly an increase in positive emotion, when compared to those experiencing depression and suicidal thoughts.

Objective Developing the capability to die by suicide, and overcoming one's natural instinct of self-preservation, is thought to occur as a result of habituation to the fear and pain surrounding suicide. However, investigations of suicide capability have yet to examine whether perceived discrimination serves as a painful and provocative event that contributes to capability for suicide. The purpose of the current study was to examine the association of perceived discrimination and suicide capability for Black and White adults. Method The study sample included 173 Black adults (67.6% female; Mage = 23.18, SD = 5.74) and 272 White adults (60.7% female; Mage = 22.80, SD = 5.90). Participants completed a questionnaire battery that included measures of perceived discrimination, depression, and suicide ideation. Results Regression analyses revealed for Black adults (but not White adults), perceived discrimination was associated with an increased capability for suicide after accounting for depressive symptomatology, suicide ideation, non-discriminatory painful and provocative events experienced, age, and gender (β = .226, t = 3.154, p = .002). Conclusions These findings provide preliminary evidence that perceived discrimination may play a role in suicide capability for Black adults and highlight the importance of considering contextual experiences when examining suicidality in underserved groups.

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This study aims to (a) describe demographic and mental health (MH) differences between truant juvenile justice–involved youth (JJY) and nontruant JJY; (b) classify MH needs of truant JJY; and (c) investigate if the interactions between race, ethnicity, gender, and MH needs predict truancy recidivism. Participants were 10,603 truant JJY (55.4% male; non-Hispanic White, 46.8%; 16.2% with a history of pretrial detention). Of these participants, 2,167 with MH data were included in latent profile analyses and recidivism analyses. Hispanic youth and female youth were more likely to be truant. Non-Hispanic White JJY had a higher likelihood of a repeated truancy charge. Four MH classes emerged: elevated Alcohol/Drug Use (7.9%), elevated Angry–Irritable and Depressed–Anxious symptoms (19.5%), elevated Suicide Ideation (7.1%), and low MH needs (65.5%). Race, ethnicity, gender, and MH needs are informative as potential factors contributing to truancy. These factors should be examined in future studies that compare truant with nontruant non-JJY.

The Unified Protocols for Transdiagnostic Treatment of Emotional Disorders in Children and Adolescents (UP-C/A) have been adapted into a stepped care intervention (UP-C/A-SC) that may be delivered via telehealth. Stepped care models are a type of service delivery system designed to be efficient, effective, accessible, and cost-effective and to personalize service by matching clients to the most appropriate dosage or the best type of treatment for their needs. This chapter discusses the adaptations to the original interventions necessary to deliver UP-C/A-SC as a two-step intervention via telehealth. A case example of a child who responded to the first step of UP-C/A-SC illustrates the components of the stepped care model, including a collaborative decision-making process to determine treatment response status after the first step. To address common implementation issues, barriers to providing UP-C/A-SC and solutions are discussed.

Racial discrimination is associated with depressive symptoms for young African American adults. Yet few studies have examined the psychological mechanisms for this association. The purpose of this preliminary study was to examine the mediating effect of helplessness on the association between perceived racial discrimination and depressive symptoms in a sample of 172 African American young adults. Measures of perceived racial discrimination, depression, and helplessness were administered. Though the majority of the sample reported minimal or no symptoms of depression, approximately 37% of the sample reported dysphoric or more severe depression symptomatology. After controlling for age, perceived racial discrimination was directly and indirectly associated with depressive symptoms via helplessness. These findings provide some insight into the cognitive mechanisms through which depressive symptoms may emerge for African American young adults exposed to racial discrimination.

BACKGROUND: Hispanic and Black adults are disproportionately affected by HIV and experience poorer HIV-related health outcomes relative to non-Hispanic White adults. The current study adopted Sørensen’s (2012) Integrated Model to test the hypothesis that lower functional and critical health literacy competencies contribute to poorer HIV-related health and CD4 cell count for Hispanic and Black individuals. METHODS: Eighty-one non-Hispanic White, Hispanic, and Black HIV seropositive individuals from a large, Southwestern metropolitan area were administered measures of health literacy, including the Expanded Numeracy Scale (ENS), Newest Vital Sign (NVS), Rapid Estimate of Adult Literacy in Medicine (REALM), the Test of Functional Health Literacy (TOHFLA)-numeracy, and the TOHFLA-reading. RESULTS: Hispanic and Black individuals demonstrated less HIV knowledge than non-Hispanic White individuals. Black participants demonstrated fewer health literacy-appraisal skills. Importantly, lower levels of health literacy were linked to poorer CD4 cell count, an index of immune functioning for Hispanic and Black individuals and not for non-Hispanic White individuals. DISCUSSION: These findings suggest race-group differences for health literacy on current CD4 count such that very specific dimensions of low health literacy (e.g., poorer judgment of health-related information) but not other presumed deficits (e.g., motivation, access) play an important role in clinical health outcomes in HIV.

The objective was to delineate the prevalence of criminal behavior and school discipline in juvenile justice-involved youth (JJY) with autism. A sample of 143 JJY with autism was matched to comparison groups of JJY without a special education classification, JJY with learning disabilities, and JJY with other special educational needs (N = 572). Results showed that JJY with autism committed significantly fewer property crimes. With regard to school discipline, JJY with autism were least likely to receive policy violations, out-of-school suspensions, and in-school suspensions. Finally, regardless of special education classification, JJY who had a history of fighting in school were more likely to recidivate. Our results suggest that JJY with autism are not more likely to commit crimes compared to JJY without SEN.

There has been an increase in literature that addresses risks associated with suicide vulnerability and death for American Indian/Alaska Native, Asian American, Black American, and Hispanic American adults. However, much more definitive work is needed. In comparison to previous decades, research in the area of ethnic minority suicide may have lost some momentum for certain racial/ethnic groups. As the U.S. population becomes increasingly diverse, the need for advanced research efforts regarding the full spectrum of suicide behavior grows increasingly urgent. Objective: To provide a summary of putative risk factors and plausible protective factors highlighting both unique and common factors for American Indian/Alaska Native, Asian American, Black American, and Hispanic American adults. The dearth of literature is also addressed by the proposition of emergent needs in the study of ethnic minority suicide. Further, we will examine the ways in which the last decade of research has expanded suicide science as well as areas that have been understudied. Conclusions: A review of empirical studies and conceptual reports published in the last decade revealed common trends associated with suicide across ethnic groups, including sociodemographic variables, psychiatric risks, cultural factors, and factors related to interpersonal relations. Ethnic minority groups also shared notable protective factors, such as religious and spiritual beliefs, and familial ties. Suggested directions for future research include the examination of individual subgroups within ethnic communities as well as the exploration of understudied correlates that show promising evidence as influential to suicidal behavior. Additionally, factors that lead to suicide attempts for American Indian/Alaska Native, Asian American, Black American, and Hispanic American adults remain relatively unexamined.

OBJECTIVE To examine purpose in life (PIL) and ethnic identity (EI) as buffers to suicide ideation for Asian American, Hispanic, and Black emerging adults who perceive racial discrimination. METHOD Two-hundred eighty-nine undergraduate students enrolled at a large university in the southwestern region of the United States (40.8% Asian American, 32.5% Hispanic, 26.6% Black; 61.2% women; mean age = 20.47, SD = 1.83) reported on experiences of racial discrimination, PIL, EI, and suicidal thoughts. Covariates were intrinsic religiosity, gender, and age. RESULTS Regression analysis showed that EI was not a significant moderator for the association between perceived racial discrimination (PRD) and suicidal ideation (β = -.08, p = .13; 95% confidence interval (CI) [-.19, .03]). However, PIL was a significant moderator (β = -.11, p = .025; CI [-.20, -.01]). A hierarchical regression showed that PIL as a moderator explained additional variance (ΔR2 = 0.11, p < .001) in suicide ideation above and beyond EI. CONCLUSIONS These findings provide some insight into how life purpose might ameliorate the impact of social stressors above and beyond a positive cultural identity for young racial/ethnic minority adults. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

To better characterize the relation of acculturation, based on language use, to smoking status among Mexican-Americans, a large study sample from an ongoing cohort of Mexican-American households in Texas was stratified into current smokers and non-smokers. Four language-use groups were created based on Low/High use of Spanish and English, representing different degrees of acculturation. Participants who reported high English but low Spanish use had the highest smoking prevalence (20.1 %), followed by High English/High Spanish (13.6 %), Low English/High Spanish (8.7 %), and Low English/Low Spanish (6.4 %). Current smokers were more likely to be male, have lower than high school education, currently consume alcohol or had consumed alcohol but quit, and report low Spanish/high English use. Consistent with recent models of acculturation, individuals can differ both in their maintenance of the native language and adoption of a new language and both dimensions are important in predicting tobacco use.

Background and Objectives To assess tobacco use among lesbian, gay, bisexual, and transgender (LGBT) individuals from the 2014 Houston Pride Parade and Festival in Houston, Texas (TX). Methods Cross-sectional study using convenience sample of LGBT individuals (n = 99) examining tobacco use, sexual orientation, and other socio-demographic factors through survey participation. Results Findings showed a high prevalence of tobacco and electronic cigarettes use. White LGBT individuals had greater odds of using any type of tobacco product. Discussion and Conclusions Despite a high smoking prevalence among the surveyed LGBT individuals, this study sample did not identify tobacco use as a health issue. Scientific Significance Supports the need for further investigation on tobacco-related disparities among LGBT individuals in Houston, TX. (Am J Addict 2015;24:391 –395)

The aim of this study was to investigate a new measure, the Wetterneck-Hart OCD Screener (WHOS), as a self-report screening tool for obsessive-compulsive disorder (OCD). The authors examined relationships between the WHOS and severity scores of OCD measures taken via three methods of data collection: online, at OCD consumer conferences, and from an intensive, residential OCD program. Severity measures included the Yale-Brown Obsessive-Compulsive Scale-Self Report (Y-BOCS-SR), the Dimensional Obsessive-Compulsive Scale (DOCS), and the Obsessive-Compulsive Inventory-Revised (OCI-R). A total of 525 participants took the measures: 298 from online websites, 100 from OCD conferences, and 127 from a residential OCD program. Significant differences were found between the OCD and non-OCD groups classified by the WHOS for each of the OCD severity measures. The authors conclude that the WHOS is useful in predicting the presence of clinically severe OCD symptoms and could be employed in clinical and research endeavors.

To assess tobacco use among lesbian, gay, bisexual, and transgender (LGBT) individuals from the 2014 Houston Pride Parade and Festival in Houston, Texas (TX).Cross-sectional study using convenience sample of LGBT individuals (n = 99) examining tobacco use, sexual orientation, and other socio-demographic factors through survey participation.Findings showed a high prevalence of tobacco and electronic cigarettes use. White LGBT individuals had greater odds of using any type of tobacco product.Despite a high smoking prevalence among the surveyed LGBT individuals, this study sample did not identify tobacco use as a health issue.Supports the need for further investigation on tobacco-related disparities among LGBT individuals in Houston, TX.

Rates of tobacco use are increasing in the regions of Latin America and the Caribbean (LAC). Unfortunately, tobacco cessation education is not a standard component of the dental curriculum in LAC dental schools. The objective of this study was to identify the perceptions of LAC dental faculty members regarding the tobacco use prevention and cessation (TUPAC) competencies that should be addressed in the dental curricula. Dental deans and faculty completed a web-based questionnaire in Spanish, Portuguese, French, or English. The questionnaire contained 32 competencies grouped into the five A's (Ask, Advise, Assess, Assist, and Arrange) of tobacco cessation and six supplementary questions for identifying barriers to providing TUPAC education to dental students. Respondents indicated the degree to which they believed each competency should be incorporated into the dental curricula using a five-point Likert scale (“1” = strongly disagree to “5” = strongly agree). Responses were obtained from 390 faculty members (66 % South America, 18 % Mexico/Central America, 16 % the Caribbean). Of the respondents, 2, 12, and 83 % reported that smoking was allowed in clinical environments, other indoor environments, and outdoor environments of their dental schools, respectively. Mean importance ratings for each of the competencies were as follows: Ask (4.71), Advise (4.54), Assess (4.41), Assist (4.07), and Arrange (4.01). Overall, LAC dental educators agree that TUPAC training should be incorporated into the dental curricula. Assist and Arrange competencies were rated lower, relative to other competencies. Tobacco use among dental educators and high rates of on-campus smoking could potentially pose barriers to promoting cessation interventions in the LAC dental schools.