Biomedical subjects

Alex H S Harris

Publications and source records attributed to Alex H S Harris.

10 recordsLinked to original sources

PubMed2006

Physical activity, exercise coping, and depression in a 10-year cohort study of depressed patients.

BACKGROUND: Epidemiological research examining the relationship between physical activity and depression has been conducted almost exclusively with community samples. We examined associations between physical activity, exercise coping, and depression in a sample of initially depressed patients, using four waves of data spanning 10 years. METHODS: A cohort (n=424) of depressed adults completed measures of physical activity, exercise coping, depression, and other demographic and psychosocial constructs at baseline, 1-year, 4-years, and 10-years, with a 90% wave-to-wave retention rate. Multilevel modeling was used to analyze individual depression trajectories. RESULTS: More physical activity was associated with less concurrent depression, even after controlling for gender, age, medical problems, and negative life events. Physical activity counteracted the effects of medical conditions and negative life events on depression. However, physical activity was not associated with subsequent depression. The findings for exercise coping were comparable. LIMITATIONS: Measures of physical activity and exercise coping encompassed a limited set of activities and did not include information about duration or intensity. CONCLUSION: Our results suggest that more physical activity is associated with reduced concurrent depression. In addition, it appears that physical activity may be especially helpful in the context of medical problems and major life stressors. Clinically, encouraging depressed patients to engage in physical activity is likely to have potential benefits with few obvious risks.

Adaptation, Psychological↗

PubMed2006

Predictors of engagement in continuing care following residential substance use disorder treatment.

BACKGROUND: Patients in intensive SUD programs who subsequently participate in continuing care for a longer interval have better outcomes than those who participate for a shorter interval. We sought to identify patient and program factors associated with duration of engagement in SUD continuing care after residential/inpatient treatment. METHODS: Patients (n=3032) at 15 geographically diverse SUD residential treatment programs provided data on demographics, symptom patterns, recovery resources, and perceptions of treatment environment. We identified patient characteristics associated with the number of consecutive months of engagement in continuing care. We then consolidated and classified risk factors into an integrated model. RESULTS: Being African American, having more SUD and psychiatric symptoms, more resources for recovery, and perceiving the treatment staff as being supportive were associated with longer engagement in continuing care. African Americans' engagement in continuing care was 17% longer than Caucasians'. The positive effect of being African American was partially mediated by having taken actions toward changing use, and by the presence of psychotic symptoms. CONCLUSION: These results extend previous research on the predictors of continuing care engagement after residential SUD programs. Clinicians can use information about characteristics that put patients at risk for shorter engagement in continuing care to target patients who might benefit from interventions to increase engagement in continuing care.

Adaptation, Psychological↗

PubMed2006

Effects of a group forgiveness intervention on forgiveness, perceived stress, and trait-anger.

The goal of this study was to evaluate the effects of a 6-week forgiveness intervention on three outcomes: (a) offense-specific forgiveness, (b) forgiveness-likelihood in new situations, and (c) health-related psychosocial variables, such as perceived stress and trait-anger. Participants were 259 adults who had experienced a hurtful interpersonal transgression from which they still felt negative consequences. They were randomized to a forgiveness-training program or a no-treatment control group. The intervention reduced negative thoughts and feelings about the target transgression 2 to 3 times more effectively than the control condition, and it produced significantly greater increases in positive thoughts and feelings toward the transgressor. Significant treatment effects were also found for forgiveness self-efficacy, forgiveness generalized to new situations, perceived stress, and trait-anger.

Adult↗

PubMed2006

Does expressive writing reduce health care utilization? A meta-analysis of randomized trials.

This meta-analysis examined whether writing about stressful experiences affects health care utilization (HCU) compared with writing on neutral topics or no-writing control groups. Randomized controlled trials of 30 independent samples representing 2,294 participants were located that contained sufficient information to calculate effect sizes. After omitting one study as an outlier, the effects were combined within 3 homogeneous groups: healthy samples (13 studies), samples with preexisting medical conditions (6 studies), and samples prescreened for psychological criteria (10 studies). Combined effect sizes, Hedges's g (95% confidence interval), with random effects estimation were 0.16 (0.02, 0.31), 0.21 (-0.02, 0.43), and 0.06 (-0.12, 0.24), respectively. Writing about stressful experiences reduces HCU in healthy samples but not in samples defined by medical diagnoses or exposure to stress or other psychological factors. The significance of these effects for individuals' health is unknown.

Health Services↗

PubMed2005

Recent suicide attempt and the effectiveness of inpatient and outpatient substance use disorder treatment.

BACKGROUND: The present study investigated whether or not the effect of treatment setting (inpatient or outpatient) on 6-mo follow-up substance use varied for suicidal and non-suicidal patients. In particular, the study tested the hypothesis that treatment setting would have no differing effect for non-suicidal participants, but for suicidal participants, inpatient setting would be more closely associated with positive outcomes than the outpatient setting. METHODS: A national sample of patients presenting for treatment of substance use disorders in the Veterans Administration health care system was selected to participate in the study. A total of 1,289 participants provided complete data on psychiatric and substance-related problems at baseline and 6-mo follow-up. RESULTS: At baseline, 4% (n=53) of the sample reported having made a suicide attempt within the past 30 days. Those who reported a suicide attempt were no more likely to have been treated in an inpatient setting than in an outpatient setting. A significant interaction between baseline suicide attempt and treatment setting was found, such that non-suicidal patients reported similar patterns of substance use when treated in inpatient or outpatient settings, but suicidal patients were significantly more likely to have better substance-related outcomes at 6-mo follow-up if they were treated in inpatient compared with outpatient settings. CONCLUSIONS: Suicidal patients displayed substantial improvement after substance use disorders treatment and seem particularly responsive to treatment in inpatient settings.

Adult↗

PubMed2005

Continuity of care practices and substance use disorder patients' engagement in continuing care.

BACKGROUND: Substance use disorder (SUD) patients who engage in more continuing care have better outcomes, but information on practices associated with greater patient engagement and retention in continuing care remains elusive. OBJECTIVES: The objectives of this study were to determine if staff's continuity of care practices predict patients' engagement in continuing care in the 6 months after discharge from intensive SUD treatment and to determine if the impact of continuity of care practices on patients' engagement in continuing care differs for patients treated in inpatient/residential versus outpatient programs. RESEARCH DESIGN: Staff in 28 Veterans Affairs (VA) intensive SUD treatment programs with varying continuity of care practices provided data on 878 patients' alcohol and drug problems at treatment entry. At discharge, staff provided data on patients' motivation, treatment intensity, and on the continuity of care practices they used with each patient. VA administrative databases supplied data on patients' subsequent engagement in continuing care. Mixed-effects modeling was used to examine predictors of patients' engagement in care. RESULTS: Patients in outpatient programs who received more continuity of care engaged in continuing care significantly longer. More highly motivated outpatients, those with fewer alcohol problems at treatment entry, and patients who used VA services in the year before treatment also remained in continuing care longer. These findings did not hold for patients treated in inpatient/residential programs. CONCLUSIONS: Continuity of care practices predicted engagement in continuing care only for patients treated in outpatient SUD programs. More research is needed to identify effective continuity of care practices for patients treated in inpatient/residential programs.

Alcohol Drinking↗

PubMed2005

Volunteering is associated with delayed mortality in older people: analysis of the longitudinal study of aging.

The Longitudinal Study of Aging (LSOA) assessed the health and social functioning of a representative sample of 7527 American community-dwelling older people (>70 years). We tested the hypothesis that frequent volunteering is associated with less mortality risk when the effects of socio-demographics, medical status, physical activity and social integration are controlled. We used Cox proportional hazards analyses to assess the unadjusted and adjusted associations between frequency of volunteering and time-to-death (96-month follow-up). Death occurred in 38.3 percent of the sample. After adjusting for covariates, frequent volunteers had significantly reduced mortality compared to non-volunteers. This association was greatest for those who frequently visited with friends or attended religious services.

Aged↗

PubMed2002

The accuracy of abstracts in psychology journals.

This article provides an empirically supported reminder of the importance of accuracy in scientific communication. The authors identify common types of inaccuracies in research abstracts and offer suggestions to improve abstract-article agreement. Abstracts accompanying 13% of a random sample of 400 research articles published in 8 American Psychological Association journals during 1997 and 1998 contained data or claims inconsistent with or missing from the body of the article. Error rates ranged from 8% to 18%, although between-journal differences were not significant. Many errors (63%) were unlikely to cause substantive misinterpretations. Unfortunately, 37% of errors found could be seriously misleading with respect to the data or claims presented in the associated article. Although deficient abstracts may be less common in psychology journals than in major medical journals (R. M. Pitkin, M. A. Branagan, & L. F. Burmeister, 1999), there is still cause for concern and need for improvement.

Abstracting and Indexing↗

PubMed2002

Spirituality and health: what's the evidence and what's needed?

In this article, we familiarize readers with some recent empirical evidence about possible associations between religious and/or spiritual (RS) factors and health outcomes. In considering this evidence, we believe a healthy skepticism is in order One needs to remain open to the possibility that RS-related beliefs and behaviors may influence health, yet one needs empirical evidence based on well-controlled studies that support these claims and conclusions. We hope to introduce the dismissing critic to suggestive data that may create tempered doubt and to introduce the uncritical advocate to issues and concerns that will encourage greater modesty in the making of claims and drawing of conclusions. We comment on the following questions: Do specific RS factors influence health outcomes? What possible mechanisms might explain a relation, if one exists? Are there any implications for health professionals at this point in time? Recommendations concern the need to improve research designs and measurement strategies and to clarify conceptualizations of RSfactors. RSfactors appear to be associated with physical and overall health, but the relation appears far more complex and modest than some contend. Which specific RS factors enhance or endanger health and well-being remains unclear.

Clinical Trials as Topic↗

PubMedDate not supplied

Does writing affect asthma? A randomized trial.

OBJECTIVE: Nonpharmacologic treatments for asthma may act as useful adjuncts to pharmacotherapy but should be recommended to patients only after several well-controlled studies provide evidence of efficacy. Research demonstrating that written emotional expression can improve pulmonary function in patients with asthma consists of one impressive yet unreplicated study. Our main objective was to test and extend previous research finding that written emotional expression improves pulmonary function in patients with asthma compared with writing on neutral topics. METHODS: We conducted a randomized, controlled trial of outpatient asthmatics recruited from hospitals and the community. Of the 137 adult patients with asthma who were randomized, 117 began and 114 completed the study. Patients were randomly assigned to write for 20 minutes, once per week, for 3 weeks about stressful experiences (n = 41), positive experiences (n = 37), or neutral experiences (n = 36; control group). At baseline, postintervention, and 2-month follow up, patients were assessed by spirometry. RESULTS: The mean change from baseline to 2-month follow up in percentage of predicted forced expiratory volume in 1 second (FEV1) was 4.2% in the stress-writing group, 1.3% in the positive-writing group, and 3.0% in the control group. In forced vital capacity (FVC), there was 3.1% improvement in the stress-writing group, 3.6% in the positive-writing group, and 2.4% in the control group. These changes were not statistically or clinically significant. CONCLUSIONS: The present study reduces confidence in the ability of written emotional expression to benefit the disease status of asthma patients.

Adolescent↗