Behavioral Medicine Research Articles

Oh, I Need One Too! Integration of a Behavioral Medicine Specialist into Residency and Fellowship Programs

Oh, I Need One Too! Integration of a Behavioral Medicine Specialist into Residency and Fellowship Programs

Upregulation of Amy1 in the salivary glands of mice exposed to a lunar gravity environment using the multiple artificial gravity research system.

Introduction: Space is a unique environment characterized by isolation from community life and exposure to circadian misalignment, microgravity, and space radiation. These multiple differences from those experienced on the earth may cause systemic and local tissue stress. Autonomic nerves, including sympathetic and parasympathetic nerves, regulate functions in multiple organs. Saliva is secreted from the salivary gland, which is regulated by autonomic nerves, and plays several important roles in the oral cavity and digestive processes. The balance of the autonomic nervous system in the seromucous glands, such as the submandibular glands, precisely controls serous and mucous saliva. Psychological stress, radiation damage, and other triggers can cause an imbalance in salivary secretion systems. A previous study reported that amylase is a stress marker in behavioral medicine and space flight crews; however, the detailed mechanisms underlying amylase regulation in the space environment are still unknown. Methods: In this study, we aimed to elucidate how lunar gravity (1/6g) changes mRNA expression patterns in the salivary gland. Using a multiple artificial gravity research system during space flight in the International Space Station, we studied the effects of two different gravitational levels, lunar and Earth gravity, on the submandibular glands of mice. All mice survived, returned to Earth from space, and their submandibular glands were collected 2days after landing. Results: We found that lunar gravity induced the expression of the salivary amylase gene Amy1; however, no increase in Aqp5 and Ano1, which regulate water secretion, was observed. In addition, genes involved in the exocrine system, such as vesicle-associated membrane protein 8 (Vamp8) and small G proteins, including Rap1 and Rab families, were upregulated under lunar gravity. Conclusion: These results imply that lunar gravity upregulates salivary amylase secretion via Rap/Rab signaling and exocytosis via Vamp8. Our study highlights Amy1 as a potential candidate marker for stress regulation in salivary glands in the lunar gravity environment.

The effectiveness of cognitive behavioral therapy for insomnia on sleep outcomes in the context of pain among older adult veterans.

Cognitive behavioral therapy for insomnia (CBT-I) is the gold-standard treatment for insomnia disorder in adults. Compared to young adults, older adults have increased risk for the development of conditions associated with chronic pain, which may impact the efficacy of CBT-I in improving insomnia symptoms in older adults. This study evaluated the effect of participant-rated pain on sleep-related outcomes of a supervised, non-clinician administered CBT-I program in older adult patients with chronic insomnia disorder. Secondary analysis was conducted using data from a randomized controlled trial among 106 community-dwelling older adult veterans (N = 106; mean age 72.1 years, 96% male, 78.3% White, 6.6% Hispanic, 5.7% African American) with chronic (≥3 months) insomnia disorder. Participants engaged in five sessions of manual-based CBT-I in individual or group format within one Department of Veterans Affairs healthcare system, provided by non-clinician "sleep coaches" who had weekly telephone supervision by behavioral sleep medicine specialists. Insomnia symptoms (Insomnia Severity Index), perceived sleep quality (Pittsburgh Sleep Quality Index), fatigue (Flinder's Fatigue Scale), daytime sleepiness (Epworth Sleepiness Scale), and perceived pain severity (items from the Geriatric Pain Measure) were assessed at 4 time points: baseline, one-week posttreatment, 6-month follow-up, and 12-month follow-up. Mixed effects models with time invariant and time varying predictors were employed for analyses. CBT-I improved insomnia symptoms, perceived sleep quality, fatigue, and daytime sleepiness among older veterans with chronic insomnia. Participant-reported pain was associated with greater improvements in insomnia symptoms following CBT-I. Pain did not affect improvements in other sleep-related outcomes (-0.38 ≤ b ≤ 0.07, p > 0.05). Between-subjects differences in pain, but not within-subject changes in pain over time, appeared to play a central role in insomnia symptom improvement at posttreatment, with individuals with higher-than-average pain showing greater insomnia symptom improvement (ISI score reduction; -0.32 ≤ b ≤ -0.28, p ≤ 0.005). Pain did not meaningfully hinder the effects of CBT-I on sleep outcomes. Among older veterans with chronic insomnia disorder, individuals with higher pain exhibited slightly greater improvement in insomnia than those with lower levels of pain. These findings suggest that experiencing pain does not impair treatment response and should not preclude older adults with insomnia from being offered CBT-I.

Complementary medicine in patients with head and neck cancer

ObjectivesLiterature shows that up to 40 % of cancer patients use complementary medicine treatments. Most patients do not communicate the usage with their practitioner. There are no studies investigating the prevalence and extent of complementary medicine in head and neck cancer in Germany. Material and methodsPatients undergoing tumor aftercare in our department answered a questionnaire, that investigates subsets of demographic data, health behavior, cancerogenesis and complementary medicine. Data was evaluated in total and relative numbers. Also, Chi-squared test and Phi coefficient were performed to evaluate significant correlations. ResultsA total of 102 patients could be included in this study. In the analyzed collective 30 % of patients were interested in complementary medicine. Of those, 71 % have experienced complementary medicine treatments. There was a wide variety of modalities being used. None of the patients has talked with the doctors at tumor aftercare about this usage. Correlation of data showed that gender influenced i.a. health behavior and the usage of complementary medicine before cancer. ConclusionInvestigation revealed that a relevant number of head and neck cancer patients used complementary treatments, but no one talked about it during tumor aftercare. As a “blind spot” in anamnesis and diagnostic, evaluation of complementary medicine before tumor treatment and in aftercare are necessary to improve therapeutic outcome and to prevent potential negative influences like medication interactions.

Demystifying Open Science in health psychology and behavioral medicine: a practical guide to Registered Reports and Data Notes

ABSTRACT Open Science practices are integral to increasing transparency, reproducibility, and accessibility of research in health psychology and behavioral medicine. Drives to facilitate Open Science practices are becoming increasingly evident in journal editorial policies, including the establishment of new paper formats such as Registered Reports and Data Notes. This paper provides: (i) an overview of the current state of Open Science policies within health psychology and behavioral medicine, (ii) a call for submissions to an Article Collection of Registered Reports and Data Notes as new paper formats within the journal of Health Psychology & Behavioral Medicine, (iii) an overview of Registered Reports and Data Notes, and (iv) practical considerations for authors and reviewers of Registered Reports and Data Notes.

Building a Patient Navigation Program to Improve the Student and Patient Experience at a Student-Run Free Clinic

Introduction: Patient navigation programs improve patients’ access to care. The existing literature on patient navigation programs affiliated with Student-run Free Clinics (SRFCs) is limited. The Patient Navigation Program (PNP) was developed to give health professions students early experience in patient-centered care while helping patients overcome barriers to care. First-year student volunteers at our SRFC, the Delivering Equal Access to Care (DEAC) clinic, have limited opportunities to participate in direct patient care. A subset of our patient population faces additional challenges accessing health-related services, resulting in a need for coordinated care. This descriptive report describes a sustainable patient navigation program designed to improve the student and patient experience at an SRFC. Methods: One medical director and three third-year medical students supervised all participants. First-year students from the Doctor of Medicine (MD) and Physician Associate (PA) programs applied for Patient Navigator (PN) positions, and upper-level students from the MD and PA programs applied for Navigation Manager (NM) positions. Two mandatory student trainings were provided, one led by the program’s medical director and the other by an associate professor in Psychiatry and Behavioral Medicine. Patients were referred from the primary care service. A voluntary, program satisfaction survey was emailed to PNs at the end of the year. Results: Seven of the eight PNs completed their 12-month commitment and one PN transitioned into another DEAC clinic leadership role before the end of the year. Seven PNs completed the survey, and all indicated wanting to stay involved with the program in some capacity. Four of seven (57%) respondents were interested in continuing with their current patient due to perceived ongoing needs. Perceived impact of PNP on patients’ health includes obtaining additional health services, reliable transportation, and someone to discuss health concerns. Discussion: Over half of PNs joined DEAC clinic leadership at the end of their 12-month commitment, pointing to the potential of patient navigator programs to develop committed leaders at SRFCs. Building a sustainable program like PNP at another SRFC is feasible and has potential for meaningful student and patient impact.

Effect of Sleep Restriction on Adolescent Cognition by Adiposity

Pediatric obesity is associated with impaired cognitive function; however, the mechanisms underlying this association demand assessment. Sleep may be a relevant moderator, as poor sleep predicts both increased adiposity and impaired cognitive function. To determine the effects of adiposity and sleep on adolescent cognitive function. This single-blind randomized crossover trial was conducted from September 2020 to October 2022. Parents or caregivers provided demographic information for adolescent participants. Body mass index percentile and bioelectrical impedance analysis assessed adiposity. Adolescents completed 2 actigraphy-confirmed sleep conditions, adequate and restricted, followed by in-person cognitive assessment. No additional follow-up was provided. Data collection for this population-based study took place in a behavioral medicine clinic in Birmingham, Alabama. A total of 323 participants were assessed for eligibility (ages 14-19 years and healthy). Of the 244 eligible adolescents, 157 declined participation. Eighty-seven were randomized and 26 dropped out postenrollment. The final sample included 61 adolescents, 31 with healthy weight and 30 with overweight or obesity. Data were analyzed from April to October 2023. Following a 2-day washout period of adequate sleep, adolescents completed 2 sleep conditions: adequate (mean [SD] duration, 8 hours, 54 minutes [58.0 minutes]) and restricted (mean [SD] duration, 4 hours, 12 minutes [50.7 minutes]). The National Institutes of Health Cognitive Toolbox assessed global and fluid cognition, cognitive flexibility, working and episodic memory, attention, and processing speed. The Stroop Task assessed inhibition. The final sample included 61 adolescents (mean [SD] age, 16.3 [1.6] years; 35 [57.4%] female). Restricted sleep predicted poorer global cognition scores (restricted mean [SD], 98.0 [2.8]; adequate mean [SD], 103.2 [2.9]), fluid cognition scores (restricted mean [SD], 94.5 [3.2]; adequate mean [SD], 102.0 [3.6]), and cognitive flexibility scores (restricted mean [SD], 84.8 [3.0]; adequate mean [SD], 92.8 [3.0]) for adolescents with overweight or obesity. No differences emerged for adolescents with healthy weight. Adolescents with overweight or obesity also had poorer attention scores (mean [SD], 80.0 [2.3]) compared to adolescents with healthy weight (mean [SD], 88.4 [SD, 2.3]) following restricted sleep. No differences emerged following adequate sleep. Findings were similar for total body fat percentage (TBF%); however, for adolescents with TBF% above 42, restricted sleep also predicted poorer processing speed, and the association between sleep and attention did not vary based on TBF%. Adolescents with overweight or obesity may be more vulnerable to negative cognitive effects following sleep restriction. Improved sleep hygiene and duration in this group may positively impact their cognitive health. ClinicalTrials.gov Identifier: NCT04346433.

Applications of turning point analysis in behavioral medicine research: A systematic scoping review

BackgroundTurning Point Analysis (TPA) is a methodological approach that allows scholars to retrospectively capture change over time by identifying instances of critical change (i.e., turning points) encountered across a given time period. While TPA has been used to examine time as a variable in health and illness experiences, the use of the method in behavioral medicine scholarship may be limited by the lack of understanding of TPA procedures and applicability. ObjectiveTo describe how TPA has been used and enhance its accessibility by identifying and synthesizing methods of TPA data collection and analysis. MethodsA systematic search of electronic databases, including Academic Source Premier, Psychology and Behavioral Sciences Collection, APA PsycInfo, and ProQuest Dissertation and Theses Database, was conducted in May 2020. In July 2020, we used hand searching to identify additional articles, including forward and back tracking seminal articles on TPA. Studies were screened in duplicate. ResultsOf the 1184 studies screened for this review, we included 52. Studies used TPA to examine relational (k = 40), organizational (k = 6), and individual (k = 6) variables and included an analysis of either turning points (k = 28), the trajectories of change over time created by the turning points (k = 3), or both (k = 21). Turning points and trajectories were captured and analyzed using qualitative and quantitative analytic approaches, with most studies using either purely qualitative (k = 26) or mixed methods (k = 21). ConclusionsThe findings of this review provide insight into the varied applications of TPA and suggest the potential value of this methodological approach in better understanding health experiences across time. By synthesizing the procedural and analytic steps to conducting a TPA, this review could also increase the accessibility and use of TPA in behavioral medicine research.

The Society of Behavioral Medicine urges passage of the PLANT (Peas, Legumes, And Nuts Today) Act.

Current US diets negatively impact human health and the environment, while shifting toward increased intake of plant-based foods could mitigate these issues. Current food policies exacerbate these problems, necessitating a reevaluation and the implementation of new policies. The Society of Behavioral Medicine urges legislators to support the PLANT Act (H.R.5023), which would enhance production, research, and development of plant-based foods and address both health and environmental concerns.

N-of-1 behavioural medicine: Revolutionizing health promotion in public health through personalized intervention

N-of-1 behavioural medicine: Revolutionizing health promotion in public health through personalized intervention

Assessing the effectiveness of cannabidiol additive supplementation on canine behavior and cortisol levels

In veterinary medicine, Cannabis has been used to treat pain conditions, inflammation, and seizures. However, little is known about its effect on dogs’ behavior. This preliminary research aims to address this knowledge gap by evaluating the effectiveness of cannabidiol (CBD) oil in canine behavioral therapy. Twenty dogs, diagnosed with behavioral disorders and housed in a municipal shelter, participated in a double-blind trial. Ten dogs received CBD oil treatment, while the other ten received a control oil without CBD. Before (T0) and after (T1) the treatment, all the dogs underwent a temperament test to assess their behavior in the presence of four different stimuli: a human stranger, a novel object, a child-like doll, and a conspecific (another dog). Each stimulus was presented individually, and the dogs' behaviors were recorded on video and analyzed. Additionally, hair samples were collected using a shave-reshave technique for cortisol determination through Radio-Immuno-Assay. No behavioral differences were found between the two groups at both T0 and T1. There were no significant differences in the behavioral responses of either group when comparing T0 and T1. However, individual responses to the CBD oil treatment appeared to vary among subjects. A significant increase in hair cortisol levels (p-value <0.05) was observed in the group treated with CBD oil [T0 = 1.60 (1.44–1.93) pg/mg, T1 = 4.81(2.57–6.01) pg/mg]. These findings highlight the importance of individualized treatment when using Cannabis and encourage further research on the use of CBD oil in animal behavioral medicine.

Is it pain, or is it behaviour?

This year BVA Live will, for the first time, feature farm animal and equine CPD. Among the varied topics on offer, Gemma Pearson will be presenting an introduction to equine behavioural medicine, examining the link between emotional and physical health in horses.

Improving Eye-Tracking Data Quality: A Framework for Reproducible Evaluation of Detection Algorithms.

High-quality eye-tracking data are crucial in behavioral sciences and medicine. Even with a solid understanding of the literature, selecting the most suitable algorithm for a specific research project poses a challenge. Empowering applied researchers to choose the best-fitting detector for their research needs is the primary contribution of this paper. We developed a framework to systematically assess and compare the effectiveness of 13 state-of-the-art algorithms through a unified application interface. Hence, we more than double the number of algorithms that are currently usable within a single software package and allow researchers to identify the best-suited algorithm for a given scientific setup. Our framework validation on retrospective data underscores its suitability for algorithm selection. Through a detailed and reproducible step-by-step workflow, we hope to contribute towards significantly improved data quality in scientific experiments.

Psychosocial effects of hidradenitis suppurativa in the literature: A systematic review.

Hidradenitis suppurativa (HS) is an inflammatory disorder characterized by painful, deep follicular nodules, abscesses, sinus tracts, and scarring, most commonly presenting in the inguinal, axillary, and anogenital regions. This condition substantially decreases quality of life in affected individuals, resulting in higher rates of psychiatric disorders including depression, anxiety, suicidality, and substance use. The detrimental effects of HS are well documented by dermatologists, as individuals with HS make up a large proportion of the patients that they see daily. However, it is unclear whether psychiatrists are aware of the degree of psychosocial impairment present in HS patients. It is important that those in the field of psychiatry and behavioral medicine are aware of this condition and are comfortable managing it from a psychosocial perspective. This systematic review chronicles the existing literature on the psychosocial effects of HS and assesses the extent to which dermatology journals review these effects in comparison to psychiatry or behavioral medicine.

Abstract 6301: Mapping survivor-specific supportive care resources: A digital landscape analysis of NCI-designated cancer centers

Abstract Background: Optimal care for cancer survivors requires a comprehensive array of supportive care services to address the multitude of physical, psychological, social, financial, and health promotion needs of this population. To understand options to address their unique needs, survivors and their caregivers may seek information from online sources. Although National Cancer Institute-Designated Cancer Centers (NCIDCCs) serve as leaders in cancer treatment and care delivery, as well as credible sources for survivors to receive information on their recovery, no study has characterized the digital landscape of survivorship offerings on their website. This study aims to characterize the supportive care services offered to cancer survivors on NCIDCCs. Methods: Of the 72 NCIDCCs, 65 provide clinical care. We reviewed the webpage of each to identify supportive care offerings. Services were categorized based on the four domains of the quality-of-life model: (1) physical well-being, (2) psychological well-being, (3) social well-being, and (4) spiritual well-being. Supportive care services were classified as survivor-specific if the online description included information that specifically catered to cancer survivors. Results: Of the 65 clinical NCIDCC websites, 100% offer supportive care services and 54% offer supportive care services specific to survivors (Table). The most common supportive care service offered was nutrition (90.6%) and the least commonly offered was caregiver support (7.9%). Behavioral medicine was offered most frequently for survivors (28.3%) and caregiver support was offered the least (0%). Out of the four domains of the quality-of-life model, spiritual well-being services were offered the least at NCIDCCs. Conclusion: More than half of the NCIDCC websites provided survivor-specific supportive care services. Supportive care services on websites of NCI-Designated or Comprehensive Cancer Centers (N = 65) Supportive Care Service (n) % Supportive Care Service Specific to Cancer Survivors (n) % Physical Well Being Services Nutrition 58 90.6 14 24.1 Genetics 53 82.8 5 9.4 Pain and Palliative Care 52 81.3 8 15.4 Complementary and Alternative Medicine 49 75.4 6 12.2 Integrative Medicine 47 73.4 9 19.1 Occupational Therapy 45 70.3 6 13.3 Fertility Preservation 43 66.2 6 14 Tobacco Cessation 38 58.5 6 15.8 Speech 36 56.3 3 8.3 Exercise 29 45.3 5 17.2 Primary Care 6 9.2 3 50 Psychological Well-Being Services Behavioral Medicine 53 81.5 15 28.3 Recreational Therapy 36 58.1 5 13.9 Social Well-Being Services Oncology Social Work 56 87.5 5 8.9 Patient Navigation 33 51.6 3 9.1 Financial Counseling 32 50 4 12.5 Self-Image 27 41.5 3 11.1 Reproductive and Sexual Health 22 33.8 5 22.7 Caregiver Support 5 7.9 0 0 Spiritual Well-Being Services Pastoral Services 49 75.4 5 10.2 Citation Format: Alexis Taylor, Katherine Sterba, Evan Graboyes. Mapping survivor-specific supportive care resources: A digital landscape analysis of NCI-designated cancer centers [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 6301.

2023 International Conference on Mental Health and Behavioral Medicine Abstracts

2023 International Conference on Mental Health and Behavioral Medicine Abstracts

Improve accessibility to evidence-based treatment for insomnia disorder.

The Society of Behavioral Medicine supports increasing access to evidence-based treatment of insomnia by addressing barriers at the patient, provider, and systemic levels including support from government agencies to raise awareness about sleep and sleep disorders, health payors providing fair reimbursement for evidence-based insomnia assessment and therapy consistent with standard of care recommendations, and relevant training programs (e.g. psychologists, nurses, physicians, social workers, licensed professional counselors) to prioritize sleep health education.

POSITION STATEMENT: Pass the RESTORE (Re-entry Support Through Opportunities for Resources and Essentials) Act.

Under the Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA), current federal policy mandates a lifetime ban for individuals with a past felony drug conviction from receiving Supplemental Nutrition Assistance Program (SNAP) and Temporary Assistance for Needy Families (TANF) benefits. Denying nutritional and financial assistance to individuals with a past felony conviction will widen existing structural health inequities, set back individuals' successful re-entry into society, and contribute to recidivism and poorer health outcomes. Therefore, the Society of Behavioral Medicine supports the RESTORE ACT (Re-Entry Support Through Opportunities for Resources and Essentials Act), which would repeal the lifetime ban on receiving SNAP and TANF benefits for individuals convicted of a drug felony.

Prioritize "Food is Medicine" initiatives in the 2024 Farm Bill for human and planetary health.

The Society of Behavioral Medicine (SBM) supports increased funding for policies in the 2024 Farm Bill that align with a Food is Medicine (FIM) framework and address multiple dimensions of human and planetary health.

Psychoanalytically informed care and behavioral medicine: Consideration and recommendations for evidence-based practice in institutions.

Psychoanalytically informed care and behavioral medicine: Consideration and recommendations for evidence-based practice in institutions.