Psychology Research Works

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Hello World! Building Computational Models to Represent Social and Organizational Theory
(2024) Grand, James A.; Braun, Michael T.; Kuljanin, Goran
Computational modeling holds significant promise as a tool for improving how theory is developed, expressed, and used to inform empirical research and evaluation efforts. However, the knowledge and skillsets needed to build computational models are rarely developed in the training received by social and organizational scientists. The purpose of this manuscript is to provide an accessible introduction to and reference for building computational models to represent theory. We first discuss important principles and recommendations for “thinking about” theory and developing explanatory accounts in ways that facilitate translating their core assumptions, specifications, and ideas into a computational model. Next, we address some frequently asked questions related to building computational models that introduce several fundamental tasks/concepts involved in building models to represent theory and demonstrate how they can be implemented in the R programming language to produce executable model code. The accompanying supplemental materials describes additional considerations relevant to building and using computational models, provides multiple examples of complete computational model code written in R, and an interactive application offering guided practice on key model-building tasks/concepts in R.
Emotion dysregulation and reward responsiveness as predictors of autonomic reactivity to an infant cry task among substance-using pregnant and postpartum women
(Wiley, 2023-12-14) Bounoua, Nadia; Tabachnick, Alexandra R.; Eiden, Rina D.; Labella, Madelyn H.; Dozier, Mary
Maternal substance use may interfere with optimal parenting, lowering maternal responsiveness during interactions with their children. Previous work has identified maternal autonomic nervous system (ANS) reactivity to parenting-relevant stressors as a promising indicator of real-world parenting behaviors. However, less is known about the extent to which individual differences in emotion dysregulation and reward processing, two mechanisms of substance use, relate to maternal ANS reactivity in substance-using populations. The current study examined associations among emotion dysregulation, reward responsiveness, and ANS reactivity to an infant cry task among 77 low-income and substance-using women who were either pregnant (n = 63) or postpartum (n = 14). Two indicators of ANS functioning were collected during a 9 min computerized infant cry task (Crybaby task): respiratory sinus arrhythmia (RSA) and pre-ejection period. Mothers also completed self-reported measures of emotion dysregulation and reward responsiveness. Analyses revealed that trait emotion regulation was associated with RSA reactivity to the Crybaby task, such that greater emotion dysregulation was associated with greater RSA reduction during the infant cry task than lower emotion dysregulation. Reward responsiveness was not significantly associated with either indicator of ANS reactivity to the task. Findings revealed distinct patterns of associations linking emotion dysregulation with ANS reactivity during a parenting-related computerized task, suggesting that emotion regulation may be a key intervention target for substance-using mothers.
Development and empirical test of the research-informed South African Relationship Functioning Assessment (SARFA)
(Wiley, 2023-10-13) Belus, Jennifer M.; Hines, Abigail C.; Magidson, Jessica F.; Iwamoto, Derek K.; Rose, Alexandra L.; Li, Alison; Barnabas, Ruanne V.; van Heerden, Alastair
Intimate partners play an important role in chronic diseases. Despite the chronic disease burden in sub-Saharan Africa, very few culturally relevant quantitative measures of intimate relationship functioning are available. We conducted an empirical investigation evaluating the psychometric properties of the South African Relationship Functioning Assessment (SARFA) assessing healthy relationship functioning in N = 150 community members (50% women; M age = 27.2 years) living in the Vulindlela area of KwaZulu-Natal, South Africa. Item development was based on prior qualitative research from two South African communities. All assessments were conducted in isiZulu, participants' primary language. An exploratory factor analysis was conducted on the initial 39-item measure. The best-fitting model consisted of one factor with 22 items. The SARFA's internal consistency was α = .94. Convergent validity was observed via significant positive associations (all rs ≥ .38, p < .001) between the SARFA's total score and measures of trust, emotional intimacy, constructive communication, sexual satisfaction, and relationship control (women only). Divergent validity was observed for women only. Encouraging initial psychometric properties of a culturally relevant measure of relationship functioning in KwaZulu-Natal may have relevance to other communities and potential to be used in research involving couples and health in chronic disease-burdened communities.
Structural barriers explain the link between negative community re-entry experiences and motives for illegal behavior in street-identified Black men and women
(Wiley, 2023-10-17) Bounoua, Nadia; Sadeh, Naomi; Payne, Yasser A.; Hitchens, Brooklynn K.
This study examines how the re-entry process is related to structural barriers in the community and to motives for engaging in illegal behavior—two key risk factors for recidivism. We analyzed survey data collected on perceptions of community re-entry, employment opportunities, neighborhood violence, and illegal behavior motives from 379 formerly incarcerated and street-identified Black-American community members residing in Wilmington, Delaware (Mage = 32.3/8.9 years old; 77.0% men; 100% Black) by employing Street Participatory Action Research (Street PAR) methodology. We found that negative perceptions of re-entry correlated positively with (i) hardship caused by structural barriers in the community, specifically blocked employment opportunities and neighborhood violence, and (ii) motives for engaging in illegal behavior. Notably, the link between negative perceptions of re-entry and motives for illegal behavior became significantly weaker when the influence of structural barriers on these individual-level factors was included in a multivariate model. Results suggest negative views of the re-entry process reflect the resource-scarce and stressful environments people are living in, and structural barriers can account for the relationship between negative re-entry experiences and why individuals are motivated to engage in illegal behavior. Findings underscore the importance of improving the economic conditions of communities with high numbers of returning citizens.
Dark Entanglement: Narcissistic Leaders, Their Followers, and the Contexts They Create.
(Edward Elgar Publishing Ltd, 2024-01) Forgo, Emily E.; Hanges, Paul J.; Gruda, Dritjon
This chapter describes the complex interplay between narcissistic leaders and their followers and how different contexts influence this dynamic relationship. In contrast to the traditional narcissistic leadership literature, which has concentrated on the leader’s characteristics and tendencies, we apply a relational-based perspective to argue that followers can enhance or suppress these characteristics of the leader. We also discuss how contexts also have a similar effect on leaders and followers. Narcissistic relationships flourish under certain circumstances and whither under others. We argue that a complete understanding of narcissistic leadership requires understanding of and empirical study of the entangled nature of these three variables.
Testing reciprocal associations between child anxiety and parenting across early interventions for inhibited preschoolers
(Wiley, 2023-08-29) Novick, Danielle R.; Meyer, Christian T.; Wagner, Nicholas J.; Rubin, Kenneth H.; Danko, Christina M.; Dougherty, Lea R.; Druskin, Lindsay R.; Smith, Kelly A.; Chronis-Tuscano, Andrea
Background Given the robust evidence base for the efficacy of evidence-based treatments targeting youth anxiety, researchers have advanced beyond efficacy outcome analysis to identify mechanisms of change and treatment directionality. Grounded in developmental transactional models, interventions for young children at risk for anxiety by virtue of behaviorally inhibited temperament often target parenting and child factors implicated in the early emergence and maintenance of anxiety. In particular, overcontrolling parenting moderates risk for anxiety among highly inhibited children, just as child inhibition has been shown to elicit overcontrolling parenting. Although longitudinal research has elucidated the temporal unfolding of factors that interact to place inhibited children at risk for anxiety, reciprocal transactions between these child and parent factors in the context of early interventions remain unknown. Method This study addresses these gaps by examining mechanisms of change and treatment directionality (i.e., parent-to-child vs. child-to-parent influences) within a randomized controlled trial comparing two interventions for inhibited preschoolers (N = 151): the multicomponent Turtle Program (‘Turtle’) and the parent-only Cool Little Kids program (‘CLK’). Reciprocal relations between parent-reported child anxiety, observed parenting, and parent-reported accommodation of child anxiety were examined across four timepoints: pre-, mid-, and post-treatment, and one-year follow-up (NCT02308826). Results Hypotheses were tested via latent curve models with structured residuals (LCM-SR) and latent change score (LCS) models. LCM-SR results were consistent with the child-to-parent influences found in previous research on cognitive behavioral therapy (CBT) for older anxious youth, but only emerged in Turtle. LCS analyses revealed bidirectional effects of changes in parent accommodation and child anxiety during and after intervention, but only in Turtle. Conclusion Our findings coincide with developmental transactional models, suggesting that the development of child anxiety may result from child-to-parent influences rather than the reverse, and highlight the importance of targeting parent and child factors simultaneously in early interventions for young, inhibited children.
Neural sensitivity to social reward predicts links between social behavior and loneliness in youth during the COVID-19 pandemic
(Wiley, 2023-08-04) Dziura, Sarah L.; McNaughton, Kathryn A.; Giacobbe, Elizabeth; Yarger, Heather A.; Hickey, Alexandra C.; Shariq, Deena; Redcay, Elizabeth
Neural reward network sensitivity in youth is proposed to differentially impact the effects of social environments on social outcomes. The COVID-19 pandemic provided an opportunity to test this hypothesis within a context of diminished in-person social interaction. We examined whether neural sensitivity to interactive social reward moderates the relationship between a frequency of interactive or passive social activity and social satisfaction. Survey reports of frequency of interactions with friends, passive social media use, and loneliness and social satisfaction were gathered in 2020 during mandated precautions limiting in-person contact. A subset of participants (age = 10–17) previously participated in a functional magnetic resonance imaging (fMRI) study examining social-interactive reward during a simulated peer interaction (survey n = 76; survey + fMRI n = 40). We found evidence of differential response to social context, such that youth with higher neural reward sensitivity showed a negative association between a frequency of interactive connections with friends and a combined loneliness and social dissatisfaction component (LSDC) score, whereas those with lower sensitivity showed the opposite effect. Further, high reward sensitivity was associated with greater LSDC as passive social media use increased, whereas low reward sensitivity showed the opposite. This indicates that youth with greater sensitivity to social-interactive reward may be more susceptible to negative effects of infrequent contact than their low reward-sensitive counterparts, who instead maintain social well-being through passive viewing of social content. These differential outcomes could have implications for supporting youth during times of major social disruption as well as ensuring mental health and well-being more broadly.
Emotion regulation and reactivity are associated with cortical thickness in early to mid-childhood
(Wiley, 2023-07-26) Ewell, Arcadia; Allard, Tamara; Botdorf, Morgan; Ji, Angela; Riggins, Tracy
This study explored the neural correlates of emotion regulation and emotional reactivity in early to mid-childhood. A sample of 96 children (70% White, mid-to-high socioeconomic status) aged 3–8 years provided structural neuroimaging data and caregivers reported on emotion regulation and emotional reactivity. The amygdala, insula, inferior frontal gyrus, anterior cingulate cortex, and medial orbitofrontal cortex were explored as a priori regions of interest (ROIs). ROI analyses revealed that emotion regulation was positively associated with cortical thickness in the insula, whereas emotional reactivity was negatively associated with cortical thickness in the inferior frontal gyrus. Exploratory whole-brain analyses suggested positive associations between emotion regulation and both left superior temporal thickness and right inferior temporal thickness, as well as negative associations between emotional reactivity and left superior temporal thickness. There were no significant associations between emotional regulation or reactivity and amygdala volume or cortical surface area. These findings support the notion that surface area and cortical thickness are distinct measures of brain maturation. In sum, these findings suggest that children may rely on a wider set of neural regions for emotion regulation and reactivity than adults, which is consistent with theories of interactive specialization across the life span.
Early emotional caregiving environment and associations with memory performance and hippocampal volume in adolescents with prenatal drug exposure
(Frontiers, 2023-11-20) Kohn, Brooke H.; Cui, Zehua; Candelaria, Margo A.; Buckingham-Howes, Stacy; Black, Maureen M.; Riggins, Tracy
Early adversities, including prenatal drug exposure (PDE) and a negative postnatal emotional caregiving environment, impact children’s long-term development. The protracted developmental course of memory and its underlying neural systems offer a valuable framework for understanding the longitudinal associations of pre- and postnatal factors on children with PDE. This study longitudinally examines memory and hippocampal development in 69 parent–child dyads to investigate how the early caregiving emotional environment affects children with PDE’s neural and cognitive systems. Measures of physical health, drug exposure, caregiver stress, depression, and distress were collected between 0 and 24 months At age 14 years, adolescents completed multiple measures of episodic memory, and at ages 14 and 18 years, adolescents underwent magnetic resonance imaging (MRI) scans. Latent constructs of episodic memory and the caregiving environment were created using Confirmatory Factor Analysis. Multiple regressions revealed a negative emotional caregiving environment during infancy was associated with poor memory performance and smaller left hippocampal volumes at 14 years. Better memory performance at 14 years predicted larger right hippocampal volume at 18 years. At 18 years, the association between the emotional caregiving environment and hippocampal volume was moderated by sex, such that a negative emotional caregiving environment was associated with larger left hippocampal volumes in males but not females. Findings suggest that the postnatal caregiving environment may modulate the effects of PDE across development, influencing neurocognitive development.
Initial Findings from the Maryland Trans Survey
(Trans Maryland, 2024-03) Pease, M Valle; Taylor, Son; Blinder, Lee; Clements, Zakary A.; Galupo, M. Paz
The Maryland Trans Survey is a community-based research project conducted by Trans Maryland and the Queer/Trans Collective for Research on Equity and Wellness examining experiences of trans people in the State of Maryland in areas such as health and healthcare, employment and economic wellbeing, and legal and policy experiences. To date, it is the largest survey of trans people in the State, with 750 trans people representing all 23 counties in Maryland and Baltimore City. Data were collected from May to December 2023 through in-person and online community outreach and the project was approved by the Towson University Institutional Review Board. This brief contains preliminary descriptive results from the project for advocates, policymakers, and community-serving entities to better understand and support the current needs of trans people in Maryland.
Family Rejection and LGBTQ+ Asian Americans’ Psychological Distress and Disordered Eating: The Role of Conflicts in Allegiances and Familial Shame
(2024) Pease, M V.; Le, Thomas P.; Ahn, Lydia HaRim
LGBTQ+ Asian Americans experience unique psychological health concerns at the intersection of multiple forms of marginalization. White supremacist, cisheteronormative, and colonial ideals and their structural and interpersonal manifestations may encourage family rejection of LGBTQ+ identities within Asian American family units. Family shame, conflicts in allegiances, and internalized anti-LGBTQ+ stigma were hypothesized as mediators in the association between family rejection and psychological distress and disordered eating. The current study examined family rejection and its impacts on psychological distress and disordered eating in a sample of LGBTQ+ Asian American adults (N = 155; MAge = 24.26; 30.3% Gender Diverse) using a cross-sectional survey design and path analysis. There was a significant serial mediation such that family rejection was positively associated with conflicts in allegiances, which was positively associated with familial shame, which was positively associated with psychological distress (B = .12, p = .01). The same serial mediation was nonsignificant for disordered eating (B = .04, p = .26). Results indicate the importance of considering conflicts in allegiances, family shame, and the interpersonal dynamics of LGBTQ+ Asian Americans in understanding experiences of psychological distress and disordered eating. Implications are drawn for further research, clinical work, and broader efforts addressing the larger sociocultural environment that encourages familial rejection of LGBTQ+ identity.
Reactive and Proactive Adaptation of Cognitive and Motor Neural Signals during Performance of a Stop-Change Task
(MDPI, 2021-05-11) Brockett, Adam T.; Roesch, Matthew R.
The ability to inhibit or suppress unwanted or inappropriate actions, is an essential component of executive function and cognitive health. The immense selective pressure placed on maintaining inhibitory control processes is exemplified by the relatively small number of instances in which these systems completely fail in the average person’s daily life. Although mistakes and errors do inevitably occur, inhibitory control systems not only ensure that this number is low, but have also adapted behavioral strategies to minimize future failures. The ability of our brains to adapt our behavior and appropriately engage proper motor responses is traditionally depicted as the primary domain of frontal brain areas, despite evidence to the fact that numerous other brain areas contribute. Using the stop-signal task as a common ground for comparison, we review a large body of literature investigating inhibitory control processes across frontal, temporal, and midbrain structures, focusing on our recent work in rodents, in an effort to understand how the brain biases action selection and adapts to the experience of conflict.
Gendered racial microaggressions and emerging adult Black women's social and general anxiety: Distress intolerance and stress as mediators
(Wiley, 2022-11-22) Burke, Lindsey A.; Chijioke, Sandra; Le, Thomas P.
There is robust evidence that gendered racial microaggressions affect Black women's mental health. However, few studies have examined how this form of discrimination affects Black women's social anxiety in addition to their general anxiety, as well as the underlying mechanisms related to gendered racial microaggressions and anxiety. Objective The purpose of this study was to examine the associations between gendered racial microaggressions stress (GRMS) and gendered racial microaggressions frequency (GRMF), and Black women's social anxiety and general anxiety symptoms. We also examined the mediating roles of distress intolerance and stress in these associations. Method One hundred and sixty-three Black women, between the ages of 18 and 25 years old, completed a cross-sectional survey. Regression analyses were used to examine the associations between gendered racial microaggressions and social anxiety and general anxiety, and mediation analyses examined the indirect effect of gendered racial microaggressions on the outcome variables through distress intolerance and stress. Results GRMS was associated with greater social and general anxiety through the mechanisms of distress intolerance and stress. GRMF was associated with reduced social anxiety and was not associated with general anxiety. Conclusions Intervention efforts should be aimed to prevent the experience of gendered racial microaggressions to prevent subsequent stress and mental health outcomes for Black women.
The neural distribution of the avian homologue of oxytocin, mesotocin, in two songbird species, the zebra finch and the canary: A potential role in song perception and production
(Wiley, 2022-05-22) Haakenson, Chelsea M.; Balthazart, Jacques; Madison, Farrah N.; Ball, Gregory F.
The avian homologue of oxytocin (OT), formerly called mesotocin, influences social behaviors in songbirds and potentially song production. We sought to characterize the distribution of OT peptide in the brain of two songbird species: canaries (Serinus canaria) and zebra finches (Taeniopygia guttata). To visualize OT, we performed immunocytochemistry using an antibody previously shown to identify OT in avian species. In both canaries and zebra finches, dense OT-ir perikarya were located in the paraventricular nucleus (PVN), preoptic area (POA), supraoptic nucleus (SON), and medial bed nucleus of the stria terminalis (BNSTm). We also observed morphologically distinct OT-ir cells scattered throughout the mesopallium. OT-ir fibers were observed in the PVN, ventral medial hypothalamus (VMH), periaqueductal gray (PAG), intercollicular nucleus (ICo), and ventral tegmental area (VTA). We also observed punctate OT-ir fibers in the song control nucleus HVC. In both male and female canaries, OT-ir fibers were present in the lateral septum (LS), but innervation was greater in males. We did not observe this sex difference in zebra finches. Much of the OT staining observed is consistent with general distributions within the vertebrate hypothalamus, indicating a possible conserved function. However, some extra-hypothalamic distributions, such as perikarya in the mesopallium, may be specific to songbirds and play a role in song perception and production. The presence of OT-ir fibers in HVC and song control nuclei projecting dopaminergic regions provides anatomical evidence in support of the idea that OT can influence singing behavior—either directly via HVC or indirectly via the PAG, VTA, or POA.
A meta-analysis of the relation between hippocampal volume and memory ability in typically developing children and adolescents
(Wiley, 2022-03-17) Botdorf, Morgan; Canada, Kelsey L.; Riggins, Tracy
Memory is supported by a network of brain regions, with the hippocampus serving a critical role in this cognitive process. Previous meta-analyses on the association between hippocampal structure and memory have largely focused on adults. Multiple studies have since suggested that hippocampal volume is related to memory performance in children and adolescents; however, the strength and direction of this relation varies across reports, and thus, remains unclear. To further understand this brain–behavior relation, we conducted a meta-analysis to investigate the association between hippocampal volume (assessed as total volume) and memory during typical development. Across 25 studies and 61 memory outcomes with 1357 participants, results showed a small, but significant, positive association between total hippocampal volume and memory performance. Estimates of the variability across studies in the relation between total volume and memory were not explained by differences in memory task type (delayed vs. immediate; relational vs. nonrelational), participant age range, or the method of normalization of hippocampal volumes. Overall, findings suggest that larger total hippocampal volume relates to better memory performance in children and adolescents and that this relation is similar across the memory types and age ranges assessed. To facilitate enhanced generalization across studies in the future, we discuss considerations for the field moving forward.
Patient and provider perceptions of a peer-delivered intervention (‘Khanya’) to improve anti-retroviral adherence and substance use in South Africa: a mixed methods analysis
(Cambridge University Press, 2022-08-26) Rose, Alexandra L.; Belus, Jennifer M.; Hines, Abigail C.; Barrie, Issmatu; Regenauer, Kristen S.; Andersen, Lena S.; Joska, John A.; Ciya, Nonceba; Ndamase, Sibabalwe; Myers, Bronwyn; Safren, Steven A.; Magidson, Jessica F.
Background. Despite a high prevalence of problematic substance use among people living with HIV in South Africa, there remains limited access to substance use services within the HIV care system. To address this gap, our team previously developed and adapted a six-session, peer-delivered problem-solving and behavioral activation-based intervention (Khanya) to improve HIV medication adherence and reduce substance use in Cape Town. This study evaluated patient and provider perspectives on the intervention to inform implementation and future adaptation. Methods. Following intervention completion, we conducted semi-structured individual interviews with patients (n = 23) and providers (n = 9) to understand perspectives on the feasibility, acceptability, and appropriateness of Khanya and its implementation by a peer. Patients also quantitatively ranked the usefulness of individual intervention components (problem solving for medication adherence ‘Life-Steps’, behavioral activation, mindfulness training, and relapse prevention) at post-treatment and six months follow-up, which we triangulated with qualitative feedback to examine convergence and divergence across methods. Results. Patients and providers reported high overall acceptability, feasibility, and appropriateness of Khanya, although there were several feasibility challenges. Mindfulness and Life-Steps were identified as particularly acceptable, feasible, and appropriate components by patients across methods, whereas relapse prevention strategies were less salient. Behavioral activation results were less consistent across methods. Conclusions. Findings underscore the importance of examining patients’ perspectives on specific intervention components within intervention packages. While mindfulness training and peer delivery models were positively perceived by consumers, they are rarely used within taskshared behavioral interventions in low- and middle-income countries.
Expanding the I-O psychology mindset to organizational success
(Cambridge University Press, 2022-09-09) Schneider, Benjamin; Pulakos, Elaine D.
The paper proposes that industrial-organizational (I-O) psychology will benefit greatly from expanding our research focus from predominantly individual differences to studying organizational differences. We argue here that an increased organizational frame of reference on variables of interest to I-O psychology (e.g., selection, job design, performance management (PM), work motivation) is important because it will enhance our understanding of organizational behavior and make I-O research more effective in practice. After noting some organizational-level research already being done, several examples are provided for how an organizational mindset and methods can provide new insights into traditional areas of I-O effort. Also discussed is how methodological issues that may have constrained the study of organizational differences in the past and the potential new issues such research may yield can be addressed. We conclude that the future maintenance and enhancement of the I-O psychology brand as a science–practice profession requires enhanced attention to the organization level of analysis as our frame of reference for research.
Why weight? Analytic approaches for large-scale population neuroscience data
(Elsevier, 2023-01-06) Gard, Arianna M.; Hyde, Luke W.; Heeringa, Steven G.; West, Brady T.; Mitchell, Colter
Population-based neuroimaging studies that feature complex sampling designs enable researchers to generalize their results more widely. However, several theoretical and analytical questions pose challenges to researchers interested in these data. The following is a resource for researchers interested in using population-based neuroimaging data. We provide an overview of sampling designs and describe the differences between traditional model-based analyses and survey-oriented design-based analyses. To elucidate key concepts, we leverage data from the Adolescent Brain Cognitive Development℠ Study (ABCD Study®), a population-based sample of 11,878 9–10-year-olds in the United States. Analyses revealed modest sociodemographic discrepancies between the target population of 9–10-year-olds in the U.S. and both the recruited ABCD sample and the analytic sample with usable structural and functional imaging data. In evaluating the associations between socioeconomic resources (i.e., constructs that are tightly linked to recruitment biases) and several metrics of brain development, we show that model-based approaches over-estimated the associations of household income and under-estimated the associations of caregiver education with total cortical volume and surface area. Comparable results were found in models predicting neural function during two fMRI task paradigms. We conclude with recommendations for ABCD Study® users and users of population-based neuroimaging cohorts more broadly.
The giant escape neurons of crayfish: Past discoveries and present opportunities
(Frontiers, 2022-12-20) Herberholz, Jens
Crayfish are equipped with two prominent neural circuits that control rapid, stereotyped escape behaviors. Central to these circuits are bilateral pairs of giant neurons that transverse the nervous system and generate escape tail-flips in opposite directions away from threatening stimuli.
Harm reduction behaviors are associated with carrying naloxone among patients on methadone treatment
(Springer Nature, 2023-02-14) Kozak, Zofia; Ciccarone, Daniel; Thrul, Johannes; Cole, Thomas O.; Pappas, Alexander L.; Greenblatt, Aaron D.; Welsh, Christopher; Yoon, Mark; Gann, Donald Jr.; Artigiani, E. Erin; Wish, Eric D.; Belcher, Annabelle M.
Despite the widespread availability of naloxone, US opioid overdose rates continue to rise. The “Cascade of Care” (CoC) is a public health approach that identifies steps in achieving specific outcomes and has been used to identify gaps in naloxone carriage among individuals with opioid use disorder (OUD). We sought to apply this framework to a treatment-seeking population with OUD that may be more inclined to engage in harm reduction behaviors. Patients were recruited from an urban methadone program to complete a survey. We assessed naloxone familiarity, availability, obtainability, training, and possession, as well as naloxone carriage rates, demographics, and harm reduction behaviors. A multivariable logistic regression examined associations between naloxone carriage and individual-level factors. Participants (n = 97) were majority male (59%), with a mean age of 48 (SD = 12), 27% had college education or higher, 64% indicated injection drug use, and 84% reported past naloxone training. All participants endorsed familiarity with naloxone, but only 42% regularly carried naloxone. The following variables were associated with carrying naloxone: White race (aOR = 2.94, 95% CI 1.02–8.52), college education (aOR = 8.11, 95% CI 1.76–37.47), and total number of self-reported harm reduction behaviors (aOR = 1.45, 95% CI 1.00–2.11). We found low rates of naloxone carriage among methadone-treated patients. Methadone programs provide opportunities for naloxone interventions and should target racial/ethnic minorities and individuals with lower education. The spectrum of harm reduction behaviors should be encouraged among these populations to enhance naloxone carriage.

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