1992 — 1993 |
Hope, Debra A. |
R03Activity Code Description: To provide research support specifically limited in time and amount for studies in categorical program areas. Small grants provide flexibility for initiating studies which are generally for preliminary short-term projects and are non-renewable. |
Social Phobia &Dysthymia--a Multidimensional Comparison @ University of Nebraska Lincoln
Accumulating evidence that anxiety and depression may be less distinct than previously thought has resulted in increased interest in the relationship between the two syndromes. Furthermore, comorbid presentations of anxiety and depression are particularly resistant to psychosocial and pharmacological interventions. Unfortunately our knowledge of the relationship between the two has been limited by a number of factors including a paucity of studies offering direct comparisons in clinical samples. a;so, despite the well-recognized heterogeneity of both anxiety and depression, most studies have employed samples of mixed anxiety and depressive disorders. In light of these difficulties, the proposed study will examine the interpersonal and cognitive functioning of clinically severe socially phobic and dysthymic individuals. Theoretical accounts and research evidence suggests these two disorders may have many common aspects despite distinct clinical presentations. For example, similar interpersonal and cognitive deficits are often the focus of interventions for the two disorders and are thought to be central in their etiology and maintenance. However, despite this similarity, few studies have compared the two groups. Furthermore, research suggests distinguishable subtypes of social phobia exist but little is known about how the subtypes differ from one another or from depressive disorders. This study will compare chronically depressed (dysthymic), social phobic (generalized and nongeneralized subtypes), and normal control subjects on cognitive, behavioral, physiological and self-report measures. Following a careful diagnostic screening, subjects will complete a battery of self-report measures of anxiety, depression and general psychopathology, participate in three brief roleplays (two interactions and a public speaking task) and complete two information processing tasks (a memory and an attention task). It is hypothesized that dysthymics' verbal and nonverbal behavior during the roleplays will be characterized by help-seeking and a negative affective tone, in contrast to generalized social phobics who are expected to adopt submissive, acquiescent strategies. Dysthymics are expected to devote excessive cognitive resources to processing negative information about themselves and to be overly concerned with failing to achieve their own internal standards of success. Social phobics, in contrast, are expected to demonstrate attentional and memory biases for information related to how others are evaluating them. Only nongeneralized social phobics are expected to experience excessive physiological arousal when public speaking. Results from the proposed study should increase our understanding of the cognitive and interpersonal aspects of both social phobia and dysthymia by identifying which aspects may be unique to the particular disorder (or to an anxiety versus a mood disorder) and which may be common to emotional disorders in general. Such information may suggest potential etiological variables which could be explored in future research. Also, these findings will be useful in refining psychosocial treatments for the two disorders and in the development of a treatment strategy for those who experience both social phobia and depression. The detailed examination of interpersonal behavior and cognitive functioning will be particularly useful for improving social skills and cognitive treatments, respectively.
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2016 — 2017 |
Hope, Debra A. |
R21Activity Code Description: To encourage the development of new research activities in categorical program areas. (Support generally is restricted in level of support and in time.) |
Community Partnership to Identify Intervention Targets to Improve Mental Health Services to Transgender Individuals in Underserved Areas @ University of Nebraska Lincoln
Abstract Individuals who fall outside of the binary male/female classification of gender that matches the sex they were assigned at birth?termed transgender or simply trans?face innumerable challenges to their personal, interpersonal, and cultural identity that provoke significant health disparities. Although standards of care and other guidelines have been established for mental health services for trans individuals, these documents tend to be broad and aspirational and provide little specific information for front line providers or evidence-based practice. Furthermore, the history of stigmatization and discrimination, including in health care settings, has created many barriers to treatment seeking by trans individuals. This project seeks to reduce these health disparities and improve psychological services through two specific aims: #1 Develop culturally sensitive evidence-based principles of care for psychological services and assessment for the trans community in service impoverished areas. #2. Assess the needs and barriers for mental health services through an iterative development process in partnership with the Central Great Plains trans community that includes a deep understanding of stigma that can then inform the principles of care. Using a community-based participatory research model, the research team will partner with the Central Great Plains rural and urban trans community and local mental health providers through an iterative series of focus groups. Transcripts of the focus groups will be subjected to two analyses ? an inductive analysis based in grounded theory to identify themes and a critical, cultural, and rhetorical approach to link key topics in the transcripts to the cultural context to better understand trans stigma. The project will be guided by the already established local and national advisory boards. Deliverables include principles of care that can inform trans-affirmative adaptations of first-line psychological interventions for common disorders; a self- report instrument to inform process and outcomes for trans psychological services; and a publishable taxonomy of stigmatizing and destigmatizing discourse to provide critical information to clinicians about the way language is used to marginalize or heal trans people in the healthcare context. These deliverables and the establishment of a partnership with trans community will prepare the research team to apply the principles of care in a specific context (e.g., adapting a first-line treatment for anxiety) and, eventually, randomized controlled trials. This project will enhance public health services to a population subject to large health disparities, offering a pathway to improve best practices in mental health care for the trans population.
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