Individuals experiencing chronic pain are at greater risk for suicidal behavior. The mechanism of action for this association is unexplored, but may involve the influence of pain on interpersonal functioning. We examined the mediating role of unsatisfied interpersonal needs on the relation between pain severity and interference, and suicidal behavior. Low income, uninsured participants completed self-report measures of pain severity and interference, thwarted interpersonal needs and suicidal behavior. Our hypotheses were partially supported; in simple mediation models, an indirect only effect existed for both thwarted belongingness and perceived burdensomeness in the relation between pain severity and pain interference and suicidal behavior. These effects did not persist in multiple mediation analyses. Our findings suggest that, for patients experiencing pain, assessment and improvement of the quantity and quality of interpersonal relationships may reduce risk for suicide ideation and attempts.

Introduction: Childhood obesity has more than quadrupled in the last 30 years, with the prevalence in adolescents aged 12-17 years increasing from 5% in 1980 to 21% in 2012. The purpose of this study was to estimate the extent to which childhood obesity in Tennessee is associated with between-context differences (districts, schools and classes) and to identify factors at the district, school, class, and individual level that influence the individual weight status among 64,790 Tennessee children and adolescents. Methods: Crosssectional data from the Youth Risk Behavior Survey (YRBS) conducted in Tennessee (2010) were used to conduct multilevel analyses that account for the nesting of students in classes, classes in schools and schools in districts. The outcome variable was childhood obesity (>95th percentile). Explanatory variables included district-level factors (the proportion of children wearing seat belts or helmets in district and the proportion of being asked to show proof of age), school-level factors (current tobacco use in school, and HIV/AIDS education in school), class-level factors (the average of smoking days in past 30 days and the proportion of ever having exercised to lose weight in class) and individual-level factors (state geographical regions, age, gender, grade, ever ridden in a car driven by someone who had been drinking alcohol, ever carried a weapon, made a plan to kill yourself, ever used or early onset use of tobacco, alcohol, marijuana, exercised to control weight, school day television time, days of physical education (PE) classes. Odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were reported. Results: Multilevel analyses indicate that 0.90%, 0.08%, and 0.45% of the variation in obesity is associated with class, school and district differences, respectively. Male middle schoolers were at greater risk for obesity [OR: 1.82, C.I. (1.75, 1.89)] compared to females. For every one year increase in age, the relative odds of obesity increased by 11% (OR 0.89, 95% CI 0.88-0.91). Students with worse grades were more likely to have obesity [OR: 1.33, C.I. (1.13, 1.56)]. Students who watched TV 3 hours or more per day were more likely to be obese [OR: 1.31, C.I. (1.23, 1.40)] compared to those who did less than 3 hours per day. Similarly students who ever tried cigarettes were more likely to be obese [OR: 2.15, C.I. (1.62, 2.85)] compared to those students who did not. Students who reported wearing seat belts [OR: 0.05, C.I. (0.02, 0.16)] were less likely to be obese. Conclusions: This study highlights a number of modifiable factors on multiple levels associated with child and adolescent obesity in the state of Tennessee. The results emphasize the importance of targeting programs beyond individual adolescent factors to the child’s classes, schools, and school districts, to reduce the prevalence of obesity among Tennessee adolescents.

We examined associations between trait hope and preparation for future care needs (PFCN) among 66 older adult primary care patients in western New York. Participants completed a questionnaire assessing PFCN (awareness, information gathering, decision-making, concrete planning, and avoidance), and the Adult Trait Hope Scale. In multivariate regressions, lower hope, particularly less agency, was associated with more awareness of needing care, whereas higher hopefulness, particularly pathways thinking, was associated with increased decision-making and concrete planning. Greater hopefulness appears to be linked to goal-directed planning behaviors, although those with lower hope may actually be more aware of the need for planning. Evidence-based programming that encourages learned hopefulness may contribute to enhanced health planning and decision-making among older adult primary care patients.

This study examined academic motivation and basic psychological needs as predictors of suicidal risk (namely, depressive symptoms and suicidal behaviors) in a sample of 348 college students. Results from regression analyses indicated that academic motivation was a significant predictor of suicidal risk. The inclusion of basic psychological needs significantly augmented the prediction model. The authors discuss implications for considering academic motivation and basic psychological needs in college counseling on the basis of the results.

Suicide is a significant public health concern and the second leading cause of death for college students. Perceived stress, depression, and mental health stigma are established risk factors for suicidal behavior; however, their interrelationships are unknown. Data were collected from 913 collegiate housing residents (70.8% female; N = 646). Using data from self-report measures, depressive symptoms were examined as a mediator of the relation between stress and suicidal behavior, along with the moderating effect of mental health stigma. Depressive symptoms partially mediated the stress–suicide linkage, and mental health stigma was a significant moderator of the associations between stress and depression, depression and suicidal behavior, and stress and suicidal behavior. Stigmatized attitudes toward mental health treatment, including fear of social repercussion, may exacerbate the deleterious impact of stress on psychopathology and suicide risk. Individual-level therapeutic strategies targeting stress and psychopathology, as well as public health approaches that directly address and attempt to reduce mental health stigma, may reduce suicide risk in college students.

Defines Beck Hopelessness Inventory.

With the growth of fashion consumption through websites and e-tailers, the question of when and why consumers engage in shopping without the intent to purchase has gained new relevance. A novel framework for understanding this phenomenon comes from studies examining the neural basis of aesthetic appreciation. Previous studies in neuroaesthetics have identified brain regions associated with value and reward, including the nucleus accumbens (NAcc) and ventromedial prefrontal cortex (VMPFC), as involved during attractiveness judgments even when no physical product is consumed. Along with research demonstrating that attractive stimuli can serve as economic incentives to motivate behavior, these results suggest that the experience of aesthetic appreciation can have value in and of itself, similar to the hedonic value previously proposed to explain shopping without the intent to purchase. The proposed study examines whether fashion browsing can be considered a type of aesthetic experience. Functional magnetic resonance imaging (fMRI) will be used to measure neural activation as female subjects (N=50) view fashion images. If fashion browsing is a type of aesthetic experience, we would expect it serve as an economic incentive and motivate work. Additionally, the NAcc and VMPFC during browsing should show increasing activation with increasing attractiveness of fashion content. Individual differences in self-reported fashion browsing behavior will correlate with the degree of neural differentiation to fashion content such that individuals who spend more time per week browsing will have higher BOLD signal NAcc and VMPFC activation during the experimental task. Fashion browsing as an aesthetic experience could serve as a crucial mechanism to develop a greater understanding of an important aspect of the consumer shopping experience.

Cocaine use disorder is a significant health problem, negatively impacting individuals afflicted. While preclinical self-administration research has provided invaluable insight into the neurobehavioral mechanisms that underlie cocaine abuse, cocaine use outside of the laboratory occurs within an environment where other goods are also available ubiquitously. Although there is an ever-increasing literature investigating drug vs. non-drug choice in rodent models and how alternative goods can compete with the subjective value of cocaine, the neurobiological mechanisms that are associated with cocaine preference remains largely unknown. Additionally, current drug vs. non-drug choice studies use procedures that confound preference with intake, such that preference measures are directly reflective of individual experience with drug and non-drug reinforcers earned through the choices that are made; simply, preference and intake are the same. Moreover, differences in cocaine experience can result in differential neural adaptations, thus making it difficult to determine if the neurobiological mechanisms underlying choice are related to preference or drug intake. Herein a novel choice procedure, which controls for reinforcer intake (controlled reinforcer ratio; CRR), was used to explore how certain reinforcer dimensions (i.e., magnitude and frequency) influence cocaine preference. In addition, neuronal activity, measured via c-fos expression, in the orbitofrontal cortex and nucleus accumbens, areas associated with decision-making and valuation, for cocaine and food were independently targeted and labeled using fluorescent in situ hybridization and fluorescent immunohistochemistry. First, unlike prototypical choice procedures where preference and intake are confounded, the CRR choice procedure was able to dissociate the two. Under the CRR choice procedure, it was revealed that both magnitude and frequency, independent dimensions of reinforcement, greatly influence preference for cocaine. Furthermore, the CRR choice procedure was sensitive to manipulations known to influence cocaine preference while keeping reinforcer intake constant. When neuronal activity was examined after CRR training, the number of cocaine activated cells, relative to food activated cells, did not correlate with individual preferences for cocaine despite overall reinforcer intake being held constant. Instead, results suggest neuronal activity for cocaine was related to overall cocaine intake. Overall, these results give impetus for utilizing the CRR choice procedure to better investigate how drug and non-drug reinforcers are afforded differential subjective value and compete for preference. Moreover, use of a CRR choice procedure may lead to identification of specific neurobehavioral mechanisms and lead toward future development of more effective pharmacological and behavioral treatments to ameliorate substance use disorders.

The marriage of perspectives from behavioral economic theory and learning theory has the potential to advance an understanding of substance use and substance use disorder. Behavioral economic demand is a central concept to this interdisciplinary approach. Evaluating demand in the laboratory and clinic can improve previous research on the relative reinforcing effects of drugs by accounting for the multi-dimensional nature of reinforcement rather than viewing reinforcement as a unitary construct. Recent advances in the commodity purchase task methodology have further simplified the measurement of demand values in human participants. This dissertation project presents a programmatic series of studies designed to demonstrate the utility of using a behavioral economic demand framework and the purchase task methodology for understanding substance use disorder through basic and applied science research. Experiments are presented spanning a continuum from theoretical and methodological development to longitudinal work and clinical application. These experiments demonstrate three key conclusions regarding behavioral economic demand. First, behavioral economic demand provides a reliable and valid measure of drug valuation that is applicable to varied drug types and participant populations. Second, behavioral economic demand is a stimulus-selective measure specifically reflecting valuation for the commodity under study. Third, behavioral economic demand provides incremental information about substance use in the laboratory and clinical setting above and beyond traditional measures of reinforcer valuation and other behavioral economic variables. These findings collectively highlight the benefits of behavioral economic demand and provide an important platform for future work in addiction science.

Background:Non-medical use of prescription opioids (NMUPO) has become a clear threat to public health. Young adults (aged 18 to 25) have a high risk of NMUPO. My prior work on Chinese undergraduates indicates a high prevalence of lifetime NMUPO (49.2%). Health behavior theories propose that outcome expectancies are robust psychosocial determinants of substance use. Literature has identified the influence of outcome expectancies on alcohol and drug use. However, the role of outcome expectancies in NMUPO in China is unknown, and a scarcity of a valid measures for NMUPO outcome expectancies may be a barrier. Our previous research also found an association of cultural orientation with NMUPD in Chinese college students, implying that cultural orientation may affect NMUPD-related perceptions, such as outcome expectancies. The purposes of this study were to (1) conduct initial work to develop and validate an NMUPO outcome expectancies scale (NMUPOES) for Chinese college students; (2) examine the association of cultural orientation with factors identified in NMUPOES. Method: Partial data (n = 202) derived from a bigger online dataset collected from 849 undergraduates (average age = 19.65) at two universities in Beijing and Macau in Jan-April 2017 was used in this study. Participants completed the NMUPOES and reported their past-3-month NMUPO and cultural orientation. Exploratory factor analysis, confirmatory factor analysis, and structural equation modeling were employed to test the study hypotheses. Results: Findings suggested four subscales in the 50-item NMUPOES (i.e., social enhancement and tension reduction, academic enhancement, physiological discomfort, and guilt and dependence) and two higher-order factors (i.e., positive expectancies and negative expectancies). All subscales were positively correlated and had good internal consistency. The negative expectancies scale was negatively associated with past-3-month NMUPO. No significant association was found between cultural orientation and the two expectancy factors. Conclusion:NMUPOES is a psychometrically appropriate measure of NMUPO expectancies for Chinese college students. Future research may validate the NMUPOES using a large sample size in both clinical and non-clinical populations in China. An intervention program tailored to outcome expectancies may be beneficial to reduce the risk of NMUPO in Chinese college students.