Psychology
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The Department of Psychology will provide a collaborative environment for innovation and scientific discovery in psychological science and for attainment of psychological literacy.
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Item Training community members to deliver an intervention for substance use disorder: Overcoming implementation barriers in American Indian communities(Elsevier BV, 2024-10) Skewes, Monica C.; Gonzalez, Vivian M.; Stix, AmyIntroduction. Although American Indian and Alaska Native (AI/AN) people have high rates of abstinence from alcohol and other drugs, there also is evidence of greater rates of substance use disorders (SUDs) in Native communities. Health disparities associated with substance use are compounded by inadequate access to evidence-based treatments (EBTs). Lack of mental health providers is one notable barrier to EBT implementation in rural AI reservation communities. Our Indigenous Recovery Planning (IRP) intervention merges cultural lessons and culturally adapted relapse prevention strategies to facilitate SUD recovery in the reservation environment. One key implementation strategy is training non-specialist community-based facilitators to deliver IRP, thereby increasing its acceptability and sustainability. This manuscript reports the facilitator training, supervision, and fidelity monitoring procedures used in our ongoing clinical trial of IRP. Method. The study recruited four AI non-specialist providers from the community to serve as IRP facilitators. Initial training involved an introductory motivational interviewing workshop followed by a 2-day workshop in the IRP curriculum. Then we conducted an open trial of the 6-week intervention with weekly supervision meetings as part of the facilitator training process. During the open trial we also assessed participant and facilitator receptivity to the IRP intervention and pilot tested our fidelity monitoring protocol. Results. The initial training workshops provided facilitators with information they needed to understand the rationale behind IRP and determine whether the facilitator role was a good fit; however, additional training and supervision during the open trial was needed to ensure proper treatment delivery. Although participant and facilitator feedback ratings were positive, the open trial helped us identify revisions needed to improve our approach to facilitator training, supervision, and fidelity monitoring. We revised these procedures, and also developed a protocol to train new facilitators who join the study midstream. Conclusion. The open trial was an important aspect of the facilitator training process and helped our team identify several areas of improvement. Our approach to training, supervising, and monitoring community member facilitators may serve as an example of how to overcome one barrier to implementing evidence-based SUD treatments in rural reservation communities with few mental health professionals.Item The Role of Complicated Grief in Health Inequities in American Indian Communities(SAGE Publications, 2024-09) Gameon, Julie A.; McNamee, Alex; Firemoon, Paula; Skewes, Monica C.Complicated grief is both a cause and a consequence of health inequities in Native (American Indian/Alaska Native [AI/AN]) communities. Given disproportionately high rates of physical (e.g., cancer, diabetes, and heart disease) and mental health problems (e.g., substance use disorder, posttraumatic stress disorder) in Native communities, it is common for AI/AN people to suffer many losses each year. Experiences of traumatic or repeated losses may lead to the development of maladaptive grief, often known as complicated grief. The aim of the current study was to understand the perspectives of community members on grief and its connection with health inequities among AI people who have experienced the loss of a person with whom they were close. Using a community-based participatory research framework, we conducted semi-structured interviews with 12 AI adults from a rural reservation community. The ages of the participants ranged from 32 to 80 years (M = 54.33, SD = 14.46) and women (n = 7, 58.3%) and men (n = 5, 41.7%) were included. The participants reported many barriers to healthy grieving and linked chronic, complicated grief with the development of multifaceted health problems, which were seen as exacerbating health disparities and leading to additional losses and grief. While coping with loss was difficult, many people were able to heal from extraordinary losses through community support and cultural practices. Future research with AI/AN communities is needed to develop, implement, and evaluate culturally responsive therapeutic grief treatments. There is also a pressing need to address current physical and mental health inequities to reduce the mortality rate and, thus, complicated grief in AI/AN communities.Item Perceived discrimination, political efficacy, and political participation in American Indian adults(Frontiers Media SA, 2024-03) Wood, Zachary J.; John-Henderson, Neha A.Introduction: Psychological factors linked to political participation are largely understudied in American Indians. Prior work notes relatively low levels of participation compared to other racial and ethnic groups and suggests that identification with being American Indian is linked to overall levels of civic engagement in part through perceptions of group discrimination. Methods: In the current work, in a sample of 727 American Indian adults, we created two groups: Group 1 (N = 398) reported perceived discrimination related to race, and Group 2 (N = 329) reported perceived discrimination not related to race or ethnicity. We investigated the relationships between individual experiences of everyday discrimination related to race, levels of political efficacy, and political participation (Group 1), and individual experiences of everyday discrimination not related to race or ethnicity, political efficacy, and political participation (Group 2). Results: We found that greater experiences of everyday discrimination related to race was associated with higher levels of political participation through increased levels of internal and collective efficacy. In contrast, greater experiences of everyday discrimination related to race was associated with higher levels of political participation through lower external political efficacy. For Group 2, we found that greater experiences of everyday discrimination not related to race or ethnicity was not directly associated with political participation, but mediation analyses revealed a relationship with lower levels of political participation through decreased internal and collective efficacy. The indirect effect through external political efficacy was not significant. Discussion: Given low levels of American Indian political participation, political efficacy could be a target for interventions aiming to increase participation in the political system.Item Association of racism and substance use treatment with belief in the myth of an American Indian/Alaska Native biological vulnerability to alcohol problems(American Psychological Association, 2023-06) Gonzalez, Vivian M.; Skewes, Monica C.Objectives: Belief in an American Indian/Alaska Native (AIAN) specific biological vulnerability (BV) to alcohol problems is associated with worse alcohol outcomes among AIANs. Despite a notable lack of evidence that biogenetic factors play a greater role in the development of alcohol problems among AIANs than other groups, many people still believe this myth. Consistent with theory and evidence that greater experiences with discrimination leads to the internalization of stereotypes and oppression, we hypothesized that greater perceived racial discrimination (racism) would be associated with greater BV belief, but that having a stronger ethnic identity would weaken this association. We also examined whether previous substance use treatment as well as participation in Alcoholics Anonymous (AA) or Narcotics Anonymous (NA) was associated with BV belief. Method: Participants were 198 reservation-dwelling AI adults with a substance use problem who completed a survey as part of a larger community-based participatory study. Results: A multiple regression analysis revealed that greater systemic racism was associated with greater belief in a BV; this association was not moderated by ethnic identity. Greater interpersonal racism was also associated with greater BV belief—but only among those low in ethnic identity. A regression analysis revealed that previous treatment, AA, and NA participation were not associated with BV belief. Conclusions: Greater systemic and interpersonal racism were associated with belief in a BV, and greater ethnic identity buffered the association between interpersonal racism and BV belief. This suggests that both combatting racism and fostering positive ethnic identity may help to lessen BV belief. (PsycInfo Database Record (c) 2023 APA, all rights reserved)