Interactive online HIV prevention program reduces STIs in young men who have sex with men

An interactive online HIV prevention program significantly lowered sexually transmitted infections (STIs) in ethnically diverse young men who have sex with men (YMSM), according to a recent NIMH- and NIDA-funded study.

From 2013 to 2017, 901 HIV-negative men (18–29 yrs.) participated in either Keep It Up! (KIU!), a multimedia online intervention program, or a control group consisting of existing online HIV information. After enrollment, participants completed questionnaires and either at-home or in-person STI testing. Follow-up questionnaires were completed at 3, 6, and 12 months with additional STI testing at 12 months (gonorrhea or chlamydia). KIU! involved videos, interactive animation, and games to increase HIV knowledge, promote self-efficacy, teach safe sex practices, and encourage repeated HIV testing.

At the end of the 12 months, infection rates generally increased in the control group and decreased in the KIU! group. Specifically, those in the KIU! Program had 40 percent fewer STIs at month 12 compared to the control group (risk ratio = 0.60). Both the control and KIU! group reported less unsafe sex, however KIU! participants had greater reductions (44 percent) compared to the control (37 percent).

These results suggest interactive online prevention programs specially tailored to YMSM reduce STIs and unsafe sex.

Citation:
Mustanski B, Parsons JT, Sullivan PS, Madkins K, Rosenberg E, Swann G. 2018. Biomedical and Behavioral Outcomes of Keep It Up!: An eHealth HIV Prevention Program RCT. Am J Prev Med. 55(2):151-158.

Brain reactivity to facial expressions may explain why some disadvantaged young adults experience different socioeconomic outcomes despite similar resources

In a recent NIMH-, NIDA-, and NICHD-supported study, socioeconomic resources, later antisocial behavior, and income can be predicted by amygdala reactivity to facial expressions in a sample of urban men from impoverished families.

Participants were young men (n = 310) from low-income urban neighborhoods selected from the Pitt Mother and Child Project, an ongoing longitudinal study of child risk and resilience in low-income families. Children and mothers had yearly laboratory or in-home assessments from the age of 1.5–22 (child’s age) which included questionnaires, a psychiatric interview, and, at age 20, a functional MRI (fMRI) scanning session.

Findings indicated that socioeconomic resources at age 20 were associated with less antisocial behavior and greater income at age 22 in low-income, urban young men. Amygdala reactivity to all faces was positively correlated with amygdala reactivity to fearful facial expressions and negatively correlated with income at age 22. Surprisingly, amygdala reactivity at age 20 was not significantly related to antisocial behavioral age 22, and antisocial behavior and income at age 22 were not correlated.

These results are consistent with previous research that also has shown that increased amygdala reactivity as a marker of an individual’s sensitivity or “plasticity” to the environment and theory on differential susceptibility to context. This research increases our understanding of differential susceptibility and why young adults demonstrate divergent outcomes even when exposed to similar socioemotional contexts.

Citation:
Gard AM, Shaw DS, Forbes EE, Hyde LW. 2018. Amygdala Reactivity as a Marker of Differential Susceptibility to Socioeconomic Resources during Early Adulthood. Dev Psychol. 54(12):2341-2355.

Group therapies: Efficacious and cost-effective interventions for chronic post-traumatic stress disorder in veteran populations

In a recent randomized controlled trial (RCT), researchers funded by the NIMH and the U.S. Department of Veterans Affairs demonstrated the efficacy of group therapies (trauma-focused and non-trauma-focused treatments) for chronic post-traumatic stress disorder (PTSD) in veterans.

Male veterans with PTSD were randomly assigned to either group cognitive behavioral therapy (GCBT; n = 98) or group present-centered treatment (GPCT; n = 100); both treatments were 14 sessions. Patient assessments occurred at baseline, mid- and post-treatment, and at 3-, 6-, and 12-month follow-ups. The following interview and self-report measures were used for assessing PTSD and comorbid conditions: the CAPS-5 structured diagnostic interview, the PTSD Checklist for DSM-5, the Structured Clinical Interview for DSM-IV, the Beck Depression Inventory–II, and the Beck Anxiety Inventory. Functional impairment was assessed with two subscales of the Medical Outcomes Study Short-Form Health Survey: Role Limitations Due to Emotional Problems and Social Functioning.

The findings from this study indicate that both GCBT and GPCT resulted in reductions in PTSD severity and PTSD diagnostic status following treatment (GCBT, d = 0.97, and GPCT, d = 0.61), with no significant difference between GCBT and GPCT for treatment efficacy. Additionally, both treatment groups had significant reductions in depression and anxiety symptoms and in functional impairment. These positive treatment effects were maintained at the 12-month follow-up.

Additional studies are needed to further investigate group treatment approaches for PTSD in veterans and active-duty service members due to the limited number of large RCTs and study limitations. This study provides additional evidence for the continued utilization of group treatment for PTSD.

Citation:
Sloan DM, Unger W, Lee DJ, Beck JG. 2018. A Randomized Controlled Trial of Group Cognitive Behavioral Treatment for Veterans Diagnosed with Chronic Posttraumatic Stress Disorder. J Trauma Stress. 31(6):886-898.