Judith T Moskowitz

Judith T Moskowitz
University of California, San Francisco | UCSF

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121
Publications
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Publications

Publications (121)
Article
Background eHealth interventions have proven to be valuable resources for users with diverse mental and behavioral health concerns. As these technologies continue to proliferate, both academic researchers and commercial app creators are leveraging the use of features that foster a sense of social connection on these digital platforms. Yet, the lite...
Article
Full-text available
Introduction Burnout poses a substantial, ongoing threat to healthcare worker (HCW) wellbeing and to the delivery of safe, quality healthcare. While systemic and organization-level changes in healthcare are critically important, HCWs also need individual-level skills to promote resilience. The objective of this trial is to test feasibility, accepta...
Article
Background Alzheimer disease is a degenerative neurological condition that requires long-term care. The cost of these responsibilities is often borne by informal caregivers, who experience an elevated risk of negative physical and psychological outcomes. Previously, we designed a positive emotion regulation intervention that was shown to improve we...
Preprint
BACKGROUND Alzheimer disease is a degenerative neurological condition that requires long-term care. The cost of these responsibilities is often borne by informal caregivers, who experience an elevated risk of negative physical and psychological outcomes. Previously, we designed a positive emotion regulation intervention that was shown to improve we...
Preprint
BACKGROUND eHealth interventions have proven to be valuable resources for users with diverse mental and behavioral health concerns. As these technologies continue to proliferate, both academic researchers and commercial app creators are leveraging the use of features that foster a sense of social connection on these digital platforms. Yet, the lite...
Preprint
BACKGROUND The responsibilities of being a primary caregiver for a loved one with Alzheimer's disease can produce significant stress for the caregiver, leading to deleterious outcomes for the caregiver’s physical and psychological health. Hence, researchers are developing online interventions to provide support for caregivers. Members of our resear...
Article
Full-text available
Background The responsibilities of being a primary caregiver for a loved one with dementia can produce significant stress for the caregiver, leading to deleterious outcomes for the caregiver’s physical and psychological health. Hence, researchers are developing eHealth interventions to provide support for caregivers. Members of our research team pr...
Preprint
BACKGROUND Adherence to self-guided interventions tends to be very low, especially in people with depression. Prior studies have demonstrated that enhancements may increase adherence, but little is known about the efficacy of various enhancements in comparison to, or in combination with, one another. OBJECTIVE The objective of our study was to tes...
Article
Full-text available
Background Adherence to self-guided interventions tends to be very low, especially in people with depression. Prior studies have demonstrated that enhancements may increase adherence, but little is known about the efficacy of various enhancements in comparison to, or in combination with, one another. Objective The aim of our study is to test wheth...
Article
Full-text available
Background: Adults with type 2 diabetes may experience health benefits, including glycemic control and weight loss, from following a very low-carbohydrate, ketogenic (VLC) diet. However, it is unclear which ancillary strategies may enhance these effects. Objective: This pilot study aims to estimate the effect sizes of 3 intervention enhancement...
Article
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There has been extensive discussion about gender gaps in representation and career advancement in the sciences. However, psychological science itself has yet to be the focus of discussion or systematic review, despite our field's investment in questions of equity, status, well-being, gender bias, and gender disparities. In the present article, we c...
Preprint
BACKGROUND Adults with type 2 diabetes may experience health benefits, including glycemic control and weight loss, from following a very low–carbohydrate, ketogenic (VLC) diet. However, it is unclear which ancillary strategies may enhance these effects. OBJECTIVE This pilot study aims to estimate the effect sizes of 3 intervention enhancement stra...
Article
Full-text available
Objective: Dysfunction in positive affect is a defining symptom of bipolar I disorder (BD), both during and between mood episodes. We hypothesize that helping people with BD learn skills to create balance in their affective experiences by engaging in strategies that increase low activation positive emotion (LAP; e.g., relaxation) could help to imp...
Article
Introduction: In this study we examined the acceptability and feasibility of a mindfulness based group intervention for socio-economically disadvantaged women in an urban community health center (M-Body). Method: Women ages 18-65 with depressive symptoms who participated in an 8-week mindfulness based group intervention were invited to attend fo...
Article
Introduction: In the present study, the authors pilot a streamlined mindfulness teacher training protocol for Federally Qualified Health Center (FQHC) staff and examine the distribution and variability of psychologic outcomes for participants in groups led by an experienced instructor compared to a FQHC staff instructor who received the streamlined...
Article
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This systematic review examines the socio-economic and demographic characteristics of adults enrolled in US-based randomized controlled trials of mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT). We conducted a literature search using Medline, PsycINFO, and CINAHL electronic databases from the earliest availa...
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Background: Contingency management (CM) is an evidence-based intervention providing rewards in exchange for biomarkers that confirm abstinence from stimulants such as methamphetamine. We tested the efficacy of a positive affect intervention designed to boost the effectiveness of CM with HIV-positive, methamphetamine-using sexual minority men. Met...
Article
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While negative emotions are associated with risk behaviors and risk avoidance among people with HIV, emerging evidence indicates that negative self-conscious emotions, those evoked by self-reflection or self-evaluation (e.g., shame, guilt, and embarrassment), may differentially influence health-risk behaviors by producing avoidance or, conversely,...
Article
Objective: Evidence links depression and stress to more rapid progression of HIV-1 disease. We conducted a randomized controlled trial to test whether an intervention aimed at improving stress management and emotion regulation, mindfulness-based stress reduction (MBSR), would improve immunological (i.e. CD4+ t-cell counts) and psychological outcom...
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Objectives Mounting evidence links positive psychological functioning to restorative health processes and favourable medical outcomes. However, very little is known about the relationship between optimism, an indicator of psychological functioning and the American Heart Association (AHA)-defined concept of cardiovascular health (CVH), particularly...
Article
Background Text messaging is a promising strategy to support HIV care engagement, but little is known about its efficacy in urban safety-net HIV clinic populations. Methods We conducted a randomized controlled trial of a supportive and motivational text messaging intervention, Connect4Care (C4C), among viremic patients who had a history of poor re...
Article
Full-text available
Alice Verstaen,1 Judith T Moskowitz,2 Karin E Snowberg,1 Jennifer Merrilees,3 Glenna A Dowling1 1Department of Physiological Nursing, University of California, San Francisco, San Francisco, CA, 2Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, 3UCSF Memory and Aging Center, Weill Institute fo...
Article
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Dietary treatment is important in management of type 2 diabetes or prediabetes, but uncertainty exists about the optimal diet. We randomized adults (n = 34) with glycated hemoglobin (HbA1c) > 6.0% and elevated body weight (BMI > 25) to a very low-carbohydrate ketogenic (LCK) diet (n = 16) or a moderate-carbohydrate, calorie-restricted, low-fat (MCC...
Article
This reply addresses observations of Drs. Larsen, Kruse, and Sweeny, and Scherer in their reviews of our published work on the link between positive psychological assets and outcomes of physical health. Inspired by Obama’s Precision Medicine Initiative we argue that the interplay between the emotion spectrum and health is likely a complex and heter...
Article
A paradigm shift in public health and medicine has broadened the field from a singular focus on the ill effects of negative states and psychopathology to an expanded view that examines protective psychological assets that may promote improved physical health and longevity. We summarize recent evidence of the link between psychological well-being (i...
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Objective: This study examines the acceptability and preliminary efficacy of Positive Adaptations for Trauma and Healing (PATH), a manualized treatment for Latino youth and their caregivers. PATH is a culturally adapted program that incorporates a trauma model, positive psychology, and resilience. Method: Latino youth (N = 16) recruited from an...
Article
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Objective: We conducted a randomized controlled trial to determine whether IRISS (Intervention for those Recently Informed of their Seropositive Status), a positive affect skills intervention, improved positive emotion, psychological health, physical health, and health behaviors in people newly diagnosed with HIV. Method: One-hundred and fifty-n...
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Background Type 2 diabetes is a prevalent, chronic disease for which diet is an integral aspect of treatment. In our previous trial, we found that recommendations to follow a very low-carbohydrate ketogenic diet and to change lifestyle factors (physical activity, sleep, positive affect, mindfulness) helped overweight people with type 2 diabetes or...
Article
Background: We conducted a randomized pilot trial to examine the feasibility, acceptability, and preliminary efficacy of a 5 week positive affect skills intervention (LILAC: lessons in linking affect and coping) for women with metastatic breast cancer. Additionally, we examined whether online delivery of the intervention would offer comparable ben...
Article
Background: In this study we examine the feasibility and preliminary effectiveness of mindfulness based stress reduction adapted for delivery in an urban Federally Qualified Health Center (FQHC). Methods: Thirty-one African- American adult women ages 18-65 with depressive symptoms enrolled to participate in an 8-week mindfulness group interventi...
Article
Full-text available
Background Contingency management (CM) is an evidence-based intervention providing tangible rewards as positive reinforcement for abstinence from stimulants such as methamphetamine. Integrative approaches targeting affect regulation could boost the effectiveness of CM in community-based settings and optimize HIV/AIDS prevention efforts. Methods/De...
Article
We used a stress and coping model to examine the association of dispositional mindfulness, defined as the tendency to intentionally bring non-judgmental attention and awareness to one's experience in the present moment, with psychological and physical health in adults with HIV. Data were collected at baseline of a randomized controlled trial of Min...
Article
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Background: People with prehypertension (120-130/80-90 mmHg) are at increased risk of progressing to hypertension. Recommendations for prehypertension include engaging in regular physical activity. We aimed to assess feasibility and acceptability and collect preliminary outcome data on ChiRunning for people with elevated blood pressure. ChiRunning...
Article
Objectives: Positive psychological states are linked to superior health and longevity, possibly due to behavioral factors. We evaluated cross-sectional and 5-year associations between positive affect and health behaviors in patients with coronary heart disease (CHD). Methods: Outpatients with CHD reported positive affect, physical activity, slee...
Article
Full-text available
Contingency management (CM) is an evidence-based intervention that provides tangible rewards as positive reinforcement for biologically confirmed abstinence from substance use. Integrative approaches targeting positive affect regulation could boost the effectiveness of CM by sensitizing individuals to non-drug-related sources of reward and assistin...
Chapter
This chapter describes areas of potential synergy between health psychology and positive psychology and the collective contributions these disciplines can provide for promoting health and well-being. It describes these two subfields of psychology and summarizes the relationship of common positive psychology constructs and health outcomes. It discus...
Article
Among men who have sex with men (MSM), sexual compulsivity is associated with overlapping psychosocial and behavioral health problems. Because difficulties with emotion regulation are thought to be one important feature, this study examined whether affective states and traumatic stress symptoms were independently associated with key dimensions of s...
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Background: Few data exist on the use of text messaging as a tool to promote retention in HIV care and virologic suppression at the clinic level in the United States. We describe the protocol for a study designed to investigate whether a text messaging intervention that supports healthy behaviors, encourages consistent engagement with care, and pr...
Article
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Among men who have sex with men (MSM), the co-occurrence of trauma and stimulant use has negative implications for HIV/AIDS prevention. HIV-positive, methamphetamine-using MSM were recruited to pilot test a 7-session, multicomponent resilient affective processing (RAP) intervention that included expressive writing exercises targeting HIV-related tr...
Article
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Increasing evidence suggests that positive affect plays an important role in adaptation to chronic illness, independent of levels of negative affects like depression. Positive affect may be especially beneficial for people in the midst of severe stress, such as the diagnosis of human immunodeficiency virus (HIV). As medical treatments for HIV have...
Article
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Unlabelled: Although current treatments help to alleviate some of the symptoms of schizophrenia, people with schizophrenia often continue to experience residual symptoms. An emotion-focused treatment approach may help to improve well-being in this population by increasing positive experiences and resources. In this article, we discuss the feasibil...
Article
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Positive affect predicts improved glycemic control and longevity in adults with type 2 diabetes. We tested DAHLIA, a self-paced online intervention for type 2 diabetes that teaches positive affect skills such as savoring, gratitude, and acts of kindness. Participants (n=49) were randomized to the 5-week DAHLIA course or an emotion-reporting waitlis...
Article
Full-text available
We compared the effects of two diets on glycated hemoglobin (HbA1c) and other health-related outcomes in overweight or obese adults with type 2 diabetes or prediabetes (HbA1c>6%). We randomized participants to either a medium carbohydrate, low fat, calorie-restricted, carbohydrate counting diet (MCCR) consistent with guidelines from the American Di...
Conference Paper
Objective: Disadvantaged students may be at increased risk of experiencing distress, anxiety and lower scores, while preparing for graduate entrance exams. Positive affect may be beneficial as a target of stress reduction interventions. The purpose of this study was to adapt a pre-existing positive affect intervention to address positive affect, st...
Article
What can a speech reveal about someone's state? We tested the idea that greater stress reactivity would relate to lower linguistic cognitive complexity while speaking. In Study 1, we tested whether heart rate and emotional stress reactivity to a stressful discussion would relate to lower linguistic complexity. In Studies 2 and 3, we tested whether...
Article
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Objective: Revised Stress and Coping Theory proposes that positive affect serves adaptive functions, and its beneficial effects are heightened during stressful periods. This study examined the prospective relationship between positive affect and engagement in care during the 18 months after a HIV seropositive diagnosis. Methods: The Coping, HIV,...
Article
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Illness appraisals provide important context to help understand the way individuals cope with chronic illness. In the present study, a qualitative approach to the analysis of HIV diagnosis experience narratives in a sample of 100 people newly diagnosed with HIV revealed five groups that differed in their initial illness appraisals: HIV as Chronic I...
Article
Aberrant psychological and behavioral symptoms are common in patients with dementia. These symptoms have negative consequences for family caregivers, causing stress and burden. Frontotemporal dementia (FTD) symptoms cause more pronounced stress and burden on caregivers than those associated with Alzheimer dementia. In this randomized, attention con...
Article
Background: Revised Stress and Coping Theory proposes that positive affect serves adaptive functions, independent of negative affect. However, scant research has examined whether, how, and under what circumstances positive affect is associated with decreased substance use. Methods: Eighty-eight methamphetamine-using men who have sex with men (MS...
Article
Stress has been shown to deplete the self-regulation resources hypothesized to facilitate effective role functioning. However, recent research suggests that positive affect may help to replenish these vital self-regulation resources. Based on revised Stress and Coping theory and the Broaden-and-Build theory of positive emotion, three studies provid...
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Position in the social hierarchy is a major determinant of health outcomes. We examined the associations between aspects of social hierarchy and depressive symptoms with a specific focus on one potential psychological mechanism: emotion suppression. Suppressing negative emotion has mental health costs, but individuals with low social power and low...
Article
Full-text available
Disclosing HIV status to friends, family, and sex partners is often stressful. However, HIV disclosure has been associated with improved physical health, psychological well-being, and improved health behaviors. The aim of this study was to address some of the gaps in the literature regarding the disclosure process by conducting a mixed-methods stud...
Article
Research in the past few decades has demonstrated that positive affect co-occurs with negative affect in the context of stressful life events, has unique beneficial consequences, and may be a useful focus of intervention. The purpose of this chapter is to provide an overview of the variety of single-and multiple-component interventions that hold pr...
Article
Prior research established that psychological factors are associated with the frequency of stimulant (i.e., cocaine, crack, and methamphetamine) use among substance-using men who have sex with men (MSM). The present investigation examined whether and how psychological factors are associated with engagement in any stimulant use in the broader popula...
Conference Paper
Substance abuse treatment is effective in decreasing stimulant (i.e., methamphetamine) use and sexual risk taking behaviors among men who have sex with men (MSM). However, prior research has documented that elevated HIV-specific traumatic stress (i.e., symptoms of post-traumatic stress disorder related to the experience of living with HIV/AIDS) is...
Article
Full-text available
In this article we present background, theoretical rationale, and pilot data on the development of an intervention designed to increase positive affect in people living with serious health-related stress. This proof-of-concept study demonstrated that a multiple-component positive affect intervention is feasible and acceptable for people newly diagn...
Article
Background: There is increasing evidence showing beneficial effects of mindfulness and mindfulness training on various indicators of mental and physical health. Purpose: This paper reports the 6-month follow-up effects of a mindfulness stress reduction training program among patients treated for cancer on perceived stress, depression, anxiety, p...
Article
Advances in antiretroviral therapy (ART) for HIV offer life-extending benefit; however, the side effects associated with ART use negatively impact quality of life and medication adherence among people living with HIV. This study tested the efficacy of Mindfulness-Based Stress Reduction (MBSR) for reducing ART symptoms and bother/distress related to...
Article
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The objective of this study was to determine and compare the cost to treat HIV(+) and HIV(-) pediatric patients both before and after HIV prophylaxis became the standard of care. Retrospective chart review of a pediatric HIV/AIDS specialty clinic's medical charts was conducted for clinical and healthcare utilization data on 125 children diagnosed f...
Article
There is increasing recognition of the links between mindfulness, decreased stress, and healthier psychological functioning. However, the majority of this research has been conducted in US samples and the mechanisms through which mindfulness decreases stress and increases well-being are not well understood. The aim of this study was to examine the...
Chapter
Mounting scientific evidence indicates that positive psychological states are reflected in biological processes, objective physical health, and mortality. This chapter examines the mechanisms through which positive psychological states influence physical health outcomes, focusing on biological processes. To that end, it first reviews the literature...
Article
Full-text available
Deciding to initiate antiretroviral treatment (ART) for HIV involves a number of factors, including how one thinks about disease (illness appraisals) and how one thinks about treatment (medication appraisals). We con-ducted semi-structured interviews with 20 adults who were deciding whether to begin ART, in which partici-pants were asked to relate...
Article
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Life has changed dramatically for infants exposed perinatally to HIV to HIV primarily because of a successful translational research program that has also affected treatment costs. We compared treatment costs among HIV+ patients in an HIV/AIDS specialty clinic across 3 treatment eras: monotherapy (pre-1990), combination therapy (1990-1996), and hig...
Article
Full-text available
The use of stimulants has important implications for HIV prevention and care. However, few investigations have examined psychological correlates of substance use and adherence to anti-retroviral therapy (ART) among HIV-positive stimulant users. This cross-sectional investigation examined affective correlates of stimulant use and ART adherence among...
Article
Full-text available
There is increasing recognition of mindfulness and mindfulness training as a way to decrease stress and increase psychological functioning. The aims of this study were to examine the effects of mindfulness stress reduction training on perceived stress and psychological well-being and to examine if changes in mindfulness mediate intervention effects...
Article
After experiencing a stressful or traumatic event, many individuals report positive changes in their lives, or benefit finding. Preliminary evidence suggests that benefit finding may lead to improvements in physical health. However, the mechanisms linking benefit finding to physical health outcomes have not been determined. This article describes a...
Article
Understanding the malleable determinants of cellular aging is critical to understanding human longevity. Telomeres may provide a pathway for exploring this question. Telomeres are the protective caps at the ends of chromosomes. The length of telomeres offers insight into mitotic cell and possibly organismal longevity. Telomere length has now been l...
Article
New CDC guidelines for HIV testing as well as the introduction of rapid tests may increase the number of HIV tests conducted in the USA and make testing a more routine part of medical care. However, little is currently known about the experience of those receiving positive results. In this study, face-to-face interviews were conducted with 50 parti...