Maria L Pacella

Maria L Pacella
  • PhD
  • University of Pittsburgh

About

51
Publications
12,756
Reads
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1,527
Citations
Current institution
University of Pittsburgh

Publications

Publications (51)
Article
Full-text available
Introduction Sickle cell disease (SCD) is associated with vaso-occlusive events (VOEs) that can lead to disease complications, including early mortality. Given that similar inflammatory responses characterize VOE and traumatic injury, injured patients with SCD may be vulnerable to acute complications. This study is the first to examine whether trau...
Article
Approximately one-quarter of emergency department patients who are injured or experience medical emergencies will develop clinically significant posttraumatic stress disorder (PTSD) symptoms, which can evolve into PTSD. Emergency clinicians and rapid response teams (eg, trauma, cardiac, stroke) can play a critical role in recognizing symptoms of po...
Article
The COVID-19 pandemic has increased healthcare workers' (HCWs) risk for posttraumatic stress disorder (PTSD). Although subthreshold PTSD symptoms (PTSS) are common and increase vulnerability for health impairments, they have received little attention. We examined the prevalence of subthreshold PTSS and their relationship to physical health symptoms...
Article
Aims: To test the effectiveness of five interventions each utilizing a unique set of behavior change techniques on reducing alcohol consumption at 3- and 6-months among young adults with hazardous drinking. Design: A 5-arm parallel randomized controlled multicentre trial with 3- and 6-month follow-ups. Setting: Recruitment at four emergency de...
Article
Full-text available
Importance Approximately 1 in 10 adults do not always wear a seat belt, with the lowest use rates reported among young adults. Objective To determine the efficacy of a 6-week automated behavioral text message program promoting seat belt use compared with an attention control. Design, Setting, and Participants This parallel, 2-group, single-blind,...
Article
Purpose: This randomized clinical trial tested the efficacy of a 6-week text message program to reduce texting while driving (TWD) for young adults. Methods: Eligible individuals recruited from four emergency departments from December 2019 to June 2021 were aged 18-25 years who reported TWD in the past 2 weeks. Participants were randomly assigne...
Article
Posttraumatic symptom severity (PTSS) conveys amplified vulnerability to the development of chronic pain-related processes after physical injury, namely pain catastrophizing (PC) (e.g., magnification of threat, helplessness, and rumination). Yet, early relationships between PTSS and PC in the aftermath of injury remain relatively unexplored. We exa...
Preprint
Full-text available
Background Seat belt use is an effective way to reduce the morbidity and mortality of motor vehicle crashes. However, 1 in 10 adults do not always wear a seat belt, with the lowest use rates of seat belt use among young adults. Digital behavioral interventions could be useful to increase seat belt use, but remain under-developed. This randomized cl...
Article
Infusing community-level risk factors into traumatic stress research can broaden intervention targets. The Neighborhood Deprivation Index (NDI) and the Index of Concentration at the Extremes (ICE) are two common community-level risk factors derived from U.S. census data. We provide R scripts facilitating the computation of these risk factors and de...
Article
Full-text available
Purpose/objective: The role of perceived social support from specific sources (e.g., families, friends, and significant others) on the development of postinjury posttraumatic stress disorder (PTSD) and associated psychological symptoms (e.g., depression and anxiety) remains relatively unexplored. We examined the predictive role of social support f...
Article
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Pain is a complex construct contributing to significant impairment, particularly among physically injured patients seeking treatment in trauma and orthopedic surgery settings in which social workers are an integral component of care. The biopsychosocial theory, fear-avoidance, and cognitive mediation models of pain suggest that psychological factor...
Article
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Objective: Vaccine hesitancy limits population protection from SARS-CoV (coronavirus disease [COVID-19]). Vaccine hesitancy among healthcare workers (HCW) could put patients and coworkers at risk. Methods: We surveyed 475 emergency department and emergency medical service workers from January to February 2021 to determine vaccine intent/uptake,...
Article
Musculoskeletal (MSK) pain can be assessed in terms of its intensity and by how it interferes with daily activities. This study examined whether: 1) MSK pain intensity is associated with pain interference, and 2) demographic and psychological factors explain variability in pain interference. We recruited adult patients who presented to the emergenc...
Article
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Managing acute pain in individuals with a history of substance use disorders (SUD) is complex. Distress tolerance (DT) (e.g., the ability to handle uncomfortable sensations) may serve as an ideal non‐pharmacological intervention target in this population. Among 293 emergency department (ED) patients seeking treatment for pain (Mage = 41; 42% Female...
Article
Background: The relationship between event centrality (i.e., the degree to which a stressful event is integrated into one's identity) and acute posttraumatic outcomes after relatively minor physical injury is unknown. We examined pre-injury and Emergency Department (ED) predictors of event centrality at 6-weeks post-injury, and whether event centr...
Article
Full-text available
Frontline healthcare workers face unprecedented physical and psychological strain during the coronavirus disease (COVID-19) pandemic, fueled by simultaneous digital interconnectedness and social isolation. Key stressors include surges in patient volume and acuity, rapid evolving guidelines and responsibilities, and uncertainty regarding personal sa...
Article
Objective: Posttraumatic stress disorder (PTSD) symptoms (PTSS) are common after minor injuries and can impair recovery. We sought to understand whether an evidence-based mobile phone application with self-help tools (PTSD Coach) could be useful to improve recovery after acute trauma among injured emergency department (ED) patients. This pilot stu...
Article
Background Long-term assessment of global functional outcomes in cardiac arrest (CA) survivors allows for evaluation of acute care practices and referral to rehabilitation services. Given that many post-CA patients are lost to follow-up (LTFU), we explored whether these patients are systematically different from those who complete follow-up based o...
Article
Full-text available
Adolescent gang members are at high risk for polytraumatization (i.e., experiencing two or more types of trauma), which may contribute to behavioral problems, such as delinquency or drug distribution, and mental health symptoms, such as posttraumatic stress disorder (PTSD) and depression. The present study examined the associations between polytrau...
Article
Background Injured patients are at risk for prolonged opioid use after discharge from care. Limited evidence exists regarding how continued opioid use may be related to opioid medication misuse and opioid use disorder (OUD) following injury. This pilot study characterized opioid consumption patterns, health characteristics, and substance use among...
Article
Background Despite the risk of developing posttraumatic stress disorder (PTSD) and associated comorbidities after physical injury, few Emergency Departments (ED) in the United States screen for the presence of psychological symptoms and conditions. Barriers to systematic screening could be overcome by using a tool that is both comprehensive yet bri...
Article
Full-text available
Objective: Although residual symptoms remain following clinical treatment for posttraumatic stress disorder (PTSD), little is known about the characteristics of these residual symptoms. We aimed to determine the type, severity, and frequency of symptoms that remain after trauma-focused psychotherapy. Methods: We conducted a systematic review of...
Article
Motor vehicle accidents (MVAs) account for 4 million annual emergency department (ED) visits, and injured patients are at risk of chronic pain (CP). Posttraumatic stress disorder symptoms (PTSS) are common post-injury, and contribute to the transition from acute to CP. We tested a novel, biopsychosocial, non-pharmacological method to prevent post-i...
Article
Objectives Psychosocial factors and responses to injury modify the transition from acute to chronic pain. Specifically, posttraumatic stress disorder symptoms (PTSS; reexperiencing, avoidance, and hyperarousal symptoms) exacerbate and co‐occur with chronic pain. Yet no study has prospectively considered the associations among these psychological pr...
Article
Objective: Acute postinjury negative affect (NA) may contribute to headache pain following physical injury. Early psychiatric-headache comorbidity conveys increased vulnerability to chronic headache-related disability and impairment. Yet, it is unknown whether NA is involved in the transition to chronic headache related-disability after injury. Th...
Article
Objective: This study examined changes in postconcussive symptoms (PCS) over the acute postinjury recovery period, focusing on how daily PCSs differ between mild traumatic brain injury (mTBI) and other injury types. Setting: An urban emergency department (ED) in Western Pennsylvania. Subjects: A total of 108 adult patients with trauma being di...
Article
Full-text available
Background Refining and individualizing treatment of acute pain in the emergency department (ED) is a high priority, given that painful complaints are the most common reasons for ED visits. Few tools exist to objectively measure pain perception in the ED setting. We speculated that variation in perception of fixed painful stimuli would explain indi...
Article
This study aimed to identify and predict inconsistency in perceived trauma severity reports over time among trauma survivors. Hospitalized adult survivors of a traumatic injury completed trauma exposure assessments within 40 days post-injury and 6 weeks later (n = 77). The following trauma severity characteristics were examined: (1) threat of loss...
Article
People living with HIV (PLWH) have extensive interpersonal trauma histories and higher rates of posttraumatic stress disorder (PTSD) than the general population. Prolonged exposure (PE) therapy is efficacious in reducing PTSD across a variety of trauma samples; however, research has not examined factors that influence how PTSD symptoms change durin...
Article
Full-text available
The self-medication hypothesis proposes that individuals experiencing posttraumatic stress disorder (PTSD) symptoms may use alcohol (or other substances) to self-medicate distress, while the mutual maintenance hypothesis proposes that alcohol use also exacerbates or maintains distress. Existing research largely supports the self-medication hypothes...
Article
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This study investigates interfaith groups from across the United States to understand how these religious settings may serve as mediating structures to facilitate individual political action. Based on a multilevel modeling analysis with 169 individuals from 25 interfaith groups, we found that core activities of the group, such as group members shar...
Article
Rationale: Although cortisol alterations have been associated with posttraumatic stress disorder (PTSD) and PTSD symptoms (PTSS), the direction of association is mixed. Cortisol which is measured in blood, saliva, or urine is subject to transient factors that may confound results. Recent advances in cortisol sampling techniques provide novel oppor...
Article
Background: Adolescent gang members are a source of concern due to their involvement in criminal activity, violence, substance use, and high-risk sexual behaviors. Adolescent gang theories hypothesize that social institutions, including the family and school, fail to meet the needs of adolescents who therefore feel less attachment to these institu...
Article
Full-text available
The majority of research on risky sexual behavior in African American women has examined global associations between individual-level predictors and behavior. However, this method obscures the potentially significant impact of the specific relationship or relationship partner on risky sexual behavior. To address this gap, we conducted partnership-l...
Article
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Gang members are exposed to unique sexual risks, yet little work has explored the influence of gang social norms. This study examines the functions and meanings of sex within gangs, with a specific focus on the ways in which sex is used to reinforce gang membership and norms, gender roles, and group cohesion. We conducted 58 semi-structured intervi...
Article
High-risk sexual behaviours include practices such as relationship violence and substance use, which often cluster together among young people in high-risk settings. Youth gang members often show high rates of such behaviours, substance use and relationship violence. This paper draws on data from in-depth interviews with male and female gang member...
Article
Full-text available
Objective: Prior research has identified different PTSD symptom (PTSS) trajectories over months and years posttrauma that warrant different levels of clinical attention. Earlier identification of at-risk trauma victims can facilitate efficient and appropriate intervention efforts. Method: Using latent class growth analysis, we examined daily PTS...
Article
Full-text available
We conducted a latent class analysis (LCA) on 249 recent motor vehicle accident (MVA) victims to examine subgroups that differed in posttraumatic stress disorder (PTSD) symptom severity, current major depressive disorder and alcohol/other drug use disorders (MDD/AoDs), gender, and interpersonal trauma history 6-weeks post-MVA. A 4-class model best...
Article
Background Posttraumatic stress disorder (PTSD) is associated with abnormal functioning of the hypothalamic–pituitary–adrenal (HPA) axis; however, limited research has examined whether cortisol levels change following successful PTSD treatment. The current study examined the impact of successful PTSD treatment on the cortisol awakening response (CA...
Article
It has been suggested that a history of trauma exposure is associated with increased vulnerability to the physical health consequences of subsequent trauma exposure, and that posttraumatic stress symptoms (PTSS) may serve as a key pathway in this vulnerability. However, few studies have modeled these relationships using mediation, and most have fai...
Chapter
The diagnosis of acute stress disorder (ASD) was created to identify survivors soon after a trauma who were likely to develop posttraumatic stress disorder (PTSD). Though ASD demonstrates acceptable predictive power, subsequent research has often failed to display high rates of sensitivity or specificity. These qualities, in combination with the la...
Article
People living with HIV (PLWH) report elevated levels of posttraumatic stress disorder symptoms (PTSS) and associated comorbidities. The present study tested the efficacy of prolonged exposure (PE) at reducing PTSS, depression, negative posttraumatic cognitions, and substance use in PLWH. Participants were randomly assigned to receive PE (n = 40) or...
Article
Peritraumatic dissociation consistently predicts posttraumatic stress disorder (PTSD). Avoidant coping may serve as a mechanism through which peritraumatic dissociation contributes to PTSD symptoms. Path analysis was used to examine whether avoidant coping assessed 6 weeks following a motor vehicle accident mediated the relationship between in-hosp...
Article
Women with breast cancer frequently report cognitive problems to healthcare providers during and after adjuvant therapy. Patients' perceptions of their cognitive problems would be expected to relate to objectively measured cognitive impairments. We explored the relationship between perceived cognitive function and objective ratings of thinking abil...

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