J. Alexis Ortiz’s research while affiliated with Stanford University and other places

Objectives Latinos comprise a sizeable and growing population that experiences unmet health needs and health inequities. Mindfulness-based interventions may be a cost-effective way to address mental health problems in primary care. We sought to adapt a mindfulness-based intervention to better serve and improve the mental health of Latinos in the primary care setting. Methods The authors employed a unique set of adaptations to increase retention and engagement of Latinos in a mindfulness-based stress reduction (MBSR) intervention. These adaptations included (1) group motivational interviewing, (2) problem-solving barriers to retention, (3) a testimonial by a prior Latino MBSR participant, and (4) modifications to increase perceived applicability of MBSR for Latinos. Thirty Latino participants were recruited for an 8-week mindfulness intervention adapted (MBSR-A) specifically for Latino populations. Results Twenty-six out of thirty (87%) participants completed at least five of the eight sessions, which was significantly greater than in previous studies targeting Latino participants (60–66%). Of those who completed and provided pre- and post-data, there were decreases in anxiety and depression, and increases in measures of general mental health and physical health. Conclusions The adaptations utilized in this pilot study may increase retention and engagement of Latinos in mindfulness-based interventions and may be a cost-effective way to reduce mental health problems in this growing population.

Background: Evaluation of differences in neuropsychological outcomes in patients undergoing surgical clipping (SC) vs endovascular coiling (EC) for unruptured cerebral aneurysms is essential in guiding patients seeking treatment of asymptomatic cerebral aneurysms. Objective: To perform a prospective longitudinal analysis of neuropsychological outcomes in patients who underwent microsurgery or coiling for unruptured cerebral aneurysms. Methods: SC (50 patients), EC (35 patients), and healthy controls (43 individuals) were included. A detailed neuropsychological evaluation was performed at baseline and at 2 wk, 3 mo, 6 mo, and 12 mo. Student's t-test was utilized for comparing neuropsychological outcomes among the 3 groups. A mixed-effects model allowed for evaluation of neuropsychological outcome changes among the groups over time. Results: Both the SC and EC groups had nonsignificant differences in procedure-related complications. SC patients had the greatest initial declines in short-term memory, fine motor control, and executive functioning; however, these patients also recovered to a greater degree in neuropsychological functionality. Over the next year, all groups achieved similar neuropsychological outcomes with no significant differences among groups. Conclusion: Whereas the initial decline in neuropsychological functioning was greater for SC patients, 1 yr after treatment there was no significant difference in neuropsychological outcome among the SC, EC, and healthy control groups.

Objective: Counselor and client language have been identified as mechanisms of change in motivational interviewing (MI) counseling sessions. This study evaluated whether language patterns exhibited during MI sessions with substance users in the community would also be found during MI sessions with substance users in the criminal justice system. Method: Forty audio recordings of MI sessions with substance-using probationers were coded and analyzed sequentially using the Motivational Interviewing Skills Code (MISC) 2.5. Analyses examined the relationship between counselor and client language, and the relationship between client language and client substance use after 2 months. Results: Counselor MI inconsistent language was associated with decreased change talk (lnOR = - 0.76, p < .05) though not with increased sustain talk. Both sustain talk (b = - 4.591, t = - 18.634 p < .001) and MI inconsistent language MIIN (b = - 4.419, t = - 19.886, p < .001) were positively associated with substance use at 2 months. Sustain talk early in the session (i.e., during deciles 1 and 2) was significantly greater among clients who reported using substances at 2 months, compared to clients who did not use substances. Conclusion: These findings are broadly consistent with previous literature documenting the association between counselor language, client language, and client outcome.

Neurocognitive changes postsurgical clipping (SC) or endovascular coiling (EC) of unruptured aneurysms is not well studied. We aim to understand whether patients who undergo EC perform better on neurocognitive assessments in comparison with patients who undergo SC, and if such a difference exists how long the difference persists. This is a single-center, prospective, longitudinal study with patients divided into the microsurgical, endovascular, and healthy control (HC) groups. All three groups underwent baseline neurocognitive assessments as well as post-procedure evaluations at 2 to 3 weeks, 3 months, 6 months, and 12 months. Two mixed-effects models (postprocedure decline and subsequent recovery) were computed for each dependent variable and controlling for age, IQ, sex, and complications. Included were 50 clipped, 36 coiled, and 43 control patients. Anterior communicating artery (ACOM) and middle cerebral artery (MCA) aneurysms comprised 64% of the clipped patients, while 86.1% of the coiled aneurysms were located within the posterior circulation or paraclinoid region. Symptomatic stroke occurred within 1 patient in the clipped group and none within the coiled group. At 2 weeks postprocedure, the SC group showed significantly greater decline than the HC group on measures of verbal learning/memory, fine motor dexterity, and executive functioning. The SC group also demonstrated significantly greater decline than the EC group on measures of executive functioning and flexibility. The SC group showed greater decline than both other groups on measures of simple reaction time, verbal fluency, working memory, and executive functioning. At 3 to 6 months postprocedure, the SC group no longer exhibited these neurocognitive deficits. The SC group had greater decline in neurocognitive functioning but were generally able to return to baseline functioning within 3 to 6 months.

Clients who verbalize statements arguing for change (change talk [CT]) in psychotherapy are more likely to decrease alcohol and other drug use (AOD) compared with clients who voice statements in opposition of change (sustain talk [ST]). Little is known about how CT and ST are expressed in groups in which adolescents may vary in their AOD use severity and readiness to change. First, we examined how session content was associated with CT/ST, and then we looked at whether different subtypes of CT/ST were associated with subsequent AOD outcomes 3 months later. Audio recordings (N = 129 sessions) of a 6-session group motivational interviewing (MI) intervention, Free Talk, were coded. Session content was not associated with CT; however, some session content was associated with higher percentages of ST (e.g., normative feedback). Subtypes of CT (Commitment and Reason) were associated with improved AOD outcomes, whereas Ability subtype remarks were related to increased marijuana use, intentions, and consequences. Findings offer helpful guidance for clinical training and narrow in on the type of CT to try to elicit in Group MI sessions. Regardless of session content, adolescents can benefit from hearing CT during the group. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

The purpose of this chapter was to examine the relationship between potential resources for resilience and resilience itself. The Brief Resilience Scale [Smith et al. (International Journal of Behavioral Medicine 15:194–200, 2008)] was used to assess resilience as the ability to bounce back or recover from stress. Several potential resilience resources were assessed based on a model of resilience that involves the three stages of confronting a stressor, orienting to a positive outcome, and actively coping with the stressor. The personal and social resources assessed included active coping, mindfulness, mood clarity, optimism, purpose in life, spirituality, positive relations with others, and social support. The demographic characteristics assessed included age, gender, education, and income. The participants were 844 adults who were part of six samples: (1) general college students (n =259), (2) healthy adult women (n = 51), (3) women with fibromyalgia (n = 32), (4) cardiac patients (n = 228), (5) first-generation college students (n = 150), and (6) urban firefighters (n = 123). The results were consistent with the temporal stage model in that the personal resources targeted at each stage were related to resilience. With all samples combined, mindfulness, mood clarity, purpose in life, optimism, and active coping were related to greater resilience in both correlation and multiple regression analyses. Even when the samples were analyzed separately, these variables were consistently related to greater resilience with optimism and mood clarity having the strongest relationships with resilience. Optimism and purpose in life had very strong relationships with resilience in cardiac patients and women with fibromyalgia purpose, respectively. Age and male gender were also related to greater resilience in the multiple regression analyses of the combined samples. A revised theoretical model for understanding the foundations of resilience based on the findings is presented and implications for future research and clinical work are discussed.

Postmaterial spiritual psychology posits that consciousness can contribute to the unfolding of material events and that the human brain can detect broad, non-material communications. In this regard, this emerging field of postmaterial psychology marks a stark departure from psychology's traditional quantum measurements and tenets. The Oxford Handbook of Psychology and Spirituality codifies the leading empirical evidence in the support and application of postmaterial psychological science. Sections in this volume include: personality and social psychology factors and implications; spiritual development and culture; spiritual dialogue, prayer, and intention in Western mental health; Eastern traditions and psychology; physical health and spirituality; positive psychology; and scientific advances and applications related to spiritual psychology. With articles from leading scholars in psychology, medicine, physics, and biology, this text is an interdisciplinary reference for a rapidly emerging approach to contemporary science.

This study investigated the association between mindfulness, other resilience resources, and several measures of health in 124 urban firefighters. Participants completed health measures of posttraumatic stress disorder (PTSD) symptoms, depressive symptoms, physical symptoms, and alcohol problems and measures of resilience resources including mindfulness, optimism, personal mastery, and social support. The Mindful Awareness and Attention Scale (MAAS; Brown & Ryan, 2003) was used to assess mindfulness. Participants also completed measures of firefighter stress, number of calls, and years as a firefighter as control variables. Hierarchical multiple regressions were conducted with the health measures as the dependent variables with 3 levels of independent variables: (a) demographic characteristics, (b) firefighter variables, and (c) resilience resources. The results showed that mindfulness was associated with fewer PTSD symptoms, depressive symptoms, physical symptoms, and alcohol problems when controlling for the other study variables. Personal mastery and social support were also related to fewer depressive symptoms, firefighter stress was related to more PTSD symptoms and alcohol problems, and years as a firefighter were related to fewer alcohol problems. Mindfulness may be important to consider and include in models of stress, coping, and resilience in firefighters. Future studies should examine the prospective relationship between mindfulness and health in firefighters and others in high-stress occupations.

The purpose of this chapter is to examine the effects of neuroticism and positive personal characteristics on affective health in the context of a two-factor model. The model posits that neuroticism will primarily impact negative affect while positive personality characteristics will primarily impact positive affect. The relationship between neuroticism, positive personal characteristics, and affective health was examined in three large samples of undergraduate students. The positive personal characteristics assessed included extraversion, resilience, optimism, spirituality, purpose in life, and indicators of social and emotional intelligence. Multiple regression analyses were used to simultaneously examine the effects of neuroticism and the positive characteristics on negative affect and positive affect. The results consistently showed that neuroticism was a strong predictor of negative affect while positive characteristics were generally not related to negative affect when controlling for neuroticism. In addition, the positive characteristics were still related to positive affect when controlling for neuroticism. Finally, neuroticism was not related to positive affect when controlling for all positive characteristics at once but was usually related to less positive affect when controlling for one at a time. The main implication is that neuroticism should be considered within the context of both the positive and negative domains of human experience. Neuroticism may have its strongest impact on negative affective health while positive characteristics may have their strongest impact on positive affective health.

Objective The purpose of this study was to determine whether benefit finding was related to better emotional health in cardiac patients following cardiac rehabilitation. Benefit finding refers to the ability to find something positive or grow in response to a stressful event. Design Participants were cardiac patients (21% female and 22% ethnic minority) in a 12 week cardiac rehabilitation program. Benefit finding was assessed before and after the rehabilitation program. The main hypotheses were that benefit finding would predict increased positive emotion and decreased negative emotion at follow up when controlling for baseline emotion and other potential predictors of emotional health. The main outcome measures were positive and negative emotion following the rehabilitation program. Results Path analyses showed that benefit finding was related to more positive emotion and less negative emotion at follow-up when controlling for other predictors of emotion at follow up. In addition, positive reframing coping and income were related to more positive emotion, ethnic minority status was related to more negative emotion, and tangible social support was related to less negative emotion at follow-up. Conclusion Benefit finding may improve emotional health during cardiac rehabilitation. Health psychology interventions should focus on enabling cardiac patients to find more benefits in the process of coping with and recovering from heart disease.