Browsing by Author "Brandt, Charles Philip"
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Item Anxiety sensitivity and hazardous drinking among persons living with HIV/AIDS: An examination of the role of emotion dysregulation(Addictive Behaviors, 2016-12) Paulus, Daniel J.; Jardin, Charles; Bakhshaie, Jafar; Sharp, Carla; Woods, Steven P.; Lemaire, Chad; Leonard, Amy; Neighbors, Clayton; Brandt, Charles Philip; Zvolensky, Michael J.Hazardous drinking is prevalent among persons living with HIV/AIDS (PLWHA). Anxiety sensitivity is a vulnerability factor that is highly associated with hazardous drinking among seronegatives, but has yet to be tested in PLWHA. Additionally, there is a need to examine potential mechanisms underlying associations of anxiety sensitivity and hazardous drinking. Emotion dysregulation is one potential construct that may explain the association between anxiety sensitivity and hazardous drinking. The current study examined emotion dysregulation as a potential explanatory variable between anxiety sensitivity and four, clinically significant alcohol-related outcomes among PLWHA: hazardous drinking, symptoms of alcohol dependence, number of days consuming alcohol within the past month, and degree of past heavy episodic drinking. The sample included 126 PLWHA (Mage=48.3; SD=7.5; 65.9% male). Results indicated significant indirect effects of anxiety sensitivity via emotion dysregulation in all models. Indirect effects (κ2) were of medium effect size. Alternative models were run reversing the predictor with mediator and, separately, reversing the mediator with the proposed outcome(s); alternative models yielded non-significant indirect effects in all but one case. Together, the current results indicate that anxiety sensitivity is associated emotion dysregulation, which, in turn, is associated with hazardous drinking outcomes. Overall, these findings may provide initial empirical evidence that emotion dysregulation may be a clinical intervention target for hazardous drinking.Item Development and Implementation of an HIV and Anxiety Management/Reduction Program (HAMRT)(2017-05) Brandt, Charles Philip; Zvolensky, Michael J.; Woods, Steven P.; Reitzel, Lorraine R.; Lu, QianThe Human Immunodeficiency Virus (HIV) is a worldwide pandemic affecting over 35 million individuals worldwide. Though revolutions in antiretroviral medications can control the virus and enable infected individuals to live full lifespans with the disease, upwards of half of all persons living with HIV/AIDS (PLWHA) are not appropriately adherent to their medication. This underadherence leads to higher than expected rates of mortality, disease spread, and increasing the financial burden on the global healthcare system. Recent research has indicated that mental health disorders, particularly anxiety, predicts poor antiretroviral medication adherence. Despite this knowledge, there have not yet been treatments developed specifically to increase medication adherence via the reduction of anxiety among PLWHA. The present study aimed to fill in this gap by developing and implementing a six-session CBT-based integrated treatment/management program for PLWHA with concurrent anxiety that impedes success of HIV management. The recruited sample included 42 PLWHA (Mage = 46.95, SD = 9.93, range = 21-61, 45.2% female) who were randomized to either an active treatment condition, or a waitlist control condition of equal length. Participants were assessed pre-randomization, at the mid-treatment time point (after three sessions for the active participants and three weeks for the control participants) and post-treatment (six sessions for active participants, six weeks for control participants). Active participants were then re-assessed at 1-, 3-, and 6-months post-treatment. Attrition was high for the active condition (i.e., 73.2%). Results indicated notable effect sizes between the active and control conditions on most outcome variables including HIV medication adherence (Partial Eta Squared = .189), anxiety symptoms (Cohen’s D = .64), anxiety sensitivity (Cohen’s D = 1.5), Depressive symptoms (Cohen’s D = .8), and multiple quality of life indices (range of Cohen’s D = .43 – 1.73). These findings are discussed in terms of the feasibility and utility of administering an anxiety-reduction therapy program specifically designed for PLWHA with HIV medication adherence difficulties.Item DISTRESS TOLERANCE, EMOTION DYSREGULATION, AND ANXIETY AND DEPRESSIVE SYMPTOMS AMONG HIV+ INDIVIDUALS(2013-05) Brandt, Charles Philip; Zvolensky, Michael J.; Norton, Peter J.; Bonn-Miller, Marcell O.A disproportionately high percentage of HIV infected individuals experience clinically meaningful symptoms of anxiety and depression. To date, few studies have examined cognitive-affective factors that may account for these high rates of anxiety and depressive symptoms. The current study examined the mediational effects of emotional dysregulation in terms of the relation between perceived distress tolerance and anxiety and depressive symptoms among HIV+ individuals. Participants included 176 HIV+ adults (21.6% female, Mage = 48.40 years, SD = 8.66). Results indicated that distress tolerance was significantly related to greater depressive and anxiety symptoms (panic, social anxiety) among this sample of HIV+ individuals. Results also indicated that emotion dysregulation mediated this association. Findings were statistically significant above and beyond the variance accounted for by CD4 T-cell count, race, gender, education level, and marijuana use status. Findings are discussed in relation to the potential explanatory utility of distress tolerance and emotional dysregulation in terms of psychological well-being among HIV+ individuals.