Patients' reasons for electing to undergo total knee arthroplasty impact post-operative pain severity and range of motion
osteoarthritis; pain; Surgery; Psychology; predictors; quality-of-life; replacement; fear; fatigue; Approach-avoidance goals; chronic musculoskeletal pain; Post-operative recovery; Reasoning; Surgical outcome; Total knee arthroplasty
The present study examines the reasons cited by 103 patients for their electing to undergo total knee arthroplastic surgery and the relationship between these reasons and their post-operative pain and range of motion. Results suggest that individuals who describe different reasons for undergoing surgery vary in their post-operative recovery. Specifically, patients who cite pain as the reason they are undergoing surgery report greater levels of pain during the early post-operative period. In contrast, patients who describe goals of regaining mobility or a specific activity as their reason for undergoing surgery achieve a greater range of motion during early post-operative physical therapy. Individuals who express avoidance goals for undergoing total knee arthroplasty report more severe post-operative pain at 1 and 3 months following surgery compared to patients who express approach goals. Interventions targeted towards patients reporting pre-operative pain or avoidance goals may decrease subsequent post-operative pain and increase mobility.
Cremeans-Smith J K; Boarts J M; Greene K; Delahanty D L
Journal of Behavioral Medicine
2009
2009-06
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1007/s10865-008-9191-2" target="_blank" rel="noreferrer noopener">10.1007/s10865-008-9191-2</a>
The differential impact of PTSD and depression on HIV disease markers and adherence to HAART in people living with HIV
depression; social support; HIV; adherence; PTSD; Environmental & Occupational Health; Public; Biomedical Social Sciences; posttraumatic-stress-disorder; primary care; medication; drug-resistance; protease inhibitors; active antiretroviral therapy; CD4; cell count; outpatient clinics; viral load
Despite high rates of comorbidity, research has typically focused on the independent impact of posttraumatic stress disorder (PTSD) and depression symptoms in people living with HIV (PLWH). The present study examined the independent and comorbid influence of PTSD and depression symptoms on medication adherence, CD4 cell counts, and viral load, over the course of 3 months in 57 PLWH (82% men, 54% Caucasian, 44% African American) recruited from a clinic or social service agency. Both PTSD and depressive symptoms predicted lower subsequent adherence. However, only depressive symptoms predicted lower CD4 counts and presence of a detectable viral load. Participants reporting symptoms consistent with diagnostic levels of comorbid PTSD and depression were less likely to adhere to HAART and were more likely to have a detectable viral load. These results highlight the influences of PTSD and depression on adherence and HIV disease markers, and underscore the importance of examining comorbid symptomatology in PLWH.
Boarts J M; Sledjeski E M; Bogart L M; Delahanty D L
Aids and Behavior
2006
2006-05
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1007/s10461-006-9069-7" target="_blank" rel="noreferrer noopener">10.1007/s10461-006-9069-7</a>
PTSD, Depression, and Substance Use in Relation to Suicidality Risk among Traumatized Minority Lesbian, Gay, and Bisexual Youth
adolescents; alcohol-consumption; behavior; bullying; depression; Health; LGB; posttraumatic-stress-disorder; Psychiatry; Psychology; PTSD; service use; sexual minority; substance use; suicide; united-states; victimization; young-adults
Youths who are lesbian, gay, or bisexual (LGB) are more likely than heterosexuals to commit suicide. Substance use, PTSD, and depression are independent risk factors for suicidality; however, the extent to which these factors interact to predict suicidality is unclear. The current study examined the association between substance use, PTSD symptoms (PTSS), depressive symptoms, and suicidality in a sample of 68 traumatized minority LGB youths. Participants were recruited from an LGBT community center and completed a packet of questionnaires. Substance use and depressive symptoms were positively associated with prior suicide attempts. A significant three-way interaction revealed that substance use interacted with both PTSS and depressive symptoms to increase the odds of attempted suicide. Results underscore the importance of integrating substance use components into PTSD/depression treatment to reduce suicide risk in LGB youth.
Smith B C; Armelie A P; Boarts J M; Brazil M; Delahanty D L
Archives of Suicide Research
2016
2016-01
Journal Article
<a href="http://doi.org/10.1080/13811118.2015.1004484" target="_blank" rel="noreferrer noopener">10.1080/13811118.2015.1004484</a>