Perils and Possibilities: Sexual Violence Preventionists' Perspectives on Gathering Community Input on Prevention Practice.

There is relatively little research unpacking provider processes or tensions (e.g., leadership decision-making) when attempting to gather and incorporate community feedback into gender-based violence work. Across focus groups with 18 sexual violence preventionists, we explored experiences collecting information and perspectives from or with community members; barriers, and facilitators; and how they navigate possibilities of community-informed sexual violence prevention. We learned that preventionists want to gather input, and they gather it in nonsystematic ways; they face barriers familiar to many community-informed processes; and the topic of sexual violence complicates community-informed processes. Determining boundaries of possibility is central to navigating practice. Further, organizational settings are influential in determining boundaries.

Connecting to Community: Violence Prevention Barriers, Geography, and Preventionist Perceptions of Community Leadership and Opportunities.

Violence is a public health concern, negatively impacting individual and community health and safety. Although violence can be prevented, prevention efforts are complex in part because they require addressing community factors. Despite an increase in funding and support for community violence prevention, relatively little is known about what prevention practice barriers may be related to community factors. This study addressed this gap by surveying a statewide sample of violence preventionists. We explored if coordination and logistical barriers and rural geography are associated with perceptions of two community factors: community opportunities and leadership quality. As part of a statewide assessment of violence and prevention efforts, 130 violence preventionists completed surveys. Results showed that both perceived coordination barriers and rural geography were negatively associated with perceptions of existing community opportunities, representative/influential leadership, and leadership commitment. Perceived logistical barriers were positively associated with perceived leadership commitment. Findings suggest that support reducing community coordination barriers in particular-and to support rural violence prevention work more broadly-is needed.

Women's Experiences of Intimate Partner Violence While Incarcerated: The Measurement Structure, Reliability, and Validity of a Novel Instrument.

While incarcerated, women may continue to experience intimate partner violence (IPV), perpetrated by partners who reside in the outside community. Power and control dynamics of abusive relationships may intensify as the abuser exploits their partners' incarceration. The current study assessed IPV experiences of 832 incarcerated women (50% white, 76% mothers), testing a novel instrument. Results validated a two-factor structure: (a) general abuse (i.e., verbal, physical) and (b) deny or threaten to deny (i.e., leveraging the women's incarceration to intimidate or control). This study introduces a novel instrument to measure IPV while incarcerated and provides implications for research and practice.

Mixed methods in community psychology: A values-forward synthesis.

Mixed methods research (MMR) combines multiple traditions, methods, and worldviews to enrich research design and interpretation of data. In this virtual special issue, we highlight the use of MMR within the field of community psychology. The first MMR studies appeared in flagship community psychology journals over 30 years ago (in 1991). To explore the uses of MMR in the field, we first review existing literature by identifying all papers appearing in either Journal of Community Psychology or American Journal of Community Psychology in which the word "mixed" appeared. A total of 88 publications were identified. Many of these papers illustrate the pragmatic use of MMR to evaluate programs and to answer different research questions using different methods. We coded articles based on Green et al.'s classifications of the purpose of the mixing: triangulation, development, complementarity, expansion, and initiation. Complementarity was the most frequently used purpose (46.6% of articles), and nearly a quarter of articles mixed for multiple purposes (23.86%). We also coded for any community psychology values advanced by the use of mixed methods. We outline three themes here with corresponding exemplars. These articles illustrate how MMR can highlight ecological analysis and reconsider dominant, individual-level paradigms; center participant and community member experiences; and unpack paradoxes to increase the usefulness of research findings.

Incivility and interpersonal harm in organizational context: A qualitative exploration of values in STEM training programs.

This study investigates science, technology, engineering, and math (STEM) PhD students' perceptions of organizational values and incivility. Interviews with 26 STEM PhD students elicited examples of and perceptions surrounding incivility and related harms. Productivity, prestige, expertise, objectivity, self-sufficiency, and collaboration values were identified. Each included aspects deemed useful (e.g., productivity fueling discovery; expertise facilitating learning) as well as potentially contributing to harm when weaponized (e.g., productivity appeared in incivility stories when one "looked down" on those who did not work long days; expertise appeared when people gossiped about intelligence). Some aspects of collaboration (e.g., long-lasting working relationships fueling scientific discovery) may be protective. Organizational values such as productivity appeared to supersede considerations such as well-being. Current framing of these values may bolster refusal to engage in or support social justice and mental health efforts, which some participants identified as needed. Implications across settings are discussed.

Contradictions in change: Ecological factors in the implementation of outer layer sexual violence prevention.

This study examined the adoption and implementation process in early efforts to implement ecological ("outer layer") sexual violence (SV) prevention strategies. Interviews with 28 preventionists from 26 local sites within a large, midwestern state, were conducted to examine individual preventionists' problem definitions of SV and ecological factors surrounding implementation. Findings suggest that SV prevention in the state is primarily implemented at the individual-level; when preventionists described engaging in or anticipating outer layer interventions, they were often tertiary (i.e., responding after perpetration; e.g., Sexual Assault Response Teams). A majority expressed problem definitions rooted within the individual (e.g., perpetration due to a lack of consent education), and a majority of implemented efforts matched this individual-level conceptualization. Yet, contradictions between problem definitions (e.g., SV stemming from oppression) and implemented activities (e.g., single-session educational interventions) emerged. Such contradictions may be best understood in light of contextual implementation influences: diverse preventionist job responsibilities, less training/support for outer layer prevention, preventionist autonomy, leadership messaging, time requirements, partner reticence, and extensive work with schools. Inner layer influences, including identification with job roles, preference for, and a sense of urgency toward inner layer work, appeared to interact with contextual factors. Implications across community psychology domains are discussed.

Reflecting and rejuvenating our work, together: One team's consideration of AJCP publications on gender-based violence.

Community psychology has long valued reflexive praxis as a critical part advancing our research and action. In this Virtual Special Issue (VSI), we, a group of community psychologists and gender-based violence (GBV) researchers at many different points in our careers, reflected on GBV publications that have appeared in AJCP. We examine the ways in which community psychology broadly and articles in AJCP more specifically have conceptualized GBV as a sociocultural issue, how GBV intersects with other oppressions and forms of violence, the tension when systems that aspire to support survivors are inequitable and focused on ameliorative change, and the importance of interventions being locally informed and locally driven. By highlighting selected GBV-focused articles published in AJCP, this VSI discusses (a) understanding and transforming culture via robust research and local partnerships, (b) targeting effective interventions for survivors, (c) invoking systems and targeting change in institutional environments, and (d) making connections between local efforts and broader social movements. To continue to move forward, we conclude we must reflect, embrace methodological plurality, partner, and push for structural change. Reflective questions regarding research and action are offered, to address gender-based violence.

The impact of the COVID-19 pandemic on gender-based violence in the United States: Framework and policy recommendations.

OBJECTIVE: In response to the 2019 novel coronavirus pandemic, portions of the U.S. government implemented social distancing policies that, while necessary, yield unintended consequences. This article explores how risk for gender-based violence (GBV) has been exacerbated across the social-ecological model (SEM; e.g., by increasing economic stress and decreasing social support) and highlights differential impact across social locations (e.g., considering race, gender, social class). METHOD: Drawing on gender-based violence prevention and response research, considerations for researchers, policymakers, and practitioners are delineated. RESULTS: A comprehensive framework adapting an intersectional lens and the SEM is used to explain the changes in risk and protective factors for GBV. Policy recommendations that serve to augment (not replace) social distancing policies are proposed. CONCLUSION: The pandemic has uprooted life in a way that impacts GBV prevention and response. Yet, this is also an opportunity to define a new way forward rather than return to "business as usual"; psychologists should strive to improve social services by utilizing the SEM and intersectionality. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Suicidal Ideation Among Transgender and Gender Expansive Youth: Mechanisms of Risk.

Purpose: Suicide is a leading public health concern among transgender and gender expansive adolescents, although little research has examined mechanisms through which gender identity is associated with suicidal ideation. This study examined the indirect effects of peer victimization, dating violence, substance use (SU), SU problems, and depressive symptoms in the relationship between gender identity and suicidal ideation. Methods: Secondary data analysis was conducted from a 2018 statewide survey, including 4464 adolescents who identified as male, female, transgender, or gender expansive (n=1116 per gender). The sample was frequency matched on grade, race, geographic region, and free/reduced lunch status. Mediation analyses were performed. Results: Reports of suicidal ideation were highest among transgender (49.29%) and gender expansive (41.31%) adolescents compared with male (10.82%) and female adolescents (19.08%). Using the Karlson, Holm, and Breen approach, 50.45% of the effect of being transgender on suicidal ideation was mediated through peer victimization, dating violence, and depressive symptoms, and 39.29% through SU, SU problems, and depressive symptoms. The mediation through the same pathways for being gender expansive was 46.37% and 39.89%, respectively. Across both models, depressive symptoms predominately accounted for the mediating effect. Conclusion: Transgender and gender expansive youth are at alarming risk for suicidal ideation, which illustrates the critical need for suicide prevention within this population. Programs that promote mental health and work to prevent bullying, dating violence, SU, and SU problems are crucial; although longitudinal research is needed, targeting these mechanisms may play a critical role in reducing suicidal ideation and risk.

Dating Violence and Peer Victimization Among Male, Female, Transgender, and Gender-Expansive Youth.

BACKGROUND AND OBJECTIVES: Transgender adolescents experience disproportionately high rates of dating violence and peer victimization. However, research has relied on small samples of transgender youth and has not captured victimization experiences of gender-expansive youth (who do not identify as male, female, or transgender). In the current study, we address these limitations, comparing victimization by gender. METHODS: We examined a subsample of 4464 male, female, transgender, and gender-expansive youth (1116 per group) from the 2018 Illinois Youth Survey who were frequency matched on grade, race, geographic region, and free or reduced lunch status. Prevalence of self-reported verbal, physical, and cyber peer victimization and physical and psychological dating violence was calculated. Adjusted prevalence ratios were obtained by using log-binomial regression. RESULTS: The highest rates across all forms of victimization were reported among transgender (15.6%-51.6%) and gender-expansive (13.2%-41.4%) youth. Transgender youth had a 2.09 to 2.96 times higher frequency of victimization than male youth and a 1.34 to 2.65 times higher frequency of victimization than female youth. Transgender youth also had higher frequencies of specific forms of victimization than gender-expansive youth. Gender-expansive youth had a 1.83 to 2.61 times higher frequency of victimization than male youth and 1.18 to 2.35 times higher frequencies of most forms of victimization than female youth. CONCLUSIONS: Disparities in dating violence and peer victimization rates exist among transgender and gender-expansive adolescents compared with male and female youth. The distinct experiences of transgender and gender-expansive youth should be considered in school policies and violence prevention programs.

Instrumental variable analyses for causal inference: Application to multilevel analyses of the alliance-outcome relation.

Objective: To introduce readers to instrumental variable analyses for causal inferences using as an example a test of the hypothesis that the quality of the therapeutic alliance has a causal role in relation to the outcome of psychotherapy. Method: We used data from a recent non-inferiority trial of cognitive and dynamic therapies for major depressive disorder in a community mental health setting. The data (N = 161) were analyzed using standard approaches as well as a multilevel 2-stage instrumental variables approach that allows for causal interpretations by removing the influence of unmeasured confounds. Results: Instrumental variables were created at the patient and therapist level using baseline patient and therapist variables. These baseline variables predicted the alliance but were otherwise unrelated to treatment outcome other than through their effects on the alliance. Standard multilevel mixed effects analyses revealed statistically significant associations of the alliance with outcome at the therapist level of analysis. The therapist level effect remained statistically significant when using the instrumental variables approach. Conclusion: Our results support the hypothesis that, at least at the therapist level, the alliance plays a causal role in producing better outcomes. Instrumental variable analyses can be a useful tool to supplement standard analyses.

Psychiatry Outpatients' Willingness to Share Social Media Posts and Smartphone Data for Research and Clinical Purposes: Survey Study.

BACKGROUND: Psychiatry research has begun to leverage data collected from patients' social media and smartphone use. However, information regarding the feasibility of utilizing such data in an outpatient setting and the acceptability of such data in research and practice is limited. OBJECTIVE: This study aimed at understanding the outpatients' willingness to have information from their social media posts and their smartphones used for clinical or research purposes. METHODS: In this survey study, we surveyed patients (N=238) in an outpatient clinic waiting room. Willingness to share social media and passive smartphone data was summarized for the sample as a whole and broken down by sex, age, and race. RESULTS: Most patients who had a social media account and who were receiving talk therapy treatment (74.4%, 99/133) indicated that they would be willing to share their social media posts with their therapists. The percentage of patients willing to share passive smartphone data with researchers varied from 40.8% (82/201) to 60.7% (122/201) depending on the parameter, with sleep duration being the parameter with the highest percentage of patients willing to share. A total of 30.4% of patients indicated that media stories of social media privacy breaches made them more hesitant about sharing passive smartphone data with researchers. Sex and race were associated with willingness to share smartphone data, with men and whites being the most willing to share. CONCLUSIONS: Our results indicate that most patients in a psychiatric outpatient setting would share social media and passive smartphone data and that further research elucidating patterns of willingness to share passive data is needed.

Predictors of treatment attendance in cognitive and dynamic therapies for major depressive disorder delivered in a community mental health setting.

OBJECTIVE: Our goal was to evaluate treatment attendance patterns, including both treatment completion and premature termination from treatment, for 2 evidence-based psychotherapies for major depressive disorder (MDD) delivered in a community mental health setting. We explored rates of premature termination across the course of treatment as well as the factors that predicted and moderated premature termination and treatment completion. METHOD: This investigation included 237 patients with MDD who participated in a noninferiority trial comparing short-term dynamic psychotherapy (DT) to cognitive therapy (CT). Patients in both conditions were offered 16 sessions of treatment and had up to 5 months to complete treatment. All patients completed an extensive self-report battery at treatment baseline as well as measures of the therapeutic alliance and opinions about treatment following Session 2. RESULTS: Premature termination from both treatments was high with 27% of patients discontinuing treatment very early after only an intake session or a single treatment session. Patients in CT were significantly more likely to terminate treatment prematurely, χ²(3) = 14.35, p = .002. Baseline physical health functioning, subthreshold psychotic symptoms, Session 2 ratings of agreement on tasks, and Session 2 ratings of treatment sensibility all independently predicted premature termination of services. Trauma history significantly moderated very early termination of treatment, χ²(3) = 10.26, p = .017, with patients with high trauma histories more likely to complete DT but terminate prematurely from CT. CONCLUSIONS: Very early termination from services was higher in CT compared with DT. Including techniques to improve engagement in both therapies and matching patients to treatment based on predictors/moderators may be effective ways to optimize treatment engagement. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Trust and respect in the patient-clinician relationship: preliminary development of a new scale.

BACKGROUND: Trust and respect may be an important component of client-provider relationships. This study aimed to develop and report preliminary psychometric analyses of a new brief measure to evaluate a patient's level of trust and respect for their clinician. The scale was designed to be applicable in multiple healthcare contexts, with a particular focus on mental healthcare. METHODS: Adult patients completed the study survey in an academic outpatient psychiatric clinic waiting room. Classical and Item Response Theory (IRT) analyses were utilized to examine the adequacy of scale items. Validity was examined in relation to the patient-therapist alliance and to willingness to share private information (social media content) with one's clinician. RESULTS: Beginning with 10 items, a final 8-item version of the measure was created with an internal consistency reliability of .91. Principal components analysis indicated that the scale was best viewed as capturing one overall dimension. A Graded Response Model IRT model indicated that all items contributed information on the latent dimension, and all item curves were not flat at any region. The correlation of the trust/respect total score with the alliance was .53 when respect-related items were deleted from the alliance score. The trust/respect scale was significantly associated with patient willingness to share social media posts with their clinician but the alliance was not. CONCLUSIONS: The brief measure of patient trust and respect towards their clinician was unidimensional, showed good internal consistency, and was not redundant with existing measures of the alliance. The scale has the potential to be used in a wide variety of healthcare settings.

Symptoms of anhedonia, not depression, predict the outcome of treatment of cocaine dependence.

The purpose of this paper is to reanalyze data from two studies to determine if anhedonia specifically, rather than depression overall, predicts treatment outcome for patients with cocaine use disorders. Measures of baseline anhedonia symptoms were created using anhedonia items from the Beck Depression Inventory (BDI) to re-examine National Institute on Drug Abuse Cocaine Collaborative Treatment study data (Crits-Christoph et al., 1999) and the contingency management group from the McKay et al. (2010) trial. Baseline anhedonia was used to predict cocaine abstinence rates across the treatment period in both studies. Anhedonia was a significant predictor of cocaine abstinence, even when overall depression scores excluding anhedonia were included in the models. The development of treatments to target individuals with cocaine use disorder who have symptoms of anhedonia has the potential to improve overall outcomes for those with this disorder.