Predictors of 10-year functional independence trajectories in older adults with traumatic brain injury: A Model Systems study.

Background: Older adults have the highest traumatic brain injury (TBI)-related morbidity and mortality, and rates in older adults are increasing, chiefly due to falls.

Objective: This study used hierarchical linear modeling (HLM) to examine baseline predictors of functional independence trajectories across 1, 2, 5, and 10 years after TBI in older adults.

Methods: Participants comprised 2,459 individuals aged 60 or older at the time of TBI, enrolled in the longitudinal TBI Model Systems database, and had Functional Independence Measure Motor and Cognitive subscale scores and Glasgow Outcome Scale-Extended scores during at least 1 time point.

Insomnia Treatment Preferences Among Primary Care Patients.

Purpose: Sleep disturbance is common in primary care. The main treatment options include medication and cognitive behavioral therapy for insomnia. Best practice guidelines recommend a collaborative decision-making approach to treatment.

Changes in Physician Telemedicine Use during COVID-19: Effects of Practice Setting, Demographics, Training, and Organizational Policies.

Telemedicine use increased during the COVID-19 pandemic, but uptake was uneven and future use is uncertain. This study, then, examined the ability of personal and environmental variables to predict telemedicine adoption during the COVID-19 pandemic. A total of 230 physicians practicing in the U.

Enhanced care planning and clinical-community linkages versus usual care to address basic needs of patients with multiple chronic conditions: a clinician-level randomized controlled trial.

Background: Many patients with poorly controlled multiple chronic conditions (MCC) also have unhealthy behaviors, mental health challenges, and unmet social needs. Medical management of MCC may have limited benefit if patients are struggling to address their basic life needs. Health systems and communities increasingly recognize the need to address these issues and are experimenting with and investing in new models for connecting patients with needed services.

Sleep Disturbance Mediates the Association Between Loneliness and Health in Older Americans.

Background: As the research documenting loneliness as a risk factor for morbidity and mortality continues to grow, it becomes increasingly critical to understand the mechanics of this relationship. This study assessed whether sleep disturbance mediates the relationship between loneliness and health.

Method: Data came from the 2006, 2010, and 2014 waves of the Health and Retirement Study, a longitudinal study of older Americans; participants ≥ 65 who completed the Psychosocial and Lifestyle Questionnaire in 2006 were included (n = 5067).

Rapid telepsychology deployment during the COVID-19 pandemic: A special issue commentary and lessons from primary care psychology training.

Objective: This article positions the special issue on telepsychology amidst the COVID-19 pandemic, which has dramatically accelerated the adoption and dissemination of telepsychology.

Method: The article makes general observations about the themes emerging in the special issue with considerations for application, training, theory-driven research, and policy. It then presents as a case example the rapid deployment during the pandemic of telepsychology doctoral training and services at the Virginia Commonwealth University (VCU) Primary Care Psychology Collaborative.

Mental health and sleep disparities in an urban college sample: A longitudinal examination of White and Black students.

Objective: Racial disparities in sleep may be consequential among college students given high rates of dysfunctional sleep among this population. The present study sought to investigate whether disparities in sleep explain existing mental health disparities.

Method: Data included secondary analysis of a college risk behaviors and health study (n = 1242, mean age = 18.

Loneliness and sleep: A systematic review and meta-analysis.

Despite the mounting evidence linking loneliness with health, the mechanisms underlying this relationship remain obscure. This systematic review and meta-analysis on the association between loneliness and one potential mechanism-sleep-identified 27 relevant articles. Loneliness correlated with self-reported sleep disturbance ( = .

Reciprocal Effects Between Loneliness and Sleep Disturbance in Older Americans.

To model the relationship between loneliness and sleep disturbance over time. : Data came from the Health and Retirement Study (2006, 2010, 2014 waves; age ≥ 65 years; = 5,067). Loneliness was measured via the Hughes Loneliness Scale and sleep disturbance via a four-item scale assessing sleep and restedness.

Insomnia Disorder and Behaviorally Induced Insufficient Sleep Syndrome: Prevalence and Relationship to Depression in College Students.

: College students are at increased risk for sleep disorders, including insomnia disorder and obtaining less than 6.5 hr of sleep per night by choice, or behaviorally induced insufficient sleep syndrome (BIISS). These disorders can have deleterious daytime consequences, including depression.

Isolation, Not Loneliness or Cynical Hostility, Predicts Cognitive Decline in Older Americans.

To jointly examine isolation, loneliness, and cynical hostility as risk factors for cognitive decline in older adults. Data came from the 2006 to 2012 waves of the Health and Retirement Study (HRS), a longitudinal study of U.S.

A Curriculum for an Interprofessional Seminar on Integrated Primary Care: Developing Competencies for Interprofessional Collaborative Practice.

Health care is increasingly delivered through team-based, collaborative strategies with interprofessional education as an important mechanism for building interprofessional practice competencies. This paper describes an Interprofessional Seminar on Integrated Primary Care (IS-IPC) designed to meet this educational need with interprofessional team-based learning as the foundation of an iterative process such that education and practice inform one another. The IS-IPC can be used to educate an interprofessional group of learners about key topics relevant to working together in integrated primary care.

Relationships between potentially traumatic events, sleep disturbances, and symptoms of PTSD and alcohol use disorder in a young adult sample.

Objective: Traumatic events, particularly those that are interpersonal in nature, are associated with increased risk for co-occurring sequelae, including sleep disturbances, posttraumatic stress disorder (PTSD), and alcohol use disorder (AUD). However, the associations between these phenotypes have not been explored among college students.

Methods: We examined relationships between type of potentially traumatic event (PTE) exposure (pre-college) and sleep disturbances, as well as mediating effects of lifetime PTSD and AUD symptoms on these relationships, in a large undergraduate sample (N = 1599, 64.

The Impact of Integrated Psychological Services in a Safety Net Primary Care Clinic on Medical Utilization.

Objective: The integration of psychological and behavioral health services into safety net primary care clinics has been viewed as a step toward reducing disparities in mental health treatment and addressing behavioral factors in chronic diseases. Though it is posited that integrated behavioral health (IBH) reduces preventable medical costs, this premise has yet to be tested in a safety net primary care clinic.

Method: Retrospective pre- and posttreatment analysis with quasi-experimental control group was constructed using propensity score matching.

Information without Implementation: A Practical Example for Developing a Best Practice Education Control Group.

This article considers methodology for developing an education-only control group and proposes a simple approach to designing rigorous and well-accepted control groups. This approach is demonstrated in a large randomized trial. The Lifestyles trial (n = 367) compared three group interventions: (a) cognitive-behavioral treatment (CBT) for osteoarthritis pain, (b) CBT for osteoarthritis pain and insomnia, and (c) education-only control (EOC).

Effectiveness of a CBT Intervention for Persistent Insomnia and Hypnotic Dependency in an Outpatient Psychiatry Clinic.

Objective: To test cognitive-behavioral therapy for insomnia (CBT-I) in patients who not only receive psychiatric treatment in a outpatient psychiatry clinic but also continue to experience chronic insomnia despite receiving pharmacological treatment for sleep. CBT-I included an optional module for discontinuing hypnotic medications.

Method: Patients were randomized to 5 sessions of individual CBT-I (n = 13) or treatment as usual (n = 10).

Short-term improvement in insomnia symptoms predicts long-term improvements in sleep, pain, and fatigue in older adults with comorbid osteoarthritis and insomnia.

Unlabelled: In a primary care population of 367 older adults (aged ⩾60 years) with osteoarthritis (OA) pain and insomnia, we examined the relationship between short-term improvement in sleep and long-term sleep, pain, and fatigue outcomes through secondary analyses of randomized controlled trial data. Study participants, regardless of experimental treatment received, were classified either as improvers (⩾30% baseline to 2-month reduction on the Insomnia Severity Index [ISI]) or as nonimprovers. After controlling for treatment arm and potential confounders, improvers showed significant, sustained improvements across 18 months compared with nonimprovers in pain severity (P<0.

Who benefits from CBT for insomnia in primary care? Important patient selection and trial design lessons from longitudinal results of the Lifestyles trial.

Study Objectives: Evaluate long-term effects of group interventions on sleep and pain outcomes in a primary care population of older adults with osteoarthritis pain and sleep disturbance.

Design: Double-blind, cluster-randomized controlled trial with 18-mo follow-up.

Setting: Group Health and University of Washington, Seattle, WA, from 2009 to 2011.

Cognitive-behavioral treatment for comorbid insomnia and osteoarthritis pain in primary care: the lifestyles randomized controlled trial.

Objectives: To assess whether older persons with osteoarthritis (OA) pain and insomnia receiving cognitive-behavioral therapy for pain and insomnia (CBT-PI), a cognitive-behavioral pain coping skills intervention (CBT-P), and an education-only control (EOC) differed in sleep and pain outcomes.

Design: Double-blind, cluster-randomized controlled trial with 9-month follow-up.

Setting: Group Health and University of Washington, 2009 to 2011.

Evaluating the needs of military and veterans' families in a polytrauma setting.

Objective: To examine the perceived importance of needs and the extent to which they are met among a sample of family members in an inpatient polytrauma setting.

Method: The Family Needs Questionnaire was administered to 44 family members of patients at the Polytrauma Rehabilitation Center at McGuire Veterans Affairs Medical Center over a 30-month period.

Results: Families rated health information needs as most important and most frequently met.

The future of cognitive behavioral therapy for insomnia: what important research remains to be done?

The efficacy of cognitive-behavioral therapy for insomnia (CBT-I) to improve both short- and long-term outcomes in both uncomplicated and comorbid insomnia patients has been repeatedly and conclusively demonstrated. Further demonstrations of efficacy, per se, in additional comorbid insomnia populations are likely not the best use of limited energy and resources. Rather, we propose that future CBT-I research would be better focused on three key areas: (a) increasing treatment efficacy, particularly for more clinically relevant outcomes; (b) increasing treatment effectiveness and potential for translation into the community, with a particular focus on variants of CBT-I and alternative delivery modalities within primary healthcare systems; and (c) increasing CBT-I practitioner training and dissemination.

The discrepancy between subjective and objective measures of sleep in older adults receiving CBT for comorbid insomnia.

Objective: To examine the effect of cognitive-behavioral therapy for insomnia (CBT-I) on the underreporting of sleep relative to objective measurement, a common occurrence among individuals with insomnia.

Method: Pre-treatment and post-treatment self-report measures of sleep were compared with those obtained from home-based polysomnography (PSG) in 60 adults (mean age = 69.17; 42 women) with comorbid insomnia.

Group interventions for co-morbid insomnia and osteoarthritis pain in primary care: the lifestyles cluster randomized trial design.

Six weekly sessions of group cognitive-behavioral therapy for insomnia and osteoarthritis pain (CBT-PI), and for osteoarthritis pain alone (CBT-P) were compared to an education only control (EOC). Basic education about pain and sleep was comparable, so EOC controlled for information and group participation. Active interventions differed from EOC in training pain coping skills (CBT-P and CBT-PI) and sleep enhancement techniques (CBT-PI).

Older patients (age 65+) report better quality of life, psychological adjustment, and adherence than younger patients 5 years after heart transplant: A multisite study.

Background: Research examining age differences after heart transplant (HT) has focused primarily on morbidity and mortality outcomes, with little emphasis on potential age differences in quality of life and psychosocial outcomes. The objective of the study was to determine whether older patients have more positive adjustment and quality of life several years after HT compared with younger patients.

Methods: The study recruited 555 patients who were at least 5 years post-HT from 4 United States medical centers.