Journal of Behavioral Medicine最新文献

{"title":"Identifying facilitators and barriers to using trauma-informed care at a level 1 trauma center.","authors":"Sydney C Timmer-Murillo, Shawntell N Pace, Constance Gundacker, Courtney Barry","doi":"10.1007/s10865-026-00688-w","DOIUrl":"https://doi.org/10.1007/s10865-026-00688-w","url":null,"abstract":"<p><p>Millions of individuals sustain traumatic injuries each year, yet the emotional impact of hospitalization and acute medical care remains understudied. Trauma-informed care (TIC) offers a framework for reducing retraumatization and supporting both patients and providers, but little is known about how TIC is understood or applied in trauma centers. This qualitative study used a human-centered design approach to examine healthcare workers' experiences, perceptions, and training needs related to TIC within a Level 1 trauma center to inform development of a training on TIC. This study employed a qualitative approach guided by principles of Human-Centered Design (HCD) to explore healthcare workers' perceptions, experiences, and training needs related to trauma-informed care (TIC) within a high-acuity trauma setting. Healthcare workers, including nursing assistants, registered nurses, physical therapists, advanced practice providers, and physicians were included as key informants in defining the relevance, challenges, and applicability of trauma-informed practice at the trauma center. Participants were recruited from the Trauma and Acute Care Division and hospital unit serving predominantly traumatically injured patients. Using thematic reflexive analysis, semi-structured interviews (range: 10-25 min) with 20 multidisciplinary staff revealed three overarching themes: the emotional toll and burnout associated with trauma work; TIC-aligned practices (including empathetic communication and perspective taking); and training needs including format and content and skills needed to deliver TIC effectively. Participants emphasized the need for practical, hands-on training tailored to the realities of trauma care. Trauma-informed approaches have the potential to improve patient recovery, reduce psychological distress, and lessen strain on healthcare systems. Study findings can inform broader behavioral medicine practices by guiding the development of scalable TIC interventions that meet providers' identified needs which are adaptable to trauma centers, emergency care, and other high-acuity medical settings to enhance patient-centered care.</p>","PeriodicalId":48329,"journal":{"name":"Journal of Behavioral Medicine","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148362703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of adverse childhood experiences on cognitive behavioral interventions for chronic pain.","authors":"Erica J Martinez, Joel N Fishbein, Niloofar Afari, Matthew S Herbert","doi":"10.1007/s10865-026-00694-y","DOIUrl":"10.1007/s10865-026-00694-y","url":null,"abstract":"<p><p>Adverse childhood experiences (ACEs) increase the risk of developing chronic pain in adulthood. However, the impact of ACEs and specific ACEs subdomains on treatment response to cognitive behavioral interventions, which are among the frontline interventions for chronic pain, remains unexplored. This exploratory secondary analysis of a psychotherapy trial for chronic pain examined the associations among total ACEs and ACEs subdomains (household dysfunction and maltreatment) with pre-intervention level and treatment-related change in pain severity and interference. Trial participants (116 Veterans, M_age = 51.40; SD = 13.20) received one of two cognitive behavioral therapies for chronic pain that performed similarly in terms of pain outcomes. Participants completed self-report measures of ACEs at pre-treatment and measures of pain severity and interference at pre-treatment, weekly during treatment, post-treatment, and 3-month follow-up. There was a null association between ACEs (total and subdomains) and pain outcomes at pre-intervention. Higher total ACEs scores predicted significantly greater improvements in pain interference from pre-intervention to follow-up (p = .025). ACEs subdomains patterned differently with pain outcomes: higher maltreatment predicted significantly greater improvement in pain interference from pre-to-post-intervention (p = .049) and greater improvement from pre-intervention to follow-up, though above the threshold for statistical significance (p = .079). Further, higher household dysfunction predicted greater improvement in pain severity from pre-intervention to follow-up, though similarly above the threshold for statistical significance (p = .080). The present study yielded surprising and clinically informative results: cognitive behavioral interventions may be especially helpful for reducing pain interference in adults with higher ACEs. Furthermore, household dysfunction and maltreatment may be differentially associated with pain severity and interference. Future research is required to replicate the findings of this exploratory study.</p>","PeriodicalId":48329,"journal":{"name":"Journal of Behavioral Medicine","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148363006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"…what it all comes down to is being a good relative\": urban indigenous perspectives on caregiving, community, and culture to inform trauma transmission prevention and generational healing.","authors":"Meenakshi Richardson, Helena Darrow, Noel Trujillo, Sara F Waters","doi":"10.1007/s10865-026-00685-z","DOIUrl":"https://doi.org/10.1007/s10865-026-00685-z","url":null,"abstract":"<p><p>The colonization of Turtle Island, which includes the United States, involved the mass genocide of Indigenous Peoples and discriminatory policies. These harmful acts have resulted in massive group trauma disrupting family systems across generations. The role of historical trauma in ongoing intergenerational transmission and toxic stress among Indigenous families renders an opportunity to better understand the role of kinship systems to inform behavioral medicine. Although 87% of the American Indian and Alaska Native population in the U.S. reside in metropolitan areas, urban Indigenous peoples have often been made invisible and their experiences misrepresented. The current study centers the voices and the lived experiences of caregiving adults within the urban Indigenous community of one metropolitan area to identify what encompasses a strong sense of cultural connection and belongingness for families and communities to promote healing and break cycles of intergenerational trauma transmission. With the guidance of a Community Advisory Board, four talking circles, an Indigenous research method, were held with 14 adult participants who identified as urban Indigenous caregivers (i.e., parents, guardians, Elders, educators, practitioners) of children. Transcripts underwent hybrid coding and reflexive thematic analysis. Four primary themes were identified: (1) Grounding in identity; (2) Barriers to belongingness and strong sense of self; (3) Fostering belongingness; and (4) Pathways for healing. Participants called for culturally and trauma-informed community caregiving and healing initiatives that are inclusive of the diversity and multiplicities of urban Indigenous populations. Implications of these findings inform strengths-based approaches to promote generational healing through an Indigenous worldview.</p>","PeriodicalId":48329,"journal":{"name":"Journal of Behavioral Medicine","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148254314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Childhood maltreatment and mid-life cognitive functioning: divergent psychosocial pathways linked to ethnoracial group.","authors":"Michael J Persin, Kelsey M Julian, Jeanette M Bennett","doi":"10.1007/s10865-026-00682-2","DOIUrl":"https://doi.org/10.1007/s10865-026-00682-2","url":null,"abstract":"<p><p>Childhood maltreatment has lasting adverse effects across multiple domains, contributing to cumulative disadvantage and accelerated aging. These outcomes may reflect not only individual vulnerability, but also ethnoracial-related differences in lived experience, highlighting how sociocultural contexts shape long-term risk. The effect of childhood maltreatment on cognitive functioning later in life varies, raising questions about the mechanisms that drive this association. Data were drawn from the Midlife in the United States (MIDUS) study. Participants were categorized into two racial groups for analysis; non-Hispanic white and ethnoracial minority. Physiological and psychosocial variables were pulled from wave II and cognitive variables were extracted from waves II and III. At wave II, the analytic sample included 692 adults (56% female, 19.5% ethnoracial minority, age: 53.43 ± 10.72 years). Serial mediation models evaluated whether depression and perceived stress linked childhood maltreatment to later cognitive decline, predicting wave III cognitive functioning while controlling for wave II cognitive decline, in the overall sample and by ethnoracial subsamples. In the full sample, the relationship between childhood maltreatment and cognitive decline was fully mediated via the indirect pathway from depression to perceived stress. Ethnoracial minority status significantly moderated the association between depression and perceived stress, yet, the subgroups estimates of the indirect pathway were not significantly different from each other. In the non-Hispanic white group, the total effect of childhood maltreatment on cognitive functioning was not significant (b = - 0.0014, p = 0.283), but a significant indirect pathway existed through depression to stress (b = - 0.0012, 95%CI [- 0.0023, - 0.0003]). However, in the ethnoracial minority group, the total and direct effects of childhood maltreatment on cognitive performance were significant (b = - 0.0079, p = 0.001, and b = - 0.0066, p = 0.013, respectively) with no significant indirect pathways. These findings highlight distinct psychosocial pathways that link childhood maltreatment to cognitive aging and underscore the importance of contextually relevant prevention and intervention strategies.</p>","PeriodicalId":48329,"journal":{"name":"Journal of Behavioral Medicine","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148254256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A longitudinal study of CLDN5 DNA methylation and PTSD.","authors":"Alessandra R Grillo, Sara E Wallander, Beth M McCormick, Xiang Zhao, Mark W Logue, Mark W Miller, Erika J Wolf","doi":"10.1007/s10865-026-00681-3","DOIUrl":"10.1007/s10865-026-00681-3","url":null,"abstract":"<p><p>Posttraumatic stress disorder (PTSD) is associated with elevated risk for cognitive decline and neurodegeneration in later life, yet the underlying biological mechanisms remain poorly understood. One hypothesized pathway involves dysfunction of the blood-brain barrier (BBB) via altered expression of claudin-5 (CLDN5), a tight junction protein key to BBB integrity. Our prior cross-sectional study found that DNA methylation (DNAm) in blood at three CLDN5 loci was associated with trauma exposure, PTSD symptom severity, and plasma neurofilament light (NFL). Building on these results, this study examined whether CLDN5 DNAm in blood predicted future PTSD symptom severity, NFL, neuropsychological performance, and CLDN5 RNA expression in blood, a possible proxy for CLDN5 in the brain. Trauma-exposed Veterans (N = 221; 174 returned for follow-up) were assessed twice over 5.6 years on average. Participants completed diagnostic interviews, provided blood samples at both timepoints, and completed a neuropsychological battery at follow-up (California Verbal Learning Test-II, Wechsler Adult Intelligence Scale and Delis-Kaplan Executive Function System subtests). Baseline CLDN5 DNAm at cg21872764 predicted increased PTSD symptom severity at follow-up, accounting for baseline PTSD symptoms (β = .128, p = .035). This probe was associated with future CLDN5 RNA expression (β= -.186, p-adj = .035) as was cg00804504 (β = .185, p-adj = .035). CLDN5 DNAm at cg16773741, linked to cognitive decline, predicted working memory performance at follow-up (β = .269, p-adj = .015). No loci were associated with NFL levels after corrections for multiple testing. Results suggest that CLDN5 DNAm is associated with increased PTSD severity over time among Veterans with substantial trauma histories and is associated with neuropsychological functioning. This raises the possibility that BBB disruption is part of PTSD pathology, which may help identify the biology underlying comorbidity between PTSD and neurodegenerative disorders.</p>","PeriodicalId":48329,"journal":{"name":"Journal of Behavioral Medicine","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13390723/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148206760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations between sleep hygiene and secondary objective sleep parameters: moving beyond sleep duration.","authors":"Thomas McAlpine, Barbara A Mullan, Patrick J F Clarke","doi":"10.1007/s10865-026-00634-w","DOIUrl":"10.1007/s10865-026-00634-w","url":null,"abstract":"","PeriodicalId":48329,"journal":{"name":"Journal of Behavioral Medicine","volume":" ","pages":"514-528"},"PeriodicalIF":2.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13303661/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147487846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health self-efficacy and general health in fibromyalgia: hope, hopelessness, and role functioning as serial mediators.","authors":"Victoria A Starks, Loren Toussaint, Fuschia Sirois, Jessie Dezutter, Jörg Schelling, Niko Kohls, Martin Offenbächer, Jameson K Hirsch","doi":"10.1007/s10865-026-00632-y","DOIUrl":"10.1007/s10865-026-00632-y","url":null,"abstract":"<p><p>Fibromyalgia involves symptoms of pain, sleep disruption, and fatigue, which can have a deleterious impact on mental and physical health, and role functioning. Health self-efficacy, the perceived ability to manage and cope with health problems, may mitigate risk for functional disability and improve health perceptions. As a contributor to goal-oriented motivation, self-efficacy may facilitate hope and reduce hopelessness, thereby promoting willingness and motivation to engage in functional activities, with consequent benefit to perceived health. Our sample of 416 persons with self-reported fibromyalgia completed assessments of health self-efficacy, hope, hopelessness, role functioning, and general health. We conducted serial mediation linear regression analyses, covarying age, sex, and race/ethnicity. Supporting hypotheses, greater health self-efficacy was related to more hope and less hopelessness and, in turn, to fewer role limitations due to physical/emotional difficulties and, consequently, to better health perceptions (p < .001). Self-efficacy may facilitate health promotion engagement and use of adaptive coping (e.g., goal-setting; problem-solving), resulting in greater hope and less hopelessness, with downstream benefits for role functioning and health perceptions, perhaps as a result of strengthened motivation and determination to manage health, reduced negative emotionality, and enhanced perceptions of role capabilities. Healthcare providers should consider promoting self-efficacy and hope, and reducing hopelessness, perhaps via Cognitive Behavioral Therapy or self-management strategies, and by fostering interpersonal wellbeing, to facilitate role functionality and improve health perceptions in individuals with symptoms of fibromyalgia.</p>","PeriodicalId":48329,"journal":{"name":"Journal of Behavioral Medicine","volume":" ","pages":"540-550"},"PeriodicalIF":2.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146100836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The protective role of self-esteem for functional well-being in the context of cancer-related distress among young adults with cancer.","authors":"Sean McHugh, Katie Darabos, Shannon Desbiens","doi":"10.1007/s10865-026-00648-4","DOIUrl":"10.1007/s10865-026-00648-4","url":null,"abstract":"","PeriodicalId":48329,"journal":{"name":"Journal of Behavioral Medicine","volume":" ","pages":"493-500"},"PeriodicalIF":2.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13303588/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147500295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How do trait self-control constructs and discounting relate to each other and to modifiable risk factors for cardiovascular disease?","authors":"Lili L Kókai, Diarmaid T Ó Ceallaigh, Anne I Wijtzes, Joost Oude Groeniger, Kirsten I M Rohde, Hans van Kippersluis, Alex Burdorf","doi":"10.1007/s10865-026-00640-y","DOIUrl":"10.1007/s10865-026-00640-y","url":null,"abstract":"<p><strong>Purpose: </strong>This study examines how different trait self-control constructs and discounting relate to each other and to modifiable behavioral and cardiometabolic risk factors for cardiovascular disease (CVD). Data from 8453 adults (18-65 years) participating in the Lifelines Cohort and the LIFESTYLE Study were analyzed. Participants self-reported on trait self-control constructs (Brief Self-Control Scale Short-form, Grit Scale Short-form, Delaying Gratification Inventory Short-form, Abbreviated Impulsiveness Scale, Risk Propensity Scale), delay discounting (exponential discounting and present bias parameters of the quasi-hyperbolic discount model elicited using choice lists), probability discounting (risk premium elicited using a certainty equivalent task), physical activity, sedentary behavior, fat and sugar intake, and sleep duration. Body mass index, waist-hip ratio, and pulse pressure were measured during a Lifelines clinic visit.</p><p><strong>Results: </strong>Measures of trait self-control constructs showed moderate correlations with each other, and very weak correlations with discounting measures. Discounting measures correlated (very) weakly with each other. Regression analyses showed that the Brief Self-Control Scale Short-form, Grit Scale Short-form, and Delaying Gratification Inventory Short-form were significantly associated with all of studied outcomes in the expected direction-higher self-control linked to better health outcomes. Other trait self-control construct and discounting measures demonstrated weaker associations. Allowing measures to group into factors did not improve predictive power.</p><p><strong>Conclusion: </strong>Trait self-control constructs and discounting are very weakly to moderately related, suggesting they represent distinct facets of a broader construct. Certain trait self-control constructs are important predictors of CVD risk, highlighting potential targets for interventions aimed at improving cardiovascular health.</p>","PeriodicalId":48329,"journal":{"name":"Journal of Behavioral Medicine","volume":" ","pages":"440-455"},"PeriodicalIF":2.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13303321/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the effects of a sedentary time reduction intervention on pain, mood, and quality of life in chronic low back pain: a pilot randomized controlled trial.","authors":"Laura D Ellingson, Madeleine L Connolly, Jeni E Lansing, L Alison Phillips, Jacob D Meyer","doi":"10.1007/s10865-026-00644-8","DOIUrl":"10.1007/s10865-026-00644-8","url":null,"abstract":"<p><p>Sedentary time negatively influences health and is a risk factor for chronic low back pain (CLBP). Emerging evidence suggests breaking up prolonged sedentary behaviors may improve CLBP. This pilot trial examined the influence of decreasing sedentary behaviors on pain, mood, and quality of life in CLBP. Forty adults with CLBP and elevated depressive symptoms were randomized to wear an activity tracker with an idle alert along with receiving health coaching based on Motivational Interviewing and Habit Theory (INT) or a wait-list control condition (WLC) for eight weeks with a 12-week follow-up. Actigraphy-assessed time in total and prolonged sedentary behaviors, pain, depressed mood, quality of life, Patient Global Impression of Change (PGIC), and habits surrounding sedentary behavior were assessed at pre-intervention, post-intervention, and at follow-up. Repeated measures ANOVAs were used to examine changes in outcomes. Results demonstrated that INT reduced time spent in prolonged sedentary bouts by an average of ~ 53 min/day (95% CI - 111.8 to 5.4), compared to WLC who decreased by an average of less than 1 min/day, based on wearable activity monitor data (difference between groups, 52.9 min/day, 95% CI - 27.2 to 133.1). There were no significant group-by-time interactions for pain nor depressed mood. Significant improvements for INT over WLC were demonstrated with moderate-to-large effects in Quality of life (physical health, g = 0.95, and bodily pain, g = 0.70), PGIC (g = 1.14), and sedentary behavior habit automaticity (g = 0.71). These results demonstrate potentially meaningful improvements in patient quality of life and physical activity after an intervention that decreased prolonged sedentary time in those with CLBP, although further study in larger scale efficacy trials is warranted. Perspective: This article presents the findings from a pilot trial examining whether breaking up prolonged bouts of sedentary time improves symptoms and quality of life in chronic low back pain. Results can be used to determine whether this strategy is worthy of further investigation.</p>","PeriodicalId":48329,"journal":{"name":"Journal of Behavioral Medicine","volume":" ","pages":"501-513"},"PeriodicalIF":2.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147500253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}