Policy Insights from the Behavioral and Brain Sciences最新文献

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Biofeedback Has Therapeutic Effects on Asthma, Although Additional Research Is Needed to Document Specificity 生物反馈对哮喘有治疗作用，尽管还需要更多的研究来证明其特异性

IF 3.8 Q1 Social Sciences

Policy Insights from the Behavioral and Brain Sciences

Pub Date : 2023-03-01 DOI: 10.1177/23727322221145306

P. Lehrer, Gali Moritz

Asthma is a common disorder leading to significant disability and healthcare cost throughout the world. Although medical treatment is usually highly effective in controlling it, asthma medicines often have high costs and attendant side effects. Biofeedback is an inexpensive noninvasive alternative with minimal side effects. This paper reviews evidence for two validated biofeedback treatments for treating asthma, heart rate variability biofeedback (HRVB), and muscle relaxation with surface electromyographic biofeedback. In multiple studies, although most of them are of modest size, both methods have clinically meaningful results, often allowing decreases in the use of steroid medication. Further research is needed to prove which specific components of HRVB are responsible for clinical effects, and to determine asthma populations that can best benefit from these methods. Despite demonstrated effectiveness, few insurance schemes reimburse for biofeedback, and national guidelines consider it only as worthy of further investigation. Funding for the requisite large-scale clinical trials remains lacking, creating a limbo-like status quo for these useful methods.

哮喘是一种常见的疾病，在世界范围内导致严重的残疾和医疗保健费用。虽然医学治疗通常在控制哮喘方面非常有效，但哮喘药物往往价格高昂，并伴有副作用。生物反馈是一种廉价、无创、副作用小的替代方法。本文综述了两种有效的生物反馈治疗哮喘的证据，心率变异性生物反馈(HRVB)和表面肌电生物反馈肌肉放松。在多项研究中，尽管大多数研究的规模不大，但这两种方法都有临床意义的结果，通常可以减少类固醇药物的使用。需要进一步的研究来证明HRVB的哪些特定成分对临床效果负责，并确定最能从这些方法中受益的哮喘人群。尽管证明了生物反馈的有效性，但很少有保险计划报销生物反馈，国家指南只认为它值得进一步调查。必要的大规模临床试验的资金仍然缺乏，这使得这些有用的方法处于不稳定的状态。

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引用次数: 0

Family-Based Psychosocial Interventions for Severe Mental Illness: Social Barriers and Policy Implications 严重精神疾病的家庭心理社会干预：社会障碍与政策启示

IF 3.8 Q1 Social Sciences

Policy Insights from the Behavioral and Brain Sciences

Pub Date : 2023-03-01 DOI: 10.1177/23727322221128251

Franchesca S. Kuhney, D. Miklowitz, J. Schiffman, V. Mittal

Severe mental illnesses (SMI) such as schizophrenia, major depressive disorder, and bipolar disorder are prevalent, debilitating, and chronic conditions that come with significant costs to families, public health systems, and communities. Research indicates that emotional qualities within the family environment of the person with SMI (e.g., whether members are highly supportive, critical, or emotionally overinvolved) can either protect against or increase the risk for psychiatric relapse. Dovetailing this work is research indicating that family-based psychosocial interventions, which can increase family functioning through psychoeducation and skill building, can promote positive outcomes for individuals with SMI. Unfortunately, social barriers such as financial strain, inaccessibility of specialized care, stigma, and social marginalization may impede a patient's or family's ability to initiate and/or continue family services. We propose that improving treatment engagement requires a combination of state and federal policy initiatives supporting community resources, integrated health care, and partnerships with national organizations.

精神分裂症、重性抑郁障碍和双相情感障碍等严重精神疾病（SMI）是一种普遍的、使人衰弱的慢性疾病，给家庭、公共卫生系统和社区带来了巨大的成本。研究表明，SMI患者家庭环境中的情绪素质（例如，成员是否高度支持、挑剔或情绪过度）可以预防或增加精神病复发的风险。支持这项工作的研究表明，基于家庭的心理社会干预可以通过心理教育和技能培养来提高家庭功能，可以促进SMI患者的积极结果。不幸的是，经济压力、无法获得专业护理、污名化和社会边缘化等社会障碍可能会阻碍患者或家人开始和/或继续提供家庭服务的能力。我们建议，提高治疗参与度需要州和联邦政策举措的结合，支持社区资源、综合医疗保健以及与国家组织的伙伴关系。

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引用次数: 0

Psychology Meets Biology in COVID-19: What We Know and Why It Matters for Public Health. 心理学与生物学在COVID-19中的相遇:我们所知道的以及为什么它对公共卫生很重要。

IF 3.8 Q1 Social Sciences

Policy Insights from the Behavioral and Brain Sciences

Pub Date : 2023-03-01 DOI: 10.1177/23727322221145308

Emily J Jones, Kieran Ayling, Cameron R Wiley, Adam W A Geraghty, Amy L Greer, Julianne Holt-Lunstad, Aric A Prather, Hannah M C Schreier, Roxane Cohen Silver, Rodlescia S Sneed, Anna L Marsland, Sarah D Pressman, Kavita Vedhara

Psychosocial factors are related to immune, viral, and vaccination outcomes. Yet, this knowledge has been poorly represented in public health initiatives during the COVID-19 pandemic. This review provides an overview of biopsychosocial links relevant to COVID-19 outcomes by describing seminal evidence about these associations known prepandemic as well as contemporary research conducted during the pandemic. This focuses on the negative impact of the pandemic on psychosocial health and how this in turn has likely consequences for critically relevant viral and vaccination outcomes. We end by looking forward, highlighting the potential of psychosocial interventions that could be leveraged to support all people in navigating a postpandemic world and how a biopsychosocial approach to health could be incorporated into public health responses to future pandemics.

心理社会因素与免疫、病毒和疫苗接种结果有关。然而，在2019冠状病毒病大流行期间，这方面的知识在公共卫生行动中没有得到充分体现。本综述概述了与COVID-19结果相关的生物心理社会联系，描述了大流行前已知的这些关联的重要证据以及大流行期间进行的当代研究。重点关注大流行对社会心理健康的负面影响，以及这反过来如何可能对至关重要的病毒和疫苗接种结果产生影响。最后，我们展望未来，强调社会心理干预的潜力，可用于支持所有人应对大流行后的世界，以及如何将生物心理社会卫生方法纳入未来大流行的公共卫生应对措施。

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引用次数: 1

Waking Up to the Importance of Sleep: Opportunities for Policy Makers 觉醒到睡眠的重要性:政策制定者的机会

IF 3.8 Q1 Social Sciences

Policy Insights from the Behavioral and Brain Sciences

Pub Date : 2023-03-01 DOI: 10.1177/23727322221144651

A. Prather

Insufficient sleep is associated with an increased risk for a range of negative physical and mental health outcomes. Causes of insufficient sleep involve many factors, and the consequences are not evenly distributed across populations. Indeed, stark sleep disparities disadvantage racial and ethnic minorities and those low in socioeconomic status, who are more readily affected by poor sleep than their White and high socioeconomic status comparators. Sleep is situated in the context of a socioecological model that recognizes societal, community, and individual factors that shape poor sleep and drive sleep-related outcomes. Policy opportunities address each level of the presented model and addressing these barriers should promote better sleep for those affected and potentially reduce sleep disparities.

睡眠不足会增加一系列负面身心健康后果的风险。睡眠不足的原因涉及许多因素，其后果在人群中分布不均匀。事实上，明显的睡眠差距对少数种族和少数民族以及社会经济地位低的人不利，他们比白人和社会经济地位高的人更容易受到睡眠不足的影响。睡眠是在一个社会生态模型的背景下进行的，该模型认识到影响睡眠不良并导致睡眠相关结果的社会、社区和个人因素。政策机会解决了所提出模型的各个层面，解决这些障碍应该能促进受影响者更好的睡眠，并有可能减少睡眠差距。

引用次数: 0

Recommendations for the Use of Behavioral Economic Demand as an Abuse Liability Assessment for Drug Scheduling 使用行为经济需求作为药物计划滥用责任评估的建议

IF 3.8 Q1 Social Sciences

Policy Insights from the Behavioral and Brain Sciences

Pub Date : 2023-03-01 DOI: 10.1177/23727322221150197

Mikhail N. Koffarnus

Before being marketed in the United States, novel drugs must undergo evaluation for abuse liability. Drugs with higher abuse liability are assigned a schedule associated with stricter regulatory controls. Behavioral economic demand techniques hold great potential for use as an abuse liability assessment in the scheduling of novel drugs. Advantages of demand analyses include (1) quantitative abuse liability results that allow for relative comparisons and ranking among drugs by abuse liability, (2) the ability to collect analogous measures of abuse liability in both preclinical and human clinical models, and (3) minimal extra work to add demand analyses to those analyses that are already recommended in Food and Drug Administration (FDA) guidance. Challenges primarily arise with the standardization of experimental protocols for such assessments, but these challenges may be resolvable with directed work to compare different methodological techniques. If successful, incorporation of these methods could help avoid scheduling errors that are costly to society.

在美国上市之前，新药必须经过滥用责任评估。滥用风险较高的药物被分配了一个与更严格的监管控制相关的时间表。行为经济需求技术在新药调度中作为滥用责任评估具有巨大的潜力。需求分析的优点包括：（1）定量的滥用责任结果，允许按滥用责任对药物进行相对比较和排名；（2）能够在临床前和人类临床模型中收集类似的滥用责任衡量标准，以及（3）将需求分析添加到食品和药物管理局（FDA）指南中已经推荐的分析中的额外工作最少。挑战主要出现在此类评估的实验方案的标准化方面，但这些挑战可以通过比较不同方法技术的直接工作来解决。如果成功，这些方法的结合可以帮助避免对社会造成代价的日程安排错误。

引用次数: 0

Data Exclusion in Policy Survey and Questionnaire Data: Aberrant Responses and Missingness 政策调查与问卷数据的数据排除:异常反应与缺失

IF 3.8 Q1 Social Sciences

Policy Insights from the Behavioral and Brain Sciences

Pub Date : 2023-03-01 DOI: 10.1177/23727322221144650

Maxwell R. Hong, Matthew F. Carter, Casey Kim, Ying Cheng

Data preprocessing is an integral step prior to analyzing data in psychological science, with implications for its potentially guiding policy. This article reports how psychological researchers address data preprocessing or quality concerns, with a focus on aberrant responses and missing data in self-report measures. 240 articles were sampled from four journals: Psychological Science, Journal of Personality and Social Psychology, Developmental Psychology, and Abnormal Psychology from 2012 to 2018. Nearly half of the studies did not report any missing data treatment (111/240; 46.25%), and if they did, the most common approach was listwise deletion (71/240; 29.6%). Studies that remove data due to missingness removed, on average, 12% of the sample. Likewise, most studies do not report any aberrant responses (194/240; 80%), but if they did, they classified 4% of the sample as suspect. Most studies are either not transparent enough about their data preprocessing steps or may be leveraging suboptimal procedures. Recommendations can improve transparency and data quality.

在心理科学中，数据预处理是分析数据之前不可或缺的一步，对其潜在的指导政策具有影响。本文报告了心理学研究者如何处理数据预处理或质量问题，重点关注自我报告测量中的异常反应和缺失数据。从2012年至2018年，从《心理科学》、《人格与社会心理学》、《发展心理学》和《变态心理学》四种期刊中抽取了240篇文章。近一半的研究没有报告任何缺失的数据处理(111/240;46.25%)，如果有，最常见的方法是按列表删除(71/240;29.6%)。由于缺失而删除数据的研究平均删除了12%的样本。同样，大多数研究没有报告任何异常反应(1994 /240;80%)，但如果他们这样做了，他们将4%的样本归类为可疑样本。大多数研究要么对其数据预处理步骤不够透明，要么可能利用了次优程序。建议可以提高透明度和数据质量。

引用次数: 0

Digital Contingency Management in the Treatment of Substance Use Disorders 药物使用障碍治疗中的数字应急管理

IF 3.8 Q1 Social Sciences

Policy Insights from the Behavioral and Brain Sciences

Pub Date : 2023-03-01 DOI: 10.1177/23727322221144648

J. Dallery, Anthony Defulio, B. Raiff

Contingency management (CM) provides incentives based on drug abstinence or other treatment goals; it is one of the most efficacious and cost-effective psychosocial interventions for substance use disorders. However, CM remains severely underused in clinical care. Digital methods to deliver CM could dramatically expand access. These methods include information and drug sensing technologies to obtain objective evidence of drug abstinence, authenticate the end-user's identity, and deliver incentives immediately. Digital CM has been applied successfully to cigarette smoking, alcohol misuse, and more recently illicit drug use. Policies should continue to evolve to promote the delivery of digital CM based on decades of research.

应急管理（CM）提供基于戒毒或其他治疗目标的激励措施；它是治疗药物使用障碍最有效、最具成本效益的心理社会干预措施之一。然而，CM在临床护理中的使用仍然严重不足。提供CM的数字化方法可以极大地扩大访问范围。这些方法包括信息和药物传感技术，以获得戒毒的客观证据，验证最终用户的身份，并立即提供激励措施。数字CM已成功应用于吸烟、酗酒和最近的非法药物使用。政策应在数十年研究的基础上继续发展，以促进数字CM的交付。

引用次数: 0

National Health Guidelines for Social Connection: What Is the Evidence in Support and What Might the Guidelines Say? 国家社会联系健康指南：支持的证据是什么？指南可能会说什么？

IF 3.8 Q1 Social Sciences

Policy Insights from the Behavioral and Brain Sciences

Pub Date : 2023-03-01 DOI: 10.1177/23727322221150204

J. Holt‐Lunstad

National health guidelines provide policy makers and the public with recommendations for various behavioral factors known to promote health and reduce disease risk, such as diet and physical activity. Given public health concerns about social isolation, loneliness, and other forms of lacking social connection, the evidence supports establishing national health guidelines for “social connection.” The aggregate body of scientific evidence demonstrates social connection protects health and reduces health risks, pointing to clear relevance for public health. Taken together with national trends suggesting greater social disconnection, there is a compelling case for national preventative efforts. This article summarizes evidence on the health relevance of social connections, potential opportunities, and challenges in establishing and implementing guidelines, the process of establishing guidelines, and provides illustrative evidence-based examples of potential recommendations.

国家健康指南为决策者和公众提供了关于促进健康和减少疾病风险的各种已知行为因素的建议，例如饮食和体育活动。鉴于公共卫生对社会隔离、孤独和其他形式的缺乏社会联系的担忧，有证据支持为“社会联系”制定国家卫生指南。综合科学证据表明，社会联系可以保护健康并降低健康风险，这表明社会联系与公共卫生有着明确的关联。结合表明社会脱节加剧的国家趋势，有一个令人信服的理由，要求国家采取预防措施。本文总结了社会关系与健康相关的证据、建立和实施指南的潜在机遇和挑战、制定指南的过程，并提供了潜在建议的说明性证据示例。

引用次数: 5

Barriers to Accessing Effective Treatments for Destructive Behavior. 获得破坏性行为有效治疗的障碍

IF 3.8 Q1 Social Sciences

Policy Insights from the Behavioral and Brain Sciences

Pub Date : 2023-03-01 Epub Date: 2023-03-15 DOI: 10.1177/23727322221144653

Brian D Greer

The field of applied behavior analysis has developed and refined a comprehensive methodology for the assessment and successful treatment of destructive behavior: An individualized approach emphasizes (a) function of responding (or its cause) over its form; (b) objective and reliable measurement of behavior; (c) systematic procedures and their application; (d) rigorous, single-case experimental designs; and (e) determinations of successful intervention judged by improvements in the same individual's performance. Outcomes of this approach are often dramatic and reliably surpass those obtained by alternative means. However, significant barriers limit the accessibility of this proven therapy. Too few intensive behavioral intervention units, diagnosis- and age-dependent insurance authorization and reimbursement practices, long waitlists and slow approval processes, and the possibility of treatment relapse represent a few such barriers. This article describes these barriers and suggests some potential solutions.

应用行为分析领域已经发展和完善了一种评估和成功治疗破坏性行为的综合方法。这种个性化的方法强调(a)响应(或其原因)的功能而不是其形式;(b)客观可靠的行为测量;(c)系统程序及其应用;(d)严格的单例实验设计;(e)通过个体表现的改善来判断干预是否成功。这种方法的结果往往是戏剧性的，并且可靠地超过其他方法所获得的结果。然而，重大障碍限制了这种经过验证的治疗方法的可及性。强化行为干预单位太少，诊断和年龄相关的保险授权和报销做法，漫长的等待名单和缓慢的批准过程，以及治疗复发的可能性代表了其中的一些障碍。本文描述了这些障碍，并提出了一些可能的解决方案。

引用次数: 0

Young Adult Mental Health Beyond the COVID-19 Era: Can Enlightened Policy Promote Long-Term Change? 超越 COVID-19 时代的青少年心理健康：开明政策能否促进长期变革？

IF 3.4 Q1 EDUCATION & EDUCATIONAL RESEARCH

Policy Insights from the Behavioral and Brain Sciences

Pub Date : 2023-03-01 Epub Date: 2023-03-15 DOI: 10.1177/23727322221150199

June Gruber, Stephen P Hinshaw, Lee Anna Clark, Jonathan Rottenberg, Mitchell J Prinstein

The status of mental health for adolescents and young adults has aptly been termed a "crisis" across research, clinical, and policy quarters. Arguably, the status quo provision of mental health services for adolescents and young adults is neither acceptable nor salvageable in its current form. Instead, only a wholesale policy transformation of mental health sciences can address crises of this scope. Pandemic-related impacts on mental health, particularly among young adults, have clearly exposed the need for the mental healthcare field to develop a set of transformative priorities to achieve long overdue, systemic changes: (1) frequent mental health tracking, (2) increased access to mental health care, (3) working with and within communities, (4) collaboration across disciplines and stakeholders, (5) prevention-focused emphasis, (6) use of dimensional descriptions over categorical pronouncements, and (7) addressing systemic inequities. The pandemic required changes in mental healthcare that can and should be the beginning of long-needed reform, calling upon all mental health care disciplines to embrace innovation and relinquish outdated traditions.

青少年心理健康的现状被研究、临床和政策部门恰当地称为 "危机"。可以说，目前为青少年提供心理健康服务的现状既不可接受，也无法挽救。相反，只有对心理健康科学进行全面的政策改革，才能解决如此严重的危机。大流行病对心理健康的影响，尤其是对青壮年心理健康的影响，清楚地揭示了心理保健领域需要制定一套变革性的优先事项，以实现早该实现的系统性变革：(1) 频繁的心理健康跟踪，(2) 增加获得心理保健服务的机会，(3) 与社区合作并在社区内开展工作，(4) 跨学科和利益相关者之间的合作，(5) 以预防为重点，(6) 使用维度描述而不是分类声明，(7) 解决系统性的不公平问题。大流行病要求心理保健领域做出改变，这可以也应该成为长期需要的改革的开端，呼吁所有心理保健学科拥抱创新，放弃过时的传统。

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