Browsing by Author "Johnson-Kwochka, Annalee"

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    Development and examination of the attribution questionnaire-substance use disorder (AQ-SUD) to measure public stigma towards adolescents experiencing substance use disorders
    (Elsevier, 2021-04) Johnson-Kwochka, Annalee; Aalsma, Matthew C.; Monahan, Patrick O.; Salyers, Michelle P.; Psychiatry, School of Medicine
    BACKGROUND: Public stigma may significantly impact adolescents with substance use disorders (SUDs), leading to limited treatment accessibility and utilization. However, few measures have been validated to assess public SUD stigma towards adolescents. In this study we developed the Attribution Questionnaire-Substance Use Disorder (AQ-SUD) by modifying the Attribution Questionnaire, a commonly used measure of public mental illness stigma. We examined 1) the psychometric properties of the AQ-SUD with supporting data from other stigma scales and 2) preliminary data on adults' perceptions of public stigma toward adolescents with SUDs. METHODS: Adult participants (n = 304) were randomly assigned to one of four vignettes about an adolescent with a specific SUD diagnosis (opioid, marijuana, alcohol, and stimulant use disorders). Participants completed the AQ-SUD and three other measures of public stigma designed to assess convergent and divergent validity. RESULTS: Analyses indicated that the modified AQ-SUD has good psychometric properties, and revealed a four-factor structure: negative emotions, assessment of responsibility, social disengagement, and lack of empathy. Additional public stigma scales demonstrated good psychometrics and provided evidence of both convergent and divergent validity for the AQ-SUD. Preliminary analysis of public stigma towards adolescents with a SUD suggests that attitudes about marijuana use disorder differ significantly from attitudes about other SUDs. CONCLUSIONS: This study is the first to modify and validate a measure designed to assess perceptions of public SUD stigma towards adolescents, the AQ-SUD. Preliminary analyses suggest that adults view adolescent marijuana use disorders as less severe compared to other SUDs, which may have implications for adults' motivation to support youth in seeking treatment.
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    A new look at the attribution model: Considerations for the measurement of public mental illness stigma.
    (APA, 2021) Johnson-Kwochka, Annalee; Minor, Kyle S.; Ashburn-Nardo, Leslie; Wu, Wei; Stull, Laura G.; Salyers, Michelle P.; Psychology, School of Science
    Multiple versions of the Attribution Model and the corresponding Attribution Questionnaire have been used to assess public mental illness stigma. The objective of the current study was to examine (a) the factor structure of the Attribution Questionnaire and (b) relationships between constructs in the Attribution Model. Analyzing a sample of 334 U.S. adults recruited from Amazon Mechanical Turk, the authors employ confirmatory factor analyses to test three proposed factor structures of the Attribution Questionnaire and latent variable path analyses to reexamine relationships between variables in the stigmatization of people who experience mental illness. Confirmatory factor analyses of three previously examined versions of the Attribution Model revealed that the model proposed by the initial version of the Attribution Questionnaire had the best fit with the data comparative fit index (CFI = 0.92, root-mean-square error of approximation [RMSEA] = 0.07, standardized root-mean-square residual [SRMR] = 0.05). Subsequent path analyses among contructs in the model revealed acceptable model fit (CFI = 0.92, RMSEA = 0.07, SRMR = 0.06) and individual paths largely supported the hypotheses suggested by the Attribution Model. Analyses supported the original version of the Attribution Model and questionnaire with slight modifications, demonstrating that attributions of dangerousness and personal responsibility are associated with the endorsement of coercive treatment, and that attributions about dangerousness are associated with a lower desire to help. These findings suggest modifications in the current measurement of public mental illness stigma.
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    S50. Employing Text-Messages to Improve Motivation: Mobile Enhancement of Motivation in Schizophrenia
    (Oxford University Press, 2018-04) Luther, Lauren; Watkins, Melanie; Johnson-Kwochka, Annalee; Salyers, Michelle P.; Psychology, School of Science
    Background Motivation deficits are among the strongest determinants of reduced functioning and quality of life in people with schizophrenia. Mobile interventions are a promising approach to improving these deficits because they can provide frequent cues and reinforcements to support goal-directed behavior in daily life. The objective of this study is to assess the initial feasibility/acceptability and effectiveness of Mobile Enhancement of Motivation in Schizophrenia (MEMS), a personalized mobile text message intervention, compared to a goal-setting alone intervention. Methods Fifty-six participants with a schizophrenia-spectrum disorder have been enrolled in this ongoing controlled pilot study. Twenty-seven participants have been randomized to MEMS, while 29 participants have been randomized to the goal-setting alone condition. Participants in both groups set individualized recovery goals to complete over an 8-week period. Those in the MEMS group also receive three sets of personalized, interactive text messages each weekday to reinforce and cue goal completion. Blinded assessments are conducted before and after the 8-week period and include validated measures of motivation, quality of life, and functioning. Goal attainment and self-reported satisfaction with MEMS are also assessed. Results To date, 36 participants (n = 18 in each group) have completed both baseline and follow-up assessments. Initial results suggest that relative to the goal-setting alone group, the MEMS group demonstrated significantly greater improvements in clinician-rated motivation (F(1, 33) = 7.14, p = .01; between-group d = .89). Specifically, the MEMS group demonstrated significantly higher clinician-rated motivation after 8 weeks (within-group d = .62), while clinician-rated motivation remained the same in the goal-setting alone group (within-group d = -.02). Across both groups, participants also significantly improved on clinician-rated functioning over time (t(35) = -2.56, p = .02, d = .43), but there was no difference between the two groups (F(1, 33) = .01, p = .94; between-group d = .03). No improvement on self-reported quality of life was observed in either group or across the full sample. The MEMS group reported strong satisfaction with the text-messages. Recruitment has been completed, and analyses from the full sample will be ready to present at the meeting. Discussion Initial results indicate that MEMS is acceptable and may successfully improve motivation in people with schizophrenia-spectrum disorders. However, additional analyses with the full sample are needed to more rigorously test the feasibility and effectiveness of MEMS.
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    Treatment completion among justice-involved youth engaged in behavioral health treatment studies in the United States: A systematic review and meta-analysis
    (Cambridge University Press, 2022-06-13) Johnson-Kwochka, Annalee; Salgado, Eduardo F.; Pederson, Casey A.; Aalsma, Matthew C.; Salyers, Michelle P.; Psychology, School of Science
    Justice-involved youth (JIY) have high rates of behavioral health disorders, but few can access, much less complete, treatment in the community. Behavioral health treatment completion among JIY is poorly understood, even within treatment studies. Measurement, reporting, and rates of treatment completion vary across studies. This systematic review and meta-analysis synthesizes the literature on rates of treatment completion among JIY enrolled in research studies and identifies potential moderators. After systematically searching 6 electronic databases, data from 13 studies of 20 individual treatment groups were abstracted and coded. A meta-analysis examined individual prevalence estimates of treatment completion in research studies as well as moderator analyses. Prevalence effect sizes revealed high rates of treatment completion (pr = 82.6). However, analysis suggests a high likelihood that publication bias affected the results. Treatment groups that utilized family- or group-based treatment (pr = 87.8) were associated with higher rates of treatment completion compared to treatment groups utilizing individual treatment (pr = 61.1). Findings suggest that it is possible to achieve high rates of treatment completion for JIY, particularly within the context of family- and group-based interventions. However, these findings are limited by concerns about reporting of treatment completion and publication bias.
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    Work-Focused Cognitive Behavioral Therapy to Complement Vocational Services for People With Mental Illness: Pilot Study Outcomes Across a 6-Month Posttreatment Follow-Up
    (APA, 2019) Kukla, Marina; Salyers, Michelle P.; Strasburger, Amy M.; Johnson-Kwochka, Annalee; Amador, Emily; Lysaker, Paul H.; Psychiatry, School of Medicine
    Objective: People with mental illness frequently have trouble obtaining and keeping competitive employment and struggle with on-the-job performance. To address these issues, the manualized, group-based, 12-session Cognitive Behavioral Therapy for Work Success (CBTw) intervention was developed and tested in an open trial. Although posttreatment work outcomes were promising, lasting effects associated with the intervention are unknown. Method: This article presents the 6-month posttreatment work outcomes of the open trial of CBTw in 52 adults with mental illness who were concurrently receiving VA vocational services. Work outcomes included work status, hours worked and wages earned, steady work status, and work performance and effectiveness. Data were analyzed using repeated measures analysis of variances (ANOVAs) and within groups t tests. Results: Findings demonstrate that 75% of unemployed participants at baseline obtained competitive work during the study period. During the 6-month follow-up period, 73% of workers attained steady work status (i.e., working at least 50% of the follow-up period). In addition, during the 6-month follow-up period, working participants averaged significantly more hours of work per week and higher wages earned per hour as compared with the baseline period and the 12-week postintervention period. Finally, among workers, reports of work effectiveness remained high at 6 months and work productivity disruptions remained low at follow-up. Conclusions and Implications for Practice: These findings suggest that CBTw may potentially be a useful tool to enhance the effects of vocational programs. Future work should test CBTw in a randomized controlled trial and examine strategies for implementation in real-world vocational service settings.