Silvia M. Bigatti
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Improving the mental health of Latino youth
Professor Silvia Bigatti is concerned about the high rate of depression among Latino adolescents in Indianapolis who endure the stress of straddling two cultures. In 2012, she started a partnership with the Latino Health Organization and received funding from the Indiana Minority Health Coalition to pursue a pilot research project that investigated the stress and depressive outcomes in this population. The study revealed that nearly 60 percent of participants had some form of depressive symptoms—and that they were seven times more likely to have depression if they suffered from moderate levels of acculturative stress. Based on the ¬findings, the research team developed a program, “Your Life. Your Story.” The YLYS program begins with a one-week summer day camp that builds resilience and develops self-identities and future goals. In the second phase of the YLYS program, a monthly meeting cements components from the camp. Data suggest that one week of the YLYS camp has a statistically significant impact on participants, who showed an increase in resilience and a decrease in depressive symptoms. These differences were maintained at a six-month follow-up. YLYS has the potential to create a large and lasting impact on the Indianapolis community. While the program has been focused on Latino youth, it can be applied and tailored to any group of youth. Professor Bigatti’s work to improve the mental health of Latino youth in Indianapolis is another example of how IUPUI faculty are TRANSLATING RESEARCH INTO PRACTICE.
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Item Role Strains and Mood in Husbands of Women with Fibromyalgia Syndrome: A Test of the Stress Process Model(2008) Bigatti, Silvia M.; Lydon, Jennifer R.; Brothers, Brittany M.Spouses of patients experience role strains as a result of informal caregiving, which has been associated with mood in numerous research studies. However, most research is on female caregivers, and little is known about the experience of male spouses, or of the caregiving provided to fibromyalgia patients. The Stress Process Model was used to examine mediators and moderators of the relation between role strain and mood among 135 husbands of women with fibromyalgia. Results indicated that the more activities of daily living and instrumental activities of daily living performed by the husband, the greater the role strain. Role strain was associated with worse mood. A test of the Stress Process Model supported a partial mediation model, where social support and emotion-focused coping partially mediated the relation between role strain and mood. No evidence was found for a moderation model or for problem-focused coping as a mediator. Our research suggests significant impairment and caregiving needs among this patient population, which in turn relates to the mood of the husband who is also an informal caregiver. Our findings also support the Stress Process Model in explaining the complexity of caregiving effects. The results of the study suggest avenues for intervention for individuals strained by their partners’ illness.Item Sleep Disturbances in Fibromyalgia Syndrome: Relationship to Pain and Depression(2008-07) Bigatti, Silvia M.; Hernandez, Ann Marie; Cronan, Terry A.; Rand, Kevin L.Objective This study is an examination of sleep, pain, depression, and physical functioning at baseline and 1-year followup among patients with fibromyalgia syndrome (FMS). Although it is clear that these symptoms are prevalent among FMS patients and that they are related, the direction of the relationship is unclear. We sought to identify and report sleep problems in this population and to examine their relationship to pain, depression, and physical functioning. Methods Patients diagnosed with fibromyalgia were recruited from a Southern California health maintenance organization and evaluated according to American College of Rheumatology criteria in the research laboratory. Six hundred patients completed the baseline assessment and 492 completed the 1-year assessment. Measures included the Center for Epidemiologic Studies Depression Scale, the McGill Pain Questionnaire, the Pittsburgh Sleep Quality Index, and the Fibromyalgia Impact Questionnaire. Results The majority of the sample (96% at baseline and 94.7% at 1 year) scored within the range of problem sleepers. Path analyses examined the impact of baseline values on 1-year values for each of the 4 variables. No variable of interest predicted sleep, sleep predicted pain (β = 0.13), pain predicted physical functioning (β = −0.13), and physical functioning predicted depression (β = −0.10). Conclusion These findings highlight the high prevalence of sleep problems in this population and suggest that they play a critical role in exacerbating FMS symptoms. Furthermore, they support limited existing findings that sleep predicts subsequent pain in this population, but also extend the literature, suggesting that sleep may be related to depression through pain and physical functioning.Item Cognitive Appraisals, Coping and Depressive Symptoms in Breast Cancer Patients(2012-12) Bigatti, Silvia M.; Steiner, Jennifer L; Miller, Kathy D.Depression in breast cancer patients and survivors is related to negative disease outcomes and worse quality of life. Factors that explain this depression can serve as targets of intervention. This study, guided by the Transactional Theory of Stress, examined the relationship between cognitive appraisals, coping strategies and depressive symptoms in a group of women with mostly advanced-stage breast cancer (N = 65), who scored mostly within the normal range for depressive symptoms. Path analysis was used to determine the relationships among variables, measured with the Cognitive Appraisals of Illness Scale, the Ways of Coping Questionnaire and the Center for Epidemiological Studies Depression Scale. The results of the path analysis showed that higher appraisals of harm/loss and greater use of escape–avoidance coping predicted higher depressive symptoms. These findings enhance the prediction of depression among breast cancer patients and suggest the need to examine cognitive appraisals when attempting to understand depressive symptoms.Item Values-based action in fibromyalgia: results from a randomized pilot of acceptance and commitment therapy(2013-09) Steiner, Jennifer L; Bogusch, Leah; Bigatti, Silvia M.Fibromyalgia Syndrome (FMS) is a chronic pain condition characterized by pain, fatigue, and nonrestorative sleep. The disruptive symptoms of FMS are associated with reductions in quality of life related to family, intimate relationships, and work. The present study was part of a randomized pilot study of an 8-week Acceptance and Commitment Therapy (ACT) intervention compared to education in a sample of 28 women with FMS. The Chronic Pain Values Inventory was administered at baseline, postintervention, and 12 week follow-up. Both groups showed significant improvements in family success, which were maintained at follow-up. Groups showed a differential pattern of success in work. The ACT group demonstrated significant, maintained improvements in success in intimate relationships, while the education group reported no changes over time. Findings suggest that both interventions may lead to improvements in valued living; however different interventions may be best suited for certain valued domains. The results of this study indicate that FMS patients are able to improve their success in family and intimate relationships and losses in these areas are not necessarily permanent.Item The influences of course effort and outside activities on grades in a college course(2006-09) Svanum, Soren; Bigatti, Silvia M.The influences of course effort and outside (family, job, social) activities on grades earned in a college course were examined for 230 urban college students. Multiple measurements of hours of work, social and family activities, and course effort were collected over a semester. Path modeling revealed that cumulative GPA and course effort had significant and independent predictive paths with grades. Outside activities did not directly influence course grade. Job activities, however, negatively influenced course grade indirectly through reduced course effort and mediated the influence GPA exerted on course grade. Thus, work demands lessened course effort and lessened GPA-indexed potential for course success. Cumulative GPA positively influenced effort, and effort mediated part of the relation between cumulative GPA and grades.Item Academic course engagement during one semester forecasts college success: Engaged students are more likely to earn a degree, do it faster, and do it better(2009-01) Svanum, Soren; Bigatti, Silvia M.Item Supportive Intervention for Advanced Lung Cancer Patients and Their Partners(Office of the Vice Chancellor for Research, 2013-04-05) Davis, Breanna; Bigatti, Silvia M.In recent years, cancer has ruthlessly taken many lives. Many forms of cancer have proven to be incurable, so a good sense of well-being and significant meaning of life is important before death. Although there have been a few programs that have focused on death-related concerns of dying patients, none have included the partner. Relationship issues have surfaced as one of the crucial concerns for patients, especially at the end of life. The stress of a patient also affects the partner’s well-being in the long run. The intention of this intervention is to lessen death-related stress for cancer patients and their partners. Cancer patients and their partners will be selected through a screening process through the Indiana University Cancer Center for a four-week intervention. The patients and partners then will take a pre-intervention assessment (Quantitative) followed by the intervention (Qualitative) itself. After the intervention, the patients and partners will take a post-intervention assessment (Quantitative). When analyzing, we will look for themes in the data and determine if the numbers have improved from the preassessment to the post-assessment. The findings from the qualitative and quantitative data will be used to assist in the improvement of cancer interventions and the updating of current practices, which will enhance its efficacy.Item Dyadic influence of hope and optimism on patient marital satisfaction among couples with advanced breast cancer(Springer, 2014-09) Rock, Emily E.; Steiner, Jennifer L.; Rand, Kevin L.; Bigatti, Silvia M.; Department of Psychology, School of SciencePURPOSE: An estimated 10-40 % of breast cancer (BC) patients report negative changes to their partnered relationships. Literature suggests that for these patients, marital satisfaction is related to depression and other quality of life factors which are associated with survivorship and treatment response. However, existing literature does not provide a clear explanation of the factors that strengthen vs. create strain in couples facing cancer. Given the benefits of a satisfying relationship to patient quality of life, it is important to better understand factors that put patients at greater risk for marital difficulties. This study examined the differential and combined roles of hope and optimism among BC patients and their partners on patient marital satisfaction. METHOD: Fifty-six breast cancer patient-partner dyads completed study questionnaires as part of a larger study. Regression analyses were used to examine the main and interaction effects of patient and partner hope and optimism on patient marital satisfaction. RESULTS AND CONCLUSION: Higher patient and partner hope predicted greater patient marital satisfaction, whereas optimism did not. These results are divergent from the literature on optimism and well-being, which shows the importance of studying these two traits concurrently. Interaction effects suggest certain combinations of patient and partner hope and optimism are more beneficial than others for patient marital satisfaction and suggest a dyadic approach is important for investigation of well-being in breast cancer.Item A Comparison of Objectively- and Subjectively-Measured Adherence in Glaucoma Patients of African Descent(Office of the Vice Chancellor for Research, 2015-04-17) Awan, Nabeel; Sutaria, Ankita; Bigatti, Silvia M.; Sirk, Emily; Hosty, Elizabeth; Payton, Chloe; Grow, Shelbi; Sutton, Bradley; Torbit, Julie; Racette, LynePurpose. Adherence to medical treatment of glaucoma is challenging. People of African descent (AD) have higher prevalence of open-angle glaucoma (OAG) and have been shown to have worse adherence. The goal of this prospective, observational study was to compare objectively- and subjectively-measured adherence in patients of African descent and to determine their relationship with self-efficacy. Methods. Twenty-one patients of AD diagnosed with OAG in the past five years were included in this study. Patients used a once-daily topical prostaglandin analog eye drop and self-administered their medication. Subjective adherence was assessed through self-report. Adherence was objectively measured using MEMS bottles. The cap of these bottles records the number of times the bottle is opened. Self-efficacy was assessed using the 10-item Glaucoma Medication Self-Efficacy scale and the 6-item Eye Drop Technique Self-Efficacy scale. MEMS adherence percentages were compared to self-reported adherence using a paired sample two-tailed t-test. To assess the relationship between objectively measured adherence and self-efficacy, patients were divided into 3 groups (n=7 each): high, medium and low adherence groups. The Chi-square test was used to determine whether differences in self-efficacy between the groups were present for each question on the two self-efficacy scales. Results. Subjectiveadherence (mean ± standard deviation) (97.34% ± 5.61) was significantly higher than objective adherence (66.34% ± 26.68) (p= 0.01). Of the 21 patients, 17 self-reported higher adherence levels than MEMS adherence levels. 4 patients with the highest levels of objectively measured adherence were the only patients to correctly estimate their adherence by self-report. Only one question was significantly associated with objective adherence: patients with high adherence were significantly more confident about taking their glaucoma medications when they do not experience symptoms (p = 0.04). Conclusions. Results showed that patients with higher adherence are more confident about using their eye drops in the absence of symptoms.Item Determining the Impact of Demographic Factors on Adherence to Glaucoma Treatment in Patients of African Descent(Office of the Vice Chancellor for Research, 2015-04-17) Botros, Mark; Racette, Lyne; Bigatti, Silvia M.Primary open-angle glaucoma (POAG) affects approximately 2.5 million Americans. Elevated intraocular pressure (IOP) is the only treatable risk factor to slow the progression of the disease and prevent blindness. Topical ocular hypotensive medications, dispensed in the form of eye drops, are the first line of treatment to reduce IOP. Patients are required to use their eye drops once or twice daily throughout the rest of their lives. Patients of African descent are more vulnerable to this chronic disease, with a prevalence six times higher than patients of European descent. They also have worse adherence to the treatment regimen in general. The main purpose of this study was to determine the impact of education, age, gender, household income, marital status, employment and number of prescribed medications on the adherence to the glaucoma treatment. Twenty-one patients were included and adherence was measured using Medication Event Monitoring System caps, which electronically record every time a patient uses their eye drops. After 4 weeks, patients returned with the caps and the compliance level was recorded. During the initial interview, patients answered a questionnaire about the different factors tested in this study. There was a positive correlation between the compliance percentage and age, with patients who are 70 years or older having the highest compliance levels (82% compared to 62% in the 50s and 60s category). Education also affected compliance, with patients who have a high school degree having a lower compliance at 62% compared to the patients with some college or a bachelor’s degree with compliance of 81%. The employment status was another contributor, with higher compliance in full-time employed patients compared to other employment types. The remaining factors did not contribute to the adherence levels. Overall, education, age, and employment status were the only factors that impacted adherence levels.