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    A Longitudinal Study Among Permanent Supportive Housing Residents: Increase in Social Support Co-Occurring with Decrease in Depressive Symptoms and Substance Use Problems
    (2021) Tan, Zhengqi; Mun, Eun-Young; Nguyen, Uyen-Sa; Walters, Scott
    Purpose: Social support is a well-known protective factor against depressive symptoms and substance use problems, but very few studies have examined its protective effects among residents of Permanent Supportive Housing (PSH), a housing program for people with a history of chronic homelessness. We examined whether perceived social support improves when provided with regular health coaching visits and whether improved social support is associated with reduced depressive symptoms and substance use problems among this underserved population. Methods:Participants were 653 adult PSH residents in North Texas (56% female; 57% Black; mean age: 51 years) who participated in a monthly health coaching program from 2014 to 2017. We assessed their health behaviors at baseline and three follow-up visits for up to 18 months. We used latent growth curve models to capture changes over time and parallel process growth models to examine the associations between the trajectories of social support and the trajectories of each health measure. Results:PSH residents showed improved social support, and decreased depressive symptoms and substance use problems over time. In addition, individuals with greater needs at baseline tended to improve faster, although their improvements slowed over time. Further, those who improved in social support tended to show reduced depressive symptoms (coefficient: –0.67, p< 0.01) and substance use problems (coefficient: –0.52, p< 0.01). Conclusions:This study suggests that increases in social support may positively impact depressive symptoms and substance use problems among PSH residents. Future housing programs could emphasize social support as an early component. Supported by Medicaid1115Waiver & R01AA019511.
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    Impact of Cognitive and Behavioral Disturbances on Insomnia Symptom Frequency Among Medical Students
    (2021) Momin, Shahana; Roane, Brandy
    Background: About 30% of medical students report insomnia. Insomnia increases risk of depression, anxiety, and mental health disturbances. Both behavioral (e.g., clock watching) and cognitive factors (e.g., worry) contribute to insomnia. We hypothesized that experiencing cognitive and behavioral disturbances would predict more frequent insomnia symptoms among medical students. Methods: Participants were 128 1st/2nd year medical students. Mean age was 24.2 years (SD=3.5) with 61% female, 6% Hispanic, 51% Caucasian, 37% Asian American, and 2% Black. Data were collected during Fall/Spring semesters from 2016/2017. Students gave informed consent prior to reporting on sleep disorder symptoms including insomnia, daytime sleepiness, and sleep habits. Students reporting sleep apnea symptoms were excluded from analyses. Univariate regression analyses determined significant predictors of insomnia symptom frequency. Results: Clock watching (p< 0.001), strong emotions 1-hr before bed (p< 0.001), going to bed upset (p< 0.001) and worrying about school in bed (p=0.037) were significant predictors of more frequent insomnia symptoms. Results also showed trends for napping after 6pm; calm/relaxing activity or being very active 1-hr before bed; stomachache when going to bed; and falling asleep in bright light predicted insomnia symptom frequency. Conclusion: Cognitive disturbances were more likely to predict insomnia symptom frequency among medical students. Behavioral and cognitive disturbances increase physiological arousal, which contributes to insomnia; however, cognitive disturbances are more often associated with a negative interpretation (e.g., worrying about school versus being very active). Findings suggest that sleep hygiene, which targets mainly behavioral factors, is likely not a sufficient intervention for this population.