Nevin Manimala

Epidemiology. 2026 Jul 6. doi: 10.1097/EDE.0000000000002020. Online ahead of print.

ABSTRACT

BACKGROUND: We examined radon’s association with the complete blood count and leukocyte differential to better understand radon-related risks of stroke and myocardial infarction (MI) previously observed in the Women’s Health Initiative (WHI).

METHODS: We conducted a repeated measures analysis in this prospective cohort of post-menopausal women enrolled in 1993-1998 and examined at 5 visits over 19 years in 40 US clinical centers (n=154,630). We estimated indoor radon concentrations (pCi/L) at time-varying, geocoded addresses of participants (1993-2013) by linking them to the US Geological Survey Radon Index (1993) zoned by US Environmental Protection Agency Action Levels. We estimated covariate-adjusted, longitudinal associations of radon concentrations with complete blood count components using linear mixed-effects models. In a subset (n=6,313), we evaluated cross-sectional associations with the complete blood count differential using multivariate compositional data analysis.

RESULTS: At 2-4 and >4 pCi/L, adjusted mean (95% confidence interval) leukocytes were 48 (33, 63) and 78 (58, 98) cells/μL lower than at <2 pCi/L, while platelets, hematocrit, and hemoglobin were higher: 315 (-280, 910) and 2,033 (1,248, 2,818) cells/μL; 0.27% (0.24%, 0.30%) and 0.23% (0.19%, 0.27%); and 0.09 (0.08, 0.10) and 0.09 (0.07, 0.10) g/dL. Nonlinear spline models of the Radon Index revealed similar associations. Lymphocyte percentages were lower and other percentages were higher at higher (>4 pCi/L) vs. lower (<2 pCi/L) radon concentrations in nonlinear compositional data analysis.

CONCLUSION: The radon-related cardiovascular implications of these modest, pro-thrombotic, myeloid shifts in the complete blood count/differential among postmenopausal women in the WHI remain unknown.

PMID:42406881 | DOI:10.1097/EDE.0000000000002020

PLoS One. 2026 Jul 6;21(7):e0349441. doi: 10.1371/journal.pone.0349441. eCollection 2026.

ABSTRACT

BACKGROUND: Sickle cell disease (SCD) stands as one of the most prevalent genetic disorders in the United States (U.S.) that causes severe consequences such as organ damage and excruciating pain. Alarmingly, recent literature indicates a decline in the number of people living with SCD (PLWSCD) seeking professional care – hinting at an avoidance of the healthcare system. Therefore, this scoping review synthesizes the evidence regarding barriers and facilitators influencing healthcare utilization among PLWSCD within the U.S.

METHODS: To map the current literature on SCD management and provide a comprehensive overview of the current knowledge gaps regarding healthcare utilization for PLWSCD, a scoping review was conducted. A systematic search of articles reporting on the utilization of healthcare among PLWSCD in the U.S using seven data sources was conducted on March 24, 2023, without any restrictions on publication date and language. To capture any additional articles, the search was updated on March 4, 2024. Two reviewers independently assessed studies for inclusion, data extraction, and risk of bias (RoB).

MAIN RESULTS: A total of 708 articles were screened; 70 met the study criteria. Results indicated that the four most common barriers were social (n = 25) interpersonal (n = 23), economic (n = 15), and institutional level factors (n = 11). The top four most common facilitators were technology (n = 9), education (n = 7), autonomy (n = 6), and a positive patient-provider relationship (n = 6). The most common forms of healthcare utilization were inpatient or hospital admissions (n = 19) and emergency department (ED) visits (n = 18). Evidence-based interventions (EBI) found to decrease healthcare avoidance included individualized pain plans (IPPs) (n = 4) and quality improvement (QI) strategies (n = 3).

CONCLUSION: This scoping review identified complex multilevel barriers that impede healthcare utilization, and facilitators likely to promote healthcare utilization among PLWSCD in the U.S. Future research should prioritize developing and evaluating comprehensive, multi-level interventions that address identified barriers while leveraging facilitators to improve healthcare engagement and outcomes for this vulnerable population. Healthcare systems and health policies must urgently adopt and integrate evidence-based strategies to rebuild trust and ensure equitable, accessible care for PLWSCD.

PMID:42406873 | DOI:10.1371/journal.pone.0349441

Psychol Sci. 2026 Jul 6:9567976261453813. doi: 10.1177/09567976261453813. Online ahead of print.

ABSTRACT

Empowering people to navigate online information competently is essential to complement systemic content moderation and platform regulation. A nationally representative randomized controlled study among adults in Germany (N = 2,666) compared two media-literacy interventions: a source-focused lateral-reading strategy to help participants distinguish trustworthy from untrustworthy news outlets, and a claim-focused search strategy to help them assess the credibility of specific claims. Both interventions showed small improvements in discernment, but not all effects were statistically distinguishable from zero. At a 2-week follow-up, discernment improved in all groups, and differences between the intervention and control groups were no longer statistically distinguishable. We found no evidence of backfire effects. An exploratory analysis of discernment pretreatment indicated the lowest performance for supporters of populist radical-right parties. Behavioral measures suggested increases in information search in both intervention groups. On average, lateral reading reduced trust in untrustworthy sources, and online search increased trust in trustworthy sources.

PMID:42406504 | DOI:10.1177/09567976261453813

J Consult Clin Psychol. 2026 Jun;94(6):377-392. doi: 10.1037/ccp0001010.

ABSTRACT

OBJECTIVE: The Unified Protocol (UP) has proven effective for treating emotional disorders; however, its standard format primarily focuses on regulating negative emotions. While difficulties with negative emotion regulation are common across these disorders, difficulties with positive emotion regulation are often overlooked. This study evaluated the efficacy of a digitally adapted UP incorporating positive emotion regulation strategies (internet-delivered unified protocol+).

METHOD: In a randomized clinical trial, 120 adults (Mage = 34.0, SD = 12.0; 73% female; 75% White) with principal anxiety, depressive, or obsessive-compulsive disorders were assigned to the internet-delivered unified protocol+ (n = 80) or standard internet-delivered unified protocol (n = 40). Both 12-week programs occurred via an online platform with asynchronous clinical support through weekly messaging. Outcomes included anxiety, depression, and stress; positive/negative affect; functional impairment; savoring; positive mental health; and flourishing. Analyses included between- and within-group effect sizes, remission comparisons, and latent growth modeling.

RESULTS: Both groups demonstrated statistically significant reductions in anxiety, depression, stress, negative affect, and functional impairment (standardized mean gain effect size ≈ -0.28 to -1.13) that were maintained across a 3-month follow-up. Statistically significant, small-to-moderate gains in positive mental health and flourishing (standardized mean gain effect size ≈ 0.31-0.37) were also observed and maintained. Positive affect and savoring significantly increased by Week 8 but diminished and were no longer significant at follow-up. No group differences emerged for any outcome.

CONCLUSIONS: Digital UP interventions were associated with symptom reduction and improvements in flourishing, but adding positive emotion regulation content did not yield incremental benefits. Future research should explore whether increased intensity or duration of these strategies improves outcomes. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

PMID:42406487 | DOI:10.1037/ccp0001010

Psychol Trauma. 2026 Jul 6. doi: 10.1037/tra0002214. Online ahead of print.

ABSTRACT

OBJECTIVE: Posttraumatic stress disorder (PTSD) is a major public health problem that is associated with significant functional impairment. While many patients respond well to treatment, little is known about patterns of improvement, and especially not in residential treatment programs. In this study, we used intensive assessment to investigate early slopes of change in PTSD symptoms in veterans in their first 28 days of residential treatment using the PTSD Checklist. Based on emotional processing theory and the focus on reducing avoidance as a key PTSD treatment target, we hypothesized that avoidance would improve while other symptoms would remain unchanged early in treatment.

METHOD: Linear mixed-effects multilevel modeling was used to evaluate linear slopes of symptom change.

RESULTS: There was statistically significant improvement on avoidance of internal cues and avoidance of external cues. In contrast, none of the other items assessed (repeated disturbing memories, repeated dreams, flashbacks, physical reactions to trauma memories, hypervigilance, startle) or the total score of the PTSD Checklist changed in 28 days after admission to residential treatment.

CONCLUSIONS: These findings show that in this group of veterans with PTSD, reduction in avoidance may precede overall symptom improvement in the first 28 days of residential treatment. Future studies should replicate these findings in other residential settings and in varying treatment modalities to better understand the impact residential treatment programs have on PTSD symptom reduction. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

PMID:42406463 | DOI:10.1037/tra0002214

Psychiatr Rehabil J. 2026 Jul 6. doi: 10.1037/prj0000686. Online ahead of print.

ABSTRACT

OBJECTIVE: As mental health systems worldwide shift toward supporting personal recovery, valid tools are needed to evaluate and guide service transformation. The Recovery Self-Assessment Scale (RSA-R) is the leading patient-reported measure of recovery-oriented care. This study aimed to adapt the RSA-R to the French context and assess its psychometric properties.

METHODS: The RSA-R was translated and administered online to 169 adults with serious mental illness. Exploratory factor analyses were conducted to assess the structural validity of the French RSA-R French Recovery Self-Assessment-Revised (RSAR-Fr), and internal consistency statistics were computed. Multiple linear regression analysis tested the RSAR-Fr association with a measure of personal recovery (the French Questionnaire about the Process of Recovery). Items were mapped onto an established framework of recovery-oriented care to assess content validity.

RESULTS: Exploratory factor analyses supported a concise three-factor model: The person-centered, organizational engagement, and social inclusion dimensions accounted for 46.3% of the variance, with excellent internal consistencies (McDonald’s ω values ranging from .92 to .94). Hypotheses for construct validity were not verified, as RSAR-Fr subscales did not significantly predict personal recovery. Expert review supported content validity, confirming the items’ relevance and comprehensiveness.

CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: The RSAR-Fr demonstrated adequate psychometric properties, addressing known concerns regarding the scale’s dimensionality. Despite sample limitations and the absence of test-retest data, these findings highlight the utility of the RSAR-Fr in measuring recovery-oriented care from the perspective of service users. Routine use of the RSAR-Fr may strengthen the recognition of lived experience within services and support improvements in recovery-oriented practices. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

PMID:42406462 | DOI:10.1037/prj0000686

Psychol Methods. 2026 Jul 6. doi: 10.1037/met0000841. Online ahead of print.

ABSTRACT

Selective reporting bias arises when findings from primary research studies are incompletely reported and where the likelihood that a result is reported depends on the magnitude or statistical significance of the effect. When applied to selectively reported data, conventional meta-analytic models can produce systematically biased parameter estimates. Various statistical methods have been proposed for dealing with selective reporting in univariate meta-analysis, where each primary study contributes a single effect size estimate. However, fewer methods have been developed for handling selective reporting and publication bias in meta-analysis with dependent effect sizes, which are a common feature of meta-analyses in psychology. In this tutorial, we provide a guide for how to investigate potential selective reporting in meta-analyses of dependent effects, focusing on diagnosis and correction of selection reporting bias. We review several recently developed methods including a regression-based adjustment technique, a step-function selection model, and a sensitivity analysis approach. We demonstrate the implementation of these methods in the R statistical environment using data from two recent meta-analyses as examples. We discuss the application and interpretation of the methods, highlighting their strengths and limitations. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

PMID:42406458 | DOI:10.1037/met0000841

Psychol Methods. 2026 Jul 6. doi: 10.1037/met0000850. Online ahead of print.

ABSTRACT

Understanding variability is a key focus in many areas of psychological research, with growing interest in modeling individual- and group-level variability. Although multilevel models such as heterogeneous variance models (HVMs) and Mixed-Effects Location-Scale models have been used to capture these dynamics, they typically rely on linear assumptions and restrict temporal changes in variability to a single level. Recent calls for nonlinear approaches in psychology highlight the need for more flexible models that can better account for complex, dynamic processes. This article introduces the use of Gaussian processes (GPs) within the framework of HVMs to address these limitations. By incorporating GPs in HVMs, we allow for the modeling of nonlinear variability across multiple levels, including temporal dynamics at both the individual and group levels. We demonstrate the benefits of this approach in two empirical applications. Our findings show that using GPs provides an improved model fit compared with traditional linear methods and highlight the utility of GPs in variance modeling, offering new possibilities for studying dynamic and emergent processes in psychological and social science research. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

PMID:42406457 | DOI:10.1037/met0000850

Am Psychol. 2026 Jul-Aug;81(5):714-715. doi: 10.1037/amp0001751.

ABSTRACT

Presents a summary report of journal operations from 2025. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

PMID:42406449 | DOI:10.1037/amp0001751

J Couns Psychol. 2026 Jul 6. doi: 10.1037/cou0000876. Online ahead of print.

ABSTRACT

Measurement-based care has been shown to be an efficacious way to improve therapy outcomes. The use of advanced statistical approaches may assist in optimizing the feedback therapists receive. That is, algorithms developed within measurement-based care programs enhance their performance in predicting therapy outcomes. In this proof-of-concept article, we analyzed data from 9,591 clients who were treated at university counseling centers and completed the Behavioral Health Measure on a reoccurring basis. The sample included male and female clients of diverse ethnicities. We utilized two AI-derived approaches: ant colony optimization algorithm to derive a content-valid item subset that maximized the prediction of clinically significant change status, followed by logistic Lasso regression to identify the most influential item-level predictors. Early in treatment (i.e., the first three to five sessions), Behavioral Health Measure items were tested to determine which were the best predictors of therapy outcomes. The results demonstrated that five items, including self-esteem, general anxiety, substance use, cognitive attention, and overall work/school life purpose, were strong predictors of outcomes over the course of early treatment. These findings suggest that measurement-based care platforms or programs might benefit from more detailed attention to specific signals or patterns in the data that assist therapists and clients monitoring treatment progress. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

PMID:42406433 | DOI:10.1037/cou0000876