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Browsing by Author "Mumba, Mercy N."

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    Biomarker Response to Mindfulness Intervention in Veterans Diagnosed with Post-traumatic Stress Disorder
    (Springer, 2022) Shapira, Itamar; Richman, Joshua; Pace, Thaddeus W. W.; Lim, Kelvin O.; Polusny, Melissa A.; Hamner, Mark B.; Bremner, J. Douglas; Mumba, Mercy N.; Jacobs, M. Lindsey; Pilkinton, Patricia; Davis, Lori L.; University of Arizona; University of Minnesota Twin Cities; Geriatric Research Education & Clinical Center; US Department of Veterans Affairs; Veterans Health Administration (VHA); Minneapolis VA Health Care System; Ralph H Johnson VA Medical Center; Medical University of South Carolina; Emory University; Atlanta VA Health Care System; Atlanta VA Medical Center; University of Alabama Tuscaloosa
    Objectives This study evaluates the effects of treatment with mindfulness-based stress reduction (MBSR) compared to the active control, present-centered group therapy (PCGT), on morning plasma cortisol, interleukin-6 (IL-6), and C-reactive protein (CRP) in veterans diagnosed with post-traumatic stress disorder (PTSD). Methods In a post hoc exploratory analysis, we pooled biomarkers and clinical outcomes of mindfulness, PTSD, and depression from two randomized controlled trials comparing MBSR (n = 104) to PCGT (n = 106) in U.S. military veterans diagnosed with PTSD. Linear mixed-effects modeling was used to evaluate associations between changes in biomarkers and clinical outcomes from baseline to 9-week primary endpoint and 16-week follow-up endpoint. Results Cortisol levels were inversely related to self-reported PTSD symptoms at baseline (p = 0.02). Cortisol increased from baseline to 9-week endpoint for both groups, but significantly less so in the MBSR group compared to PCGT group (mean difference 1.69 +/- 0.8 SE; p = 0 .035). Changes in IL-6 and CRP did not differ between groups at either baseline or week 9. From baseline to week 9, increased mindfulness was significantly associated with increased cortisol (p = 0.02) and decreased PTSD and depression severity (p < 0.01). Increased IL-6 and CRP were significantly associated with decreased PTSD severity (p < 0.05), but not depression. Pooled analysis corroborated earlier findings that MBSR is significantly better than PCGT in improving clinical outcomes. Increased mindfulness was strongly associated with improved symptoms. Conclusions Increased mindfulness is associated with a recalibration of cortisol levels which may be indicative of therapeutic response, especially in patients with lower baseline cortisol. Furthermore, mindfulness-based practices improve symptoms of PTSD and depression in a significant correlation with self-reported levels of mindfulness.
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    Fostering resilience and mental health support in a post COVID-19 environment
    (Wiley, 2022) Horton, Abby Grammer; Mumba, Mercy N.; University of Alabama Tuscaloosa
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    The methods and baseline characteristics of a VA randomized controlled study evaluating supported employment provided in primary care patient aligned care teams
    (BMC, 2020) Davis, Lori L.; Blansett, Catherine M.; Mumba, Mercy N.; MacVicar, David; Toscano, Richard; Pilkinton, Patricia; Gay, Whitney; Bartolucci, Al; University of Alabama Birmingham; University of Alabama Tuscaloosa
    Background This article describes the design and baseline sample of a single-site trial comparing Individual Placement and Support (IPS) supported employment delivered within a Veterans Health Administration (VHA) primary care Patient Aligned Care Team (PACT) to treatment-as-usual vocational rehabilitation (TAU-VR) that includes transitional work. Methods Unemployed U.S. military veterans receiving care in a VHA PACT who were seeking competitive work, otherwise eligible for vocational rehabilitation, and diagnosed with a mental health condition other than a psychotic or bipolar I disorder were prospectively randomized to receive either IPS or TAU-VR. Employment outcomes and measures of quality of life, self-esteem, and community reintegration are being collected for 12 months. Results The participant sample (n = 119) is comprised of 17.6% female, 73.1% African-Americans, and 1.7% Hispanic. Average age is 38.2 (SD +/- 8.41) years; 80.7% served in the military since 2001; 78% are receiving or applying for U.S. Department of Veterans Affairs (VA) service-connected disability; 26.9% have not held a competitive job in the past 3 years; and the average length of pre-randomization unemployment is 1.4 (SD +/- 2.3) years. Conclusions Unique design features include evaluating the efficacy of evidenced-based IPS within the primary care setting, having broad diagnostic eligibility, and defining the primary outcome criterion as "steady employment", i.e. holding a competitive job for >= 26 weeks of the 12-month follow-up period. The findings illustrate the characteristics of a primary care veteran sample in need of employment services.
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    Substance Use and Sleep Disorder Comorbidity: Impacts on College Students' Mental Health
    (University of Alabama Libraries, 2025) Elijah, Odunayo Aimakhede; Mugoya, George C.T.
    Substance use, sleep disturbances, and serious mental illness (SMI) are critical and interrelated public health concerns among college students. This dissertation investigates the associations between substance use risk (tobacco, alcohol, cannabis), sleep quality, and SMI using data from the Spring 2022 American College Health Association–National College Health Assessment (ACHA-NCHA III), comprising responses from 69,131 students across 129 U.S. institutions. The study addresses four key research questions: (1) What is the relationship between substance use risk and SMI? (2) How do sleep disturbances predict SMI? (3) Are sleep disturbances associated with substance use risk? (4) Does difficulty falling asleep (DFA) mediate the relationship between substance use risk and SMI?Serious mental illness was measured using the Kessler-6 (K6) scale, substance use risk via the ASSIST-derived Substance-Specific Involvement Scores (SSIS), and sleep disturbances using five indicators: sleep onset latency (SOL), early awakening (ELA), daytime fatigue (DFT), difficulty falling asleep (DFA), and restorative sleep (RSP). Analytical methods included bivariate Chi-square tests, logistic regression, and mediation analysis using Hayes’ PROCESS Macro (Model 4).Findings showed that moderate and high-risk substance use were significantly associated with increased odds of SMI. For instance, high-risk alcohol users had 3.38 times higher odds of SMI (95% CI: 2.86–3.99), while high-risk cannabis and tobacco users had 3.33 (95% CI: 2.63–4.21) and 2.67 (95% CI: 2.06–3.46) times higher odds SMI (95% CI: 2.86–3.99), while high-risk cannabis and tobacco users had 3.33 (95% CI: 2.63–4.21) and 2.67 (95% CI: 2.06–3.46) times higher odds, respectively. Sleep disturbances, especially DFA and ELA, were also significant predictors of SMI. DFA was strongly associated with substance use risk, with high-risk users more likely to report poor sleep initiation. Mediation analysis revealed that DFA partially mediated the effect of substance use risk on SMI, accounting for 40% of the effect for tobacco, 35% for alcohol, and 27% for cannabis.These findings underscore the importance of integrated campus interventions targeting substance use and sleep health. Programs that promote sleep hygiene alongside substance use prevention may reduce SMI risk and improve overall student well-being. Future research should examine these relationships longitudinally and explore psychosocial moderators to inform tailored intervention strategies.