Open Journal of Psychology

Objective: Kratom (Mitragyna speciosa) has emerged as a widely accessible nonprescription substance that is being utilized in the United States. Kratom is commonly used for self-management of pain, psychiatric symptoms, and opioid withdrawal. Veterans receiving care within the Veterans Health Administration (VHA) represent a high-risk population due to elevated rates of chronic pain, post-traumatic stress disorder (PTSD), and substance use... Objective: Kratom (Mitragyna speciosa) has emerged as a widely accessible nonprescription substance that is being utilized in the United States. Kratom is commonly used for self-management of pain, psychiatric symptoms, and opioid withdrawal. Veterans receiving care within the Veterans Health Administration (VHA) represent a high-risk population due to elevated rates of chronic pain, post-traumatic stress disorder (PTSD), and substance use disorders (SUDs). Despite increasing prevalence, kratom use remains underrecognized and is not routinely assessed in clinical practice. This narrative review studies the pharmacology, patterns of use, and clinical implications of kratom among Veterans and proposes a standardized screening framework for implementation within the VHA. This will help to align with the patient centered care delivered to our Veterans related to mental health conditions often concurrent with substance use, pain management, and opioid safety. Methods: A targeted narrative review of the literature was conducted using PubMed, Google Scholar, and relevant federal agency reports. Search terms included “kratom,” “Mitragyna speciosa,” “substance use disorder,” “opioid withdrawal,” and “Veterans.” Articles were selected based on relevance to pharmacology, epidemiology, adverse effects, and clinical implications. Findings were synthesized and interpreted using DSM-5-TR substance use disorder criteria. Results: Kratom exhibits partial agonist activity at μ-opioid receptors, producing dose-dependent stimulant and opioid-like effects. According to the National Institutes of Health's National Library of Medicine, mu-opioid receptors, found in the brain and spinal cord, are primarily responsible for pain relief and other opioid-like effects such as euphoria and respiratory depression. Veterans frequently use kratom to self-manage pain, mood symptoms, and opioid withdrawal (Garcia-Romeu et al., 2020; Grundmann, 2017). Kratom use is associated with dependence, withdrawal, and increased risk of polysubstance use (Post et al., 2019). Detection remains limited due to lack of standardized screening tools and the absence of detection in routine toxicology panels. Conclusions: Given the rising incidence of kratom use among Veterans and associated clinical risks, implementation of a standardized screening within the VHA is an appropriate intervention. Incorporating DSM-5-TR-informed criteria into structured assessments can help improve early identification, enhance patient safety, and support evidence-based treatment strategies. Read more

Background: Sleep deprivation is increasingly prevalent among young adults due to academic, occupational, and social demands, making them susceptible to circadian disruption. Executive functioning—encompassing working memory, inhibitory control, and cognitive flexibility is essential for academic and professional success. This meta-analysis quantifies the effect of sleep deprivation on executive functioning in healthy young adults. Practical Implications: These findings highlight the need... Background: Sleep deprivation is increasingly prevalent among young adults due to academic, occupational, and social demands, making them susceptible to circadian disruption. Executive functioning—encompassing working memory, inhibitory control, and cognitive flexibility is essential for academic and professional success. This meta-analysis quantifies the effect of sleep deprivation on executive functioning in healthy young adults. Practical Implications: These findings highlight the need for evidence-based interventions such as university-level sleep education programs, flexible academic scheduling, and workplace policies promoting adequate sleep to optimize cognitive performance and productivity among young adults. Methods: Following PRISMA 2020 guidelines, PubMed, Scopus, PsycINFO, and Web of Science were searched (January 2000–March 2024) for studies assessing acute (<6 hours sleep or ≥24 hours total deprivation) or chronic (<6 hours/night over multiple days) sleep deprivation in young adults. Outcomes included validated executive function tests (e.g., Stroop, N-Back). Random-effects meta-analysis (Hedges’ g) was conducted using R (version 4.3.2) with metafor/meta packages. Heterogeneity (I², Q-test), sensitivity (leave-one-out), and publication bias (funnel plot, Egger’s test) were evaluated. Results: Out of 2,478 screened studies, 39 met inclusion criteria (n=4,578). Sleep deprivation had a moderate-to-large detrimental effect on executive functioning (Hedges’ g = -0.62, 95% CI [-0.78, -0.45], p<0.001). Subdomain analysis revealed greatest impairment in working memory (g = -0.71), followed by inhibitory control (g = -0.59) and cognitive flexibility (g = -0.49) (all p<0.001). Moderate heterogeneity was present (I² = 58%), with results robust to sensitivity analysis. Egger’s test indicated no significant publication bias (p=0.22). Interpretation: Sleep deprivation significantly impairs executive functioning in young adults, especially working memory. Interventions improve sleep may enhance cognitive performance and should be integrated into public health strategies and educational policies. Future research should assess chronic restriction and individual vulnerability factors. Read more

Background: Electronic cigarette (e-cigarette) use among adolescents is a growing public health concern, particularly in low-income and Black communities. However, little is known about how social determinants of health shape e-cigarette perceptions in this population. Aims: This study examined social determinants associated with perceptions of e-cigarette safety among Baltimore high school students. Methods: A cross-sectional survey (CEASE Youth: School Survey)... Background: Electronic cigarette (e-cigarette) use among adolescents is a growing public health concern, particularly in low-income and Black communities. However, little is known about how social determinants of health shape e-cigarette perceptions in this population. Aims: This study examined social determinants associated with perceptions of e-cigarette safety among Baltimore high school students. Methods: A cross-sectional survey (CEASE Youth: School Survey) was conducted with 604 Baltimore high school students aged 14–20. Participants completed a questionnaire assessing perceptions of e-cigarette safety, as well as parental education, race/ethnicity, parental employment, household composition, and community tobacco use. Results: Higher parental education was associated with lower perceived e-cigarette safety among students. Students in higher grades also reported lower perceived e-cigarette safety. In contrast, male students—particularly those in upper grades—were more likely to perceive e-cigarettes as safe. Race/ethnicity, household composition, parental employment, and community tobacco exposure were not associated with perceived e-cigarette safety. Conclusion: Higher parental education, female gender, and being in higher grades were associated with perceiving e-cigarettes as unsafe. These findings highlight the need for targeted interventions to address vaping perceptions among youth in urban settings. Read more

Purpose: Although the effect of loss of a loved one on depression is well established, very limited knowledge exists on racial differences in this effect. Aim: In the current study we compared Non-Hispanic White (NHW) and Non-Hispanic Black (NHB) Californians for the effects of loss of a loved one on depression in a representative sample of adults in California. Methods:... Purpose: Although the effect of loss of a loved one on depression is well established, very limited knowledge exists on racial differences in this effect. Aim: In the current study we compared Non-Hispanic White (NHW) and Non-Hispanic Black (NHB) Californians for the effects of loss of a loved one on depression in a representative sample of adults in California. Methods: This cross-sectional study used data from the Survey of California Adults on Serious Illness and End-of-Life 2019. Overall, 1603 people entered our study. We compared 901 (56.2%) NHB and 702 (43.8%) NHW adults (age 18 and older). Race/ethnicity, demographics (age and gender), socio-economic factors (education, income, employment, and marital status), religiosity, and health (self-rated health and number of chronic medical conditions), and depression were measured. To perform data analysis, we used logistic regression models. Results: In the pooled sample, loss of a loved one was not associated with self-reported depression, net of all covariates. Race, however, interacted with loss of a loved one on depression, suggesting a larger association for NHBs compared to NHWs. In race-specific models, loss of a loved one predicted depression for NHBs (OR = 1.54) but not NHWs (OR = 0.99). Conclusion: There are differences between NHBs and NHWs in the effect of loss of a loved one on depression. NHBs show a stronger association between loss of a loved one and depression than NHWs. This result is not in line with the NHB mental health paradox or with NHB resilience but is consistent with the notion that social relations may be more salient for NHBs than for NHWs. Read more

Background: Sexual and gender minority (SGM) youth are at elevated risk for adverse mental health and substance use outcomes. Stressors such as family conflict, discrimination, and trauma have been suggested as possible mediators of these disparities. Aims: This study examined whether family conflict, discrimination, and trauma mediate the associations between SGM identity and adverse outcomes, including suicide attempt, major depressive... Background: Sexual and gender minority (SGM) youth are at elevated risk for adverse mental health and substance use outcomes. Stressors such as family conflict, discrimination, and trauma have been suggested as possible mediators of these disparities. Aims: This study examined whether family conflict, discrimination, and trauma mediate the associations between SGM identity and adverse outcomes, including suicide attempt, major depressive disorder (MDD), nicotine use, and marijuana use. Methods: Participants were children from the Adolescent Brain Cognitive Development (ABCD) study. SGM identity was reported at baseline, while outcomes included past MDD and suicide attempts as well as future nicotine and marijuana use. Structural equation modeling (SEM) was used to test both direct and indirect pathways linking SGM identity to mental health and behavioral outcomes. Results: No significant mediation was found through family conflict, discrimination, or trauma. Instead, effects of SGM identity were primarily direct: SGM youth had higher odds of past suicide attempts and MDD, as well as future marijuana use, but not future nicotine use. Stressor variables, however, were independently associated with outcomes. Discrimination predicted all outcomes; trauma was positively associated with suicide, nicotine, and marijuana use but not MDD; and family conflict predicted all outcomes except MDD. Conclusion: Family conflict, discrimination, and trauma did not mediate SGM disparities in mental health and substance use, but each emerged as an independent predictor of risk. These findings highlight the complexity of mechanisms underlying SGM-related disparities and suggest the need for future research to explore additional pathways and contextual influences. Read more

Background: Electronic cigarette (e-cigarette) use is increasingly prevalent among youth and young adults, particularly college and university students. This is a population for whom e-cigarette use is not recommended due to potential health risks, including nicotine addiction and long-term respiratory effects. Social networks play a crucial role in shaping attitudes toward e-cigarettes and influencing use behaviors. However, the relative influence... Background: Electronic cigarette (e-cigarette) use is increasingly prevalent among youth and young adults, particularly college and university students. This is a population for whom e-cigarette use is not recommended due to potential health risks, including nicotine addiction and long-term respiratory effects. Social networks play a crucial role in shaping attitudes toward e-cigarettes and influencing use behaviors. However, the relative influence of different social ties—parents, siblings, and friends—on e-cigarette attitudes and use remains unclear. Objective: This study utilizes data from the SMOKES study to compare the influence of e-cigarette use within different social network sections—parents, friends, and siblings—on personal e-cigarette attitudes and use among college and university students. Methods: Using a cross-sectional survey of college and university students, we examined the associations between e-cigarette use within different social networks and individual e-cigarette attitudes and use. Multivariate regression models assessed the strength of these associations, adjusting for key demographic and behavioral covariates. Results: Findings indicate that among college and university students, the strongest influence on both e-cigarette attitudes and use comes from friends who use e-cigarettes. In contrast, parental and sibling e-cigarette use showed weak or non-significant effects. These results suggest that peer influence, rather than family influence, plays a dominant role in shaping e-cigarette-related behaviors and perceptions in young adults. Conclusion: This study underscores the importance of peer influence in e-cigarette uptake and attitudes among college and university students. Public health interventions aimed at reducing e-cigarette use in this population should consider targeting peer networks rather than focusing solely on family-based influences. Read more