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Zhang Y, Li C, Zhu Y, Contento IR, Koch PA, Yang Q, Dang Q, Hu Z, Wei Y, Chen Z, Yu H. Reliability and Validity of a Theory-Based Determinants of Eating and Physical Activity Behaviors Questionnaire for Chinese Elementary School Children. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2024; 56:466-477. [PMID: 38647517 DOI: 10.1016/j.jneb.2024.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 03/07/2024] [Accepted: 03/10/2024] [Indexed: 04/25/2024]
Abstract
OBJECTIVE The primary objective of this study was to develop and validate a Social Cognitive Theory-based instrument to identify psychosocial factors that influence diet and physical activity among Chinese children aged 10-12 years. DESIGN This is a cross-sectional study, with data collected from questionnaires. SETTING Two elementary schools in Beijing, China. PARTICIPANTS Fourth to sixth-grade students (N = 1,486) aged 10-12 years were recruited. VARIABLES MEASURED Gender, height, weight, nation, and grade were collected. Energy-balanced eating behaviors and their related sociopsychological factors were surveyed. ANALYSIS Confirmatory factor analysis, Pearson correlations, Cronbach α index, and mediation analysis were used. RESULTS (1) Confirmatory factor analysis revealed a 6-factor solution (51 items) and all factor loadings > 0.32, indicating that the model fitness was acceptable. (2) All correlation coefficients are statistically significant. All of the Cronbach α indexes were > 0.65, indicating acceptable reliability. (3) The mediating effect of goal intention and outcome expectations between self-efficacy and habit strength was statistically significant (P < 0.01), verifying the theory structure. CONCLUSIONS AND IMPLICATIONS This questionnaire exhibits good internal consistency, reliability, and structural validity. It can be effectively employed to investigate energy-balanced eating behaviors related to the Social Cognitive Theory in Chinese children.
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Affiliation(s)
- Yadi Zhang
- School of Public Health, Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, China
| | - Cheng Li
- Beijing Academy of Science and Technology, Beijing, China
| | - Yandi Zhu
- School of Public Health, Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, China
| | - Isobel R Contento
- Program in Nutrition, Department of Health Studies & Applied Educational Psychology, Teachers College, Columbia University, New York, NY
| | - Pamela Ann Koch
- Program in Nutrition, Department of Health Studies & Applied Educational Psychology, Teachers College, Columbia University, New York, NY
| | - Qian Yang
- School of Public Health, Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, China
| | - Qinyu Dang
- School of Public Health, Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, China
| | - Zhuo Hu
- School of Public Health, Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, China
| | - Yuchen Wei
- School of Public Health, Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, China
| | - Zhaoyang Chen
- School of Public Health, Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, China
| | - Huanling Yu
- School of Public Health, Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, China..
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Jensen MP, Barrett TD. The Role of Electroencephalogram-Assessed Bandwidth Power in Response to Hypnotic Analgesia. Brain Sci 2024; 14:557. [PMID: 38928559 PMCID: PMC11201437 DOI: 10.3390/brainsci14060557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Revised: 05/24/2024] [Accepted: 05/27/2024] [Indexed: 06/28/2024] Open
Abstract
Research supports the efficacy of therapeutic hypnosis for reducing acute and chronic pain. However, little is known about the mechanisms underlying these effects. This paper provides a review of the evidence regarding the role that electroencephalogram-assessed bandwidth power has in identifying who might benefit the most from hypnotic analgesia and how these effects occur. Findings are discussed in terms of the slow wave hypothesis, which posits that brain activity in slower bandwidths (e.g., theta and alpha) can facilitate hypnosis responsivity. Although the extant research is limited by small sample sizes, the findings from this research are generally consistent with the slow wave hypothesis. More research, including and especially studies with larger sample sizes, is needed to confirm these preliminary positive findings.
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Affiliation(s)
- Mark P. Jensen
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA 98195, USA;
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Mahjoob DM, Teunissen DAM, van Koeveringe GA, Leusink P, Blanker MH, Knol-de Vries GE. Depressive feelings as mediator in the relation between adverse childhood events and lower urinary tract symptoms in males and females. Neurourol Urodyn 2024; 43:479-485. [PMID: 38108493 DOI: 10.1002/nau.25368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 11/16/2023] [Accepted: 12/07/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND Adverse childhood events (ACEs) are prevalent and lead to well-established adverse health sequelae in adulthood. Recent literature has claimed that exposure to trauma in early life may worsen lower urinary tract symptoms (LUTS) because emotion can alter the perception of bodily distress in the brain. Specifically, depressive symptoms might influence the association between ACEs and LUTS. We aimed to describe the associations between ACEs and LUTS among males and females and to determine whether depressive symptoms mediated these associations. METHODS This study was a secondary analysis of the Coevorden observational cohort study (n = 1691, age ≥16 years). For this observational study participants filled in the male or female modules of the International Consultation on Incontinence Questionnaire for LUTS (ICIQ-MLUTS and ICIQ-FLUTS, respectively), the NEMESIS Childhood Trauma Questionnaire (emotional neglect, psychological abuse, physical abuse, and sexual abuse within the family), and the Patient Health Questionnaire (PHQ-9) for depression. RESULTS Overall, 564 males and 811 females answered all required items related to LUTS and ACEs. A series of regression models were then estimated to test for mediation: LUTS on ACEs, depression on ACEs, and LUTS on both ACEs and depression. The models were also adjusted for the following covariates: age, body mass index, diabetes mellitus, current smokers, educational level, and vaginal delivery (if female). Depressive symptoms were shown to mediate the association between ACEs and LUTS in both males and females. CONCLUSION Childhood adversity and depression are areas of interest during the clinical assessment of patients with LUTS. Early detection of these conditions might help to manage risk, aid in the prevention of LUTS, and facilitate trauma-informed care.
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Affiliation(s)
- Dina M Mahjoob
- Department of Urology, School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Doreth A M Teunissen
- Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Gommert A van Koeveringe
- Department of Urology, School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
- Department of Urology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | | | - Marco H Blanker
- Department of Primary and Long-term Care, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Grietje E Knol-de Vries
- Department of Primary and Long-term Care, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Cathro CJ, Brenn T, Chen SLF. Education Level and Self-Reported Cardiovascular Disease in Norway-The Tromsø Study, 1994-2016. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5958. [PMID: 37297563 PMCID: PMC10252247 DOI: 10.3390/ijerph20115958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 05/19/2023] [Accepted: 05/21/2023] [Indexed: 06/12/2023]
Abstract
BACKGROUND Cardiovascular disease (CVD) is a leading source of morbidity and mortality, and research has shown education level to be a risk factor for the disease. The aim of this study was to investigate the association between education level and self-reported CVD in Tromsø, Norway. METHODS This prospective cohort study included 12,400 participants enrolled in the fourth and seventh surveys of the Tromsø Study (Tromsø4 and Tromsø7) in 1994-1995 and 2015-2016, respectively. Logistic regression was used to obtain odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS For every 1-level increase in education, the age-adjusted risk of self-reported CVD decreased by 9% (OR = 0.91, 95% CI: 0.87-0.96), but after adjustment for covariates, the association was weaker (OR = 0.96, 95% CI: 0.92-1.01). The association was stronger for women (OR = 0.86, 95% CI: 0.79-0.94) than men (OR = 0.91, 95% CI: 0.86-0.97) in age-adjusted models. After adjustment for covariates, the associations for women and men were similarly weak (women: OR = 0.95, 95% CI: 0.87-1.04; men: OR = 0.97, 95% CI: 0.91-1.03). In age-adjusted-models, higher education level was associated with a lower risk of self-reported heart attack (OR = 0.90, 95% CI: 0.84-0.96), but not stroke (OR = 0.97, 95% CI: 0.90-1.05) or angina (OR = 0.98, 95% CI: 0.90-1.07). There were no clear associations observed in the multivariable models for CVD components (heart attack: OR = 0.97, 95% CI: 0.91-1.05; stroke: OR = 1.01, 95% CI: 0.93-1.09; angina: OR = 1.04, 95% CI: 0.95-1.14). CONCLUSIONS Norwegian adults with a higher education level were at lower risk of self-reported CVD. The association was present in both genders, with a lower risk observed in women than men. After accounting for lifestyle factors, there was no clear association between education level and self-reported CVD, likely due to covariates acting as mediators.
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Affiliation(s)
- Celina Janene Cathro
- Department of Community Medicine, UiT—The Arctic University of Norway, 9019 Tromsø, Norway
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Pressler SJ, Jung M, Giordani B, Titler MG, Gradus-Pizlo I, Lake KR, Wierenga KL, Clark DG, Perkins SM, Smith DG, Mocci E, Dorsey SG. Evaluating depressive symptoms, BDNF Val66Met, and APOE-ε4 as moderators of response to computerized cognitive training in heart failure. Heart Lung 2023; 59:146-156. [PMID: 36805256 PMCID: PMC10065971 DOI: 10.1016/j.hrtlng.2023.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 01/24/2023] [Accepted: 02/05/2023] [Indexed: 02/20/2023]
Abstract
BACKGROUND Depressive symptoms, brain-derived neurotrophic factor (BDNF) Val66Met, and apolipoprotein (APOE)-ε4 may moderate response to computerized cognitive training (CCT) interventions among patients with heart failure (HF). OBJECTIVES The purpose of this study was to examine moderators of intervention response to CCT over 8 months among patients with HF enrolled in a 3-arm randomized controlled trial. Outcomes were memory, serum BDNF, working memory, instrumental activities of daily living (IADLs), and health-related quality of life (HRQL). METHODS 256 patients with HF were randomized to CCT, computerized crossword puzzles active control, and usual care control groups for 8 weeks. Data were collected at enrollment, baseline, 10 weeks, and 4 and 8 months. Mixed effects models were computed to evaluate moderators. RESULTS As previously reported, there were no statistically significant group by time effects in outcomes among the 3 groups over 8 months. Tests of moderation indicated that depressive symptoms and presence of BDNF Val66Met and APOE-ε4 were not statistically significant moderators of intervention response in outcomes of delayed recall memory, serum BDNF, working memory, IADLs, and HRQL. In post hoc analysis evaluating baseline global cognitive function, gender, age, and HF severity as moderators, no significant effects were found. HF severity was imbalanced among groups (P = .049) which may have influenced results. CONCLUSIONS Studies are needed to elucidate biological mechanisms of cognitive dysfunction in HF and test novel interventions to improve memory, serum BDNF, working memory, IADLs and HRQL. Patients may need to be stratified or randomized by HF severity within intervention trials.
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Affiliation(s)
- Susan J Pressler
- Indiana University School of Nursing, 600 Barnhill Drive, Indianapolis, IN 46202, United States.
| | - Miyeon Jung
- Indiana University School of Nursing, 600 Barnhill Drive, Indianapolis, IN 46202, United States.
| | - Bruno Giordani
- University of Michigan, Michigan Alzheimer's Disease Research Center and Department of Psychiatry, Suite C, 2101 Commonwealth Blvd., Ann Arbor, MI 48105, United States.
| | - Marita G Titler
- University of Michigan School of Nursing, 400 North Ingalls, Ann Arbor, MI 48109-5482, United States.
| | - Irmina Gradus-Pizlo
- University of California Irvine School of Medicine, 333 City Blvd, West, Suite 400, Orange, CA 92868-32988, United States.
| | - Kittie Reid Lake
- Indiana University School of Nursing, 600 Barnhill Drive, Indianapolis, IN 46202, United States
| | - Kelly L Wierenga
- Indiana University School of Nursing, 600 Barnhill Drive, Indianapolis, IN 46202, United States.
| | - David G Clark
- Indiana University School of Medicine, 355 W. 16th Street, Suite 4020, Indianapolis, IN 46202, United States.
| | - Susan M Perkins
- Indiana University School of Medicine, Department of Biostatistics and Health Data Science, 410 West 10th Street, Suite 3000, Indianapolis, IN 46202, United States.
| | - Dean G Smith
- Louisiana State University School of Public Health 2020 Gravier Street, 3rd Floor, New Orleans, LA 70112.
| | - Evelina Mocci
- University of Maryland School of Nursing, Department of Pain and Translational Science, 655 West Lombard Street, Baltimore, MD 21201, United States.
| | - Susan G Dorsey
- University of Maryland School of Nursing, Department of Pain and Translational Science, 655 West Lombard Street, Baltimore, MD 21201, United States.
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Ryen L, Lundqvist S, Cider Å, Börjesson M, Larsson MEH, Hagberg L. Cost-Effectiveness of Prolonged Physical Activity on Prescription in Previously Non-Complying Patients: Impact of Physical Activity Mediators. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3801. [PMID: 36900811 PMCID: PMC10001088 DOI: 10.3390/ijerph20053801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 02/10/2023] [Accepted: 02/15/2023] [Indexed: 06/18/2023]
Abstract
In Sweden, physical activity on prescription (PAP) is used to support patients in increasing their levels of physical activity (PA). The role of healthcare professionals in supporting PA behavior change requires optimization in terms of knowledge, quality and organization. This study aims to evaluate the cost-effectiveness of support from a physiotherapist (PT) compared to continued PAP at a healthcare center (HCC) for patients who remained insufficiently active after 6-month PAP treatment at the HCC. The PT strategy was constituted by a higher follow-up frequency as well as by aerobic physical fitness tests. The analysis was based on an RCT with a three-year time horizon, including 190 patients aged 27-77 with metabolic risk factors. The cost per QALY for the PT strategy compared to the HCC strategy was USD 16,771 with a societal perspective (including individual PA expenses, production loss and time cost for exercise, as well as healthcare resource use) and USD 33,450 with a healthcare perspective (including only costs related to healthcare resource use). Assuming a willingness-to-pay of USD 57,000 for a QALY, the probability of cost-effectiveness for the PT strategy was 0.5 for the societal perspective and 0.6 for the healthcare perspective. Subgroup analyses on cost-effectiveness based on individual characteristics regarding enjoyment, expectations and confidence indicated potential in identifying cost-effective strategies based on mediating factors. However, this needs to be further explored. In conclusion, both PT and HCC interventions are similar from a cost-effectiveness perspective, indicating that both strategies are equally valuable in healthcare's range of treatments.
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Affiliation(s)
- Linda Ryen
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, 701 82 Örebro, Sweden
| | - Stefan Lundqvist
- Department of Health and Rehabilitation, Unit of Physiotherapy, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden
- Center for Physical Activity Gothenburg, Region Västra Götaland, 413 45 Gothenburg, Sweden
| | - Åsa Cider
- Department of Health and Rehabilitation, Unit of Physiotherapy, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden
- Department of Occupational Therapy and Physiotherapy, Sahlgrenska University Hospital/Östra, 416 85 Gothenburg, Sweden
| | - Mats Börjesson
- Center for Health and Performance (CHP), University of Gothenburg, 405 30 Gothenburg, Sweden
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden
- Department of MGA, Sahlgrenska University Hospital, Region Västra Götaland, 416 50 Gothenburg, Sweden
| | - Maria E. H. Larsson
- Department of Health and Rehabilitation, Unit of Physiotherapy, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden
- Research, Education, Development and Innovation, Primary Health Care, Region Västra Götaland, 411 18 Gothenburg, Sweden
- Centre of Clinical Research and Education, Region Värmland, 651 82 Karlstad, Sweden
| | - Lars Hagberg
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, 701 82 Örebro, Sweden
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Promoting First Relationships ® for Primary Caregivers and Toddlers in a Native Community: a Randomized Controlled Trial. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2023; 24:39-49. [PMID: 35997845 DOI: 10.1007/s11121-022-01415-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/22/2022] [Indexed: 02/03/2023]
Abstract
This study tested the effectiveness of Promoting First Relationships® (PFR), a preventive intervention program aimed at fostering positive caregiver-child relationships in Native families living on a rural reservation. Participants were 162 primary caregivers (96% Native; 93% female) and their Native toddlers (10-31 months old; 50% female). Families were randomized to a PFR group (n = 81) or Resource and Referral (RR) control group (n = 81), after baseline data collection (Time 1) to assess the quality of caregiver-child interaction, caregiver knowledge about children's social-emotional needs, caregiver depressive symptoms, and child externalizing behavior. After delivery of the PFR intervention or the RR service, follow-up assessments were repeated immediately post-intervention (Time 2) and 3 months later (Time 3). After controlling for baseline assessments, multivariate analyses of covariance revealed that caregivers in the PFR group had significantly higher scores on knowledge about children's social-emotional needs at Time 2 (p < .01, η2 = .06) and Time 3 (p < .05, η2 = .04) and less severe depressive symptoms at Times 2 and 3 (both p < .05, η2 = .04). At Time 3, the quality of caregiver-child interaction was better in the PFR group (p < .01, η2 = .06), an effect that was moderated by severity of depressive symptoms (p = .05, η2 = .06), with PFR having the greatest impact at low levels of initial symptoms (p = .02). Results support the positive impact of PFR in a Native community and suggest conditions under which the intervention may be most effective.
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Appearance-based health promotion messages for increasing fruit and vegetable consumption: gender, age and adverse effects. J Public Health (Oxf) 2022. [DOI: 10.1007/s10389-022-01746-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022] Open
Abstract
Abstract
Aim
This study sought to investigate the effects of body-weight-based compared to health-based public health messages for encouraging fruit and vegetable consumption, dependent on gender and age, while also gauging adverse consequences.
Subject and methods
Using an independent groups design, male and female participants, aged 18–65 years, were randomized to view either a weight-based (N = 245) or a health-based (N = 231) public health message for increasing fruit and vegetable consumption, and intentions to consume, immediate selection and subsequent consumption of fruit and vegetables and biscuit/cake-bars, adverse consequences and various confounders were assessed.
Results
Weight-based messages resulted in greater immediate selection and subsequent fruit and vegetable consumption compared to health-based messages in females (smallest Beta = 0.375, p = 0.04), specifically younger females (least significant Beta = 0.683, p = 0.04). No effects were found in males. Intentions to consume fruit and vegetables, biscuit/cake-bars and subsequent biscuit/cake-bar consumption were predicted only by confounders. Adverse consequences of the messages were low (χ2(1) = 44.16, p < 0.05; smallest t(148) = 10.22, p < 0.01), and did not differ between weight-based and health-based messages (χ2(2) = 2.72, p > 0.05; largest t(278) = 0.75, p = 0.46).
Conclusions
This work demonstrates a role for weight-based compared to health-based public health promotion messages for increasing fruit and vegetable selection and consumption in young females. Adverse consequences following the messages were low, but care may still be needed.
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Smith CG, Jones EJH, Wass SV, Pasco G, Johnson MH, Charman T, Wan MW. Infant Effortful Control Mediates Relations Between Nondirective Parenting and Internalising-Related Child Behaviours in an Autism-Enriched Infant Cohort. J Autism Dev Disord 2022; 52:3496-3511. [PMID: 34448110 PMCID: PMC9296408 DOI: 10.1007/s10803-021-05219-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2021] [Indexed: 11/12/2022]
Abstract
Internalising problems are common within Autism Spectrum Disorder (ASD); early intervention to support those with emerging signs may be warranted. One promising signal lies in how individual differences in temperament are shaped by parenting. Our longitudinal study of infants with and without an older sibling with ASD investigated how parenting associates with infant behavioural inhibition (8-14 months) and later effortful control (24 months) in relation to 3-year internalising symptoms. Mediation analyses suggest nondirective parenting (8 months) was related to fewer internalising problems through an increase in effortful control. Parenting did not moderate the stable predictive relation of behavioural inhibition on later internalising. We discuss the potential for parenting to strengthen protective factors against internalising in infants from an ASD-enriched cohort.
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Affiliation(s)
- C G Smith
- Henry Wellcome Building, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK.
| | - E J H Jones
- Centre for Brain and Cognitive Development, Birkbeck, University of London, London, UK
| | - S V Wass
- School of Psychology, University of East London, London, UK
| | - G Pasco
- Henry Wellcome Building, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK
| | - M H Johnson
- Centre for Brain and Cognitive Development, Birkbeck, University of London, London, UK.,Department of Psychology, University of Cambridge, Cambridge, UK
| | - T Charman
- Henry Wellcome Building, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK
| | - M W Wan
- School of Health Sciences, University of Manchester, Manchester, UK
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Nehumba D, Paiero A, Tafessu H, Salters K, Moore D, Lima VD. Household food insecurity, sense of community belonging, and access to a regular medical doctor as mediators in the relationship between mood and/or anxiety disorders and self-rated general health in Canada between 2011 and 2016: a serial cross-sectional analysis. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2022; 113:944-954. [PMID: 35764860 PMCID: PMC9663790 DOI: 10.17269/s41997-022-00658-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 05/19/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To assess whether (household) food insecurity, access to a regular medical doctor, and sense of community belonging mediate the relationship between mood and/or anxiety disorders and self-rated general health. METHODS We used six annual cycles of the Canadian Community Health Survey, including Canadian adults aged 18-59 years, between 2011 and 2016. Mediation models, adjusted for key determinants of health, were based on a series of weighted logistic regression models. The Sobel products of coefficients approach was used to estimate the indirect effect, and bootstrapping to estimate uncertainty. RESULTS The annual (weighted) prevalence of mood and/or anxiety disorders increased from 11.3% (2011) to 13.2% (2016). Across the 6 years, 23.9-27.7% of individuals with mood and/or anxiety disorders reported fair/poor self-rated health as compared with 4.9-6.5% of those without mood and/or anxiety disorders (p<0.001). Similarly, the 7.2-8.9% of the population reporting fair/poor self-rated health were disproportionately represented among individuals reporting food insecurity (21.1-26.2%, p<0.001) and a weak sense of community belonging (10.0-12.2%, p<0.001). A significantly lower prevalence of poor self-rated health was observed among respondents reporting having access to a regular medical doctor in 2012, 2015, and 2016. In 2016, sense of community belonging and food insecurity significantly mediated the effect of mood and/or anxiety disorders on self-rated general health. Access to a regular medical doctor did not mediate this relationship. CONCLUSION Efficient policies that address food insecurity and sense of community belonging are needed to decrease the mental health burden and improve health satisfaction of Canadians.
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Affiliation(s)
- Doreen Nehumba
- Division of Infectious Diseases, Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC Canada
| | - Adrianna Paiero
- British Columbia Centre for Excellence in HIV/AIDS, 608-1081 Burrard Street, Vancouver, BC V6Z 1Y6 Canada
| | - Hiwot Tafessu
- British Columbia Centre for Excellence in HIV/AIDS, 608-1081 Burrard Street, Vancouver, BC V6Z 1Y6 Canada
| | - Kate Salters
- British Columbia Centre for Excellence in HIV/AIDS, 608-1081 Burrard Street, Vancouver, BC V6Z 1Y6 Canada ,Faculty of Health Sciences, Simon Fraser University, Burnaby, BC Canada
| | - David Moore
- Division of Infectious Diseases, Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC Canada ,British Columbia Centre for Excellence in HIV/AIDS, 608-1081 Burrard Street, Vancouver, BC V6Z 1Y6 Canada
| | - Viviane D. Lima
- Division of Infectious Diseases, Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC Canada ,British Columbia Centre for Excellence in HIV/AIDS, 608-1081 Burrard Street, Vancouver, BC V6Z 1Y6 Canada
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Pine JG, Moe AM, Wastler HM, Breitborde NJK. Improvements in metacognition mediate the effect of metacognitive remediation therapy: A non-randomized controlled study among individuals with first-episode psychosis. Early Interv Psychiatry 2022; 16:683-686. [PMID: 34494357 DOI: 10.1111/eip.13225] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 07/30/2021] [Accepted: 08/15/2021] [Indexed: 12/19/2022]
Abstract
AIM Metacognitive remediation therapy (MCR) has been shown to help individuals with first-episode psychosis experience improvements in cognition, social functioning, vocational/educational functioning and quality of life. The theoretical model underlying MCR has yet to be empirically validated. METHODS Seventy-three individuals with first-episode psychosis completed measures of metacognition and cognition at enrollment and after 6-months of care at a specialized clinical program for individuals with first-episode psychosis. Among this group, we compared changes in these variables between the 21 individuals who opted to participate in MCR and the 52 individuals who did not participate in MCR. RESULTS Improvements in metacognition were moderated by MCR treatment participation. Consistent with the MCR theoretical model of change, increases in metacognition mediated the relationship between treatment and longitudinal changes in cognition. CONCLUSIONS Our findings suggest that the benefits of MCR on cognitive functioning may stem, in part, from the ability of MCR to produce improvements in metacognitive functioning.
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Affiliation(s)
- Jacob G Pine
- Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, Ohio, USA
| | - Aubrey M Moe
- Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, Ohio, USA
| | - Heather M Wastler
- Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, Ohio, USA
| | - Nicholas J K Breitborde
- Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, Ohio, USA.,Department of Psychology, The Ohio State University, Columbus, Ohio, USA
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Henderson TO, Bardwell JK, Moskowitz CS, McDonald A, Vukadinovich C, Lam H, Curry M, Oeffinger KC, Ford JS, Elkin EB, Nathan PC, Armstrong GT, Kim K. Implementing a mHealth intervention to increase colorectal cancer screening among high-risk cancer survivors treated with radiotherapy in the Childhood Cancer Survivor Study (CCSS). BMC Health Serv Res 2022; 22:691. [PMID: 35606736 PMCID: PMC9128150 DOI: 10.1186/s12913-022-08082-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 05/13/2022] [Indexed: 11/10/2022] Open
Abstract
Background Cancer survivors treated with any dose of radiation to the abdomen, pelvis, spine, or total body irradiation (TBI) are at increased risk for developing colorectal cancer (CRC) compared to the general population. Since earlier detection of CRC is strongly associated with improved survival, the Children’s Oncology Group (COG) Long-Term Follow-Up Guidelines recommend that these high-risk cancer survivors begin CRC screening via a colonoscopy or a multitarget stool DNA test at the age of 30 years or 5 years following the radiation treatment (whichever occurs last). However, only 37% (95% CI 34.1–39.9%) of high-risk survivors adhere to CRC surveillance. The Activating cancer Survivors and their Primary care providers (PCP) to Increase colorectal cancer Screening (ASPIRES) study is designed to assess the efficacy of an intervention to increase the rate of CRC screening among high-risk cancer survivors through interactive, educational text-messages and resources provided to participants, and CRC screening resources provided to their PCPs. Methods ASPIRES is a three-arm, hybrid type II effectiveness and implementation study designed to simultaneously evaluate the efficacy of an intervention and assess the implementation process among participants in the Childhood Cancer Survivor Study (CCSS), a North American longitudinal cohort of childhood cancer survivors. The Control (C) arm participants receive electronic resources, participants in Treatment arm 1 receive electronic resources as well as interactive text messages, and participants in Treatment arm 2 receive electronic educational resources, interactive text messages, and their PCP’s receive faxed materials. We describe our plan to collect quantitative (questionnaires, medical records, study logs, CCSS data) and qualitative (semi-structured interviews) intervention outcome data as well as quantitative (questionnaires) and qualitative (interviews) data on the implementation process. Discussion There is a critical need to increase the rate of CRC screening among high-risk cancer survivors. This hybrid effectiveness-implementation study will evaluate the effectiveness and implementation of an mHealth intervention consisting of interactive text-messages, electronic tools, and primary care provider resources. Findings from this research will advance CRC prevention efforts by enhancing understanding of the effectiveness of an mHealth intervention and highlighting factors that determine the successful implementation of this intervention within the high-risk cancer survivor population. Trial registration This protocol was registered at clinicaltrials.gov (identifier NCT05084833) on October 20, 2021. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-08082-3.
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Affiliation(s)
- Tara O Henderson
- Department of Pediatrics, The University of Chicago, Chicago, IL, USA
| | - Jenna K Bardwell
- Department of Pediatrics, The University of Chicago, Chicago, IL, USA.
| | | | | | | | - Helen Lam
- The University of Chicago, Chicago, IL, USA
| | - Michael Curry
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | | | | | - Paul C Nathan
- The Hospital for Sick Children, Toronto, Ontario, Canada
| | | | - Karen Kim
- The University of Chicago, Chicago, IL, USA
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Baumeister H, Ebert DD, Snoek F. Special issue on digital health interventions in chronic medical conditions: Editorial. Internet Interv 2021; 28:100457. [PMID: 35646604 PMCID: PMC9136333 DOI: 10.1016/j.invent.2021.100457] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Chronic medical conditions are increasingly common and associated with a high burden for persons affected by them. Digital health interventions might be a viable way to support persons with a chronic illness in their coping and self-management. The present special issue's editorial on digital health interventions in chronic medical conditions summarizes core findings and discusses next steps needed to further the field while avoiding to reinvent the wheel, thereby elaborating on four topics extracted from the special issue's articles: 1) Needs assessment and digital intervention development, 2) Efficacy and (cost-)effectiveness, 3) Dissemination and implementation research: reach and engagement as well as 4) next generation of digital interventions.
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Affiliation(s)
- Harald Baumeister
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Germany,Correspondence: Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Lise-Meitner-Straße 16, D-89081 Ulm, Germany.
| | - David D. Ebert
- Psychology and Digital Mental Health Care, Department of Sport and Health Sciences, Technical University of Munich, Germany
| | - Frank Snoek
- Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, the Netherlands
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14
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Bieleninik Ł, Ettenberger M, Epstein S, Elefant C, Arnon S. Potential Psychological and Biological Mechanisms Underlying the Effectiveness of Neonatal Music Therapy during Kangaroo Mother Care for Preterm Infants and Their Parents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:8557. [PMID: 34444304 PMCID: PMC8394319 DOI: 10.3390/ijerph18168557] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 08/06/2021] [Accepted: 08/11/2021] [Indexed: 12/11/2022]
Abstract
Neonatal music therapy (MT) has become more accessible worldwide. Previous research suggests multiple benefits of MT for preterm infants and their caregivers; however, far too little attention has been paid to understanding the mechanisms of change in previous Neonatal Intensive Care Unit (NICU)-MT research so far. This perspective article describes potential mechanisms of MT interventions exposed during kangaroo mother care on the preterm infant's response (behavioral and physiological outcomes) and the mother-infant relationship. The paper focuses on the hypothalamic-pituitary-adrenal axis' role in stabilization of behavioral state, the autonomic nervous system's role in stabilization of physiologic state, as well as co-regulation as a potential mechanism for the developing of the parent-infant relationship. Mechanisms play a pivotal role in understanding variables related to the therapy course and well as in generating new knowledge regarding treatment susceptibility and optimizing resources. Understanding of the mechanisms of how interventions may lead to specific outcomes plays an important role in addressing the issue of improvement of currently available approaches of MT used in the NICU.
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Affiliation(s)
- Łucja Bieleninik
- Department of Clinical and Health Psychology, Faculty of Social Sciences, Institute of Psychology, University of Gdansk, 80-309 Gdansk, Poland
- GAMUT—The Grieg Academy Music Therapy Research Centre, NORCE Norwegian Research Centre AS, 5029 Bergen, Norway
| | - Mark Ettenberger
- Music Therapy Service, University Hospital Fundación Santa Fe de Bogotá, Bogotá 110111, Colombia;
- SONO—Centro de Musicoterapia, Bogotá 110221, Colombia
| | - Shulamit Epstein
- School for Creative Arts Therapies, University of Haifa, Haifa 3498838, Israel; (S.E.); (C.E.)
| | - Cochavit Elefant
- School for Creative Arts Therapies, University of Haifa, Haifa 3498838, Israel; (S.E.); (C.E.)
| | - Shmuel Arnon
- Department of Neonatology, Meir Medical Center, Kfar Saba 44281, Israel;
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
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15
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Breitborde NJK, Wastler H, Pine JG, Moe AM. Suicidality and social problem-solving skills among individuals with first-episode psychosis participating in Coordinated Specialty Care. Early Interv Psychiatry 2021; 15:497-504. [PMID: 32291972 DOI: 10.1111/eip.12967] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Revised: 01/29/2020] [Accepted: 04/02/2020] [Indexed: 11/27/2022]
Abstract
AIM Although suicidal ideation may decrease over the course of participation in specialized clinical programmes for first-episode psychosis (FEP), it is unclear whether such improvements exceed those that occur during treatment as usual. Clarifying the mechanisms underlying reductions in suicidal ideation and behaviour among individuals with first-episode psychosis may highlight important strategies through which specialized clinical programmes can increase the potency of their services to reduce suicidality among this high-risk population. Thus, the goal of this study is to evaluate the longitudinal relationships between suicidality and social problem-solving skills among individuals with FEP participating in Coordinated Specialty Care. METHODS Within-subject mediational and moderational models were applied to explore the interrelationships and longitudinal course of suicidality, social problem-solving and duration of untreated psychosis (DUP). RESULTS Over the first 6 months of care, individuals with FEP experienced improvements in social problem-solving skills that were found to mediate concurrent reductions in suicidality. Although longitudinal changes in social problem-solving skills were moderated by DUP, these results should be interpreted cautiously as they may stem in part from a relatively limited number of participants with longer durations of illness. CONCLUSIONS Improvements in social problem-solving skills during participation in CSC may facilitate reductions in suicidality. Treatments targeting suicidality among individuals with FEP may thus benefit from working to enhance social problem-solving skills among these individuals. Further research is needed to clarify if and how DUP may influence the magnitude of change in social problem-solving skills during participation in CSC.
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Affiliation(s)
- Nicholas J K Breitborde
- Department of Psychiatry and Behavioural Health, The Ohio State University, Columbus, Ohio, USA.,Department of Psychology, The Ohio State University, Columbus, Ohio, USA
| | - Heather Wastler
- Department of Psychiatry and Behavioural Health, The Ohio State University, Columbus, Ohio, USA
| | - Jacob G Pine
- Department of Psychiatry and Behavioural Health, The Ohio State University, Columbus, Ohio, USA
| | - Aubrey M Moe
- Department of Psychiatry and Behavioural Health, The Ohio State University, Columbus, Ohio, USA
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Xu H, Sheng J, Wu X, Zhan K, Tao S, Wen X, Liu W, Cudjoe O, Tao F. Moderating effects of plastic packaged food on association of urinary phthalate metabolites with emotional symptoms in Chinese adolescents. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2021; 216:112171. [PMID: 33812210 DOI: 10.1016/j.ecoenv.2021.112171] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 03/02/2021] [Accepted: 03/17/2021] [Indexed: 05/26/2023]
Abstract
Previous research reports that diet is the main source of phthalate exposure to adolescents, and phthalate is associated with adolescent mental and behavioral problems. However, no study has explored the moderating effects of eating behavior in this association. This study aimed to analyze the moderating effects of plastic packaged food consumption in the longitudinal association between phthalate metabolite concentration and emotional symptoms in adolescents. This school-based survey was carried out among adolescents in two Chinese provinces. We conducted a baseline and follow-up surveys for 893 freshmen using the purposive sampling method from December 2018 to November 2019. We used food frequency questionnaire to assess eating behavior. The Chinese version of 21-item Depression Anxiety Stress Scales was used to assess emotional symptoms, and high-performance liquid chromatography-tandem mass spectrometry was used to analyze the concentration of six urine phthalate metabolites. The results of latent moderation model indicated that plastic packaged food consumption moderated the association of low molecular weight phthalate (LMWP) with depressive symptoms (β = 0.27, P = 0.002), anxiety symptoms (β = 0.89, P < 0.01), and stress symptoms (β = 0.23, P = 0.019). The moderating effects were significant at the higher scores (β = 0.14-0.35, P < 0.05) and/or the lower scores (β = -0.35 to -0.12, P < 0.05) of plastic packaged food consumption. The results suggest that plastic packaged food consumption to some extent moderates the longitudinal association of phthalate exposure with emotional symptoms in adolescents.
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Affiliation(s)
- Honglv Xu
- School of Medicine, Kunming University, 2 Puxin Road, Kunming 650214, Yunnan, PR China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, 81 Meishan Road, Hefei 230032, Anhui, PR China
| | - Jie Sheng
- Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, 81 Meishan Road, Hefei 230032, Anhui, PR China
| | - Xiaoyan Wu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, Anhui, PR China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, 81 Meishan Road, Hefei 230032, Anhui, PR China
| | - Kai Zhan
- Anhui Key Laboratory of Livestock and Poultry Product Safety Engineering, Institute of Animal Husbandry and Veterinary Medicine, Anhui Academy of Agricultural Science, Hefei 230031, Anhui, PR China
| | - Shuman Tao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, Anhui, PR China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, 81 Meishan Road, Hefei 230032, Anhui, PR China
| | - Xing Wen
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, Anhui, PR China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, 81 Meishan Road, Hefei 230032, Anhui, PR China
| | - Wenwen Liu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, Anhui, PR China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, 81 Meishan Road, Hefei 230032, Anhui, PR China
| | - Obed Cudjoe
- University of Cape Coast, Department of Microbiology and Immunology, School of Medical Sciences, Cape Coast, Ghana; Department and the Key Laboratory of Microbiology and Parasitology, Anhui, School of Basic Medical Sciences, Anhui Medical University, Hefei 230032, China
| | - Fangbiao Tao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, Anhui, PR China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, 81 Meishan Road, Hefei 230032, Anhui, PR China.
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Annoni AM, Petrocchi S, Camerini AL, Marciano L. The Relationship between Social Anxiety, Smartphone Use, Dispositional Trust, and Problematic Smartphone Use: A Moderated Mediation Model. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052452. [PMID: 33801510 PMCID: PMC7967585 DOI: 10.3390/ijerph18052452] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 02/16/2021] [Accepted: 02/24/2021] [Indexed: 01/21/2023]
Abstract
BACKGROUND The pervasiveness of smartphones has raised concerns about an increase in the prevalence of problematic smartphone use (PSU), which depends on a set of psychological and behavioral risk factors. Previous research has yielded mixed results on factors predicting PSU, including social anxiety and trust. In particular, the role of trust remained largely unexplored. In the present study, we aimed to investigate the relationship between social anxiety and PSU, via the mediating role of time spent on the phone, and to explore the moderating role of dispositional trust toward others, by using a moderated mediation model with PSU as the outcome. METHODS A total of 240 young adults (Mage = 23.33, SD = 3.90, 50% male) answered an online questionnaire, which included the 12-item Social Anxiety Scale, a question on the daily duration of smartphone use, a single-item measure of dispositional trust, and the 10-item Smartphone Addiction Scale Short Version. Gender and occupational status were included as covariates. RESULTS Social anxiety was significantly and positively related to PSU; however, smartphone use did not mediate this relationship. Although the relationship between smartphone use and PSU was significant and positive, the link between social anxiety and smartphone use was not. Dispositional trust moderated and strengthened the direct relationships between social anxiety and PSU as well as smartphone use and PSU. CONCLUSIONS Heavy smartphone users as well as socially anxious individuals, with the tendency of trusting others, are more at risk of PSU, which can be explained by their preference and search for online connections.
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Affiliation(s)
- Anna Maria Annoni
- Institute of Public Health, Università della Svizzera italiana, 6900 Lugano, Switzerland;
- Competence Centre on Ageing, Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, 6928 Manno, Switzerland
- Correspondence:
| | - Serena Petrocchi
- Faculty of Communication, Culture and Society, Università della Svizzera italiana, 6900 Lugano, Switzerland; (S.P.); (L.M.)
| | - Anne-Linda Camerini
- Institute of Public Health, Università della Svizzera italiana, 6900 Lugano, Switzerland;
- Faculty of Communication, Culture and Society, Università della Svizzera italiana, 6900 Lugano, Switzerland; (S.P.); (L.M.)
| | - Laura Marciano
- Faculty of Communication, Culture and Society, Università della Svizzera italiana, 6900 Lugano, Switzerland; (S.P.); (L.M.)
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18
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Sánchez-Dinorín G, Rodríguez-Violante M, Cervantes-Arriaga A, Navarro-Roa C, Ricardo-Garcell J, Rodríguez-Camacho M, Solís-Vivanco R. Frontal functional connectivity and disease duration interactively predict cognitive decline in Parkinson's disease. Clin Neurophysiol 2020; 132:510-519. [PMID: 33450572 DOI: 10.1016/j.clinph.2020.11.035] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 09/25/2020] [Accepted: 11/16/2020] [Indexed: 01/27/2023]
Abstract
OBJECTIVE Cognitive decline does not always follow a predictable course in Parkinson's disease (PD), with some patients remaining stable while others meet criteria for dementia from early stages. Functional connectivity has been proposed as a good correlate of cognitive decline in PD, although it has not been explored whether the association between this connectivity and cognitive ability is influenced by disease duration, which was our objective. METHODS We included 30 patients with PD and 15 healthy controls (HC). Six cognitive domains were estimated based on neuropsychological assessment. Phase-based connectivity at frontal and posterior cortical regions was estimated from a resting EEG. RESULTS The PD group showed significant impairment for the executive, visuospatial, and language domains compared with HC. Increased connectivity at frontal regions was also found in the PD group. Frontal delta and theta connectivity negatively influenced general cognition and visuospatial performance, but this association was moderated by disease duration, with increased connectivity predicting worse performance after 8 years of disease duration. CONCLUSION Subtle neurophysiological changes underlie cognitive decline along PD progression, especially around a decade after motor symptoms onset. SIGNIFICANCE Connectivity of EEG slow waves at frontal regions might be used as a predictor of cognitive decline in PD.
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Affiliation(s)
- Gerardo Sánchez-Dinorín
- Neuropsychology Laboratory, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez (INNN), Mexico City, Mexico; Faculty of Psychology, Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico
| | | | | | | | | | | | - Rodolfo Solís-Vivanco
- Neuropsychology Laboratory, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez (INNN), Mexico City, Mexico; Faculty of Psychology, Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico.
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19
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Rudge MVC, Souza FP, Abbade JF, Hallur RLS, Marcondes JPC, Piculo F, Marini G, Vesentini G, Thabane L, Witkin SS, Calderon IMP, Barbosa AMP, Rudge MV, Barbosa AMP, Calderon IMP, Souza FP, Abbade JF, Hallur LSR, Piculo F, Marini G, Vesentini G, Thabane L, Palma MS, Graeff CFO, Arni RK, Herculano RD, Salvadori DF, Mateus S, Dal Pai Silva M, Magalhães CG, Costa RA, Lima SAM, Felisbino SL, Barbosa W, Atallah A, Girão MJB, Di Bella Z, Uchoa SM, Payão S, Hijas A, Berghman B, De Bie R, Sobrevia L, Junginger B, Alves FCB, Rossignoli PS, Prudencio CB, Orlandi MIG, Gonçalves MI, Nunes SK, Catinelli BB, Quiroz S, Sarmento BV, Pinheiro FA, Sartorão CI, Lucas RR, Reyes DRA, Quiroz SBCV, Enriquez EMA, Oliveira RG, Floriano JF, Marcondes JPC, Barneze S, Dangió TD, Pascon T, Rossignoli P, Freitas JV, Takano L, Reis F, Caldeirão TD, Fernandes JN, Carr AM, Gaitero MVC, Corrente JE, Nunes HRC, Candido AF, Costa SMB, Dangió TD, Pascon T, Melo JVF, Takano L, Reis FVDS, Caldeirão TD, Carr AM, Garcia GA, Rabadan GB, Bassin HCM, Suyama KS, Damasceno LN, Takemoto MLS, Menezes MD, Bussaneli DG, Nogueira VKC, Lima PR, Lourenço IO, Marostica de Sá J, Megid RA, Caruso IP, Rasmussen LT, Prata GM, Piculo F, Vesentini G, Arantes MA, Ferraz GAR, Camargo LP, Kron MR, Corrente JE, Nunes HRC. Study protocol to investigate biomolecular muscle profile as predictors of long-term urinary incontinence in women with gestational diabetes mellitus. BMC Pregnancy Childbirth 2020; 20:117. [PMID: 32075598 PMCID: PMC7031907 DOI: 10.1186/s12884-020-2749-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2019] [Accepted: 01/17/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Pelvic floor muscles (PFM) and rectus abdominis muscles (RAM) of pregnant diabetic rats exhibit atrophy, co-localization of fast and slow fibers and an increased collagen type I/III ratio. However, the role of similar PFM or RAM hyperglycemic-related myopathy in women with gestational diabetes mellitus (GDM) remains poorly investigated. This study aims to assess the frequency of pelvic floor muscle disorders and pregnancy-specific urinary incontinence (PS-UI) 12 months after the Cesarean (C) section in women with GDM. Specifically, differences in PFM/RAM hyperglycemic myopathy will be evaluated. METHODS The Diamater is an ongoing cohort study of four groups of 59 pregnant women each from the Perinatal Diabetes Research Centre (PDRC), Botucatu Medical School (FMB)-UNESP (São Paulo State University), Brazil. Diagnosis of GDM and PS-UI will be made at 24-26 weeks, with a follow-up at 34-38 weeks of gestation. Inclusion in the study will occur at the time of C-section, and patients will be followed at 24-48 h, 6 weeks and 6 and 12 months postpartum. Study groups will be classified as (1) GDM plus PS-UI; (2) GDM without PS-UI; (3) Non-GDM plus PS-UI; and (4) Non-GDM without PS-UI. We will analyze relationships between GDM, PS-UI and hyperglycemic myopathy at 12 months after C-section. The mediator variables to be evaluated include digital palpation, vaginal squeeze pressure, 3D pelvic floor ultrasound, and 3D RAM ultrasound. RAM samples obtained during C-section will be analyzed for ex-vivo contractility, morphological, molecular and OMICS profiles to further characterize the hyperglycemic myopathy. Additional variables to be evaluated include maternal age, socioeconomic status, educational level, ethnicity, body mass index, weight gain during pregnancy, quality of glycemic control and insulin therapy. DISCUSSION To our knowledge, this will be the first study to provide data on the prevalence of PS-UI and RAM and PFM physical and biomolecular muscle profiles after C-section in mothers with GDM. The longitudinal design allows for the assessment of cause-effect relationships between GDM, PS-UI, and PFMs and RAMs myopathy. The findings may reveal previously undetermined consequences of GDM.
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Affiliation(s)
- Marilza V C Rudge
- Department of Gynecology and Obstetrics, Botucatu Medical School (FMB), São Paulo State University (UNESP), CEP18618-687, Sao Paulo, Brazil.
| | - Fátima P Souza
- Physics Department, Institute of Biosciences, Letters and Exact Sciences, Multiuser Center for Biomolecular Innovation, UNESP-São Paulo State University, Sao Paulo, Brazil
| | - Joelcio F Abbade
- Department of Gynecology and Obstetrics, Botucatu Medical School (FMB), São Paulo State University (UNESP), CEP18618-687, Sao Paulo, Brazil
| | - Raghavendra L S Hallur
- Department of Gynecology and Obstetrics, Botucatu Medical School (FMB), São Paulo State University (UNESP), CEP18618-687, Sao Paulo, Brazil
| | - João Paulo C Marcondes
- Department of Gynecology and Obstetrics, Botucatu Medical School (FMB), São Paulo State University (UNESP), CEP18618-687, Sao Paulo, Brazil
| | - Fernanda Piculo
- Department of Gynecology and Obstetrics, Botucatu Medical School (FMB), São Paulo State University (UNESP), CEP18618-687, Sao Paulo, Brazil.,Physiotherapy Department, Faculdades Integradas de Bauru, FIB, Sao Paulo, Brazil
| | - Gabriela Marini
- Department of Gynecology and Obstetrics, Botucatu Medical School (FMB), São Paulo State University (UNESP), CEP18618-687, Sao Paulo, Brazil.,Universidade do Sagrado Coração (USC), Jardim Brasil, Bauru, Sao Paulo, Brazil
| | - Giovana Vesentini
- Department of Gynecology and Obstetrics, Botucatu Medical School (FMB), São Paulo State University (UNESP), CEP18618-687, Sao Paulo, Brazil
| | - Lehana Thabane
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.,Biostatistics Unit, Father Sean O'Sullivan Research Centre, St Joseph's Healthcare-Hamilton, Hamilton, ON, Canada
| | - Steven S Witkin
- Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York, NY, USA.,Institute of Tropical Medicine, University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - Iracema M P Calderon
- Department of Gynecology and Obstetrics, Botucatu Medical School (FMB), São Paulo State University (UNESP), CEP18618-687, Sao Paulo, Brazil
| | - Angélica M P Barbosa
- Department of Gynecology and Obstetrics, Botucatu Medical School (FMB), São Paulo State University (UNESP), CEP18618-687, Sao Paulo, Brazil.,School of Philosophy and Sciences, Department of Physiotherapy and Occupational Therapy, UNESP-São Paulo State University, Marília, Sao Paulo, Brazil
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Breitborde NJK, Guirgis H, Stearns W, Carpenter KM, Lteif G, Pine JG, Storey N, Wastler H, Moe AM. The Ohio State University Early Psychosis Intervention Center (EPICENTER) step-based care programme for individuals at clinical high risk for psychosis: study protocol for an observational study. BMJ Open 2020; 10:e034031. [PMID: 31992606 PMCID: PMC7045181 DOI: 10.1136/bmjopen-2019-034031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 12/02/2019] [Accepted: 12/03/2019] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION In October 2018, the Substance Abuse and Mental Health Services Administration funded 21 sites throughout the USA to develop, implement and evaluate specialised care programmes for individuals at clinical high risk for developing a psychotic disorder (CHR-P). Per the funding requirements, such programmes were required to provide 'step-based care'-a model in which individuals are initially provided with low-intensity, non-psychosis-specific and more benign (ie, least side effects) interventions and only progress onto higher-intensity, psychosis-specific interventions with a greater risk of more severe side effects should they not meet a priori criteria for clinical response to such lower-intensity interventions. Here, we outline the evaluation component of the step-based care programme for individuals at CHR-P at The Ohio State University Early Psychosis Intervention Center (EPICENTER). METHODS AND ANALYSES The EPICENTER CHR-P programme provides a step-based care model comprising psychotherapy, medication management, family support/education, peer support and vocational/educational support. All participants who opt to receive care at the EPICENTER will complete a standardised assessment battery as part of usual care. This battery will be administered on enrolment and will be re-administered at 6-month intervals throughout individuals' participation in EPICENTER clinical services. Participants will have the opportunity to allow for data from these usual care assessments to be used as part of an evaluation project for this new clinical service. The primary outcome for this evaluation project is time to remission of symptomatic and functional deficits commonly experienced by individuals at CHR-P. Participants will also have the opportunity to participate in a supplemental research project designed to further evaluate treatment outcomes and patient characteristics among individuals participating in EPICENTER clinical services. ETHICS AND DISSEMINATION This project was approved by The Ohio State University Institutional Review Board. Results from this project will be disseminated through publications and presentations. TRIAL REGISTRATION NUMBER NCT03970005; Pre-results.
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Affiliation(s)
- Nicholas J K Breitborde
- Psychiatry and Behavioral Health & Psychology, The Ohio State University, Columbus, Ohio, USA
| | - Hossam Guirgis
- Psychiatry and Behavioral Health, The Ohio State University, Columbus, Ohio, USA
| | - Walter Stearns
- Psychiatry and Behavioral Health, The Ohio State University, Columbus, Ohio, USA
| | - Kristen M Carpenter
- Psychiatry and Behavioral Health, Psychology, & Obstetrics and Gynecology, The Ohio State University, Columbus, Ohio, USA
| | - Ghada Lteif
- Psychiatry and Behavioral Health, The Ohio State University, Columbus, Ohio, USA
| | - Jacob G Pine
- Psychiatry and Behavioral Health, The Ohio State University, Columbus, Ohio, USA
| | - Nichole Storey
- Psychiatry and Behavioral Health, The Ohio State University, Columbus, Ohio, USA
| | - Heather Wastler
- Psychiatry and Behavioral Health, The Ohio State University, Columbus, Ohio, USA
| | - Aubrey M Moe
- Psychiatry and Behavioral Health, The Ohio State University, Columbus, Ohio, USA
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Rayce SB, Rasmussen IS, Væver MS, Pontoppidan M. Effects of parenting interventions for mothers with depressive symptoms and an infant: systematic review and meta-analysis. BJPsych Open 2020; 6:e9. [PMID: 31928569 PMCID: PMC7001473 DOI: 10.1192/bjo.2019.89] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 10/11/2019] [Accepted: 11/10/2019] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Postpartum depression is common in the perinatal period and poses a risk for the development of the infant and the mother-infant relationship. Infancy is a critical developmental period of life and supportive parenting is crucial for healthy development, however, the effects of interventions aimed at improving parenting among mothers with depression are uncertain. AIMS To assess the effects of parenting interventions on parent-child relationship and child development among mothers with depressive symptoms with 0-12-month-old infants. METHOD We conducted a systematic review with the inclusion criteria: (a) randomised controlled trials of structured psychosocial parenting interventions for women with depressive symptoms and a child aged 0-12 months in Western Organisation for Economic Co-operation and Development countries, (b) minimum three sessions with at least half of these delivered postnatally and (c) outcomes relating to the parent-child-relationship and/or child development. Publications were extracted from 10 databases in September 2018 and supplemented with grey search and hand search. We assessed risk of bias, calculated effect sizes and conducted meta-analysis. RESULTS Eight papers representing seven trials were included. We conducted meta-analysis on the post-intervention parent-child relationship. The analysis included six studies and showed no significant effect. For individual study outcomes, no significant effects on the majority of both the parent-child relationship and child development outcomes were reported. CONCLUSIONS No evidence of the effect of parenting interventions for mothers with depressive symptoms was found on the parent-child relationship and child development. Larger studies with follow-up assessments are needed, and future reviews should examine the effects in non-Western countries.
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Affiliation(s)
- Signe B. Rayce
- Senior Researcher, VIVE – The Danish Center for Social Science Research, Denmark
| | - Ida S. Rasmussen
- Research Assistant, VIVE – The Danish Center for Social Science Research, Denmark
| | | | - Maiken Pontoppidan
- Senior Researcher, VIVE – The Danish Center for Social Science Research, Denmark
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22
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Himberg-Sundet A, Kristiansen AL, Gebremariam MK, Moser T, Andersen LF, Bjelland M, Lien N. Exploring the workplace climate and culture in relation to food environment-related factors in Norwegian kindergartens: The BRA-study. PLoS One 2019; 14:e0225831. [PMID: 31790486 PMCID: PMC6886843 DOI: 10.1371/journal.pone.0225831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 11/13/2019] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Kindergartens represent an important arena for promoting vegetable intake when it is essential to establish healthy dietary behaviours early in life. To develop and implement successful interventions targeting dietary behaviours in kindergartens, a good understanding of the factors influencing their food environment and the interplay between these factors is essential. The present study aimed to explore associations between workplace climate and culture in the kindergarten setting and the staff's food-related practices, vegetables served and the possible mediating role of staff's food-related practices. METHOD Vegetables served, staff's food-related practices, and data on workplace climate and culture were collected using a 5-day, weighted, vegetable diary and three paper-based questionnaires. Seventy-three kindergartens in the Norwegian counties of Vestfold and Buskerud participated in the study. Spearman's rho was used to assess the association between workplace climate and culture, and staff's food-related practices and vegetables served. Mediation analyses were conducted to assess the mediating role of staff's food-related practices in the relationship between workplace climate and culture and vegetables served in this setting. RESULTS There was one significant positive correlation between factors in the workplace climate and culture, and staff's food-related practices and vegetables served. The staff's food-related practices were found to mediate the association between support from superior and the variety of vegetables served. They also mediated the association between commitment to the organization and the frequency, as well as the variety, of vegetables served. CONCLUSION The results identified commitment to the organization and support from superior as two important factors in the workplace climate and culture. Furthermore, these two factors seems to be important to target when developing kindergarten-based interventions aimed at increasing the variety and frequency of vegetables served as they were associated with more favourable food-related practices among staff.
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Affiliation(s)
- Anne Himberg-Sundet
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Norway
| | - Anne Lene Kristiansen
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Norway
| | - Mekdes K. Gebremariam
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Norway
| | - Thomas Moser
- Department of Educational Science, Faculty of Humanities, Sports and Educational Science, University of South-Eastern Norway, Norway
| | - Lene Frost Andersen
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Norway
| | - Mona Bjelland
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Norway
| | - Nanna Lien
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Norway
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23
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Breitborde NJK, Pine JG, Moe AM. Specialized, multi-component care for individuals with first-episode psychosis: Effects on autonomy, competence and relatedness. Early Interv Psychiatry 2019; 13:1503-1505. [PMID: 30644170 DOI: 10.1111/eip.12784] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 11/06/2018] [Accepted: 12/26/2018] [Indexed: 11/29/2022]
Abstract
AIM Self-determination theory (SDT) has demonstrated that human well-being is associated with the satisfaction of three basic psychological needs (ie, autonomy, competence and relatedness)-with more recent research highlighting the applicability of SDT to individuals with first-episode psychosis (FEP). These findings suggest that satisfaction of basic psychological need may be an important treatment target for specialized clinical programs for FEP. METHODS We examined the effects of participation in specialized, multi-component care for FEP on basic psychological need satisfaction. RESULTS After 6 months of treatment, individuals with FEP experienced gains in autonomy and relatedness and a near significant improvement in competence. CONCLUSIONS Although our results should be interpreted cautiously given the uncontrolled study design and small sample size, our data suggest that the benefits of participation in comprehensive, early intervention for psychotic disorders may include increased satisfaction of basic psychological needs.
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Affiliation(s)
- Nicholas J K Breitborde
- Early Psychosis Intervention Center (EPICENTER), Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, Ohio.,Department of Psychology, The Ohio State University, Columbus, Ohio
| | - Jacob G Pine
- Early Psychosis Intervention Center (EPICENTER), Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, Ohio
| | - Aubrey M Moe
- Early Psychosis Intervention Center (EPICENTER), Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, Ohio
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24
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Levi-Bliech M, Kurtser P, Pliskin N, Fink L. Mobile apps and employee behavior: An empirical investigation of the implementation of a fleet-management app. INTERNATIONAL JOURNAL OF INFORMATION MANAGEMENT 2019. [DOI: 10.1016/j.ijinfomgt.2019.07.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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25
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[Current State of Family-Based Prevention and Therapy of Substance-Use Disorders in Children and Adolescents: A Review]. Prax Kinderpsychol Kinderpsychiatr 2019; 68:376-401. [PMID: 31250722 DOI: 10.13109/prkk.2019.68.5.376] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Current State of Family-Based Prevention and Therapy of Substance-Use Disorders in Children and Adolescents: A Review Adolescence is a vulnerable period for substance use disorders (SUD) as indicated by epidemiological studies. Research demonstrates the family's role for the etiology of SUD and provides a rationale for interventions based on family-associated risk and resilience factors. In this article, we summarize published results for family-based interventions from 2008-2018. Taken together, prevention programs can be effective when they focus on the promotion of broader developmental competencies and familial resources, rather than narrowly addressing substance use. Moreover, programs could benefit from targeting youth and parents as done in the "Strengthening Families Program 10-14"; most existing programs however target parents and do not include the adolescents. Family-based treatment programs with an evidence base are Multisystemic Therapy, Functional Family Therapy, Multidimensional Family Therapy and Brief Strategic Family Therapy. Overall, the effects of family-based interventions are small-to-middle sized but vary significantly across populations. Across the field of family-based interventions, there is a need for more knowledge on effective components and differential effects. The results could be improved by translational research such as on the emerging concept of mindfulness. Moreover, there is a need for implementation research and the effectiveness of service delivery programs on the community level in Germany.
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Lundqvist S, Börjesson M, Larsson MEH, Cider Å, Hagberg L. Which patients benefit from physical activity on prescription (PAP)? A prospective observational analysis of factors that predict increased physical activity. BMC Public Health 2019; 19:482. [PMID: 31046720 PMCID: PMC6498468 DOI: 10.1186/s12889-019-6830-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Accepted: 04/15/2019] [Indexed: 11/29/2022] Open
Abstract
Background There is robust evidence that regular physical activity (PA) has positive health effects. However, the best PA methods and the most important correlates for promoting PA remain unclear. Physical activity on prescription (PAP) aims to increase the patient’s motivation for and level of PA. This study investigated possible predictive baseline correlates associated with changes in the PA level over a 6-month period of PAP treatment in order to identify the primary care patients most likely to benefit from a PAP intervention. Methods The study included 444 patients with metabolic risk factors who were aged 27 to 85 years and physically inactive. The patients received PAP treatment that included individual counseling plus an individually-tailored PA recommendation with a written prescription and individualised structured follow-up for 6 months. Eight baseline correlates of PA were analysed against the PA level at the 6-month follow-up in a predictor analysis. Results Five baseline correlates predicted the PA level at the 6-month follow-up: self-efficacy expectations for changing PA; the patient’s preparedness and confidence regarding readiness to change PA; a BMI < 30; and a positive valued physical health. The proportion of patients increasing the PA level and achieving a PA level that was in accordance with public health recommendations was higher with a positive valued baseline correlate. The odds of achieving the recommended PA level increased substantially when 2 to 4 predictive correlates were present. PA levels increased to a greater extent among patients with low PA at baseline than patients with high PA at baseline, especially in combination with 2 to 4 positively-valued correlates (87–95% vs. 62–75%). Conclusions This study identified potential predictive correlates of an increased PA level after a 6-month PAP intervention. This contributes to our understanding of PAP and could help individualise PAP support. The proportion of patients with the lowest PA level at baseline increased their PA level in a higher extent (84%) and thus may benefit the most from PAP. These results have clinical implications for behavioural change in those patients having the greatest health gains by increasing their PA level. Trial registration ClinicalTrials.gov; NCT03586011. Retrospectively registered on July 17, 2018. Electronic supplementary material The online version of this article (10.1186/s12889-019-6830-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Stefan Lundqvist
- Department of Health and Rehabilitation, Unit of Physiotherapy, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. .,Närhälsan Göteborg centrum för fysisk aktivitet, Region Västra Götaland, Gothenburg, Sweden.
| | - Mats Börjesson
- Department of Food and Nutrition and Sport Science, Faculty of Education, University of Gothenburg, Gothenburg, Sweden.,Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Sahlgrenska University Hospital/Östra, Gothenburg, Sweden
| | - Maria E H Larsson
- Department of Health and Rehabilitation, Unit of Physiotherapy, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Närhälsan Research and Development Primary Health Care, Region Västra Götaland, Gothenburg, Sweden
| | - Åsa Cider
- Department of Health and Rehabilitation, Unit of Physiotherapy, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Lars Hagberg
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
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Lee RSC, Hermens DF, Naismith SL, Kaur M, Guastella AJ, Glozier N, Scott J, Scott EM, Hickie IB. Clinical, neurocognitive and demographic factors associated with functional impairment in the Australian Brain and Mind Youth Cohort Study (2008-2016). BMJ Open 2018; 8:e022659. [PMID: 30567821 PMCID: PMC6303611 DOI: 10.1136/bmjopen-2018-022659] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVES We sought to determine the unique and shared contributions of clinical, neurocognitive and demographic factors to functional impairment in a large, transdiagnostic, clinical cohort of adolescents and young adults. DESIGN Cross-sectional baseline data from a prospective, cohort study. SETTING Help-seeking youth referred from outpatient services were recruited to the Brain and Mind Youth Cohort (2008-2016) in Sydney, Australia. PARTICIPANTS In total, 1003 outpatients were recruited, aged between 12 and 36 years (mean= 20.4 years, 54% female), with baseline diagnoses of affective, psychotic, developmental or behavioural disorders. INTERVENTIONS Treatment as usual. PRIMARY OUTCOME MEASURES Social and occupational functioning was used to index level of functional impairment. Structural equation modelling was used to examine associations between neurocognition, core clinical symptoms and alcohol and substance use, and clinician-rated and researcher-rated functional impairment. Moderator analyses were conducted to determine the potential influence of demographic and clinical factors (eg, medication exposure). RESULTS Independent of diagnosis, we found that neurocognitive impairments, and depressive, anxiety and negative symptoms, were significantly associated with functioning. The association of neurocognition with social and occupational functioning remained significant even when constraining for age (15-25-year-olds only) or diagnosis (affective disorders only) in the final model. CONCLUSIONS This study demonstrated that, in a clinically representative sample of youth, the key determinants of functioning may not be disorder specific. Further, evidence of neurocognitive dysfunction suggests that interventions that target cognition and functioning should not necessarily be reserved just for older adults with established illness.
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Affiliation(s)
- Rico S C Lee
- Brain and Mind Centre, University of Sydney, Sydney, New South Wales, Australia
- Brain and Mental Health Research Hub, Monash University, Melbourne, Victoria, Australia
| | - Daniel F Hermens
- Brain and Mind Centre, University of Sydney, Sydney, New South Wales, Australia
| | - Sharon L Naismith
- Brain and Mind Centre, University of Sydney, Sydney, New South Wales, Australia
- Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia
| | - Manreena Kaur
- Brain and Mind Centre, University of Sydney, Sydney, New South Wales, Australia
- The Monash Alfred Psychiatry Research Centre, Monash University, Melbourne, Victoria, Australia
| | - Adam J Guastella
- Brain and Mind Centre, University of Sydney, Sydney, New South Wales, Australia
| | - Nick Glozier
- Brain and Mind Centre, University of Sydney, Sydney, New South Wales, Australia
- Marie Bashir Institute, University of Sydney, Sydney, New South Wales, Australia
| | - Jan Scott
- Academic Psychiatry, Institute of Neuroscience, Newcastle University, Newcastle, UK
- Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Elizabeth M Scott
- Brain and Mind Centre, University of Sydney, Sydney, New South Wales, Australia
| | - Ian B Hickie
- Brain and Mind Centre, University of Sydney, Sydney, New South Wales, Australia
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Woolverton CB, Bell EK, Moe AM, Harrison-Monroe P, Breitborde NJK. Social cognition and the course of social functioning in first-episode psychosis. Early Interv Psychiatry 2018; 12:1151-1156. [PMID: 28402046 DOI: 10.1111/eip.12432] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Revised: 11/25/2016] [Accepted: 12/24/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND Social functioning deficits greatly affect individuals with psychotic disorders resulting in decreased ability to maintain relationships, jobs and pursuit of educational goals. Deficits in social cognition have been hypothesized to be an important contributor to these deficits in social functioning. In particular, 5 domains of social cognition have been suggested to be relevant in the study of psychotic disorders: (1) attributional style, (2) emotion recognition, (3) social knowledge, (4) social perception and (5) theory of mind. Yet, to date, no study has simultaneously investigated the association between these 5 domains of social cognition and social functioning. METHODS We investigated the cross-section and longitudinal association between social cognition and social functioning among 71 individuals with first-episode psychosis. RESULTS We found modest cross-sectional associations between social cognition and social functioning that were often in the unexpected direction (ie, greater social cognition associated with worse social functioning). Social cognition at baseline was not associated with the longitudinal course of social functioning. CONCLUSIONS These unexpected findings fail to align with previous research that has documented a more robust relationship between these 2 constructs, and raise critical questions with regard to the nature of the association between social cognition and social functioning among individuals with first-episode psychosis.
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Affiliation(s)
| | - Emily K Bell
- Early Psychosis Intervention Center (EPICENTER), Department of Psychiatry, The University of Arizona, Tucson, Arizona
| | - Aubrey M Moe
- Early Psychosis Intervention Center (EPICENTER), Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, Ohio
| | - Patricia Harrison-Monroe
- Early Psychosis Intervention Center (EPICENTER), Department of Psychiatry, The University of Arizona, Tucson, Arizona
| | - Nicholas J K Breitborde
- Early Psychosis Intervention Center (EPICENTER), Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, Ohio.,Department of Psychology, The Ohio State University, Columbus, Ohio
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29
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Neuhauser A, Ramseier E, Schaub S, Burkhardt SCA, Lanfranchi A. MEDIATING ROLE OF MATERNAL SENSITIVITY: ENHANCING LANGUAGE DEVELOPMENT IN AT-RISK FAMILIES. Infant Ment Health J 2018; 39:522-536. [PMID: 30088285 DOI: 10.1002/imhj.21738] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Home-visiting programs have gained increasing importance in family-centered prevention and intervention. However, few studies have examined the mechanisms underlying early intervention treatment effects. The goal of this study is to analyze the mediating role of maternal sensitivity in enhancing language development with the home-visiting program Parents as Teachers (PAT). Data were collected and analyzed within the ongoing, long-term ZEPPELIN study, a randomized controlled trial with 251 participating at-risk families. Via longitudinal mediation analysis, we examined whether effects of the PAT on receptive and expressive language outcomes at 24 and 36 months were mediated by maternal sensitivity at 12 months. Within a moderated mediation framework, we investigated whether the level of family psychosocial stress affects this mediation. Results showed that intervention effects on language outcomes are mediated by maternal sensitivity-weakly and through specific pathways. Moderation and moderated mediation analyses indicated that effects of the PAT and also specific mediation effects increase with the level of psychosocial stress. Implications of the results for practice are discussed.
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Affiliation(s)
- Alex Neuhauser
- University of Applied Sciences of Special Needs Education Zurich
| | | | - Simone Schaub
- University of Applied Sciences of Special Needs Education Zurich
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Breitborde NJK, Moe AM, Woolverton C, Harrison-Monroe P, Bell EK. An uncontrolled trial of multi-component care for first-episode psychosis: Effects on social cognition. Early Interv Psychiatry 2018; 12:464-468. [PMID: 28124452 DOI: 10.1111/eip.12417] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 07/07/2016] [Accepted: 10/26/2016] [Indexed: 11/26/2022]
Abstract
Growing evidence suggests that specialized, multi-component treatment programmes produce improvements in numerous outcomes among individuals with first-episode psychosis. However, these programmes often lack interventions specifically designed to address deficits in social cognition. This raises questions about the effectiveness of such programmes in addressing deficits in social cognition that accompany psychotic disorders. We investigated the effect of participation in a multi-component treatment programme on social cognition among 71 individuals with first-episode psychosis. Participants experienced gains in emotion processing, social knowledge, social perception and theory of mind. However, after controlling for multiple comparisons, these improvements were limited to theory of mind and recognition of social cues in low emotion interactions. Although our findings should be interpreted cautiously, they raise the possibility that individuals participating in multi-component treatment programmes for first-episode psychosis without interventions specifically targeting social cognition may still experience gains in social cognition.
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Affiliation(s)
- Nicholas J K Breitborde
- Early Psychosis Intervention Center (EPICENTER), Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, Ohio.,Department of Psychology, The Ohio State University, Columbus, Ohio
| | - Aubrey M Moe
- Early Psychosis Intervention Center (EPICENTER), Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, Ohio
| | - Cindy Woolverton
- Department of Psychology, The University of Arizona, Tucson, Arizona
| | - Patricia Harrison-Monroe
- Early Psychosis Intervention Center (EPICENTER), Department of Psychiatry, The University of Arizona, Tucson, Arizona
| | - Emily K Bell
- Early Psychosis Intervention Center (EPICENTER), Department of Psychiatry, The University of Arizona, Tucson, Arizona
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Insight, self-stigma and psychosocial outcomes in Schizophrenia: a structural equation modelling approach. Epidemiol Psychiatr Sci 2018; 27:176-185. [PMID: 27974084 PMCID: PMC6998951 DOI: 10.1017/s2045796016000950] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
AIMS Poor insight is prevalent in patients with schizophrenia and has been associated with acute illness severity, medication non-adherence and poor treatment outcomes. Paradoxically, high insight has been associated with various undesirable outcomes, including low self-esteem, depression and low subjective quality of life (QoL) in patients with schizophrenia. Despite the growing body of studies conducted in Western countries supporting the pernicious effects of improved insight in psychosis, which bases on the level of self-stigma, the effects are unclear in non-Western societies. The current study examined the role of self-stigma in the relationship between insight and psychosocial outcomes in a Chinese population. METHODS A total of 170 outpatients with schizophrenia spectrum disorders were recruited from two general university hospitals. Sociodemographic data and clinical variables were recorded and self-report scales were employed to measure self-stigma, depression, insight, self-esteem and subjective QoL. Structural equation modelling (SEM) was used to analyse the cross-sectional data. RESULTS High levels of self-stigma were reported by 39% of the participants (n = 67). The influences of insight, self-stigma, self-esteem and depression on subjective QoL were confirmed by the SEM results. Our model with the closest fit to the data (χ 2 = 33.28; df = 20; p = 0.03; χ 2/df = 1.66; CFI = 0.98; TLI = 0.97; RMSEA = 0.06) demonstrated that self-stigma might fully mediate the association of insight with low self-esteem, depression and poor subjective QoL. High insight into illness contributed to self-stigma, which caused low self-esteem and depression and, consequently, low QoL. Notably, insight did not directly affect self-esteem, depression or QoL. Furthermore, the association of insight with poor psychosocial outcomes was not moderated by self-stigma. CONCLUSIONS Our findings support the mediating model of insight relevant to the poor psychosocial outcomes of individuals diagnosed with schizophrenia in non-Western societies, in which self-stigma plays a pivotal role. These findings elucidate the direct and indirect effects of insight on psychosocial outcomes and imply that identifying and correcting self-stigma in people with schizophrenia could be beneficial. Additional studies are required to identify whether several other neurocognitive or psychosocial variables mediate or moderate the association of insight with self-esteem, depression and QoL in patients with schizophrenia. Studies with detailed longitudinal assessments are necessary to confirm our findings.
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Hayes AF, Rockwood NJ. Regression-based statistical mediation and moderation analysis in clinical research: Observations, recommendations, and implementation. Behav Res Ther 2017; 98:39-57. [DOI: 10.1016/j.brat.2016.11.001] [Citation(s) in RCA: 783] [Impact Index Per Article: 111.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Revised: 11/02/2016] [Accepted: 11/04/2016] [Indexed: 02/03/2023]
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34
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Reznik SJ, Allen JJB. Frontal asymmetry as a mediator and moderator of emotion: An updated review. Psychophysiology 2017; 55. [DOI: 10.1111/psyp.12965] [Citation(s) in RCA: 167] [Impact Index Per Article: 23.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2016] [Revised: 01/08/2017] [Accepted: 04/06/2017] [Indexed: 01/17/2023]
Affiliation(s)
| | - John J. B. Allen
- Department of Psychology; University of Arizona; Tucson Arizona USA
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Malek-Ahmadi M, Mufson EJ, Perez SE, Chen K. Statistical considerations for assessing cognition and neuropathology associations in preclinical Alzheimer's disease. ACTA ACUST UNITED AC 2017. [DOI: 10.1080/24709360.2017.1342186] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
| | - Elliott J. Mufson
- Department of Neurobiology, Barrow Neurological Institute, Phoenix, AZ, USA
| | - Sylvia E. Perez
- Department of Neurobiology, Barrow Neurological Institute, Phoenix, AZ, USA
| | - Kewei Chen
- Banner Alzheimer's Institute, Phoenix, AZ, USA
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Breitborde NJK, Moe AM, Ered A, Ellman LM, Bell EK. Optimizing psychosocial interventions in first-episode psychosis: current perspectives and future directions. Psychol Res Behav Manag 2017; 10:119-128. [PMID: 28490910 PMCID: PMC5414722 DOI: 10.2147/prbm.s111593] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Psychotic-spectrum disorders such as schizophrenia, schizoaffective disorder, and bipolar disorder with psychotic features are devastating illnesses accompanied by high levels of morbidity and mortality. Growing evidence suggests that outcomes for individuals with psychotic-spectrum disorders can be meaningfully improved by increasing the quality of mental health care provided to these individuals and reducing the delay between the first onset of psychotic symptoms and the receipt of adequate psychiatric care. More specifically, multicomponent treatment packages that 1) simultaneously target multiple symptomatic and functional needs and 2) are provided as soon as possible following the initial onset of psychotic symptoms appear to have disproportionately positive effects on the course of psychotic-spectrum disorders. Yet, despite the benefit of multicomponent care for first-episode psychosis, clinical and functional outcomes among individuals with first-episode psychosis participating in such services are still suboptimal. Thus, the goal of this review is to highlight putative strategies to improve care for individuals with first-episode psychosis with specific attention to optimizing psychosocial interventions. To address this goal, we highlight four burgeoning areas of research with regard to optimization of psychosocial interventions for first-episode psychosis: 1) reducing the delay in receipt of evidence-based psychosocial treatments; 2) synergistic pairing of psychosocial interventions; 3) personalized delivery of psychosocial interventions; and 4) technological enhancement of psychosocial interventions. Future research on these topics has the potential to optimize the treatment response to evidence-based psychosocial interventions and to enhance the improved (but still suboptimal) treatment outcomes commonly experienced by individuals with first-episode psychosis.
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Affiliation(s)
- Nicholas JK Breitborde
- Department of Psychiatry and Behavioral Health
- Department of Psychology, The Ohio State University, Columbus, OH
| | | | - Arielle Ered
- Department of Psychology, Temple University, Philadelphia, PA
| | - Lauren M Ellman
- Department of Psychology, Temple University, Philadelphia, PA
| | - Emily K Bell
- Department of Psychiatry, University of Arizona, Tucson, AZ, USA
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Breitborde NJK, Bell EK, Dawley D, Woolverton C, Ceaser A, Waters AC, Dawson SC, Bismark AW, Polsinelli AJ, Bartolomeo L, Simmons J, Bernstein B, Harrison-Monroe P. The Early Psychosis Intervention Center (EPICENTER): development and six-month outcomes of an American first-episode psychosis clinical service. BMC Psychiatry 2015; 15:266. [PMID: 26511605 PMCID: PMC4625429 DOI: 10.1186/s12888-015-0650-3] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Accepted: 10/14/2015] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND There is growing evidence that specialized clinical services targeted toward individuals early in the course of a psychotic illness may be effective in reducing both the clinical and economic burden associated with these illnesses. Unfortunately, the United States has lagged behind other countries in the delivery of specialized, multi-component care to individuals early in the course of a psychotic illness. A key factor contributing to this lag is the limited available data demonstrating the clinical benefits and cost-effectiveness of early intervention for psychosis among individuals served by the American mental health system. Thus, the goal of this study is to present clinical and cost outcome data with regard to a first-episode psychosis treatment center within the American mental health system: the Early Psychosis Intervention Center (EPICENTER). METHODS Sixty-eight consecutively enrolled individuals with first-episode psychosis completed assessments of symptomatology, social functioning, educational/vocational functioning, cognitive functioning, substance use, and service utilization upon enrollment in EPICENTER and after 6 months of EPICENTER care. All participants were provided with access to a multi-component treatment package comprised of cognitive behavioral therapy, family psychoeducation, and metacognitive remediation. RESULTS Over the first 6 months of EPICENTER care, participants experienced improvements in symptomatology, social functioning, educational/vocational functioning, cognitive functioning, and substance abuse. The average cost of care during the first 6 months of EPICENTER participation was lower than the average cost during the 6-months prior to joining EPICENTER. These savings occurred despite the additional costs associated with the receipt of EPICENTER care and were driven primarily by reductions in the utilization of inpatient psychiatric services and contacts with the legal system. CONCLUSIONS The results of our study suggest that multi-component interventions for first-episode psychosis provided in the US mental health system may be both clinically-beneficial and cost-effective. Although additional research is needed, these findings provide preliminary support for the growing delivery of specialized multi-component interventions for first-episode psychosis within the United States. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT01570972; Date of Trial Registration: November 7, 2011.
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Affiliation(s)
- Nicholas J. K. Breitborde
- Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, Ohio USA ,Department of Psychiatry, The University of Arizona, Tucson, Arizona USA
| | - Emily K. Bell
- Department of Psychiatry, The University of Arizona, Tucson, Arizona USA
| | - David Dawley
- Department of Psychiatry, The University of Arizona, Tucson, Arizona, USA.
| | - Cindy Woolverton
- Department of Psychology, The University of Arizona, Tucson, Arizona, USA.
| | - Alan Ceaser
- Department of Psychiatry, The University of Arizona, Tucson, Arizona, USA. .,Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California, USA.
| | - Allison C. Waters
- Department of Psychiatry, The University of Arizona, Tucson, Arizona USA ,Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia USA
| | - Spencer C. Dawson
- Department of Psychology, The University of Arizona, Tucson, Arizona USA
| | - Andrew W. Bismark
- VISN-22 Mental Illness, Research, Education and Clinical Center (MIRECC), VA San Diego Healthcare System, San Diego, California USA
| | | | - Lisa Bartolomeo
- Department of Psychiatry, The University of Arizona, Tucson, Arizona, USA.
| | - Jessica Simmons
- Department of Education, The University of Arizona, Tucson, Arizona, USA.
| | - Beth Bernstein
- Department of Psychiatry, The University of Arizona, Tucson, Arizona, USA.
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Abstract
Mediation statistical models help clarify the relationship between independent predictor variables and dependent outcomes of interest by assessing the impact of third variables. This type of statistical analysis is applicable for many clinical nursing research questions, yet its use within nursing remains low. Indeed, mediational analyses may help nurse researchers develop more effective and accurate prevention and treatment programs as well as help bridge the gap between scientific knowledge and clinical practice. In addition, this statistical approach allows nurse researchers to ask - and answer - more meaningful and nuanced questions that extend beyond merely determining whether an outcome occurs. Therefore, the goal of this paper is to provide a brief tutorial on the use of mediational analyses in clinical nursing research by briefly introducing the technique and, through selected empirical examples from the nursing literature, demonstrating its applicability in advancing nursing science.
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Affiliation(s)
- Jianghong Liu
- a School of Nursing, Faculty Member of MPH, School of Medicine , University of Pennsylvania , 418 Curie Blvd., Room 426, Claire M. Fagin Hall, Philadelphia , Pennsylvania 19104-6096
| | - Connie Ulrich
- a School of Nursing, Faculty Member of MPH, School of Medicine , University of Pennsylvania , 418 Curie Blvd., Room 426, Claire M. Fagin Hall, Philadelphia , Pennsylvania 19104-6096
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Jansen JE, Gleeson J, Cotton S. Towards a better understanding of caregiver distress in early psychosis: a systematic review of the psychological factors involved. Clin Psychol Rev 2014; 35:56-66. [PMID: 25531423 DOI: 10.1016/j.cpr.2014.12.002] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Revised: 12/04/2014] [Accepted: 12/07/2014] [Indexed: 01/28/2023]
Abstract
OBJECTIVES We sought to review empirical studies of psychological factors accounting for distress in caregivers of young people with early psychosis. METHOD Following the PRISMA guidelines, we included studies that empirically tested psychological models of caregiver distress in early psychosis by searching the following databases up until March 2014: PsycINFO, EMBASE and Cochrane Central Register of Controlled Trials (CENTRAL). This was followed by additional manual searches of reference lists and relevant journals. RESULTS The search identified 15 papers describing 13 studies together comprising 1056 caregivers of persons with early psychosis. The mean age of caregivers was 47.2years (SD=9.8), of whom 71.5% were female and 74.4% were parents. Nine different psychological variables were examined in the included studies, which were categorised in the following non-mutually exclusive groups: coping, appraisal/attribution and interpersonal response. There was considerable data to support the link between distress and psychological factors such as avoidant coping, appraisal and emotional over-involvement. However, the possibilities of drawing conclusions were limited by a number of methodological issues, including cross-sectional data, small sample sizes, confounding variables not being accounted for, and a wide variation in outcome measures. DISCUSSION The strengths of the review were the systematic approach, the exclusion of non-empirical papers and the rating of methodological quality by two independent raters. Limitations were that we excluded studies published in languages other than English, that data extraction forms were developed for this study and hence not tested for validity, and that there was a potential publication bias in favour of significant findings. CONCLUSION AND IMPLICATIONS A better grasp of the psychological factors accounting for caregiver distress early in the course of illness may help us understand the trajectory of distress. This is an important step in preventing long-term distress in caregivers and supporting recovery in the whole family.
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Affiliation(s)
- Jens Einar Jansen
- Early Psychosis Intervention Center/Psychiatric Research Unit, Region Zealand, Smedegade 10, 4000 Roskilde, Denmark; Department of Psychology, University of Copenhagen, Øster Farimagsgade 2A, 1353 Copenhagen, Denmark.
| | - John Gleeson
- School of Psychology, Australian Catholic University, Locked Bag 4115, Fitzroy MDC, Victoria 3065, Australia
| | - Sue Cotton
- Orygen Youth Health Research Centre, Locked Bag 10, Parkville, Victoria 3052, Australia; Centre for Youth Mental Health, University of Melbourne, Parkville, Victoria, 3052, Australia
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Jansen JE, Harder S, Haahr UH, Lyse HG, Pedersen MB, Trauelsen AM, Simonsen E. The Role of Metacognitions in Expressed Emotion and Distress: A Study on Caregivers of Persons with First-Episode Psychosis. Clin Psychol Psychother 2014; 22:525-32. [PMID: 24889322 DOI: 10.1002/cpp.1907] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2013] [Revised: 04/23/2014] [Accepted: 05/02/2014] [Indexed: 11/10/2022]
Abstract
BACKGROUND In first-episode psychosis, the family is considered an important part in the recovery process. This is often accompanied by significant distress, which is acknowledged in numerous studies. However, little is known about the psychological factors involved. METHOD One hundred and twenty-seven caregivers of persons with first-episode psychosis completed a series of questionnaires aimed at investigating the contribution of expressed emotion and metacognitions to caregiver distress. RESULTS Linear mixed model analysis found that emotional over-involvement and metacognitions independently predicted caregiver distress. Mediation analysis using bootstrapping showed that emotional over-involvement could be seen as mediating the effect of metacognitions on distress. CONCLUSION The current study is a first step towards understanding the role of metacognitions in caregiver distress, thus opening up for the possibility of using interventions from 'contextual behaviour therapies'. Implications and future studies are discussed. KEY PRACTITIONER MESSAGE This study is the first attempt to address caregiver concerns from the perspective of contextual cognitive behavioural therapy. The metacognitive framework for caregiver distress in first-episode psychosis may help develop new therapeutic interventions to better support families. The study proposes a psychological understanding of emotional over-involvement and caregiver distress.
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Affiliation(s)
- Jens Einar Jansen
- Early Psychosis Intervention Center, Zealand Region Psychiatry Roskilde, Roskilde, Denmark.,Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Susanne Harder
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Ulrik Helt Haahr
- Early Psychosis Intervention Center, Zealand Region Psychiatry Roskilde, Roskilde, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Hanne-Grethe Lyse
- Early Psychosis Intervention Center, Zealand Region Psychiatry Roskilde, Roskilde, Denmark
| | - Marlene Buch Pedersen
- Early Psychosis Intervention Center, Zealand Region Psychiatry Roskilde, Roskilde, Denmark
| | - Anne Marie Trauelsen
- Psychiatric Research Unit, Zealand Region Psychiatry Roskilde, Roskilde, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Erik Simonsen
- Psychiatric Research Unit, Zealand Region Psychiatry Roskilde, Roskilde, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Psychology and Educational Studies, Roskilde University, Roskilde, Denmark
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Perceptions of efficacy, expressed emotion, and the course of schizophrenia: the case of emotional overinvolvement. J Nerv Ment Dis 2013; 201:833-40. [PMID: 24080669 PMCID: PMC4167397 DOI: 10.1097/nmd.0b013e3182a5bf1d] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Although it is clear that expressed emotion (EE) is associated with the course of schizophrenia, proposed models for this association have struggled to account for the relationship between the EE index of emotional overinvolvement (EOI) and relapse. To expand our understanding of the EOI-relapse association, we first attempted to replicate the finding that the EOI-relapse association is curvilinear among 55 Mexican-Americans with schizophrenia and their caregiving relatives. Second, we evaluated whether the caregivers' perception of their ill relative's efficacy may account for the EOI-relapse association. Our results comport with past findings with regard to the curvilinear nature of the EOI-relapse association among Mexican-Americans and suggest that EOI may only seem to be a risk factor of relapse because of its strong association with a true risk factor for relapse (i.e., caregivers' perception of their ill relative's efficacy).
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Siller M, Hutman T, Sigman M. A parent-mediated intervention to increase responsive parental behaviors and child communication in children with ASD: a randomized clinical trial. J Autism Dev Disord 2013; 43:540-55. [PMID: 22825926 DOI: 10.1007/s10803-012-1584-y] [Citation(s) in RCA: 144] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Longitudinal research has demonstrated that responsive parental behaviors reliably predict subsequent language gains in children with autism spectrum disorder. To investigate the underlying causal mechanisms, we conducted a randomized clinical trial of an experimental intervention (Focused Playtime Intervention, FPI) that aims to enhance responsive parental communication (N = 70). Results showed a significant treatment effect of FPI on responsive parental behaviors. Findings also revealed a conditional effect of FPI on children's expressive language outcomes at 12-month follow up, suggesting that children with baseline language skills below 12 months (n = 24) are most likely to benefit from FPI. Parents of children with more advanced language skills may require intervention strategies that go beyond FPI's focus on responsive communication.
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Affiliation(s)
- Michael Siller
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA 90024, USA.
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Rogers CE, Lenze SN, Luby JL. Late preterm birth, maternal depression, and risk of preschool psychiatric disorders. J Am Acad Child Adolesc Psychiatry 2013; 52:309-18. [PMID: 23452687 PMCID: PMC3589137 DOI: 10.1016/j.jaac.2012.12.005] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2012] [Revised: 11/19/2012] [Accepted: 12/07/2012] [Indexed: 01/19/2023]
Abstract
OBJECTIVE Preterm children are at greater risk for psychiatric disorders, including anxiety disorders and attention-deficit/hyperactivity disorder (ADHD), than their term-born peers. Prior research has focused primarily on children born at early gestational ages. Less is known about the rate of psychiatric disorders among late preterm or early term children. In addition, whether a history of maternal depression also associated with prematurity has an impact on the risk for psychiatric disorders remains underexplored. METHOD Preschoolers between ages 3 and 6 years (N = 306) were recruited for a study examining preschool depression that included healthy and disruptive preschoolers. Preschoolers were placed in the following groups: late preterm (34-36 weeks, n = 39), early term (37-39 weeks, n = 78), and full term (40-41 weeks, n = 154). DSM-IV psychiatric disorders were assessed via the Preschool Age Psychiatric Assessment. Maternal history of psychiatric disorders was assessed using the Family Interview for Genetic Studies. RESULTS Late preterm children had higher rates of any Axis I psychiatric diagnosis (odds ratio = 3.18, 95% confidence interval = 1.09-4.76) and of any anxiety disorder (odds ratio = 3.74, 95% confidence interval = 1.59-8.78) than full term children after adjusting for gender, ethnicity, family income, and IQ. There were no differences in rates of psychiatric diagnoses between early term and full term children. A history of maternal depression mediated the relationship between late preterm birth and anxiety disorders in preschoolers. CONCLUSIONS Late preterm children were at increased risk for anxiety disorders at preschool age. A history of maternal depression mediated this association. Findings confirm the extension of the risk of psychiatric disorders associated with prematurity to the late preterm group, and suggest that maternal depression may play a key role in this risk trajectory.
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