Clinical and psychological factors associated with resilience in patients with schizophrenia: data from the Italian network for research on psychoses using machine learning

BACKGROUND

Resilience is defined as the ability to modify thoughts to cope with stressful events. Patients with schizophrenia (SCZ) having higher resilience (HR) levels show less severe symptoms and better real-life functioning. However, the clinical factors contributing to determine resilience levels in patients remain unclear. Thus, based on psychological, historical, clinical and environmental variables, we built a supervised machine learning algorithm to classify patients with HR or lower resilience (LR).

METHODS

SCZ from the Italian Network for Research on Psychoses (N = 598 in the Discovery sample, N = 298 in the Validation sample) underwent historical, clinical, psychological, environmental and resilience assessments. A Support Vector Machine algorithm (based on 85 variables extracted from the above-mentioned assessments) was built in the Discovery sample, and replicated in the Validation sample, to classify between HR and LR patients, within a nested, Leave-Site-Out Cross-Validation framework. We then investigated whether algorithm decision scores were associated with the cognitive and clinical characteristics of patients.

RESULTS

The algorithm classified patients as HR or LR with a Balanced Accuracy of 74.5% (p < 0.0001) in the Discovery sample, and 80.2% in the Validation sample. Higher self-esteem, larger social network and use of adaptive coping strategies were the variables most frequently chosen by the algorithm to generate decisions. Correlations between algorithm decision scores, socio-cognitive abilities, and symptom severity were significant (pFDR < 0.05).

CONCLUSIONS

We identified an accurate, meaningful and generalizable clinical-psychological signature associated with resilience in SCZ. This study delivers relevant information regarding psychological and clinical factors that non-pharmacological interventions could target in schizophrenia.

Stressful Life Events and Life Satisfaction among Chinese Older Adults: The Role of Coping Styles

This study aims to investigate the mediating effect of coping styles in the relationship between stressful life events and life satisfaction among Chinese older adults. To test the hypotheses, cross-sectional data (n = 8799) from the 2016 China Longitudinal Aging Social Survey (CLASS) were analyzed by Stata 15/SE in this study. Results indicated that stressful life events directly affected life satisfaction. Moreover, the association between stressful life events and life satisfaction was partially mediated by coping styles. This study had implications for the current body of knowledge and provided empirical evidence for social work practice and social policy.

Contributors to Women's Perceived Stress at the Start of Assisted Reproductive Technology

Clinicians are often called upon to treat the stress that accompanies Assisted Reproductive Technology (ART). In this study, we sought to examine the contribution of the internal resources of meaning in life and attachment style and the interpersonal resource of self-disclosure to her mother to a woman's level of perceived stress upon commencement of ART. In addition, we examined the association between age and perceived stress. The sample consisted of 180 Israeli women (106 aged 20-34; 74 aged 35-44) who completed a series of self-report questionnaires after their initial meeting with a fertility specialist. Regression analysis indicated that older age, lower attachment anxiety, higher perception of meaning in life, and greater self-disclosure to the mother were related to lower levels of perceived stress. Self-disclosure was also found to mediate the association between avoidant attachment and stress. The study highlights the importance of a woman's personal and interpersonal resources for reducing the experience of stress in the early stages of ART. The results have practical implications for the development of professional interventions seeking to enhance these resources among women embarking on fertility treatment.

Changes in mood after screening for antenatal anxiety and depression

BACKGROUND

Screening programmes with referral are a valuable strategy for mitigating consequences of perinatal depression on mothers and their families. The effectiveness of these screening programmes needs to be measured. One potential problem in assessing outcomes is measurement reactivity where the actual measure results in changes in the people being measured.

AIM

The aim of this article is to explain the mechanisms and circumstances by which measurement reactivity occurred in a sample of antenatal women who participated in a screening interview.

METHODS

Fifty-five women who participated in an antenatal screening interview in their second trimester were re-interviewed in their third trimester. These qualitative interviews were conducted between September 2015 and April 2016.

RESULTS

The qualitative data suggested that measurement reactivity occurred through mechanisms such as the disclosure, gaining self-knowledge, validation of experiences, and personal agency which resulted in them seeking out support from others.

CONCLUSION

Although the screening interview appeared to improve women's outcomes, this may have occurred through measurement reactivity. This needs to be considered when designing studies that aim to assess the effectiveness of screening with intervention for antenatal depression.

Communicative responses to the painful self-disclosures of familial and non-familial older adults

Data from 365 college students were used to assess young adults' communicative responses to older persons' painful self-disclosures (PSDs). Coupland, Coupland, and Giles (1991) proposed that recipients of PSD may respond to such disclosures via a variety of"next moves." These responses may broadly be considered to reflect forms of pro-social engagement, passive disengagement, and active disengagement. We investigated whether young adults' tendency to use certain responses to PSD were influenced by their affective reactions to PSD, their communicative background and characteristics, and the sociorelational context of the encounter in which PSD occurred. Results are discussed with respect to their implications for intergenerational interaction, and interpreted through the lens of communication accommodation theory.

A self-administered, mild form of exposure therapy for older adults

Despite the effectiveness of exposure therapy to alleviate trauma-related distress, many older adults are unable or unwilling to enter therapy. Mild forms of exposure therapy, such as completing memory questionnaires about a stressful event, have been shown to reduce distress in younger adults. This study attempted to examine the impact of a mild form of exposure therapy in an older adult population. A community-living sample of 263 older adults nominated a stressful event from their lives, and were randomly assigned to either complete questionnaires concerning their memory of the stressful event, or a control task. Results indicated that those who had completed the memory questionnaires about a nominated stressful event evidenced lower levels of distress two weeks later. This effect was stronger for events that were either more recent or had elevated initial levels of distress. These findings suggest an alternative treatment for older adults who have experienced a stressful or traumatic event.

Heading into fatherhood--nervously: support for fathering from online dads

Men are becoming increasingly aware of and keen about the promises of involved fathering, and there is growing recognition of the need to support fathers, especially in the postnatal period. However, there is limited evidence of how best to offer this support. In this article, we investigate a new avenue of support that is gaining popularity in the public health sector: the Internet. Using qualitative methods, we examine messages in an asynchronous online chat room for new fathers to reveal how fathers themselves requested, offered, and received social support. Features of their communication style included humor and self-disclosure. An emergent, overarching purpose of their communications was to make fathering more "visible," and to encourage each other to engage confidently and wholeheartedly in fathering.