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Tan ASC, Ali F, Poon KK. Subjective well-being of children with special educational needs: Longitudinal predictors using machine learning. Appl Psychol Health Well Being 2025; 17:e12625. [PMID: 39529312 DOI: 10.1111/aphw.12625] [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: 08/05/2024] [Accepted: 10/30/2024] [Indexed: 11/16/2024]
Abstract
Children with special educational needs (SEN) are a diverse group facing numerous challenges related to well-being and mental health. Understanding the predictors of well-being in this population requires the incorporation of diverse factors along with approaches that can uncover complexity in how these factors work together to influence well-being. We longitudinally predicted subjective well-being in a group of children with diverse special educational needs (N = 499; M = 8.4 ± 0.9 years). Thirty-two variables - ranging from demographics to various categories of life experiences - were used as predictors for both nonlinear machine learning and classical linear classifiers. Nonlinear machine learning classifiers exhibited much performance in predicting subjective well-being (F1 score = 0.72 to 0.84) compared to traditional linear classifiers. Overall, across all children, prior subjective well-being, numeracy, literacy skills, and interpersonal dimensions played important roles. However, clustering further identified four distinct clusters sharing important predictors: a 'socializer' cluster dominated by interpersonal functioning predictors, an 'analyzer' cluster emphasizing academic skills predictors, and two clusters with more diverse sets of important predictors. Our research highlights the multiple pathways toward well-being in children with SEN as uncovered by machine learning, with implications for understanding and supporting their well-being.
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Affiliation(s)
- Amanda Swee-Ching Tan
- Learning Sciences and Assessment, National Institute of Education, Nanyang Technological University, Singapore
| | - Farhan Ali
- Learning Sciences and Assessment, National Institute of Education, Nanyang Technological University, Singapore
| | - Kenneth K Poon
- Psychology and Child & Human Development, National Institute of Education, Nanyang Technological University, Singapore
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2
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Omar M, Levkovich I. Exploring the efficacy and potential of large language models for depression: A systematic review. J Affect Disord 2025; 371:234-244. [PMID: 39581383 DOI: 10.1016/j.jad.2024.11.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2024] [Revised: 10/21/2024] [Accepted: 11/15/2024] [Indexed: 11/26/2024]
Abstract
BACKGROUND AND OBJECTIVE Depression is a substantial public health issue, with global ramifications. While initial literature reviews explored the intersection between artificial intelligence (AI) and mental health, they have not yet critically assessed the specific contributions of Large Language Models (LLMs) in this domain. The objective of this systematic review was to examine the usefulness of LLMs in diagnosing and managing depression, as well as to investigate their incorporation into clinical practice. METHODS This review was based on a thorough search of the PubMed, Embase, Web of Science, and Scopus databases for the period January 2018 through March 2024. The search used PROSPERO and adhered to PRISMA guidelines. Original research articles, preprints, and conference papers were included, while non-English and non-research publications were excluded. Data extraction was standardized, and the risk of bias was evaluated using the ROBINS-I, QUADAS-2, and PROBAST tools. RESULTS Our review included 34 studies that focused on the application of LLMs in detecting and classifying depression through clinical data and social media texts. LLMs such as RoBERTa and BERT demonstrated high effectiveness, particularly in early detection and symptom classification. Nevertheless, the integration of LLMs into clinical practice is in its nascent stage, with ongoing concerns about data privacy and ethical implications. CONCLUSION LLMs exhibit significant potential for transforming strategies for diagnosing and treating depression. Nonetheless, full integration of LLMs into clinical practice requires rigorous testing, ethical considerations, and enhanced privacy measures to ensure their safe and effective use.
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Affiliation(s)
- Mahmud Omar
- Tel-Aviv University, Faculty of Medicine, Israel.
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3
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Clark E, Brown T, Yu ML. Interoception and its application to paediatric occupational therapy: A scoping review. Aust Occup Ther J 2025; 72:e12997. [PMID: 39505563 DOI: 10.1111/1440-1630.12997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 08/13/2024] [Accepted: 09/23/2024] [Indexed: 11/08/2024]
Abstract
INTRODUCTION Paediatric occupational therapists assess and provide intervention for children presenting with sensory processing challenges that impact their daily occupational performance. Interoception, the ability to sense internal body signals, is an emerging practice area, yet it remains unclear how and why paediatric clinicians are applying interoception and related concepts in practice. METHODS A scoping review was conducted to report on the current body of published literature related to interoception and its application to paediatric occupational therapy practice. A comprehensive search of 10 electronic databases and related grey literature was conducted. Title and abstract screening were completed prior to full-text review of evidence. The PRISMA-ScR Checklist and the Crowe Critical Appraisal Tool were used to support a systematic scoping review process and increase robust extraction and appraisal of data. Narrative synthesis was used to analyse and synthesise data. CONSUMER AND COMMUNITY INVOLVEMENT No consumer and community involvement. RESULTS A total of 18 articles were included in this review, including original research articles (n = 8), published books (n = 4), theses/dissertations (n = 3), opinion pieces (n = 2), and one government document. Narrative synthesis analysis identified six themes: (1) occupational therapy principles relevant to interoception, (2) what is interoception?, (3) assessment of interoception, (4) clinical application of interoception, (5) clinical populations receiving interoception-based intervention, and (6) relationships between interoception and other performance components. Findings indicated that paediatric occupational therapists are integrating interoception concepts alongside occupational therapy principles to inform assessment and intervention processes. Several assessments and interventions are utilised to support children; however, evidence to strengthen use is lacking. Further, there are limited occupation-based assessments and intervention programs to address interoception deficits in children. CONCLUSION Findings from this scoping review contribute to the emerging body of empirical evidence related to interoception and paediatric occupational therapy practice. These findings provide an informed basis for practice and research by occupational therapists in this area. PLAIN LANGUAGE SUMMARY Interoception allows us to feel what is going on inside our body and helps us to notice how our body might be feeling (e.g. if our stomach grumbles, we might feel hungry; if our heart is beating very fast, we might feel scared; if we are sweating, our body is feeling overheated). Some children may present with problems recognising interoceptive feelings in their bodies. Therefore, occupational therapists can help children learn about their own interoception related to their bodies. This is a new topic for therapists, and they need to know more about it so that they best help children and their families. There is not a lot of information about how to use interoception in occupational therapy practice, and we wanted to know what information already exists about interoception and occupational therapy. This review provides a summary of the current knowledge that is available and summarises it. Some information about interoception and how it relates to occupational therapy services with children was found, but more research knowledge about this topic is needed.
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Affiliation(s)
- Emma Clark
- Department of Occupational Therapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Peninsula Campus, Frankston, Victoria, Australia
- Occupational Science and Therapy Program, School of Health and Social Development, Faculty of Health, Deakin University, Waterfront Campus, Geelong, Victoria, Australia
| | - Ted Brown
- Department of Occupational Therapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Peninsula Campus, Frankston, Victoria, Australia
| | - Mong-Lin Yu
- Department of Occupational Therapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Peninsula Campus, Frankston, Victoria, Australia
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Iorfino F, Oliveira R, Cripps S, Marchant R, Varidel M, Capon W, Crouse JJ, Prodan A, Scott EM, Scott J, Hickie IB. A prognostic model for predicting functional impairment in youth mental health services. Eur Psychiatry 2024; 67:e87. [PMID: 39697104 DOI: 10.1192/j.eurpsy.2024.1787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2024] Open
Abstract
BACKGROUND Functional impairment is a major concern among those presenting to youth mental health services and can have a profound impact on long-term outcomes. Early recognition and prevention for those at risk of functional impairment is essential to guide effective youth mental health care. Yet, identifying those at risk is challenging and impacts the appropriate allocation of indicated prevention and early intervention strategies. METHODS We developed a prognostic model to predict a young person's social and occupational functional impairment trajectory over 3 months. The sample included 718 young people (12-25 years) engaged in youth mental health care. A Bayesian random effects model was designed using demographic and clinical factors and model performance was evaluated on held-out test data via 5-fold cross-validation. RESULTS Eight factors were identified as the optimal set for prediction: employment, education, or training status; self-harm; psychotic-like experiences; physical health comorbidity; childhood-onset syndrome; illness type; clinical stage; and circadian disturbances. The model had an acceptable area under the curve (AUC) of 0.70 (95% CI, 0.56-0.81) overall, indicating its utility for predicting functional impairment over 3 months. For those with good baseline functioning, it showed excellent performance (AUC = 0.80, 0.67-0.79) for identifying individuals at risk of deterioration. CONCLUSIONS We developed and validated a prognostic model for youth mental health services to predict functional impairment trajectories over a 3-month period. This model serves as a foundation for further tool development and demonstrates its potential to guide indicated prevention and early intervention for enhancing functional outcomes or preventing functional decline.
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Affiliation(s)
- Frank Iorfino
- Brain and Mind Centre, The University of Sydney, Camperdown, NSWAustralia
| | - Rafael Oliveira
- Brain and Mind Centre, The University of Sydney, Camperdown, NSWAustralia
- Data61, CSIRO, Sydney, NSWAustralia
| | - Sally Cripps
- Human Technology Institute, University of Technology Sydney, Sydney, NSWAustralia
- School of Mathematical and Physical Sciences, University of Technology Sydney, Sydney, NSW, Australia
| | - Roman Marchant
- Human Technology Institute, University of Technology Sydney, Sydney, NSWAustralia
- School of Mathematical and Physical Sciences, University of Technology Sydney, Sydney, NSW, Australia
| | - Mathew Varidel
- Brain and Mind Centre, The University of Sydney, Camperdown, NSWAustralia
| | - William Capon
- Brain and Mind Centre, The University of Sydney, Camperdown, NSWAustralia
| | - Jacob J Crouse
- Brain and Mind Centre, The University of Sydney, Camperdown, NSWAustralia
| | - Ante Prodan
- Brain and Mind Centre, The University of Sydney, Camperdown, NSWAustralia
- Translational Health Research Institute, Western Sydney University, Sydney, NSWAustralia
- School of Computer, Data and Mathematical Sciences, Western Sydney University, Sydney, NSWAustralia
| | - Elizabeth M Scott
- Brain and Mind Centre, The University of Sydney, Camperdown, NSWAustralia
| | - Jan Scott
- Academic Psychiatry, Institute of Neuroscience, Newcastle University, Newcastle, UK
| | - Ian B Hickie
- Brain and Mind Centre, The University of Sydney, Camperdown, NSWAustralia
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Osicka DA, Hao J, Tiles-Sar N, Ali MP, Bruggeman R, van der Meer L, Alizadeh BZ. Life-course perspective on the causal mechanism of social functioning in schizophrenia spectrum disorder. Int J Soc Psychiatry 2024:207640241298894. [PMID: 39699090 DOI: 10.1177/00207640241298894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2024]
Abstract
BACKGROUND Due to prior emphasis on clinical recovery in Schizophrenia Spectrum Disorder (SSD), improving social functioning (SF) was oftentimes neglected, with ⩽15% of patients achieving social recovery. Priorly, we and others have shown that life-course factors, including childhood adversities, play a role in the occurrence and severity of postmorbid SF impairments, highlighting the need to understand these factors for effective interventions. AIM This study investigates the mechanisms influencing SF in SSD and examines the causal roles of childhood trauma, premorbid adjustment, perceived stigma, self-esteem, and quality of life. METHODS This longitudinal study utilized data of 1,057 SSD patients, with measures at baseline, 3 and 6-year follow-up, from the Genetic Risk and Outcome of Psychosis cohort, to unravel the causal mechanism underlying SF utilizing Structural Equation Modeling. Determinants were assessed using validated retrospective and self-report questionnaires. Model development and testing involved a multistage process, encompassing relationships exploration, fit evaluation and model comparison. RESULTS We developed a probable causal model. Impaired premorbid adjustment emerged as a crucial factor, exerting negative influence on long-term SF, with a direct effect of β = -.252, p < .001 on SF at 3-year follow-up and β = -.056, p = .073 at 6-year follow-up. Childhood trauma exhibited a negative direct effect on SF at 3-year follow-up (β = -.087, p = .039), while demonstrating a substantial carry-over, indirect effect. Elevated perceived stigma negatively affected SF at 3-year follow-up (β = -.112, p = .008). The model explained 9.9% of SF variation at the 3-year follow-up and 54.3% at the 6-year follow-up. CONCLUSIONS While validation is necessary, we found a foundational basis for causal interpretation. Premorbid adjustment, childhood trauma, and perceived stigma are essential life-course factors shaping postmorbid SF in SSD. We recommend interventions covering both prevention and treatment for individuals with established symptoms-addressing childhood trauma, premorbid adjustment, and perceived stigma-to enhance long-term social outcomes and offer actionable insights for clinicians.
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Affiliation(s)
- Dominika A Osicka
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, The Netherlands
| | - Jiasi Hao
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, The Netherlands
| | - Natalia Tiles-Sar
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, The Netherlands
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, The Netherlands
| | - Mariam P Ali
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, The Netherlands
| | - Richard Bruggeman
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, The Netherlands
| | - Lisette van der Meer
- Department of Clinical and Developmental Neuropsychology, University of Groningen, The Netherlands
- Department of Psychiatric Rehabilitation, Lentis Psychiatric Institute, Zuidlaren, The Netherlands
| | - Behrooz Z Alizadeh
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, The Netherlands
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, The Netherlands
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Kaoser R, Thakore P, Peterson S, Wiedmeyer ML, Sierra-Heredia C, Goldenberg S, Machado S, Hagos S, Tayyar E, Bozorgi Y, Lavergne MR. The relationship between neighbourhood income and youth mental health service use differs by immigration experience: analysis of population-based data in British Columbia, Canada. Int J Equity Health 2024; 23:270. [PMID: 39696392 DOI: 10.1186/s12939-024-02352-8] [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: 04/25/2024] [Accepted: 12/02/2024] [Indexed: 12/20/2024] Open
Abstract
BACKGROUND We investigated the relationship between neighbourhood income quintile and mental health service use by immigration experience among youth and explored changes during the COVID-19 pandemic. METHOD We used administrative data to examine mental health service use among youth aged 10 to 24 in British Columbia, Canada, between April 1, 2019, and March 31, 2022. We compared rates of community-based mental health service use, emergency department visits, and hospitalizations and the proportion of involuntary admissions by neighbourhood income quintile and immigration. We used models stratified by immigration to estimate the relationship with income. RESULTS Non-immigrant youth used substantially more services than immigrant youth. Service use increased following the pandemic's start and peaked between January and March 2021. We observed a clear income gradient for community-based service use among both immigrant and non-immigrant youth, but the direction of the gradient was reversed. Service use was highest among non-immigrant youth in lower-income neighbourhoods and lowest for immigrant youth in lower-income neighbourhoods. We observed similar patterns of income gradient for non-immigrant youth for emergency department visits and hospitalization. The proportion of involuntary admissions was higher for immigrant youth. CONCLUSIONS Mental health service use was substantially lower among immigrant youth than non-immigrant youth, but higher proportions of immigrant youth were hospitalized involuntarily. The reverse income gradient patterns observed for community-mental health service use are noteworthy and suggest significant barriers to accessing preventable care among immigrant youth, particularly those living in lower-income neighbourhoods.
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Affiliation(s)
- Ridhwana Kaoser
- Faculty of Health Sciences, Simon Fraser University, 515 W Hastings St, Vancouver, BC, V6B 5K3, Canada
| | - Padmini Thakore
- Centre for Gender & Sexual Health Equity, UBC Faculty of Medicine, 1190 Hornby St, Vancouver, BC, V6Z 2K5, Canada
| | - Sandra Peterson
- Centre for Health Services and Policy Research, University of British Columbia, 201-2206 East Mall, Vancouver, BC, V6T 1Z3, Canada
| | - Mei-Ling Wiedmeyer
- Centre for Gender & Sexual Health Equity, UBC Faculty of Medicine, 1190 Hornby St, Vancouver, BC, V6Z 2K5, Canada
- Department of Family Practice, University of British Columbia, 3rd Floor David Strangway Building 5950 University Boulevard, Vancouver, BC, V6T 1Z3, Canada
| | - Cecilia Sierra-Heredia
- Faculty of Health Sciences, Simon Fraser University, 515 W Hastings St, Vancouver, BC, V6B 5K3, Canada
| | - Shira Goldenberg
- Centre for Gender & Sexual Health Equity, UBC Faculty of Medicine, 1190 Hornby St, Vancouver, BC, V6Z 2K5, Canada
- School of Public Health, San Diego State University, 5500 Campanile Dr, San Diego, CA, 92182, USA
| | - Stefanie Machado
- Centre for Gender & Sexual Health Equity, UBC Faculty of Medicine, 1190 Hornby St, Vancouver, BC, V6Z 2K5, Canada
- Department of Family Medicine, Dalhousie University, 1465 Brenton Street, Suite 402, Halifax, NS, B3J 3T4, Canada
| | - Selamawit Hagos
- Centre for Gender & Sexual Health Equity, UBC Faculty of Medicine, 1190 Hornby St, Vancouver, BC, V6Z 2K5, Canada
| | - Elmira Tayyar
- Centre for Gender & Sexual Health Equity, UBC Faculty of Medicine, 1190 Hornby St, Vancouver, BC, V6Z 2K5, Canada
| | - Yasmin Bozorgi
- Centre for Gender & Sexual Health Equity, UBC Faculty of Medicine, 1190 Hornby St, Vancouver, BC, V6Z 2K5, Canada
| | - M Ruth Lavergne
- Department of Family Medicine, Dalhousie University, 1465 Brenton Street, Suite 402, Halifax, NS, B3J 3T4, Canada.
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Read RW, Schlauch KA, Elhanan G, Neveux I, Koning S, Cooper T, Grzymski JJ. A study of impulsivity and adverse childhood experiences in a population health setting. Front Public Health 2024; 12:1447008. [PMID: 39697282 PMCID: PMC11652370 DOI: 10.3389/fpubh.2024.1447008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2024] [Accepted: 11/15/2024] [Indexed: 12/20/2024] Open
Abstract
As complex mental health traits and life histories are often poorly captured in hospital systems, the utility of using the Barratt Impulsivity Scale (BIS) and Adverse Childhood Experiences (ACEs) for assessing adult disease risks is unknown. Here, we use participants from the Healthy Nevada Project (HNP) to determine if two standard self-assessments could predict the incidence and onset of disease. We conducted a retrospective cohort study involving adult participants who completed the Behavioral and Mental Health Self-Assessment (HDSA) between September 2018 and March 2024. Impulsivity levels were measured using the BIS-15, and retrospective self-reports of ACEs were collected through a standardized questionnaire. In total, 17,482 HNP participants completed the HDSA. Our findings indicate that ACEs were significantly associated with impulsivity. Disease associations with impulsivity and ACEs were evaluated using a phenome-wide association study, identifying 230 significant associations with impulsivity. Among these, 44 were related to mental health diagnoses, including major depressive disorder (MDD). Kaplan-Meier survival estimates characterized the differences in the lifetime predicted probability between high and low impulsivity for major depressive disorder and essential hypertension. This analysis showed that having both high ACEs and high impulsivity confer substantial risk of MDD diagnosis (hazard ratios 2.81, 2.17, respectively). Additionally, lifetime predicted probability of MDD was approximately 40% higher for high ACEs and high impulsivity compared to no ACEs and low impulsivity. Essential hypertension demonstrated similar trends, with an approximate 20% increase in predicted lifetime probability of diagnosis. These results demonstrate that high ACES and elevated impulsivity scores are associated with a range of negative health outcomes and a simple self-assessment of complex traits and life history may significantly impact clinical risk assessments.
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Affiliation(s)
- Robert W. Read
- Department of Internal Medicine, School of Medicine, University of Nevada, Reno, Reno, NV, United States
| | - Karen A. Schlauch
- Department of Internal Medicine, School of Medicine, University of Nevada, Reno, Reno, NV, United States
| | - Gai Elhanan
- Department of Internal Medicine, School of Medicine, University of Nevada, Reno, Reno, NV, United States
| | - Iva Neveux
- Department of Internal Medicine, School of Medicine, University of Nevada, Reno, Reno, NV, United States
| | - Stephanie Koning
- Department of Health Behavior, Policy, and Administrative Sciences, School of Public Health, University of Nevada, Reno, Reno, NV, United States
| | - Takeesha Cooper
- Renown Health, Reno, NV, United States
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Nevada, Reno, Reno, NV, United States
| | - Joseph J. Grzymski
- Department of Internal Medicine, School of Medicine, University of Nevada, Reno, Reno, NV, United States
- Renown Health, Reno, NV, United States
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Wissow LS, Richardson LP. A "Next Generation" of Pediatric Mental Health Systems. Pediatr Clin North Am 2024; 71:1165-1182. [PMID: 39433385 DOI: 10.1016/j.pcl.2024.07.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2024]
Abstract
An optimistic view of the future child/youth mental health system is that it will be oriented toward prevention and shaped by innovations in early detection and treatment of functional problems, coupled with the power of digital technology to provide new ways to help individuals and families monitor their well-being and seek or agree to help as it is needed. These innovations will be deployed within a community-based health care system, centered on primary care that fully implements ideas about continuity and comprehensiveness (including social determinants, substance use, and multigenerational care) that have been around for decades.
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Affiliation(s)
- Lawrence S Wissow
- Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, Seattle, WA, USA.
| | - Laura P Richardson
- Department of Pediatrics, School of Medicine, University of Washington, Seattle, WA, USA
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Carlsson IM, Bräutigam Ewe M, Nymberg P, Jormfeldt H. Building up bit by bit, parent's experiences of equine-assisted intervention among children and adolescents with mental illness: a grounded theory study. Int J Qual Stud Health Well-being 2024; 19:2354945. [PMID: 38758980 PMCID: PMC11104696 DOI: 10.1080/17482631.2024.2354945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 05/09/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND Mental ill health among children and adolescents has increased worldwide. Mental health difficulties from a young age are associated with school absence and educational underachievement. A holistic perspective of treatments besides medical treatment is essential Thus, there is a need for research regarding equine-assisted intervention (EAI). PURPOSE The present study aimed to understand the outcomes of an equine-assisted intervention for children and adolescents with mental ill health from the perspectives of parents and close relatives. METHODS This study used a qualitative research design informed by Charmaz's Grounded Theory, with a purposive sample including six in-depth interviews. RESULTS The theory "building up bit by bit" was constructed, explaining the recognition that their children/adolescents were built up bit by bit and created a stronger self-identity. The participants referred to changes in the child's or adolescent's way of being and emotional regulation, which constituted building blocks leading to the child's or adolescent's 1. increased Harmony. 2. enhanced Self-identity, and 3. improved Capability. CONCLUSION Parents and close relatives experienced that their child or adolescent was built up bit by bit and gained a stronger foundation to stand on. This led to increased harmony in everyday life with stronger self-worth, better performance, and reduced school absenteeism.
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Affiliation(s)
| | | | - Peter Nymberg
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
- Center for Primary Health Care Research, Region Skåne: Helsingborg/Malmö, Skåne, Sweden
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10
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Valeria S, Francesco T, Sonia A, Laura VP, Luca C, Marcello S, Roberta L, Patrizia P, Arnau BG, Roberto F, Miriam M. Sex-specific maladaptive responses to acute stress upon in utero THC exposure are mediated by dopamine. Pharmacol Res 2024; 210:107536. [PMID: 39622370 DOI: 10.1016/j.phrs.2024.107536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2024] [Revised: 11/04/2024] [Accepted: 11/29/2024] [Indexed: 12/20/2024]
Abstract
Cannabis remains by far the most consumed illicit drug in Europe. The availability of more potent cannabis has raised concerns regarding the enhanced health risks associated with its use, particularly among pregnant women. Growing evidence shows that cannabis use during pregnancy increases the risks of child psychopathology. We have previously shown that only male rat offspring prenatally exposed to Δ9-tetrahydrocannabinol (THC), a rat model of prenatal cannabinoid exposure (PCE), display a hyperdopaminergic phenotype associated with a differential susceptibility to acute THC- and stress-mediated effects on sensorimotor gating functions. Here, we explore the contribution of the hypothalamic-pituitary-adrenal (HPA) axis, key regulator of body adaptive stress responses, to the detrimental effects of acute stress on ventral tegmental area (VTA) dopamine neurons and sensorimotor gating function of PCE rats. We report a sex-dependent compromised balance in mRNA levels of genes encoding mineralocorticoid and glucocorticoid receptors in the VTA, alongside with stress-induced pre-pulse inhibition (PPI) impairment. Notably, VTA dopamine neuronal activity is causally linked to the manifestation of stress-dependent deterioration of PPI. Finally, pharmacological manipulations targeting glycogen-synthase-kinase-3-β signaling during postnatal development correct these stress-induced, sex-specific and dopamine-dependent disruption of PPI. Collectively, these results highlight the critical sex-dependent interplay between HPA axis and dopamine system in the regulation of sensorimotor gating functions in rats.
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Affiliation(s)
- Serra Valeria
- Dept. Biomedical Sciences, Div. Neuroscience and Clinical Pharmacology, University of Cagliari, Italy
| | - Traccis Francesco
- Dept. Biomedical Sciences, Div. Neuroscience and Clinical Pharmacology, University of Cagliari, Italy
| | - Aroni Sonia
- Dept. Biomedical Sciences, Div. Neuroscience and Clinical Pharmacology, University of Cagliari, Italy
| | | | - Concas Luca
- Dept. Biomedical Sciences, Div. Neuroscience and Clinical Pharmacology, University of Cagliari, Italy
| | - Serra Marcello
- Dept. Biomedical Sciences, Div. Neuroscience and Clinical Pharmacology, University of Cagliari, Italy
| | - Leone Roberta
- Dept. Biomedical Sciences, Div. Neuroscience and Clinical Pharmacology, University of Cagliari, Italy
| | - Porcu Patrizia
- Institute of Neurosciences, National Research Council (C.N.R.), Cagliari, Italy
| | | | - Frau Roberto
- Dept. Biomedical Sciences, Div. Neuroscience and Clinical Pharmacology, University of Cagliari, Italy
| | - Melis Miriam
- Dept. Biomedical Sciences, Div. Neuroscience and Clinical Pharmacology, University of Cagliari, Italy.
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11
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Aljuwaiser S, Brazzelli M, Arain I, Poobalan A. Common mental health problems in medical students and junior doctors - an overview of systematic reviews. J Ment Health 2024; 33:779-815. [PMID: 37933550 DOI: 10.1080/09638237.2023.2278095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Revised: 08/10/2023] [Accepted: 09/24/2023] [Indexed: 11/08/2023]
Abstract
BACKGROUND Common mental health problems (CMHP) are prevalent among junior doctors and medical students, and the COVID-19 pandemic has brought challenging situations with education disruptions, early graduations, and front-line work. CMHPs can have detrimental consequences on clinical safety and healthcare colleagues; thus, it is vital to assess the overall prevalence and available interventions to provide institutional-level support. AIMS This overview summarises the prevalence of CMHPs from existing published systematic reviews and informs public health prevention and early intervention practice. METHODS Four electronic databases were searched from 2012 to identify systematic reviews on the prevalence of CMHPs and/or interventions to tackle them. RESULTS Thirty-six reviews were included: 25 assessing prevalence and 11 assessing interventions. Across systematic reviews, the prevalence of anxiety ranged from 7.04 to 88.30%, burnout from 7.0 to 86.0%, depression from 11.0 to 66.5%, stress from 29.6 to 49.9%, suicidal ideation from 3.0 to 53.9% and one obsessive-compulsive disorder review reported a prevalence of 3.8%. Mindfulness-based interventions were included in all reviews, with mixed findings for each CMHP. CONCLUSIONS The prevalence of CMHPs is high among junior doctors and medical students, with anxiety remaining relatively stable and depression slightly increasing during the COVID-19 pandemic. Future research on mindfulness-based interventions is required for a resilient and healthy future workforce. PRISMA/PROSPERO the researchers have followed PRISMA guidance. This overview was not registered with PROSPERO as it was conducted as part of an MSc research project.
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Affiliation(s)
- Sameera Aljuwaiser
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | - Miriam Brazzelli
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | - Imran Arain
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | - Amudha Poobalan
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
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12
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Song H, Qiu SS, Zhao B, Liu X, Tseng YT, Wang L. A Machine Learning Approach for Behavioral Recognition of Stress Levels in Mice. Neurosci Bull 2024; 40:1950-1954. [PMID: 39227540 PMCID: PMC11625035 DOI: 10.1007/s12264-024-01291-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 05/24/2024] [Indexed: 09/05/2024] Open
Affiliation(s)
- Hao Song
- College of Electronic and Information Engineering, Hebei University, Baoding, 071002, China
- Key Laboratory of Digital Medical Engineering of Hebei, Hebei University, Baoding, 071002, China
| | - Shirley Shimin Qiu
- CAS Key Laboratory of Brain Connectome and Manipulation, Shenzhen-Hong Kong Institute of Brain Science, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
- Guangdong Provincial Key Laboratory of Brain Connectome and Behavior, the Brain Cognition and Brain Disease Institute, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
| | - Binghao Zhao
- CAS Key Laboratory of Brain Connectome and Manipulation, Shenzhen-Hong Kong Institute of Brain Science, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
- Guangdong Provincial Key Laboratory of Brain Connectome and Behavior, the Brain Cognition and Brain Disease Institute, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
| | - Xiuling Liu
- College of Electronic and Information Engineering, Hebei University, Baoding, 071002, China.
- Key Laboratory of Digital Medical Engineering of Hebei, Hebei University, Baoding, 071002, China.
| | - Yu-Ting Tseng
- CAS Key Laboratory of Brain Connectome and Manipulation, Shenzhen-Hong Kong Institute of Brain Science, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China.
- Guangdong Provincial Key Laboratory of Brain Connectome and Behavior, the Brain Cognition and Brain Disease Institute, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China.
| | - Liping Wang
- CAS Key Laboratory of Brain Connectome and Manipulation, Shenzhen-Hong Kong Institute of Brain Science, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China.
- Guangdong Provincial Key Laboratory of Brain Connectome and Behavior, the Brain Cognition and Brain Disease Institute, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China.
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13
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Bégin V, Vergunst F, Haeck C, Vitaro F, Tremblay RE, Côté SM, Fontaine NMG. Childhood behavior problems and adverse economic outcomes: a 30-year population-based study of intergenerational income mobility. J Child Psychol Psychiatry 2024; 65:1554-1563. [PMID: 38659297 DOI: 10.1111/jcpp.13992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/28/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND The objectives of this study were to (a) assess the associations between early behavioral problems and intergenerational income mobility (i.e., the degree to which income status is transmitted from one generation to the next), (b) verify whether these associations are moderated by child sex, and (c) explore indirect effects of early behavioral problems on income mobility via high school graduation. METHODS Data were drawn from the Quebec Longitudinal Study of Kindergarten Children (n = 3,020; 49.17% girls). Participants were followed from age 6 to 37 years. Measures included parents' and teachers' ratings of behavioral problems at age 6 years as well as participants' (ages 30-35 years) and their parents' (when participants were aged 10-19 years) income data obtained from tax return records. Regression models were used to predict upward and downward mobility (i.e., increased or decreased income status from one generation to the next) from attention-deficit/hyperactivity problems, conduct/opposition problems, depression/anxiety problems, prosociality, and the quality of children's relationship with their caregiver. Two-way interaction effects between behavioral problems and child sex were examined and indirect effect models including high school graduation as a mediator of these associations were conducted. RESULTS Despite their higher educational attainment, females had lower incomes and experienced lower upward (but higher downward) income mobility than males. For both females and males, higher levels of attention-deficit/hyperactivity and conduct/opposition problems were associated with decreased odds of upward mobility, whereas higher levels of attention-deficit/hyperactivity were associated with increased odds of downward mobility. Attention-deficit/hyperactivity problems, conduct/opposition problems as well as low prosociality were associated with lower educational attainment (no high school diploma), which in turn was associated with increased odds of downward mobility. CONCLUSIONS Results highlight the importance of providing intensive support to children with early behavioral problems as a means of improving educational attainment and intergenerational income mobility.
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Affiliation(s)
- Vincent Bégin
- Department of Psychoeducation, University of Sherbrooke, Sherbrooke, QC, Canada
- Group for Research and Intervention on Children's Social Adjustment, Sherbrooke, QC, Canada
- Research Unit on Children's Psychosocial Maladjustment, Montreal, QC, Canada
| | - Francis Vergunst
- Research Unit on Children's Psychosocial Maladjustment, Montreal, QC, Canada
- Special Needs Education, University of Oslo, Oslo, Norway
- Sainte-Justine University Hospital Research Center, Montreal, QC, Canada
- School of Public Health, University of Montreal, Montreal, QC, Canada
| | - Catherine Haeck
- Research Unit on Children's Psychosocial Maladjustment, Montreal, QC, Canada
- Research Group on Human Capital, Montreal, QC, Canada
- Department of Economics, Université du Québec à Montréal, Montreal, QC, Canada
| | - Frank Vitaro
- Research Unit on Children's Psychosocial Maladjustment, Montreal, QC, Canada
- Sainte-Justine University Hospital Research Center, Montreal, QC, Canada
- School of Psychoeducation, University of Montreal, Montreal, QC, Canada
| | - Richard E Tremblay
- Research Unit on Children's Psychosocial Maladjustment, Montreal, QC, Canada
- Sainte-Justine University Hospital Research Center, Montreal, QC, Canada
- Department of Psychology, University of Montreal, Montreal, QC, Canada
- Department of Pediatrics, University of Montreal, Montreal, QC, Canada
- School of Public Health, Physiotherapy & Population Science, University College Dublin, Dublin, Ireland
| | - Sylvana M Côté
- Research Unit on Children's Psychosocial Maladjustment, Montreal, QC, Canada
- Sainte-Justine University Hospital Research Center, Montreal, QC, Canada
- School of Public Health, University of Montreal, Montreal, QC, Canada
| | - Nathalie M G Fontaine
- Research Unit on Children's Psychosocial Maladjustment, Montreal, QC, Canada
- School of Criminology, University of Montreal, Montreal, QC, Canada
- Centre interdisciplinaire de recherche sur le cerveau et l'apprentissage, Montreal, QC, Canada
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14
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Raknes S, Townsend D, Ghostine C, Hammoud M. Expanding Access to Mental Health: Evaluating the Potential of a Serious Mental Health Game for Adolescents. CYBERPSYCHOLOGY, BEHAVIOR AND SOCIAL NETWORKING 2024; 27:873-880. [PMID: 39344801 DOI: 10.1089/cyber.2023.0688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/01/2024]
Abstract
Digital technologies are important for expanding access to mental health support in low-resource settings. The current study tests the feasibility of a blended learning mental health intervention that was implemented for adolescents in Lebanon (N = 1,234), most of whom were Syrian refugees. The intervention features a digital game called The Helping Hand, which teaches adolescents how to respond to psychosocial challenges healthily and develop effective coping strategies. The blended learning intervention was tested using a single-arm, non-blinded, mixed-methods approach, through the analysis of pre-post questionnaires and key informant interviews. Results showed that the intervention was well accepted and popular among participating adolescents and the team that implemented it. After completing the intervention, adolescents showed a significant decrease in anxiety and depression symptoms and a significant increase in overall well-being. The feasibility and potential impact observed in this study demonstrate the benefits of continuing to refine and expand digital interventions that improve access to mental health support for vulnerable populations.
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Affiliation(s)
| | - Dana Townsend
- Syrian American Medical Society (SAMS) Foundation, Washington, District of Columbia, USA
| | - Charbel Ghostine
- Syrian American Medical Society (SAMS) Foundation, Beirut, Lebanon
| | - Mahmoud Hammoud
- Syrian American Medical Society (SAMS) Foundation, Beirut, Lebanon
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15
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Zezai D, van Rensburg AJ, Babatunde GB, Kathree T, Cornick R, Levitt N, Fairall LR, Petersen I. Barriers and facilitators for strengthening primary health systems for person-centred multimorbid care in low-income and middle-income countries: a scoping review. BMJ Open 2024; 14:e087451. [PMID: 39608990 PMCID: PMC11603689 DOI: 10.1136/bmjopen-2024-087451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Accepted: 10/22/2024] [Indexed: 11/30/2024] Open
Abstract
OBJECTIVE To understand barriers and facilitators for strengthening health systems for person-centred care of people with multiple long-term conditions-multimorbidity (MLTC-M) at the primary healthcare (PHC) level in low-income and middle-income countries (LMICs). DESIGN A scoping review. METHODS We adopted a systematic scoping review approach to chart literature guided by Arksey and O'Malley's methodological framework. The review focused on studies conducted in LMICs' PHC settings from January 2010 to December 2023. Papers were extracted from the following databases: PubMed, EBSCOhost and Google Scholar. Framework analysis was undertaken to identify barriers and facilitators for strengthening MLTC-M primary care according to the five health system pillars in the Lancet Global Health Commission on High-Quality Health Systems Framework. RESULTS The literature search yielded 4322 citations, evaluated 202 studies and identified 36 for inclusion. Key barriers within the people pillar included poverty, low health education and low health literacy; within the platform pillar, fragmented services and lack of multimorbid care guidelines were mentioned; within the workforce pillar, lack of required skills and insufficient health workers; and in the tools pillar: a shortage of essential medicines and adverse polypharmacy effects were prominent. A lack of political will and the absence of relevant national health policies were identified under the governance pillar. Facilitators within the people pillar included enhancing self-management support; within the platforms, pillar included integration of services; within the tools pillar, included embracing emerging technologies and information and communication technology services; and governance issues included upscaling interventions to respond to multimorbid care needs through enhanced political commitment and financial support. CONCLUSIONS Potential solutions to strengthening the healthcare system to be more responsive to people with MLTC-M include empowering service users to self-manage, developing multimorbid care guidelines, incorporating community health workers into multimorbid care efforts and advocating for integrated person-centred care services across sectors. The need for policies and procedures in LMICs to meet the person-centred care needs of people with MLTC-M was highlighted.
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Affiliation(s)
- David Zezai
- Centre for Rural Health, University of KwaZulu-Natal College of Health Sciences, Durban, KwaZulu Natal, South Africa
| | - André Janse van Rensburg
- Centre for Rural Health, University of KwaZulu-Natal College of Health Sciences, Durban, KwaZulu Natal, South Africa
| | - Gbotemi Bukola Babatunde
- School of Public Health, University of the Western Cape Faculty of Community and Health Sciences, Cape Town, Western Cape, South Africa
- Department of Psychology, University of Denver, Graduate School of Professional Psychology, Denver, Colorado, USA
| | - Tasneem Kathree
- Centre for Rural Health, University of KwaZulu-Natal College of Health Sciences, Durban, KwaZulu Natal, South Africa
| | - Ruth Cornick
- Observatory, Department of Medicine, University of Cape Town, Cape Town, Western Cape, South Africa
- Knowledge Translation Unit, University of Cape Town, Cape Town, Western Cape, South Africa
| | - Naomi Levitt
- Division of Endocrinology, Department of Medicine, University of Cape Town, Cape Town, Western Cape, South Africa
- Chronic Disease Initiative for Africa, Department of Medicine, University of Cape Town, Cape Town, Western Cape, South Africa
| | - Lara R Fairall
- Knowledge Translation Unit, University of Cape Town, Cape Town, Western Cape, South Africa
- Global Health Institute, School of Life Course and Population Sciences, King's College London Faculty of Life Sciences & Medicine, London, UK
| | - Inge Petersen
- Centre for Rural Health, University of KwaZulu-Natal College of Health Sciences, Durban, KwaZulu Natal, South Africa
- Global Health Institute, King’s College London, London, UK
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16
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Hobbs T, Berry V, Fonagy P. Editorial Perspective: A systems approach to addressing young people's mental health. J Child Psychol Psychiatry 2024. [PMID: 39586677 DOI: 10.1111/jcpp.14077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/08/2024] [Indexed: 11/27/2024]
Abstract
This editorial explores how adopting a social determinants and systemic perspective can enhance preventative measures to boost the mental health of young people. It argues that to effectively elevate the mental health of young people, it is essential to tackle both the overarching influences and their specific local impacts. We maintain that a strategy combining systems thinking with evidence tailored to the local environment and participatory design is essential.
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Affiliation(s)
- Tim Hobbs
- Dartington Service Design Lab, Buckfastleigh, UK
| | - Vashti Berry
- NIHR Applied Research Collaboration South West Peninsula (PenARC), University of Exeter, Exeter, UK
| | - Peter Fonagy
- Division of Psychology and Language Sciences, University College London, London, UK
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17
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Igoe A, Keller S, Stallings M, Goddard A, Van Graafeiland B, Roney LN, Peck J. Trauma Informed Care: Practical Application for Pediatric-Focused Advanced Practice Registered Nurses. J Pediatr Health Care 2024:S0891-5245(24)00311-0. [PMID: 39570262 DOI: 10.1016/j.pedhc.2024.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2024] [Revised: 10/06/2024] [Accepted: 10/11/2024] [Indexed: 11/22/2024]
Abstract
Trauma-informed care (TIC) is an essential holistic framework for pediatric-focused advanced practice registered nurses (APRNs) to understand, recognize, and respond to children and families who have experienced trauma while resisting re-traumatization. TIC allows APRNs to engage with children with an understanding of how trauma impacts well-being. Universal adoption of TIC is prudent; it assumes all patients experience some degree of trauma and disclosure is limited. The National Association of Pediatric Nurse Practitioners Partners for Vulnerable Youth published an evidence-based TIC toolkit online for pediatric-focused ARPNs as a clinical guide for TIC application. This article reviews toolkit elements and demonstrates practical application of TIC.
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18
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Prabhu SG, Mallikarjun PK, Palmer A, Nag R, Khadeparkar P, Arelingaiah M, Lakshman KA, Podiya JK, Navaneetham J, Hugh-Jones S. Mental health literacy in secondary school teachers and interventions to improve it - a systematic review and narrative synthesis. J Ment Health 2024:1-20. [PMID: 39535782 DOI: 10.1080/09638237.2024.2426994] [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: 11/14/2023] [Revised: 09/28/2024] [Accepted: 10/11/2024] [Indexed: 11/16/2024]
Abstract
BACKGROUND Adolescent mental health problems have increased in prevalence. Teachers' Mental Health Literacy (MHL) may play an important role in public mental health prevention approaches. This systematic review and narrative synthesis aimed to identify what is known globally about the extent of secondary school teachers' MHL and the types and effectiveness of MHL interventions for secondary school teachers. METHODS PsycINFO, PubMed, ERIC, EBSCO-Psychological and behavioural sciences collection, Web of Science, and Google Scholar were searched to identify studies until 29/04/2024. Two independent reviewers screened the returns. RESULTS Twenty eligible studies were reviewed. Most intervention studies were from high-income countries and used a psycho-educative approach. Pre-intervention, teachers' levels of MHL were mixed across MHL domains. Post-intervention, increases in mental health knowledge and attitudes and decreases in mental health stigma were reported. Low use of standardised MHL measures, lack of randomised controlled trials, and lack of follow-up data affect evidence quality. CONCLUSION Interventions to improve secondary school teachers' MHL can be effective, at least in the short term. Evidence quality needs to be improved to inform recommendations on whether they should be part of a public mental health approach for adolescents.
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Affiliation(s)
- Sphoorthi G Prabhu
- Department of Psychiatric Social Work, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Pavan Kumar Mallikarjun
- Forward Thinking Birmingham, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | - Amy Palmer
- School of Psychology, University of Leeds, Leeds, UK
| | - Ritwika Nag
- Department of Psychiatric Social Work, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | | | - Mutharaju Arelingaiah
- Department of Psychiatric Social Work, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Krupa Arasanahalli Lakshman
- Department of Psychiatric Social Work, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | | | - Janardhana Navaneetham
- Department of Psychiatric Social Work, National Institute of Mental Health and Neurosciences, Bengaluru, India
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19
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Eisenhut L, Sadeghi-Bahmani D, Dürsteler KM, Mikoteit T, Fichter C, Brühl AB, Stanga Z, Brand S. Illuminating Hypomania in Early Adolescence: Associations Between Dark-Side and Bright-Side Hypomania, Insomnia, and Health-Related Quality of Life. J Clin Med 2024; 13:6785. [PMID: 39597929 PMCID: PMC11594785 DOI: 10.3390/jcm13226785] [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: 10/05/2024] [Revised: 11/01/2024] [Accepted: 11/03/2024] [Indexed: 11/29/2024] Open
Abstract
Background: Adolescence is a period of significant psychological, physical, and social changes. During this time, adolescents face increasing responsibilities, such as making educational and career decisions, managing peer relationships, and becoming more independent from their families. These changes are often accompanied by mood fluctuations and altered sleep patterns. This study aimed to explore the relationships between bright- and dark-side hypomania, insomnia, and various dimensions of health-related quality of life (HRQOL), such as self-esteem, family and peer relationships, social acceptance, and autonomy. Methods: A total of 1475 participants in mid-adolescence (mean age: 13.4 years; range: 11-16 years; 48.8% males) completed a series of self-reported questionnaires covering sociodemographic information, hypomania, including dark and bright-side hypomania, insomnia, and HRQOL. Results: Compared to participants with no or dark-side hypomania, participants with bright-side hypomania reported better HRQOL. Bright-side hypomania was significantly associated with favorable relationships with parents and home, peer relationships, and the school environment and with less insomnia. In contrast, dark-side hypomania showed significant associations with lower scores for self-esteem, moods and emotional states, peer relationships, social acceptance, the school environment, and more insomnia. Conclusions: Among a larger sample of adolescents, bright- and dark-side hypomania were associated with a broad, though specific variety of aspects of HRQOL and insomnia. Given that standardized programs are available to improve insomnia and resilience as a proxy of psychological well-being, such interventions may have the potential to improve adolescents' psychological well-being and sleep quality concomitantly.
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Affiliation(s)
- Larina Eisenhut
- Center for Affective, Stress and Sleep Disorders (ZASS), Psychiatric University Hospital Basel, 4002 Basel, Switzerland; (L.E.); (A.B.B.)
| | - Dena Sadeghi-Bahmani
- Department of Psychology, Stanford University, Stanford, CA 94305, USA;
- Department of Epidemiology & Population Health, Stanford University, Stanford, CA 94305, USA
| | - Kenneth M. Dürsteler
- Psychiatric Clinics, Division of Substance Use Disorders, University of Basel, 4002 Basel, Switzerland;
- Center for Addictive Disorders, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, 8057 Zurich, Switzerland
| | - Thorsten Mikoteit
- Psychiatric Services Solothurn, University of Basel, 4503 Solothurn, Switzerland;
| | - Christian Fichter
- Department of Psychology, Kalaidos Private University of Applied Sciences, 8050 Zurich, Switzerland;
| | - Annette Beatrix Brühl
- Center for Affective, Stress and Sleep Disorders (ZASS), Psychiatric University Hospital Basel, 4002 Basel, Switzerland; (L.E.); (A.B.B.)
| | - Zeno Stanga
- Centre of Competence for Military and Disaster Medicine, Swiss Armed Forces, 3008 Bern, Switzerland;
- Division of Diabetes, Endocrinology, Nutritional Medicine and Metabolism, University Hospital and University of Bern, 3010 Bern, Switzerland
| | - Serge Brand
- Center for Affective, Stress and Sleep Disorders (ZASS), Psychiatric University Hospital Basel, 4002 Basel, Switzerland; (L.E.); (A.B.B.)
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah 6714869914, Iran
- Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah 6714869914, Iran
- Department of Sport, Exercise and Health, Division of Sport Science and Psychosocial Health, University of Basel, 4052 Basel, Switzerland
- School of Medicine, Tehran University of Medical Sciences, Tehran 1417466191, Iran
- Center for Disaster Psychiatry and Disaster Psychology, Psychiatric University Hospital Basel, 4002 Basel, Switzerland
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20
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Fernandez ME, Johnstone SJ, Varcoe S, Howard SJ. EEG activation in preschool children: Characteristics and predictive value for current and future mental health status. RESEARCH IN DEVELOPMENTAL DISABILITIES 2024; 154:104840. [PMID: 39288701 DOI: 10.1016/j.ridd.2024.104840] [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: 04/15/2024] [Revised: 07/30/2024] [Accepted: 09/13/2024] [Indexed: 09/19/2024]
Abstract
BACKGROUND Previous research has characterised EEG changes associated with resting activation in primary school children and adults, while task-related activation has only been considered in adults. The current study characterises physiological activation in preschool children and examines the potential value of activation indices for predicting mental health status at two time points. AIMS To investigate how resting activation and task-related activation are represented in 4- to 5-year-old preschool children and examine if these activation indices can predict current and future mental health status. METHODS AND PROCEDURES Frontal EEG was recorded from 81 preschool children during eyes-closed resting, eyes-open resting, and an inhibitory control task to allow calculation of activation indices. The Child Behaviour Checklist was completed by the child's parent at this time, and again 6-8 months later after the child's transition to kindergarten. OUTCOMES AND RESULTS Resting activation was represented by reductions in frontal delta, theta, and alpha power in the eyes-open compared to eyes-closed condition, and an increase in frontal beta power. Task-related activation was represented by increases in frontal delta, theta, and alpha power and a decrease in beta power. Frontal delta and theta task-related activation significantly predicted externalising behaviours in both preschool and kindergarten, with stronger prediction in kindergarten. CONCLUSIONS AND IMPLICATIONS This study characterised resting and task-related activation in preschool children, and reported similar effects to those found in older children and adults for resting activation, with novel effects for task-related activation. As task-related activation indices were predictive of externalising behaviours in both preschool and kindergarten, these results have implications for early identification of children who experience externalising behavioural problems across the transition to school period. WHAT DOES THIS STUDY ADD?: This study provides new data on how the fundamental physiological processes of resting and task-related activation, both of which are theorised to contribute to "upstream" processes such as executive functions and broader behaviour, are represented in the frontal EEG of preschool aged children. We also learn that the top-down task-related activation indices for delta and theta activity were predictive of current mental health status and future status after the transition to kindergarten, while the bottom-up resting activation indices were not.
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Sadoughi M. Overparenting and adolescent's trait anxiety: Unraveling the roles of basic psychological needs frustration and emotion dysregulation. Acta Psychol (Amst) 2024; 251:104579. [PMID: 39500070 DOI: 10.1016/j.actpsy.2024.104579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2024] [Revised: 10/26/2024] [Accepted: 10/29/2024] [Indexed: 12/16/2024] Open
Abstract
Parental involvement is widely recognized for its beneficial impact on child development. However, helicopter parenting, as an excessive and developmentally inappropriate involvement, can lead to significant mental health challenges. While the general effects of overparenting on well-being have been well-documented, its specific underlying mechanisms are still underexplored. The present study aimed to examine the serial mediating roles of basic psychological needs (BPN) frustration and emotion dysregulation in the link between helicopter parenting and trait anxiety among 391 adolescents chosen via convenience sampling. The results of structural equation modeling revealed that helicopter parenting significantly predicted higher levels of trait anxiety (β=0.367, p < .01). Furthermore, the indirect effect of helicopter parenting on trait anxiety was statistically significant through the serial mediation of BPN frustration and emotion dysregulation (β=0.134, p < .01). In fact, over-controlling parenting can lead to frustration of adolescents' BPN and, in turn, restricted access to effective emotion regulation strategies, which may ultimately increase trait anxiety among adolescents. These findings underscore the critical need for balanced parental involvement to foster healthy psychological development of adolescents.
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Affiliation(s)
- Majid Sadoughi
- Psychology Department, Faculty of Humanities, University of Kashan, Kashan, Iran.
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22
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Maxwell C, Chapman E, Houghton S. Validity of the Strengths and Difficulties Questionnaire for Screening and Diagnosis in Western Australian Adolescents. Diagnostics (Basel) 2024; 14:2433. [PMID: 39518400 PMCID: PMC11545116 DOI: 10.3390/diagnostics14212433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2024] [Revised: 10/27/2024] [Accepted: 10/27/2024] [Indexed: 11/16/2024] Open
Abstract
BACKGROUND/OBJECTIVES The Strengths and Difficulties Questionnaire (SDQ) is a widely used 25-item screening and diagnostic tool for behavioral and emotional problems in young people. Despite its popularity, evaluations of the SDQ's factor structure in adolescent populations have produced disparate results, and its relationships with theoretically related variables are rarely evaluated. In the present study, these two elements of validity were evaluated based on a large sample of Western Australian adolescents. METHODS Participants were 1489 adolescents, n = 623 males with a mean age of 13.79 years (SD = 1.61) and n = 866 females, with a mean age of 14.29 years (SD = 1.51). Participants completed the SDQ alongside measures of loneliness, sense of belonging, depression, bullying, and diagnostic status to evaluate its internal structure and correlations with theoretically related variables. RESULTS Confirmatory factor analyses supported the internal structure of the SDQ both for males and for females. Relationships between the SDQ subscale scores and those from theoretically related variables were also aligned with the instrument's underpinning framework. CONCLUSIONS Despite the somewhat disparate results of previous studies, overall, this study supported the validity of the SDQ for use in the Western Australian context.
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Affiliation(s)
| | - Elaine Chapman
- Graduate School of Education, The University of Western Australia, 35 Stirling Highway, Perth 6009, Australia; (C.M.); (S.H.)
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Achterhof R, Kirtley OJ, Lafit G, Hiekkaranta AP, Hagemann N, Hermans KSFM, Lecei A, Boets B, Henquet C, Schneider M, Sips R, Vaessen T, van Winkel R, Viechtbauer W, Reininghaus U, Myin-Germeys I. Social processes as the missing link: cross-sectionally testing a conceptual model on social mediators of early psychopathological development. Psychol Med 2024; 54:1-11. [PMID: 39440445 PMCID: PMC11536120 DOI: 10.1017/s0033291724001594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 05/29/2024] [Accepted: 06/12/2024] [Indexed: 10/25/2024]
Abstract
BACKGROUND Research suggests that most mental health conditions have their onset in the critically social period of adolescence. Yet, we lack understanding of the potential social processes underlying early psychopathological development. We propose a conceptual model where daily-life social interactions and social skills form an intermediate link between known risk and protective factors (adverse childhood experiences, bullying, social support, maladaptive parenting) and psychopathology in adolescents - that is explored using cross-sectional data. METHODS N = 1913 Flemish adolescent participants (Mean age = 13.8; 63% girls) were assessed as part of the SIGMA study, a large-scale, accelerated longitudinal study of adolescent mental health and development. Self-report questionnaires (on risk/protective factors, social skills, and psychopathology) were completed during class time; daily-life social interactions were measured during a subsequent six-day experience-sampling period. RESULTS Registered uncorrected multilevel linear regression results revealed significant associations between all risk/protective factors and psychopathology, between all risk/protective factors and social processes, and between all social processes and psychopathology. Social processes (social skills, quantity/quality of daily social interactions) were uniquely predicted by each risk/protective factor and were uniquely associated with both general and specific types of psychopathology. For older participants, some relationships between social processes and psychopathology were stronger. CONCLUSIONS Unique associations between risk/protective factors and psychopathology signify the distinct relevance of these factors for youth mental health, whereas the broad associations with social processes support these processes as broad correlates. Results align with the idea of a social pathway toward early psychopathology, although follow-up longitudinal research is required to verify any mediation effect.
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Affiliation(s)
- Robin Achterhof
- Center for Contextual Psychiatry, Research Group Psychiatry, Department of Neurosciences, KU Leuven, Leuven, Belgium
- KU Leuven Child & Youth Institute, KU Leuven, Leuven, Belgium
- Erasmus School of Social and Behavioural Sciences, Department of Psychology, Education & Child Studies, Erasmus University Rotterdam, Mandeville Building Room T15-10, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands
| | - Olivia J. Kirtley
- Center for Contextual Psychiatry, Research Group Psychiatry, Department of Neurosciences, KU Leuven, Leuven, Belgium
- KU Leuven Child & Youth Institute, KU Leuven, Leuven, Belgium
| | - Ginette Lafit
- Center for Contextual Psychiatry, Research Group Psychiatry, Department of Neurosciences, KU Leuven, Leuven, Belgium
- KU Leuven Child & Youth Institute, KU Leuven, Leuven, Belgium
- Research Group on Quantitative Psychology and Individual Differences, Faculty of Psychology, KU Leuven, Leuven, Belgium
| | - Anu P. Hiekkaranta
- Center for Contextual Psychiatry, Research Group Psychiatry, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Noëmi Hagemann
- Center for Contextual Psychiatry, Research Group Psychiatry, Department of Neurosciences, KU Leuven, Leuven, Belgium
- Flemish Scientific Society for Youth Health Care (VWVJ), Leuven, Belgium
| | - Karlijn S. F. M. Hermans
- Center for Contextual Psychiatry, Research Group Psychiatry, Department of Neurosciences, KU Leuven, Leuven, Belgium
- Strategy and Academic Affairs, Administration and Central Services, Leiden University, Leiden, The Netherlands
| | - Aleksandra Lecei
- Center for Clinical Psychiatry, Research Group Psychiatry, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Bart Boets
- Center for Developmental Psychiatry, Research Group Psychiatry, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Cécile Henquet
- Open University of the Netherlands, Heerlen, the Netherlands
| | - Maude Schneider
- Clinical Psychology Unit for Intellectual and Developmental Disabilities, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
| | - Rob Sips
- Erasmus School of Social and Behavioural Sciences, Department of Psychology, Education & Child Studies, Erasmus University Rotterdam, Mandeville Building Room T15-10, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands
| | - Thomas Vaessen
- Center for Contextual Psychiatry, Research Group Psychiatry, Department of Neurosciences, KU Leuven, Leuven, Belgium
- Center for eHealth and Well-being Research, Department of Psychology, Health, and Technology, University of Twente, Enschede, The Netherlands
| | - Ruud van Winkel
- Center for Clinical Psychiatry, Research Group Psychiatry, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | | | - Ulrich Reininghaus
- Center for eHealth and Well-being Research, Department of Psychology, Health, and Technology, University of Twente, Enschede, The Netherlands
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- ESRC Centre for Society and Mental Health and Centre for Epidemiology and Public Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Inez Myin-Germeys
- Center for Contextual Psychiatry, Research Group Psychiatry, Department of Neurosciences, KU Leuven, Leuven, Belgium
- KU Leuven Child & Youth Institute, KU Leuven, Leuven, Belgium
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Mytelka C, Narendorf SC, Baumler E, Acquati C, Temple JR. Exploring reciprocal links between early adolescent coping and internalizing symptoms. J Adolesc 2024. [PMID: 39442977 DOI: 10.1002/jad.12429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Revised: 10/04/2024] [Accepted: 10/07/2024] [Indexed: 10/25/2024]
Abstract
INTRODUCTION The rising prevalence of depression and anxiety among adolescents is a public health concern. Early adolescence is a key developmental period to reduce risks for internalizing symptoms through primary prevention programs, yet additional research is needed on modifiable factors, such as coping skills, to target to mitigate risk factors. Therefore, we investigated the reciprocal link between coping style and internalizing symptoms among a racially/ethnically diverse sample of early adolescents (n = 1273) from 12 middle schools over 1 year. METHODS We leveraged a longitudinal data set of a cluster, randomized trial of a preventive intervention from 12 middle schools in a large public-school district in the United States to test our hypotheses using multilevel modeling. The sample was 49% female and racially/ethnically diverse (39% Hispanic/Latinx, 23% Black/African American, 12% Asian or Pacific Islander, 11% other, 9% White, and 5% multiracial). Participants (ages 12-14) completed a baseline questionnaire in 7th grade (Spring 2018) and a 1-year follow-up questionnaire in 8th grade (Spring 2019). RESULTS Depressive and anxious symptoms affected levels of active and avoidant coping skill use over the 1-year period of the study, indicating that symptoms can be an impetus for maladaptive coping. We also identified bidirectional links between active coping and depression in addition to avoidant coping and anxiety. CONCLUSIONS Our findings have implications for augmenting coping psychoeducation within prevention programs to reduce internalizing symptoms among early adolescents and for future longitudinal and qualitative research exploring how coping skills reduce risks for internalizing symptoms throughout adolescence and into early adulthood.
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Affiliation(s)
- Caitlyn Mytelka
- Graduate College of Social Work, University of Houston, Houston, Texas, USA
- School of Behavioral Health Sciences, Center for Violence Prevention, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Sarah C Narendorf
- Graduate College of Social Work, University of Houston, Houston, Texas, USA
| | - Elizabeth Baumler
- School of Behavioral Health Sciences, Center for Violence Prevention, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Chiara Acquati
- Graduate College of Social Work, University of Houston, Houston, Texas, USA
- Department of Clinical Sciences, Fertitta Family College of Medicine, University of Houston, Houston, Texas, USA
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Jeff R Temple
- School of Behavioral Health Sciences, Center for Violence Prevention, University of Texas Health Science Center at Houston, Houston, Texas, USA
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Bhui K, Basu D, Nagpal S, Mutiso V, Pillai R, Hadfield K, Lauwrens Z, Ndetei D. Acceptability and feasibility of a brief intervention to enhance resilience among young people and their families in India and Kenya. Glob Ment Health (Camb) 2024; 11:e86. [PMID: 39464565 PMCID: PMC11504944 DOI: 10.1017/gmh.2024.87] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 05/17/2024] [Accepted: 06/07/2024] [Indexed: 10/29/2024] Open
Abstract
Enhancing resilience is one way to prevent future mental illnesses and encourage recovery in the face of adversity. To develop and test the acceptability and feasibility (A&F) of a combined family and individual resilience intervention in two rural/semi-rural low-income settings in India and Kenya. We developed a five-session intervention including Life Skills Education (LSE) and a model of family resiliency. Among adolescents aged 14-16 years and their families in India and Kenya, we collected socio-demographics and audio records of delivery and undertook a process evaluation. Due to COVID-19, we developed a hybrid intervention. The facilitators and participants preferred the in-person model. India: Of 17 families, 10 fully completed the intervention. They identified three critical components: 1) story-telling, 2) cooperation and working together and 3) expressing feelings. Kenya: All 15 families completed the intervention. Critical elements were 1) seeing social value in learning to make good decisions, 2) promoting an optimistic view of life, 3) hearing stories that resonated with their situation and 4) enhancing family performance through knowledge-building. We mapped the active ingredients, showing fidelity and acceptability. The intervention showed promising A&F parameters. Flexibility and local adaptation were important for delivery.
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Affiliation(s)
- Kamaldeep Bhui
- CHiMES Collaborative, Department of Psychiatry, Nuffield Department of Primary Care Health Sciences, Wadham College, University of Oxford, Oxford, UK
- WPA Collaborating Centre, Oxford, UK
- Global Policy Institute, QMUL, London, England
- Oxford Health and East London NHS Foundation Trusts, London, UK
| | - Debasish Basu
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sugandha Nagpal
- Jindal School of International Affairs, O.P. Jindal Global University, Sonipat, Haryana, India
| | - Victoria Mutiso
- African Mental Research and Training Foundation, Nairobi, Kenya
| | - Renjith Pillai
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Kristin Hadfield
- Trinity Centre for Global Health, School of Psychology, Trinity College Dublin, Dublin, Ireland
| | | | - David Ndetei
- African Mental Research and Training Foundation, Nairobi, Kenya
- Department of Psychiatry, University of Nairobi, Nairobi, Kenya
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26
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Guo Z, Lai A, Thygesen JH, Farrington J, Keen T, Li K. Large Language Models for Mental Health Applications: Systematic Review. JMIR Ment Health 2024; 11:e57400. [PMID: 39423368 PMCID: PMC11530718 DOI: 10.2196/57400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Revised: 05/17/2024] [Accepted: 09/03/2024] [Indexed: 10/21/2024] Open
Abstract
BACKGROUND Large language models (LLMs) are advanced artificial neural networks trained on extensive datasets to accurately understand and generate natural language. While they have received much attention and demonstrated potential in digital health, their application in mental health, particularly in clinical settings, has generated considerable debate. OBJECTIVE This systematic review aims to critically assess the use of LLMs in mental health, specifically focusing on their applicability and efficacy in early screening, digital interventions, and clinical settings. By systematically collating and assessing the evidence from current studies, our work analyzes models, methodologies, data sources, and outcomes, thereby highlighting the potential of LLMs in mental health, the challenges they present, and the prospects for their clinical use. METHODS Adhering to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, this review searched 5 open-access databases: MEDLINE (accessed by PubMed), IEEE Xplore, Scopus, JMIR, and ACM Digital Library. Keywords used were (mental health OR mental illness OR mental disorder OR psychiatry) AND (large language models). This study included articles published between January 1, 2017, and April 30, 2024, and excluded articles published in languages other than English. RESULTS In total, 40 articles were evaluated, including 15 (38%) articles on mental health conditions and suicidal ideation detection through text analysis, 7 (18%) on the use of LLMs as mental health conversational agents, and 18 (45%) on other applications and evaluations of LLMs in mental health. LLMs show good effectiveness in detecting mental health issues and providing accessible, destigmatized eHealth services. However, assessments also indicate that the current risks associated with clinical use might surpass their benefits. These risks include inconsistencies in generated text; the production of hallucinations; and the absence of a comprehensive, benchmarked ethical framework. CONCLUSIONS This systematic review examines the clinical applications of LLMs in mental health, highlighting their potential and inherent risks. The study identifies several issues: the lack of multilingual datasets annotated by experts, concerns regarding the accuracy and reliability of generated content, challenges in interpretability due to the "black box" nature of LLMs, and ongoing ethical dilemmas. These ethical concerns include the absence of a clear, benchmarked ethical framework; data privacy issues; and the potential for overreliance on LLMs by both physicians and patients, which could compromise traditional medical practices. As a result, LLMs should not be considered substitutes for professional mental health services. However, the rapid development of LLMs underscores their potential as valuable clinical aids, emphasizing the need for continued research and development in this area. TRIAL REGISTRATION PROSPERO CRD42024508617; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=508617.
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Affiliation(s)
- Zhijun Guo
- Institute of Health Informatics University College, London, London, United Kingdom
| | - Alvina Lai
- Institute of Health Informatics University College, London, London, United Kingdom
| | - Johan H Thygesen
- Institute of Health Informatics University College, London, London, United Kingdom
| | - Joseph Farrington
- Institute of Health Informatics University College, London, London, United Kingdom
| | - Thomas Keen
- Institute of Health Informatics University College, London, London, United Kingdom
- Great Ormond Street Institute of Child Health, University College London, London, United Kingdom
| | - Kezhi Li
- Institute of Health Informatics University College, London, London, United Kingdom
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Casline E, Woodard GS, Lane E, Pollowitz S, Douglas S, Ehrenreich-May J, Ginsburg GS, Jensen-Doss A. Consultation Content and Techniques for measurement-Based Care Implementation in Youth Community Mental Health Settings. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2024:10.1007/s10488-024-01417-8. [PMID: 39397117 DOI: 10.1007/s10488-024-01417-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/28/2024] [Indexed: 10/15/2024]
Abstract
Measurement-based care (MBC) is an evidence-based practice (EBP) focused on regularly administering outcome measures to clients to inform clinical decision making. While MBC shows promise for improving youth treatment outcomes, therapist adoption remains low. Clinical consultation is one strategy that improves MBC implementation, but our limited understanding of consultation hinders the ability to optimize its impact. This research explored the content of, and techniques used during MBC consultation calls. Therapists (N = 55) in a randomized controlled trial treating adolescents with anxiety and/or depression were trained to utilize MBC with usual treatment using the Youth Outcome Questionnaire (YOQ) through an online measurement feedback system (MFS). Weekly ongoing consultation followed an initial workshop training in MBC. Case discussions (N = 294) during consultation calls were coded using a developed codebook, including 12 content and 10 consultant techniques. Results indicated that content focused predominantly on interpretation of client symptom and alliance report, planning for YOQ administration, and discussion of data with clients in session. Common consultant techniques included modeling and eliciting report viewing and interpretation, making clinical suggestions, and didactics about clinical and technical issues. Notably, role-play/behavioral rehearsal was not used. The prevalence of passive consultation techniques (suggestions, didactics) suggests a focus on teaching rather than active techniques (behavioral rehearsal, modeling), potentially influenced by the novelty of MBC and MFS. Technical aspects of MBC, such as measure administration and system usage, emerged as key consultation content, highlighting an unanticipated emphasis on logistics over clinical implementation. These findings underscore the evolving role of consultation in supporting MBC implementation and suggest that addressing technical challenges early in training might enhance adoption.
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Affiliation(s)
- Elizabeth Casline
- Institute for Public Health and Medicine, Center for Dissemination and Implementation Science, Northwestern University Feinberg School of Medicine, 633 N. St Clair, Chicago, IL, 60611, USA.
| | - Grace S Woodard
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | - Elizabeth Lane
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | - Scott Pollowitz
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | - Susan Douglas
- Department of Psychology and Human Development, Vanderbilt University, Nashville, TN, USA
| | | | - Golda S Ginsburg
- Department of Psychiatry, University of Connecticut School of Medicine, West Hartford, USA
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Dowling GJ, Hoffman EA, Cole KM, Wargo EM, Volkow N. The ABCD and HBCD Studies: Longitudinal Studies to Inform Prevention Science. FOCUS (AMERICAN PSYCHIATRIC PUBLISHING) 2024; 22:449-457. [PMID: 39563872 PMCID: PMC11571182 DOI: 10.1176/appi.focus.20240016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2024]
Abstract
Increasing rates of overdose among U.S. adolescents and young adults, along with rising rates of emotional distress in these groups, are renewing the urgency for developmentally targeted and personalized substance use and other mental health prevention interventions. Most prevention programs recognize the unique vulnerability of childhood and adolescence and target parents and youths, addressing modifiable environmental risk and protective factors that affect behavior during periods when the brain is most susceptible to change. Until recently, a scarcity of comprehensive studies has limited a full understanding of the complexity of factors that may affect neurodevelopment, including substance exposure in pregnancy and/or subsequent substance use in adolescence, alongside their dynamic interactions with environmental factors and genetics. Two large longitudinal cohort studies funded by National Institutes of Health-the Adolescent Brain Cognitive Development (ABCD) Study and the HEALthy Brain and Child Development (HBCD) Study-are collecting data on neurodevelopment and a wide range of environmental and biological factors across the first two decades of life to build databases that will allow researchers to study how individual neurodevelopmental trajectories are influenced by drugs, adverse childhood experiences, and genetics, among other factors. These studies are already deepening the understanding of risk and resilience factors that prevention programs could target and will identify critical windows where interventions can have the most impact on an individual's neurodevelopmental trajectory. This article describes what is being learned from ABCD and expected from HBCD and how these studies might inform prevention as these children grow and more data are gathered.
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Affiliation(s)
- Gayathri J Dowling
- Division of Extramural Research, National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland
| | - Elizabeth A Hoffman
- Division of Extramural Research, National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland
| | - Katherine M Cole
- Division of Extramural Research, National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland
| | - Eric M Wargo
- Division of Extramural Research, National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland
| | - Nora Volkow
- Division of Extramural Research, National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland
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29
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de Soet R, Vermeiren RRJM, Bansema CH, van Ewijk H, Nijland L, Nooteboom LA. Drop-out and ineffective treatment in youth with severe and enduring mental health problems: a systematic review. Eur Child Adolesc Psychiatry 2024; 33:3305-3319. [PMID: 36882638 PMCID: PMC11564352 DOI: 10.1007/s00787-023-02182-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 02/27/2023] [Indexed: 03/09/2023]
Abstract
Youth with severe and enduring mental health problems (SEMHP) tend to drop out of treatment or insufficiently profit from treatment in child and adolescent psychiatry (CAP). Knowledge about factors related to treatment failure in this group is scarce. Therefore, the aim of this systematic review was to thematically explore factors associated with dropout and ineffective treatment among youth with SEMHP. After including 36 studies, a descriptive thematic analysis was conducted. Themes were divided into three main categories: client, treatment, and organizational factors. The strongest evidence was found for the association between treatment failure and the following subthemes: type of treatment, engagement, transparency and communication, goodness of fit and, perspective of practitioner. However, most other themes showed limited evidence and little research has been done on organizational factors. To prevent treatment failure, attention should be paid to a good match between youth and both the treatment and the practitioner. Practitioners need to be aware of their own perceptions of youth's perspectives, and transparent communication with youth contributes to regaining their trust.
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Affiliation(s)
- R de Soet
- LUMC Curium-Department of Child and Adolescent Psychiatry, Leiden University Medical Center, Post Box 15, 2300 AA, Leiden, The Netherlands.
| | - R R J M Vermeiren
- LUMC Curium-Department of Child and Adolescent Psychiatry, Leiden University Medical Center, Post Box 15, 2300 AA, Leiden, The Netherlands
- Youz, Parnassia Group, The Hague, The Netherlands
| | - C H Bansema
- LUMC Curium-Department of Child and Adolescent Psychiatry, Leiden University Medical Center, Post Box 15, 2300 AA, Leiden, The Netherlands
| | - H van Ewijk
- LUMC Curium-Department of Child and Adolescent Psychiatry, Leiden University Medical Center, Post Box 15, 2300 AA, Leiden, The Netherlands
| | - L Nijland
- LUMC Curium-Department of Child and Adolescent Psychiatry, Leiden University Medical Center, Post Box 15, 2300 AA, Leiden, The Netherlands
| | - L A Nooteboom
- LUMC Curium-Department of Child and Adolescent Psychiatry, Leiden University Medical Center, Post Box 15, 2300 AA, Leiden, The Netherlands
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Pedruzo B, Aymerich C, Pacho M, Herrero J, Laborda M, Bordenave M, Giuliano AJ, McCutcheon RA, Gutiérrez-Rojas L, McGuire P, Stone WS, Fusar-Poli P, González-Torres MÁ, Catalan A. Longitudinal change in neurocognitive functioning in children and adolescents at clinical high risk for psychosis: a systematic review. Eur Child Adolesc Psychiatry 2024; 33:3377-3387. [PMID: 37199754 PMCID: PMC11564316 DOI: 10.1007/s00787-023-02221-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 04/29/2023] [Indexed: 05/19/2023]
Abstract
Clinical high risk of psychosis (CHR-P) population has become an attractive area of interest in preventing transitions to psychosis. The consequences of developing a psychotic disorder may be worse in cases of early onset. Thus, childhood and adolescence represent a critical developmental window, where opportunities to gain social and adaptive abilities depend on the individuals' neurocognitive performance. There have been previous syntheses of the evidence regarding neurocognitive functioning in CHR-P individuals and its longitudinal changes. However, there has been less focus on children and adolescents at CHR-P. A multistep literature search was performed from database inception until July 15th, 2022. PRIMSA/MOOSE compliant systematic review and PROSPERO protocol were used to identify studies reporting on longitudinal changes in neurocognitive functioning in children and adolescents (mean age of sample ≤ 18 years) at CHR-P and matched healthy control (HC) group. A systematic review of identified studies was then undertaken. Three articles were included, resulting in a total sample size of 151 CHR-P patients [mean (SD) age, 16.48 (2.41) years; 32.45% female] and 64 HC individuals [mean (SD) age, 16.79 (2.38) years; 42.18% female]. CHR-P individuals had worse outcomes in verbal learning, sustained attention and executive functioning domains compared to HC. Individuals taking antidepressants had better outcomes in verbal learning in contrast with those taking antipsychotics. In children and adolescents, neurocognition may be already impaired before the psychosis onset, and remains stable during the transition to psychosis. Further study should be performed to obtain more robust evidence.
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Affiliation(s)
- Borja Pedruzo
- Department of Psychiatry, Basurto University Hospital, Bilbao, Spain.
- Neuroscience Department, University of Basque Country (UPV/EHU), Leioa, Spain.
| | - Claudia Aymerich
- Department of Psychiatry, Basurto University Hospital, Bilbao, Spain
| | - Malein Pacho
- Department of Psychiatry, Basurto University Hospital, Bilbao, Spain
| | - Jon Herrero
- Department of Psychiatry, Basurto University Hospital, Bilbao, Spain
| | - María Laborda
- Department of Psychiatry, Basurto University Hospital, Bilbao, Spain
| | - Marta Bordenave
- Department of Psychiatry, Basurto University Hospital, Bilbao, Spain
| | - Anthony J Giuliano
- Worcester Recovery Center and Hospital, Massachusetts Department of Mental Health, Boston, USA
| | - Robert A McCutcheon
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Department of Psychiatry, University of Oxford, Oxford, UK
| | | | - Philip McGuire
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- National Institute for Health Research Biomedical Research Centre, London, UK
- Outreach and Support in South London Service, South London and Maudsley National Health Service Foundation Trust, London, UK
| | - William S Stone
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Paolo Fusar-Poli
- National Institute for Health Research Biomedical Research Centre, London, UK
- Outreach and Support in South London Service, South London and Maudsley National Health Service Foundation Trust, London, UK
- Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Miguel Ángel González-Torres
- Department of Psychiatry, Basurto University Hospital, Bilbao, Spain
- Neuroscience Department, University of Basque Country (UPV/EHU), Leioa, Spain
- Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
- CIBERSAM. Centro Investigación Biomédica en Red de Salud Mental, Madrid, Spain
| | - Ana Catalan
- Department of Psychiatry, Basurto University Hospital, Bilbao, Spain
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Neuroscience Department, University of Basque Country (UPV/EHU), Leioa, Spain
- Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
- CIBERSAM. Centro Investigación Biomédica en Red de Salud Mental, Madrid, Spain
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de Camargo EM, Chen S, López-Bueno R, Mesas AE, Bizzozero-Peroni B, Martín-Calvo N, Jiménez-López E, López-Gil JF. Are perceived barriers to physical activity related to depression, anxiety and stress among adolescents? The EHDLA study. BMJ Open Sport Exerc Med 2024; 10:e002069. [PMID: 39314518 PMCID: PMC11418574 DOI: 10.1136/bmjsem-2024-002069] [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: 09/01/2024] [Indexed: 09/25/2024] Open
Abstract
Objective The aim of this study was twofold: first, to examine the association between perceived barriers to physical activity (PA) practice and depression, anxiety and stress in a sample of Spanish adolescents; and second, to determine which barriers are specifically associated with depression, anxiety and stress. Methods This cross-sectional study was conducted with 765 adolescents aged 12-17 (55.6% girls) in the Valle of Ricote, Murcia, Spain. Depression, anxiety and stress symptoms were assessed using the Depression, Anxiety and Stress Scale (DASS-21), with validated cut points employed to determine the presence of each of these mental conditions. The perception of barriers to PA was assessed using a validated questionnaire for the Spanish adolescent population. Results The barrier 'Because I feel that my physical appearance is worse than that of others' was related to a higher likelihood of having depression (OR=2.41; 95% CI 1.35 to 4.28; p=0.003), anxiety (OR=2.65; 95% CI 1.51 to 4.71; p=0.001) and stress (OR=2.82; 95% CI 1.59 to 5.07; p<0.001). Similarly, the barrier 'Because nobody encourages me to engage in physical activity' was related to a higher likelihood of having depression (OR=1.92; 95% CI 1.08 to 3.43; p=0.026), anxiety (OR=1.97; 95% CI 1.11 to 3.50; p=0.021) and stress (OR=1.99; 95% CI 1.12 to 3.59; p=0.021). Conclusion Perceived barriers to PA related to physical appearance and social support seem to be associated with a greater likelihood of depression, anxiety and stress among Spanish adolescents.
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Affiliation(s)
| | - Sitong Chen
- Institute for Health and Sport, Victoria University, Melbourne, Victoria, Australia
| | - Rubén López-Bueno
- Department of Physical Medicine and Nursing, University of Zaragoza, Zaragoza, Spain
| | - Arthur Eumann Mesas
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
| | - Bruno Bizzozero-Peroni
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
- Higher Institute of Physical Education, Universidad de la República, Rivera, Uruguay
| | - Nerea Martín-Calvo
- IdiSNA, Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain
- Department of Preventive Medicine and Public Health, Facultad de Medicina, Universidad de Navarra, Pamplona, Spain
- Pathophysiology of Obesity and Nutrition, Centro de Investigación Biomédica en Red, Instituto de Salud Carlos III, Madrid, Spain
| | - Estela Jiménez-López
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
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Teigset CM, Mohn C, Mohn-Haugen CR, Larøi F, Rund BR. Psychological and social difficulties in young non-help-seeking adolescents at risk for psychosis: insights from a large cohort study. Front Psychol 2024; 15:1430805. [PMID: 39355295 PMCID: PMC11443346 DOI: 10.3389/fpsyg.2024.1430805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Accepted: 08/28/2024] [Indexed: 10/03/2024] Open
Abstract
Background This study used data from the Norwegian Mother, Father, and Child Cohort Study (MoBa), and explored the psychological and social challenges of 14-year-olds who report psychotic symptoms. Research on help-seeking youths indicates comorbid symptoms of depression, anxiety, and social deterioration, but less is known about non-help-seeking individuals who may not use healthcare services, possibly skewing comorbidity profiles. Also, findings suggest that adolescents manifesting psychotic symptoms refrain from pursuing help. This gap underscores the necessity of studying non-help-seeking adolescents to better understand their needs and the risks they face without intervention. Methods We analyzed responses from adolescents who completed the 14-year questionnaire in MoBa (N = 127), identifying those as at risk by their high scores on psychosis-risk items, within the top 0.4% (N = 58). Comparative analyses were conducted against matched controls to assess differences in psychological and social functioning (N = 69). Results Results indicated that the at-risk adolescents experience significantly more depression and anxiety and have lower self-esteem and poorer social functioning than controls. Social functioning parameters, including leisure activities, social competence, quality of parental relationship, and sense of school belonging, were significantly worse than those observed in controls. The results indicate a pronounced vulnerability among non-help-seeking adolescents at-risk, similar to issues seen in help-seeking youths. Conclusion These findings highlight the importance of early identification and intervention strategies that reach beyond traditional clinical settings, suggesting the efficacy of population or community-based screenings to prevent long-term adverse outcomes. The study proposes a broader understanding of psychosis risk, stressing the importance of inclusive approaches to support at-risk adolescents effectively.
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Affiliation(s)
| | - Christine Mohn
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | | | - Frank Larøi
- Department of Psychology, University of Oslo, Oslo, Norway
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Shaban MM, Alanazi MA, Mohammed HH, Mohamed Amer FG, Elsayed HH, Zaky ME, Ramadan OME, Abdelgawad ME, Shaban M. Advancing sustainable healthcare: a concept analysis of eco-conscious nursing practices. BMC Nurs 2024; 23:660. [PMID: 39285442 PMCID: PMC11406874 DOI: 10.1186/s12912-024-02197-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Accepted: 07/24/2024] [Indexed: 09/19/2024] Open
Abstract
BACKGROUND As the healthcare sector grapples with its environmental footprint, the concept of Eco-conscious Nursing emerges as a pivotal framework for integrating sustainability into nursing practice. This study aims to clarify and operationalize Eco-conscious Nursing, examining its attributes, antecedents, consequences, and providing operational definitions to guide future research and practice. METHODS Utilizing a systematic literature review across PubMed, Google Scholar, and CINAHL Ultimate, this study identifies and analyzes existing theories, frameworks, and practices related to eco-conscious nursing. Through conceptual analysis, key attributes, antecedents, and consequences of Eco-conscious Nursing are delineated, leading to the formulation of comprehensive operational definitions. RESULTS The study reveals Eco-conscious Nursing as a multifaceted concept characterized by environmental stewardship, sustainable healthcare practices, and a commitment to reducing the ecological impact of nursing care. Operational definitions highlight the role of education, awareness, and institutional support as antecedents, with improved environmental health and sustainable healthcare outcomes as key consequences. CONCLUSION Eco-conscious Nursing represents a crucial ethos for the nursing profession, emphasizing the necessity of sustainable practices within healthcare. The operational definitions provided serve as a foundation for embedding eco-conscious principles into nursing, addressing the urgent need for sustainability in healthcare settings. Future research should focus on the empirical application of these definitions and explore the economic and cross-cultural dimensions of eco-conscious nursing.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Mostafa Shaban
- College of Nursing, Jouf University, Sakaka, Saudi Arabia
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Derakhshan A, Archibald H, Dresner HS, Shaye DA, Hilger PA, Lyford Pike S, Gadkaree SK. Premorbid Incidence of Mental Health and Substance Abuse Disorders in Facial Trauma Patients. Craniomaxillofac Trauma Reconstr 2024:19433875241280780. [PMID: 39544317 PMCID: PMC11559583 DOI: 10.1177/19433875241280780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2024] Open
Abstract
Study Design A retrospective study. Objective Facial trauma is a prevalent cause of morbidity and mortality with increasing incidence over recent decades. Few studies have examined the prevalence of mental health and substance abuse disorders at the time of diagnosis. Herein we investigate the psychosocial demographics associated with facial trauma. Methods The 2016 State Inpatient Database (SID) was used to identify patients with facial trauma from all hospitals in New York, Florida, and Maryland. A non-trauma control group undergoing elective same-day surgeries at ambulatory surgical centers in Florida, Kentucky, Nevada, North Carolina, New York, and Maryland was identified using the State Ambulatory Surgery and Services Database (SASD) from the Healthcare Cost and Utilization Project (HCUP). 777 patients were identified with facial trauma and compared to 500 patients without facial fractures. Results Patients with facial fractures were statistically significantly more likely to have a substance abuse disorder (OR 34.78, P < .001) or mental health disorder (OR 2.75, P < .001) compared to controls. Patients with facial fractures were significantly more likely to be black than white (OR 4.80, P < .001). Patients with facial fractures were significantly more likely to have Medicaid compared to Medicare (OR 2.12, P = .005). Conclusions Patients with facial fractures are more likely to have premorbid substance abuse and mental health disorders as compared to controls.
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Affiliation(s)
- Adeeb Derakhshan
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology - Head and Neck Surgery, Loma Linda University, Loma Linda, CA, USA
| | - Hunter Archibald
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology - Head and Neck Surgery, University of Minnesota, Minneapolis, MN, USA
| | - Harley S. Dresner
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology - Head and Neck Surgery, University of Minnesota, Minneapolis, MN, USA
| | - David A. Shaye
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology - Head and Neck Surgery, Massachusetts Eye and Ear/Harvard Medical School, Boston, MA, USA
| | - Peter A. Hilger
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology - Head and Neck Surgery, University of Minnesota, Minneapolis, MN, USA
| | - Sofia Lyford Pike
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology - Head and Neck Surgery, University of Minnesota, Minneapolis, MN, USA
| | - Shekhar K. Gadkaree
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology - Head and Neck Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
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Alqntash N, AlZabin A, Almajed E, Alotaibi K, Alhindi G, Ali SI, Bakhsh H. Polycystic Ovary Syndrome: A Comprehensive Exploration of Diagnosis Experience in Saudi Women. J Clin Med 2024; 13:5305. [PMID: 39274518 PMCID: PMC11395902 DOI: 10.3390/jcm13175305] [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: 07/30/2024] [Revised: 09/03/2024] [Accepted: 09/06/2024] [Indexed: 09/16/2024] Open
Abstract
Background/Objectives: Polycystic Ovary Syndrome (PCOS) is a prevalent endocrine disorder among women of reproductive age, characterized by symptoms such as menstrual irregularities, hyperandrogenism, and polycystic ovaries. This study aimed to explore the diagnostic experiences of women with PCOS in Saudi Arabia, evaluating the timeline to diagnosis, the adequacy of information provided, and overall patient satisfaction with the healthcare process. Methods: A cross-sectional online survey was conducted with 1182 women diagnosed with PCOS across Saudi Arabia. The survey collected data on sociodemographic characteristics, the timeline from symptom onset to diagnosis, the number of healthcare visits required for diagnosis, and satisfaction with the information and support provided during the diagnostic process. Statistical analyses, including linear regression, were performed to identify factors influencing patient satisfaction. Results: The study found that 43.2% of participants sought medical attention within a year of symptom onset, yet significant delays in diagnosis were common, with 28.6% of women waiting six months or more after seeking medical care. Only 42.7% of women reported receiving adequate information at diagnosis, and satisfaction levels varied across different aspects of care. Key predictors of lower satisfaction included marital status and longer time since diagnosis, while quicker diagnosis and more healthcare visits before diagnosis positively influenced satisfaction. Conclusions: The findings highlight critical gaps in the diagnostic process and patient education for PCOS in Saudi Arabia. The widespread dissatisfaction with the information provided underscores the need for improved patient-centered care, comprehensive education, and standardized diagnostic protocols. Addressing these issues could enhance patient satisfaction and lead to better management of PCOS, both in Saudi Arabia and globally.
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Affiliation(s)
- Norah Alqntash
- College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh 11671, Saudi Arabia
| | - Alya AlZabin
- College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh 11671, Saudi Arabia
| | - Ebtesam Almajed
- College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh 11671, Saudi Arabia
| | - Kayan Alotaibi
- College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh 11671, Saudi Arabia
| | - Ghada Alhindi
- Department of Obstetrics and Gynecology, Ibn Sina National College for Medical Studies, Jeddah 22421, Saudi Arabia
| | - Sayed Ibrahim Ali
- College of Medicine, King Faisal University, Hofuf 31982, Saudi Arabia
| | - Hanadi Bakhsh
- Obstetrics and Gynecology Department, College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh 11564, Saudi Arabia
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Morey A, Samuel V, Williams M. Universal online self-help ACT interventions for youth: A systematic review. Behav Res Ther 2024; 180:104576. [PMID: 38852229 DOI: 10.1016/j.brat.2024.104576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 05/25/2024] [Accepted: 05/28/2024] [Indexed: 06/11/2024]
Abstract
Previous reviews of online self-help have not exclusively focussed on universally delivered Acceptance and Commitment Therapy (ACT). This systematic review aimed to evaluate the effectiveness of universal online self-help ACT interventions for young people. Relevant databases were searched for studies examining ACT interventions that were delivered universally, online and as self-help (guided and unguided) to young people aged 10 to 25-years-old. Eleven studies met inclusion criteria. These were assessed for quality and findings summarised using a narrative synthesis. Outcomes on mental health, well-being and ACT processes were reviewed, and results across studies were mixed. Most studies found significant improvements in mental health and well-being outcomes following the ACT intervention; however less than half found improvements in ACT process measures. Subgroups, such as those with elevated mental health symptoms, had better outcomes. There were no changes in measures of psychological inflexibility. However, methodological issues limited the interpretation of findings. Heterogeneity between studies and methodological issues made it difficult for this review to draw conclusions regarding the effectiveness of universal online self-help ACT interventions for young people. Future research with consistent approaches is needed across these types of interventions to improve methodological rigour to determine whether these interventions are effective.
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Affiliation(s)
- Alex Morey
- South Wales Doctoral Programme in Clinical Psychology, Cardiff University, Tower Building, 70 Park Place, Cardiff, CF10 3AT, UK.
| | - Victoria Samuel
- South Wales Doctoral Programme in Clinical Psychology, Cardiff University, Tower Building, 70 Park Place, Cardiff, CF10 3AT, UK.
| | - Marc Williams
- South Wales Doctoral Programme in Clinical Psychology, Cardiff University, Tower Building, 70 Park Place, Cardiff, CF10 3AT, UK.
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Prior K, Baillie AJ, Newton N, Lee YY, Deady M, Guckel T, Wade L, Rapee RM, Hudson JL, Kay-Lambkin F, Slade T, Chatterton ML, Mihalopoulos C, Teesson MR, Stapinski LA. Web-based intervention for young adults experiencing anxiety and hazardous alcohol use: Study protocol for an 18-month randomized controlled trial. Addiction 2024; 119:1635-1647. [PMID: 38725272 DOI: 10.1111/add.16522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 04/08/2024] [Indexed: 08/03/2024]
Abstract
BACKGROUND AND AIMS Alcohol use and anxiety often co-occur, causing increased severity impairment. This protocol describes a randomized controlled trial (RCT) that aims to test the efficacy and cost-effectiveness of a web-based, self-guided alcohol and anxiety-focused program, compared with a web-based brief alcohol-focused program, for young adults who drink at hazardous levels and experience anxiety. It will also test moderators and mechanisms of change underlying the intervention effects. DESIGN This RCT will be conducted with a 1:1 parallel group. SETTING The study will be a web-based trial in Australia. PARTICIPANTS Individuals aged 17-30 years who drink alcohol at hazardous or greater levels and experience at least mild anxiety (n = 500) will be recruited through social media, media (TV, print) and community networks. INTERVENTION AND COMPARATOR Participants will be randomly allocated to receive a web-based, integrated alcohol-anxiety program plus technical and motivational telephone/e-mail support (intervention) or a web-based brief alcohol-feedback program (control). MEASUREMENTS Clinical measures will be assessed at baseline, post-intervention (2 months), 6 months (primary end-point), 12 months and 18 months. Co-primary outcomes are hazardous alcohol consumption and anxiety symptom severity. Secondary outcomes are binge-drinking frequency; alcohol-related consequences; depression symptoms; clinical diagnoses of alcohol use or anxiety disorder (at 6 months post-intervention), health-care service use, educational and employment outcomes; and quality of life. Mediators and moderators will also be assessed. Efficacy will be tested using mixed models for repeated measures within an intention-to-treat framework. The economic evaluation will analyze individual-level health and societal costs and outcomes of participants between each trial arm, while mediation models will test for mechanisms of change. COMMENTS This will be the first trial to test whether a developmentally targeted, web-based, integrated alcohol-anxiety intervention is effective in reducing hazardous alcohol use and anxiety severity among young adults. If successful, the integrated alcohol-anxiety program will provide an accessible intervention that can be widely disseminated to improve wellbeing of young adults, at minimal cost.
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Affiliation(s)
- Katrina Prior
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | | | - Nicola Newton
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Yong Yi Lee
- Monash University Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- School of Public Health, The University of Queensland, Brisbane, Australia
- Queensland Centre for Mental Health Research, Brisbane, Australia
| | - Mark Deady
- Black Dog Institute, University of New South Wales, Sydney, Australia
| | - Tara Guckel
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Laura Wade
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Ronald M Rapee
- Centre for Lifespan Health and Wellbeing, Macquarie University, Sydney, Australia
| | - Jennifer L Hudson
- Black Dog Institute, University of New South Wales, Sydney, Australia
| | - Frances Kay-Lambkin
- University of Newcastle and Hunter Medical Research Institute, Newcastle, Australia
| | - Tim Slade
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Mary Lou Chatterton
- Monash University Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Cathrine Mihalopoulos
- Monash University Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Maree R Teesson
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Lexine A Stapinski
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
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Güden E, Borlu A, Yelen Akpinar Y, Olguner Eker Ö, Özsoy S, Baykan Z. A Qualitative Study on Mental Health Services in Primary Care in Türkiye. ALPHA PSYCHIATRY 2024; 25:617-625. [PMID: 39553495 PMCID: PMC11562581 DOI: 10.5152/alphapsychiatry.2024.241605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 06/21/2024] [Indexed: 11/19/2024]
Abstract
Objective Mental health services are a neglected problem within primary care. Quality mental health service delivery at the primary level hinges on identifying and addressing related questions. The aim of this study was to evaluate the issues and solution proposals regarding service delivery based on the experiences of primary care workers in managing mental illnesses. Methods This research was conducted using the focus group interview method, which is one of many qualitative research techniques. The study sample consisted of 8 physicians and 9 healthcare workers providing primary healthcare (PHC) services in a city. The data collection process was carried out using a semi-structured interview form and a personal information form. The interviews were recorded and later transcribed. Subsequently, main themes and subthemes were identified through content analysis and a detailed content analysis was conducted based on these themes. Results Themes from interviews with PHC workers included education/training needs, service delivery barriers, and recommendations. The study revealed that PHC workers lack current knowledge on mental illnesses. There was fear of stigma regarding mental illness within the community. Workers experienced systemic issues such as heavy workloads, inadequate physical space, and inability to access data. Conclusion To reduce the treatment gap in primary mental health services and enhance access to high-quality mental health care, it would be beneficial to regularly update healthcare personnel training in mental health and increase public mental health literacy to prevent stigma and promote help-seeking behavior.
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Affiliation(s)
- Emel Güden
- Department of Public Health, Erciyes University, Health Sciences Institute, Kayseri, Türkiye
| | - Arda Borlu
- Department of Public Health, Faculty of Medical, Erciyes University, Kayseri, Türkiye
| | | | | | - Saliha Özsoy
- Department of Psychiatry, Erciyes University, Kayseri, Türkiye
| | - Zeynep Baykan
- Department of Medical Education, Erciyes University, Kayseri, Türkiye
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Setia S, Tichy M, Gilbert F. Innovating Social-Emotional Learning to Enhance Positive Engagement of Youth With Social Media: A Comprehensive Review of Why and How. Cureus 2024; 16:e70130. [PMID: 39463555 PMCID: PMC11502440 DOI: 10.7759/cureus.70130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/24/2024] [Indexed: 10/29/2024] Open
Abstract
The rising mental health burden among youth, exacerbated by excessive social media use and other risks associated with digital engagement, necessitates urgent and innovative preventive solutions. The existing research supports the notion that smartphones and social media significantly impact youth mental health, advocating for age restrictions to mitigate worsening psychological distress in the young.This comprehensive narrative literature review synthesizes research on the dual role of social media in shaping well-being among youth and explores how social-emotional learning (SEL) programs can be adapted to encourage a healthy relationship with digital platforms. Innovating SEL programs by incorporating educational techniques such as Problem-Based Learning, Inquiry-Based Learning, and Project-Based Learning inculcates real-world problem-solving and holds significant promise for fostering self-realization and self-regulation among the youth. By inculcating skills related to mindful technology use within SEL programs, students can learn to navigate social media and other technology related risk factors in a way that supports their mental health and overall well-being. The goal is to empower students to make informed decisions about technology and social media use, understand its effects on their mood and mental state, and practice techniques that contribute to a healthier, more balanced digital life. This holistic approach not only mitigates the risks associated with digital overuse but also leverages technology as a tool for enhancing personal and social development. Well-designed, innovative programs backed by thorough feasibility studies can help cultivate a generation of emotionally intelligent, resilient, and adaptive learners who can thrive in an increasingly complex digital landscape. Future research should focus on longitudinal studies to assess the long-term effects of these SEL innovations and develop scalable models that can be implemented across various educational settings.
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Affiliation(s)
- Sajita Setia
- Executive Office, Transform Medical Communications Limited, Auckland, NZL
- Executive Office, Transforming Life LLC, Wilmington, USA
| | - Michelle Tichy
- Department of Psychology/Educational Psychology, Alfred University, New York, USA
- Executive Office, Transforming Life LLC, Wilmington, USA
| | - Frank Gilbert
- Department of Psychology, Norfolk State University, Norfolk, USA
- Executive Office, Transforming Life LLC, Wilmington, USA
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40
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Alruwaili AN, Alruwaili MM, Ramadan OME, Ali SI, Shaban M. Nursing strategies for enhancing calm in older Arabs with dementia: integrating Snoezelen methods, aromatherapy, and personal items to reduce agitation. Geriatr Nurs 2024; 59:379-391. [PMID: 39128143 DOI: 10.1016/j.gerinurse.2024.07.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 06/29/2024] [Accepted: 07/22/2024] [Indexed: 08/13/2024]
Abstract
BACKGROUND Agitation significantly impacts Arab elders with dementia. Multisensory stimulation, such as Snoezelen, shows promise but lacks exploration in Arab contexts. OBJECTIVE Evaluate a culturally adapted multisensory intervention-combining Snoezelen, aromatherapy, and personal items-on agitation in Arab elders with dementia. METHODS A quasi-experimental design assessed 31 patients receiving the intervention against 31 controls. Agitation, quality of life, and neuropsychiatric symptoms were measured using the Cohen-Mansfield Agitation Inventory (CMAI) and the Neuropsychiatric Inventory (NPI). RESULTS The intervention group exhibited notable reductions in CMAI scores for aggression and agitation behaviors (p < 0.001) and improvements in quality of life and NPI scores for agitation/aggression and depression/dysphoria (p < 0.001). CONCLUSION This culturally tailored multisensory approach effectively reduced agitation and improved well-being in Arab dementia patients. The findings advocate for further research and suggest such interventions can be beneficial in culturally diverse dementia care settings. TRIAL REGISTRATION ClinicalTrials.gov, ID NCT06216275.
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Affiliation(s)
- Abeer Nuwayfi Alruwaili
- Department of Nursing Administration and Education, College of Nursing, Jouf University, Sakaka 72388, Al Jouf, Saudi Arabia.
| | - Majed Mowanes Alruwaili
- Department of Nursing Administration and Education, College of Nursing, Jouf University, Sakaka 72388, Al Jouf, Saudi Arabia
| | - Osama Mohamed Elsayed Ramadan
- Maternity and Child health Nursing Department, College of Nursing, Jouf University, Sakaka 72388, Al Jouf, Saudi Arabia.
| | - Sayed Ibrahim Ali
- Department of Family and Community Medicine, College of Medicine, King Faisal University, Al Hofuf 31982, Al-Ahsa, Saudi Arabia
| | - Mostafa Shaban
- Community health Nursing Department, College of Nursing, Jouf University, Sakaka 72388, Al Jouf, Saudi Arabia.
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Kotla R, Patil PS, Ahluwalia I. Postpartum Psychosis as a Precursor to Schizophrenia: A Comprehensive Review. Cureus 2024; 16:e68451. [PMID: 39360112 PMCID: PMC11446226 DOI: 10.7759/cureus.68451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2024] [Accepted: 09/02/2024] [Indexed: 10/04/2024] Open
Abstract
Postpartum psychosis (PP) is a rare and severe mental health disorder occurring shortly after childbirth, characterized by symptoms such as delusions, hallucinations, and intense mood swings. This review examines the potential link between PP and the later development of schizophrenia, a chronic psychiatric condition that typically emerges in late adolescence or early adulthood. By reviewing existing literature and analyzing epidemiological and clinical data, this review aims to clarify whether PP can be a precursor to schizophrenia. Findings suggest that while the transition from PP to schizophrenia is not inevitable, there is an increased risk, with some studies indicating that a subset of women with PP may develop a chronic psychotic disorder later on. This underscores the importance of early detection, ongoing monitoring, and targeted interventions. The review emphasizes the need for improved diagnostic practices and preventive measures to better manage PP and its potential long-term effects. Enhanced understanding of this relationship can inform more effective treatment strategies and support better mental health outcomes for new mothers. Future research should focus on refining risk assessment tools, exploring underlying mechanisms, and developing comprehensive management approaches to address the challenges associated with PP and its potential progression to schizophrenia.
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Affiliation(s)
- Rishitha Kotla
- Psychiatry, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Pradeep S Patil
- Psychiatry, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Isha Ahluwalia
- Psychiatry, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Pines A, Tozzi L, Bertrand C, Keller AS, Zhang X, Whitfield-Gabrieli S, Hastie T, Larsen B, Leikauf J, Williams LM. Psychiatric Symptoms, Cognition, and Symptom Severity in Children. JAMA Psychiatry 2024:2822689. [PMID: 39196567 PMCID: PMC11359114 DOI: 10.1001/jamapsychiatry.2024.2399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 06/07/2024] [Indexed: 08/29/2024]
Abstract
Importance Mental illnesses are a leading cause of disability globally, and functional disability is often in part caused by cognitive impairments across psychiatric disorders. However, studies have consistently reported seemingly opposite findings regarding the association between cognition and psychiatric symptoms. Objective To determine if the association between general cognition and mental health symptoms diverges at different symptom severities in children. Design, Setting, and Participants A total of 5175 children with complete data at 2 time points assessed 2 years apart (aged 9 to 11 years at the first assessment) from the ongoing Adolescent Brain and Cognitive Development (ABCD) study were evaluated for a general cognition factor and mental health symptoms from September 2016 to August 2020 at 21 sites across the US. Polynomial and generalized additive models afforded derivation of continuous associations between cognition and psychiatric symptoms across different ranges of symptom severity. Data were analyzed from December 2022 to April 2024. Main Outcomes and Measures Aggregate cognitive test scores (general cognition) were primarily evaluated in relation to total and subscale-specific symptoms reported from the Child Behavioral Checklist. Results The sample included 5175 children (2713 male [52.4%] and 2462 female [47.6%]; mean [SD] age, 10.9 [1.18] years). Previously reported mixed findings regarding the association between general cognition and symptoms may consist of several underlying, opposed associations that depend on the class and severity of symptoms. Linear models recovered differing associations between general cognition and mental health symptoms, depending on the range of symptom severities queried. Nonlinear models confirm that internalizing symptoms were significantly positively associated with cognition at low symptom burdens higher cognition = more symptoms) and significantly negatively associated with cognition at high symptom burdens. Conclusions and Relevance The association between mental health symptoms and general cognition in this study was nonlinear. Internalizing symptoms were both positively and negatively associated with general cognition at a significant level, depending on the range of symptom severities queried in the analysis sample. These results appear to reconcile mixed findings in prior studies, which implicitly assume that symptom severity tracks linearly with cognitive ability across the entire spectrum of mental health. As the association between cognition and symptoms may be opposite in low vs high symptom severity samples, these results reveal the necessity of clinical enrichment in studies of cognitive impairment.
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Affiliation(s)
- Adam Pines
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California
| | - Leonardo Tozzi
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California
| | - Claire Bertrand
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California
| | - Arielle S. Keller
- Penn Lifespan Informatics and Neuroimaging Center, University of Pennsylvania, Philadelphia
- Department of Psychiatry, University of Pennsylvania, Philadelphia
| | - Xue Zhang
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California
| | | | - Trevor Hastie
- Department of Statistics, Stanford University, Stanford, California
- Department of Biomedical Data Science, Stanford University, Stanford, California
| | - Bart Larsen
- Penn Lifespan Informatics and Neuroimaging Center, University of Pennsylvania, Philadelphia
- Department of Psychiatry, University of Pennsylvania, Philadelphia
| | - John Leikauf
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California
| | - Leanne M. Williams
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California
- Sierra-Pacific Mental Illness Research, Education and Clinical Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, California
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Ijaz S, Rohail I, Irfan S. School-based intervention for anxiety using group cognitive behavior therapy in Pakistan: a feasibility randomized controlled trial. PSICOLOGIA-REFLEXAO E CRITICA 2024; 37:31. [PMID: 39158777 PMCID: PMC11333417 DOI: 10.1186/s41155-024-00311-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Accepted: 07/03/2024] [Indexed: 08/20/2024] Open
Abstract
BACKGROUND Anxiety and mood disorders are the main cause of illness in people under the age of 25, accounting for 45% of the global disease burden, whereas 4.6% of teenagers aged 15 to 19 are predicted to experience anxiety. Pakistan country, with a population of 200 million, has the worst mental health indicators and fewer than 500 psychiatrists. Despite the existence of various treatments for anxiety, this goes unrecognized and untreated. Due to a lack of awareness, evaluation, prevention, and interventional programs related to being implemented among adolescents in Pakistan, there is a rise in mental health issues in the earlier years of life. It calls for a critical need for indigenous, evidence-based interventions. The present study aimed to evaluate the feasibility of cognitive behavioral therapy (CBT)-based interventions to reduce anxiety symptoms among school children in Pakistan. METHODS This study was a pre-post design, two-arm, single-blinded, feasibility, randomized controlled trial. Thirty-four participants (experimental group, n = 17; control group, n = 17) were recruited from four semi-government schools in Rawalpindi with a mean age of 15 (M = 15, SD = 0.73). Two instruments Beck Anxiety Inventory for Youth (BAI-Y II) and BASC-3 Behavioural and Emotional Screening System Student (BESS-SF) were used to assess the severity of symptoms. Participants in the intervention arm received eight-group therapy CBT sessions. A two-way factorial analysis was used to examine the efficacy of CBT in reducing symptom severity. RESULTS This study's findings showed that in comparison to the wait-list control group, CBT successfully improved anxiety symptoms among school children while enhancing their social skills. CONCLUSION This study will help improve the treatment for anxiety in Pakistan by prioritizing school-based intervention and group-based CBT intervention. TRIAL REGISTRATION The trial has been registered at the American Economic Association's registry for randomized controlled trials. RCT ID AEARCTR-0009551 . Registered 2022-07-04.
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Affiliation(s)
- Saman Ijaz
- Clinical Psychology, Public Sector Organization, Islamabad, Pakistan.
| | - Iffat Rohail
- Department of Psychology, Foundation University, Islamabad, Pakistan
| | - Shahid Irfan
- Afghan Migrants and Host Communities, International Organization for Migration, Islamabad, Pakistan
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Turgeon J, Racine N, McDonald S, Tough S, Madigan S. Maternal adverse childhood experiences, child resilience factors, and child mental health problems: A multi-wave study. CHILD ABUSE & NEGLECT 2024; 154:106927. [PMID: 38970861 DOI: 10.1016/j.chiabu.2024.106927] [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: 04/09/2024] [Revised: 06/21/2024] [Accepted: 06/27/2024] [Indexed: 07/08/2024]
Abstract
BACKGROUND Research suggests that maternal ACEs have intergenerational consequences for offspring mental health. However, very few studies have investigated moderators of this association. OBJECTIVES The objective of this longitudinal study was to examine whether child resilience factors moderated the association between maternal ACEs prior to age 18, and child-reported symptoms of anxiety, depression, hyperactivity, and inattention. PARTICIPANTS AND SETTING The current study used data from 910 mother-child dyads. Participants were recruited in pregnancy from 2008 to 2010 as part of a longitudinal cohort study. METHODS Mothers had previously completed an ACEs questionnaire and reported on their child's resilience factors at child age 8-years. Children completed questionnaires about their mental health problems (symptoms of anxiety, depression, hyperactivity, and attention problems) at ages 10 and 10.5 years. Four moderation models were performed in total. RESULTS Results revealed that maternal ACEs predicted child-reported symptoms of anxiety (β = 0.174, p = .02) and depression (β = 0.37, p = .004). However, both these associations were moderated by higher levels of perceived child resilience factors (β = -0.29, p = .02, β = -0.33, p = .008, respectively). Specifically, there was no association between maternal ACEs and child mental health problems in the context of moderate and high levels of child resilience factors. CONCLUSIONS Children who have the ability to solicit support from internal and external sources (e.g., being creative, setting realistic goals, making friends easily) may be buffered against the consequences of maternal ACEs on anxiety and depression. Thus, the effects of maternal ACEs on child mental health problems are not deterministic.
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Affiliation(s)
- Jessica Turgeon
- University of Calgary, 2500 University Dr. N.W., Calgary, AB, T2N 1N4, Canada
| | - Nicole Racine
- University of Ottawa, 136 Jean-Jacques Lussier, Ottawa, ON K1N 6N5, Canada; Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Rd, Ottawa, ON K1H 5B, Canada
| | - Sheila McDonald
- University of Calgary, 2500 University Dr. N.W., Calgary, AB, T2N 1N4, Canada
| | - Suzanne Tough
- University of Calgary, 2500 University Dr. N.W., Calgary, AB, T2N 1N4, Canada
| | - Sheri Madigan
- University of Calgary, 2500 University Dr. N.W., Calgary, AB, T2N 1N4, Canada; Alberta Children's Hospital Research Institute, 3330 Hospital Dr. N.W. Calgary, AB, Canada.
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Goslin MC, Epstein C. Telehealth Delivery of the Child and Family Traumatic Stress Intervention is Associated With Reduced Posttraumatic Stress in Children and Caregivers. CHILD MALTREATMENT 2024; 29:430-439. [PMID: 38379207 DOI: 10.1177/10775595241233230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Abstract
This study evaluated whether telehealth delivery of the Child and Family Traumatic Stress Intervention (CFTSI) was associated with posttraumatic stress symptom reduction for children exposed to potentially traumatic events and their caregivers. The Child and Family Traumatic Stress Intervention is a brief (5-8 session), evidence-based, trauma-focused mental health treatment developed for implementation with children and caregivers in the early phase of the trauma response. Within traditional in-person outpatient settings, CFTSI has demonstrated effectiveness in reducing posttraumatic stress symptoms and reducing or interrupting Posttraumatic Stress Disorder in trauma-exposed youth and their caregivers, including those with extensive trauma histories. For the present study, 9 agencies that provided CFTSI via telehealth in 2020 and 2021 provided data for analysis. The sample included 129 racially and ethnically diverse caregiver-child dyads who completed CFTSI via telehealth. Paired samples t-tests revealed significant reductions in child and caregiver posttraumatic stress symptoms from pre-to post-CFTSI. Effect sizes were large and consistent with or stronger than prior studies of CFTSI implemented in person. Preliminary findings also indicated high levels of caregiver satisfaction. Current findings are particularly noteworthy given the chronic trauma exposure in the sample. The Child and Family Traumatic Stress Intervention delivered via telehealth is a viable treatment option which can increase flexibility for clinicians, families, and organizations.
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Affiliation(s)
- Megan C Goslin
- Yale Center for Traumatic Stress and Recovery, Yale Child Study Center, Yale University, New Haven, CT, USA
| | - Carrie Epstein
- Yale Center for Traumatic Stress and Recovery, Yale Child Study Center, Yale University, New Haven, CT, USA
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Koob C, Stuenkel M, Gagnon RJ, Griffin SF, Sease K. Examining Patient- and Community-Level Factors Associated with Pediatric Mental Healthcare Access Within a Patient Navigation Program. Community Ment Health J 2024; 60:1055-1067. [PMID: 38507129 PMCID: PMC11199227 DOI: 10.1007/s10597-024-01258-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 02/18/2024] [Indexed: 03/22/2024]
Abstract
In 2021, national leaders in the United States declared a "national youth mental health crisis." Still, only 1-in-4 children receive adequate mental healthcare access. Patient Navigator Programs (PNPs) can improve children's referral-to-connection to mental health services. We examined patient- and community-level factors associated with pediatric mental healthcare access. Pediatric Support Services (PSS) is a PNP that triages mental and behavioral health referrals within a large health system in a southeastern state. This study analyzes PSS data from September 2017-March 2023 and Child Opportunity Index 2.0 state-normed zip-code level data to assess social drivers of health estimates. Structural equation modeling was conducted between patient- and community-level factors and connection to mental health services. Overall, 62.7% of children connected to mental health services since PSS' inception. Regardless of SDOH, as children get older, they are more likely to connect with mental health services (β = .053, SE = .010, p < .001). Children with greater number of referral needs are more likely to connect with mental health services (β = .034, SE = .011, p = .002). Further, children who live in communities with higher opportunity levels are more likely to connect with mental health services (β = .016, SE = .008, p = .040), suggesting that children who live in low-income communities experience more barriers to mental healthcare. Social drivers may inform referral practices and tiered navigation support for optimal mental healthcare access among children. Further research should demonstrate the effectiveness of PNPs integrated within healthcare and community-based settings.
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Affiliation(s)
- Caitlin Koob
- Department of Public Health Sciences, Clemson University, 501 Edwards Hall, Clemson, SC, 29634, USA.
- Prisma Health Children's Hospital-Upstate, Greenville, SC, USA.
| | | | - Ryan J Gagnon
- Department of Parks, Recreation, Tourism, and Management, Clemson University, Clemson, SC, USA
| | - Sarah F Griffin
- Department of Public Health Sciences, Clemson University, 501 Edwards Hall, Clemson, SC, 29634, USA
| | - Kerry Sease
- Prisma Health Children's Hospital-Upstate, Greenville, SC, USA
- University of South Carolina School of Medicine Greenville, Greenville, SC, USA
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Dion KM, Ferland F, Farand L, Gauvin L, Fleury MJ. Reasons for High Emergency Department Use Among Patients With Common Mental Disorders or Substance-Related Disorders. Healthc Policy 2024; 19:55-69. [PMID: 39229663 PMCID: PMC11411648 DOI: 10.12927/hcpol.2024.27333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/05/2024] Open
Abstract
Aims This study examined the reasons for high emergency department (ED) use among patients with common mental disorders (MDs), substance-related disorders (SRDs) or co-occurring MDs-SRDs. Method Following content analysis, 42 high ED users (three-plus visits/year) recruited in two Quebec EDs were interviewed. Results The reasons included barriers to outpatient care, patient disabilities and professional practices. Patients with SRDs trust outpatient services less, those with MDs had important unmet needs and those with MDs-SRDs faced care coordination issues. Conclusion Improvements such as ED use monitoring, consolidating MD-SRD practices and continuous training are needed in EDs and outpatient services to enhance access and continuity of care.
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Affiliation(s)
- Karine-MichÈle Dion
- Researcher, Department of Social and Preventive Medicine, School of Public Health, University of Montreal, Research Assistant, Douglas Mental Health University Institute Research Centre, Montreal, QC
| | - Francine Ferland
- Researcher, School of Social Work, Laval University, Addiction Rehabilitation Centre, National Capital University Integrated Health and Social Services Centre, Quebec City, QC
| | - Lambert Farand
- Honorary Professor, Department of Health Administration, Policy and Evaluation, School of Public Health, University of Montreal, Montreal, QC
| | - Lise Gauvin
- Professor, Department of Social and Preventive Medicine, School of Public Health, University of Montreal, Theme Leader, Health Innovation and Evaluation Hub, University of Montreal Hospital Research Centre, Montreal, QC
| | - Marie-JosÉe Fleury
- Professor, Department of Psychiatry, Douglas Research Centre, McGill University, Montreal, QC
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Omisore OM, Odenigbo I, Orji J, Beltran AIH, Meier S, Baghaei N, Orji R. Extended Reality for Mental Health Evaluation: Scoping Review. JMIR Serious Games 2024; 12:e38413. [PMID: 39047289 PMCID: PMC11306946 DOI: 10.2196/38413] [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: 03/31/2022] [Revised: 09/05/2022] [Accepted: 03/24/2024] [Indexed: 07/27/2024] Open
Abstract
BACKGROUND Mental health disorders are the leading cause of health-related problems worldwide. It is projected that mental health disorders will be the leading cause of morbidity among adults as the incidence rates of anxiety and depression grow worldwide. Recently, "extended reality" (XR), a general term covering virtual reality (VR), augmented reality (AR), and mixed reality (MR), is paving the way for the delivery of mental health care. OBJECTIVE We aimed to investigate the adoption and implementation of XR technology used in interventions for mental disorders and to provide statistical analyses of the design, usage, and effectiveness of XR technology for mental health interventions with a worldwide demographic focus. METHODS In this paper, we conducted a scoping review of the development and application of XR in the area of mental disorders. We performed a database search to identify relevant studies indexed in Google Scholar, PubMed, and the ACM Digital Library. A search period between August 2016 and December 2023 was defined to select papers related to the usage of VR, AR, and MR in a mental health context. The database search was performed with predefined queries, and a total of 831 papers were identified. Ten papers were identified through professional recommendation. Inclusion and exclusion criteria were designed and applied to ensure that only relevant studies were included in the literature review. RESULTS We identified a total of 85 studies from 27 countries worldwide that used different types of VR, AR, and MR techniques for managing 14 types of mental disorders. By performing data analysis, we found that most of the studies focused on high-income countries, such as the United States (n=14, 16.47%) and Germany (n=12, 14.12%). None of the studies were for African countries. The majority of papers reported that XR techniques lead to a significant reduction in symptoms of anxiety or depression. The majority of studies were published in 2021 (n=26, 30.59%). This could indicate that mental disorder intervention received higher attention when COVID-19 emerged. Most studies (n=65, 76.47%) focused on a population in the age range of 18-65 years, while few studies (n=2, 3.35%) focused on teenagers (ie, subjects in the age range of 10-19 years). In addition, more studies were conducted experimentally (n=67, 78.82%) rather than by using analytical and modeling approaches (n=8, 9.41%). This shows that there is a rapid development of XR technology for mental health care. Furthermore, these studies showed that XR technology can effectively be used for evaluating mental disorders in a similar or better way that conventional approaches. CONCLUSIONS In this scoping review, we studied the adoption and implementation of XR technology for mental disorder care. Our review shows that XR treatment yields high patient satisfaction, and follow-up assessments show significant improvement with large effect sizes. Moreover, the studies adopted unique designs that were set up to record and analyze the symptoms reported by their participants. This review may aid future research and development of various XR mechanisms for differentiated mental disorder procedures.
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Affiliation(s)
- Olatunji Mumini Omisore
- Research Centre for Medical Robotics and Minimally Invasive Surgical Devices, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Ifeanyi Odenigbo
- Faculty of Computer Science, Dalhousie University, Halifax, NS, Canada
| | - Joseph Orji
- Faculty of Computer Science, Dalhousie University, Halifax, NS, Canada
| | | | - Sandra Meier
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Nilufar Baghaei
- School of Electrical Engineering and Computer Science, University of Queensland, St Lucia, Australia
| | - Rita Orji
- Faculty of Computer Science, Dalhousie University, Halifax, NS, Canada
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Wambua GN, Stein A, Seedat S, Sijbrandij M, Baisley K, Shahmanesh M, Seeley J, Ngwenya N. Adaptation and feasibility of WHO PM+ for adolescents living with HIV in KwaZulu-Natal Province, South Africa: an implementation feasibility study protocol. BMJ Open 2024; 14:e088992. [PMID: 38986556 PMCID: PMC11243136 DOI: 10.1136/bmjopen-2024-088992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2024] [Accepted: 06/21/2024] [Indexed: 07/12/2024] Open
Abstract
INTRODUCTION Adolescents living with HIV (ALHIV) are an extremely vulnerable population, with the burden of mental health problems carefully documented together with the constraints for receiving timely and adequate management of the problems, especially in rural settings. Problem Management Plus (PM+) is a scalable psychological intervention for individuals impaired by distress in communities exposed to adversity. Initially developed for adult populations, few studies have assessed its potential to address adolescent distress. This study aims to co-adapt PM+ with an adherence component (PM+Adherence) for ALHIV and to evaluate its acceptability and feasibility in rural Kwa-Zulu Natal Province, South Africa. METHODS AND ANALYSIS We will use a mixed-methods approach over three phases. The first phase will include a realist synthesis and collection of formative data from up to 60 ALHIV, caregivers and healthcare providers to inform the adaptation of WHO PM+, including the components of an adherence module. During the second phase, we will undertake the cultural adaptation of the PM+Adherence intervention. The third phase will involve a hybrid type 3 implementation strategy among ALHIV aged 16-19 years (n=50) to implement and evaluate the feasibility of the culturally co-adapted PM+Adherence. The feasibility indicators to be evaluated include reach, adoption, attrition, implementation and acceptability of the adapted intervention, which will be assessed qualitatively and quantitatively. In addition, we will assess preliminary effectiveness using an intention-to-treat approach on HIV-related indicators and mental health outcomes at baseline, end intervention, 2-month follow-up during the 6-month implementation. DISCUSSION We expect that the PM+Adherence will be acceptable and can feasibly be delivered by lay counsellors in resource-limited rural KwaZulu-Natal. ETHICS AND DISSEMINATION Ethical clearance has been obtained from the University of KwaZulu-Natal Biomedical Research Ethics Committee, (BREC/00005743/2023). Dissemination plans include presentations at scientific conferences, peer-reviewed publications and community level.
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Affiliation(s)
| | - Alan Stein
- Africa Health Research Institute, Durban, KwaZulu Natal, South Africa
- University of Oxford, Oxford, UK
| | - Soraya Seedat
- SAMRC/SU Genomics of Brain Disorders Research Unit, Department of Psychiatry, Stellenbosch University, Cape Town, Western Cape, South Africa
| | - Marit Sijbrandij
- Vrije Universiteit, Department of Clinical, Neuro- and Developmental Psychology, WHO Collaborating Center for Research and Dissemination of Psychological Interventions, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Kathy Baisley
- Africa Health Research Institute, Durban, KwaZulu Natal, South Africa
- London School of Hygiene and Tropical Medicine, London, UK
| | - Maryam Shahmanesh
- Africa Health Research Institute, Durban, KwaZulu Natal, South Africa
- University College London, London, UK
| | - Janet Seeley
- Africa Health Research Institute, Durban, KwaZulu Natal, South Africa
- London School of Hygiene and Tropical Medicine, London, UK
- University of KwaZulu-Natal, Durban, KwaZulu Natal, South Africa
| | - Nothando Ngwenya
- Africa Health Research Institute, Durban, KwaZulu Natal, South Africa
- University of KwaZulu-Natal, Durban, KwaZulu Natal, South Africa
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Plank L, Zlomuzica A. Reduced speech coherence in psychosis-related social media forum posts. SCHIZOPHRENIA (HEIDELBERG, GERMANY) 2024; 10:60. [PMID: 38965247 PMCID: PMC11224262 DOI: 10.1038/s41537-024-00481-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Accepted: 06/16/2024] [Indexed: 07/06/2024]
Abstract
The extraction of linguistic markers from social media posts, which are indicative of the onset and course of mental disorders, offers great potential for mental healthcare. In the present study, we extracted over one million posts from the popular social media platform Reddit to analyze speech coherence, which reflects formal thought disorder and is a characteristic feature of schizophrenia and associated psychotic disorders. Natural language processing (NLP) models were used to perform an automated quantification of speech coherence. We could demonstrate that users who are active on forums geared towards disorders with a higher degree of psychotic symptoms tend to show a lower level of coherence. The lowest coherence scores were found in users of forums on dissociative identity disorder, schizophrenia, and bipolar disorder. In contrast, a relatively high level of coherence was detected in users of forums related to obsessive-compulsive disorder, anxiety, and depression. Users of forums on posttraumatic stress disorder, autism, and attention-deficit hyperactivity disorder exhibited medium-level coherence. Our findings provide promising first evidence for the possible utility of NLP-based coherence analyses for the early detection and prevention of psychosis on the basis of posts gathered from publicly available social media data. This opens new avenues for large-scale prevention programs aimed at high-risk populations.
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Affiliation(s)
- Laurin Plank
- Department of Behavioral and Clinical Neuroscience, Ruhr-University Bochum (RUB), D-44787, Bochum, Germany
| | - Armin Zlomuzica
- Department of Behavioral and Clinical Neuroscience, Ruhr-University Bochum (RUB), D-44787, Bochum, Germany.
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