Neurocognitive Artificial Neural Network Models Are Superior to Linear Models at Accounting for Dimensional Psychopathology

Reconceptualizing mental health in cancer survivorship

Mental health for cancer survivors in both research and clinical applications has strongly adopted a traditional nosological approach, involving the classification of psychopathology into discrete disorders. However, this approach has recently faced considerable criticism due to issues such as high comorbidity and within-disorder symptom heterogeneity across populations. Moreover, there are additional specific issues impacting the validity of traditional approaches in cancer survivorship populations, including the physiological effects of cancer and its treatments. In response, we provide the case for the hierarchical dimensional approach within psycho-oncology, in particular the Hierarchical Taxonomy of Psychopathology (HiTOP). We discuss not only the potential utility of HiTOP to research and clinical applications within psycho-oncology, but also its limitations, and what is required to apply this approach within cancer survivorship.

It's about time: mitigating cancer-related cognitive impairments through findings from computational models of the Wisconsin Card Sorting Task

BACKGROUND

Many cancer survivors experience cancer-related cognitive impairment (CRCI), often with significant negative consequences across various life domains. Emerging evidence suggests that allowing additional time to process information before acting may be a useful strategy for those with CRCI to mitigate some of its impacts. The Wisconsin Card Sorting Task (WCST), a measure of general cognition, has shown that for some cancer survivors, longer task completion time facilitates similar task performance outcomes to control populations concerning perseveration errors; a key performance metric of the WCST. However, assessing if this strategy may be useful, as well as determining for whom it may be useful, with regard to strengths and weaknesses among select cognitive domains, is challenging due to factors such as the problem of task impurity. Accordingly, this study provides an initial computational and experimental assessment of whether additional time to process information before acting is a useful strategy for those with CRCI.

METHODS

We simulated individual cognitive differences observed in humans by varying contributions of executive functioning components (updating, shifting, inhibition) to yield 48 distinct computational models of the WCST. Our main manipulation was then to provide these models with more or less time (at three levels of 20, 40 and 60 cycles) before models executed an action to sort a given card. We compared the number of perseveration errors on the WCST produced by the computational models. Additionally, we determined models that simulated the performance of cancer survivors on the WCST by comparing the number of perseveration errors produced by the models to human data.

RESULTS

Additional processing time resulted in the models producing significantly fewer perseveration errors, supporting our hypothesis. In addition, 8 unique models simulated the performance of cancer survivors on the WCST. Additional time appeared to have a positive influence on performance primarily by mitigating the impacts of severe inhibition impairments. For more severe global executive function impairments, a substantial amount of additional time was required to mitigate the impacts of the impairments. For the most severe impairments, additional time was unable to adequately mitigate the impact on performance.

CONCLUSION

Additional processing time may be a useful strategy to rectify perseveration errors among cancer survivors with CRCI. Our findings have implications for the development of practical strategies, such as workload and deadline management in occupational settings, which may mitigate the negative effects of CRCI.

Cancer-related cognitive impairment as a key contributor to psychopathology in cancer survivors: implications for prevention, treatment and supportive care

A significant proportion of cancer survivors will experience some form of mental health compromise across domains including mood, anxiety, psychosis, eating disorders, and substance use. This psychopathology within cancer survivors is related to a range of negative outcomes and can also have a substantial negative impact on quality of life. Along with psychopathology, cognitive impairments are also commonly experienced, resulting in deficits in memory, reasoning, decision-making, speed of processing, and concentration, collectively referred to as cancer-related cognitive impairment (CRCI). Within the non-oncology literature, cognitive deficits are consistently demonstrated to be a key transdiagnostic aetiological feature of psychopathology, functionally contributing to the development and perpetuation of symptoms. Whilst there is an acknowledgement of the role mental health concerns might play in the development of and perception of CRCI, there has been limited acknowledgement and research exploring the potential for CRCI to functionally contribute toward the development of transdiagnostic psychopathology in cancer survivors beyond simply psychosocial distress. Given the theoretical and empirical evidence suggesting cognitive deficits to be an aetiological factor in psychopathology, we provide a rationale for the potential for CRCI to be a factor in the development and perpetuation of transdiagnostic psychopathology in cancer survivors. This potential functional association has significant implications for risk identification, prevention, treatment, and supportive cancer care approaches regarding psychopathology in cancer survivorship. We conclude by providing directions for future research in this area.

What accounts for turnover intention in the Australian public mental health workforce?

High staff turnover is common within the Australian public mental health workforce, contributing to workforce shortages and ultimately impacting the ability to provide stable efficient, effective, and ongoing optimal care to the community. In this study, we aimed to (a) establish the most pertinent factors associated with increased turnover intention in the public mental health workforce in Australia, and (b) establish whether such factors differ between metropolitan and rural services. We used a cross-sectional, correlational design using an online survey method. In total, 235 mental health service staff of various disciplines and levels, from four public hospitals in Victoria, Australia participated in the study. We used three feed-forward multiple regression analyses to assess the study aims. We found that job satisfaction, occupational burnout, and understaffing may be the most pertinent factors to consider regarding turnover intention. Job satisfaction and occupational burnout were factors endorsed across the entire sample, as well as specifically within both the metropolitan and rural services, while understaffing was a pertinent factor regarding turnover intention across the entire sample and for rural services, but not metropolitan services. Our findings regarding the pertinence of job satisfaction, occupational burnout, and understaffing in turnover intention provide key information that may be used to inform interventional targets aimed at reducing attrition from the public mental health workforce in Australia.

"Is My Brain Ever Going to Work Fully Again?": Challenges and Needs of Cancer Survivors with Persistent Cancer-Related Cognitive Impairment

Many cancer survivors experience cognitive impairments that impact memory, concentration, speed of information processing, and decision making. These impairments, collectively known as cancer-related cognitive impairments (CRCIs), are a key domain of unmet needs and can significantly impact a cancer survivor's identity and quality of life. However, there are no purpose-built, multi-domain, needs assessment tools specifically for CRCI. The development of such tools requires an in-depth understanding of cancer survivors' CRCI-specific challenges and associated needs. This study explored the challenges and associated needs of cancer survivors with persistent CRCI. An in-depth qualitative design using semi-structured interviews with (a) cancer survivors with perceived CRCI (n = 32) and (b) oncology health professionals (n = 19) was utilised. A reflexive thematic analysis of the interviews resulted in five overarching themes: (1) executing regular activities, (2) relational difficulties, (3) occupational functioning, (4) psychological distress, and (5) social functioning, as well as an additional informational needs domain. Ultimately, CRCI was found to directly produce a range of challenges that negatively, and persistently, impact cancer survivors' quality of life. Cancer survivors were also found to have a range of needs associated with these challenges. This research should be used to inform future challenges and needs assessment tools as well as treatment and supportive care priority areas directly relating to CRCI.

Perfectionistic Children and Their Parents: Is There Room for an Intergenerational Transmission? A Study of a Clinical Sample of Italian Children and Their Parents

Introduction: The relationship between maladaptive perfectionism and Internalizing (ID) and Externalizing Disorders (ED) in children needs to be better understood, along with the intergenerational transmission of these traits from parents to children. The present work aimed to share light on both these issues. Method: 39 children with ID, 19 with ED, and their parents were recruited*. The Multidimensional Perfectionism Scale, the Big Five Inventory, the Child and Adolescent Perfectionism Scale, and the Hierarchical Personality Inventory for Children were used. The association between parent personality and perfectionism traits and children’s perfectionism dimensions was evaluated through hierarchical regression analysis. Results: ID and ED groups did not differ significantly concerning perfectionism. Fathers presented higher scores than mothers in Self-Oriented Perfectionism, Other-Oriented Perfectionism, and Socially-Prescribed Perfectionism. Parents of children with ID report higher levels of Obedience in their children, while parents of children with ED reported higher levels of Creativity and Perseverance. Significant associations were found between perfectionism in parents and their children, as well as between perfectionism and the personality of children. Conclusion: Results suggest a transdiagnostic nature of Perfectionism and support the transgenerational transmission of the personality traits investigated.

Do Dimensional Measures of Mental Health Symptoms Predict Level of Alcohol Involvement in the General Population?

Background: There is a limited understanding of what specific mental health symptoms are associated to alcohol involvement. It is important to understand how the severity of different mental health dimensions may differ, and distinguish between, levels of alcohol involvement. Objectives: (a) explore for differences in severity of mental health symptoms between those with lower, and moderate/high alcohol involvement, (b) assess the degree to which mental health dimensions can distinguish between those with lower, and moderate/high alcohol involvement, and (c) examine what mental health dimensions are related to the highest risk of moderate/high alcohol involvement. Results: 400 participants representative of the general population in the USA were recruited online through Prolific and completed the Alcohol, Smoking and Substance Involvement Screening Test and Brief Symptom Inventory. Each of the nine mental health symptom dimensions significantly differed between lower and moderate/high alcohol involvement, with the moderate/high alcohol involvement group reporting greater severity symptoms. The nine symptom dimensions in combination also significantly distinguished lower and moderate/high alcohol involvement, however only somatization offered unique predictive utility. Lastly, global distress was also able to significantly distinguish the alcohol involvement groups, albeit to a lesser accuracy compared to the collection of individual symptom dimensions. Conclusions: These findings suggest that overall mental health distress may be important to understanding alcohol involvement, however individual symptom dimensions can add further explanatory variance. In particular, somatic symptoms may offer unique utility in understanding the relationship between mental health and alcohol involvement.

Mental health consequences of COVID-19 suppression strategies in Victoria, Australia: a narrative review

The COVID-19 pandemic has imposed significant mental health burdens upon the general population worldwide, either directly owing to the disease or indirectly through aggressive public health measures to control spread of the virus that causes COVID-19. In this narrative review, we used a systematic approach to summarize the impact of restrictive lockdown measures on the general mental health of people living in Victoria, Australia during 2020 and to identify the groups with an increased risk of adverse mental health outcomes. A systematic database search (Ovid Medline, PsycINFO, Embase) for articles examining the mental health of Victorians in the context of the COVID-19 pandemic during 2020 yielded 88 articles, of which 15 articles were finally included in this review. We found that the general mental health of Victorians was negatively affected by COVID-19 restrictions during 2020. Although studies reported heterogeneous mental health outcomes, we found that the general population consistently used coping strategies and demonstrated mental health help-seeking behaviors in response to the restrictions. Women, children, young people, carers, people who became unemployed owing to the pandemic, and those with pre-existing psychiatric conditions had a higher risk of adverse mental health consequences during the COVID-19 pandemic in 2020.