Examining concurrent validity and item selection of the Session Wants and Needs Outcome Measure (SWAN-OM) in a children and young people web-based therapy service

BACKGROUND

Single-session mental health interventions are frequently attended by children and young people (CYP) in both web-based and face-to-face therapy settings. The Session "Wants" and "Needs" Outcome Measure (SWAN-OM) is an instrument developed in a web-based therapy service to overcome the challenges of collecting outcomes and experiences of single-session therapies (SSTs). It provides pre-defined goals for the session, selected by the young person prior to the intervention, on which progress toward achievement is scored at the end of the session.

OBJECTIVE

The objective of this study was to evaluate the instrument's psychometric properties, including concurrent validity against three other frequently used outcome and experience measures, at a web-based and text-based mental health service.

METHODS

The SWAN-OM was administered for a period of 6 months to 1,401 CYP (aged 10-32 years; 79.3% white; 77.59% female) accessing SST on a web-based service. Item correlations with comparator measures and hierarchical logistic regressions to predict item selection were calculated for concurrent validity and psychometric exploration.

RESULTS

The most frequently selected items were "Feel better" (N = 431; 11.61%) and "Find ways I can help myself" (N = 411; 11.07%); unpopular items were "Feel safe in my relationships" (N = 53; 1.43%) and "Learn the steps to achieve something I want" (N = 58; 1.56%). The SWAN-OM was significantly correlated with the Experience of Service Questionnaire, particularly the item "Feel better" [rs₍₁₀₉₎ = 0.48, p < 0.001], the Youth Counseling Impact Scale, particularly the item "Learn the steps to achieve something I want" [rs₍₂₂₎ = 0.76, p < 0.001], and the Positive and Negative Affect Schedule, particularly the items "Learn how to feel better" [rs₍₂₂₎ = 0.72, p < 0.001] and "Explore how I feel" [rs₍₇₀₎ = -0.44, p < 0.001].

CONCLUSION

The SWAN-OM demonstrates good concurrent validity with common measures of outcome and experience. Analysis suggests that lesser-endorsed items may be removed in future iterations of the measure to improve functionality. Future research is required to explore SWAN-OM's potential to measure meaningful change in a range of therapeutic settings.

A high resolution 7-Tesla resting-state fMRI test-retest dataset with cognitive and physiological measures

Here we present a test-retest dataset of functional magnetic resonance imaging (fMRI) data acquired at rest. 22 participants were scanned during two sessions spaced one week apart. Each session includes two 1.5 mm isotropic whole-brain scans and one 0.75 mm isotropic scan of the prefrontal cortex, giving a total of six time-points. Additionally, the dataset includes measures of mood, sustained attention, blood pressure, respiration, pulse, and the content of self-generated thoughts (mind wandering). This data enables the investigation of sources of both intra- and inter-session variability not only limited to physiological changes, but also including alterations in cognitive and affective states, at high spatial resolution. The dataset is accompanied by a detailed experimental protocol and source code of all stimuli used.

Is self-generated thought a means of social problem solving?

Appropriate social problem solving constitutes a critical skill for individuals and may rely on processes important for self-generated thought (SGT). The aim of the current study was to investigate the link between SGT and social problem solving. Using the Means-End Problem Solving task (MEPS), we assessed participants' abilities to resolve daily social problems in terms of overall efficiency and number of relevant means they provided to reach the given solution. Participants also performed a non-demanding choice reaction time task (CRT) and a moderately-demanding working memory task (WM) as a context in which to measure their SGT (assessed via thought sampling). We found that although overall SGT was associated with lower MEPS efficiency, it was also associated with higher relevant means, perhaps because both depend on the capacity to generate cognition that is independent from the hear and now. The specific content of SGT did not differentially predict individual differences in social problem solving, suggesting that the relationship may depend on SGT regardless of its content. In addition, we also found that performance at the WM but not the CRT was linked to overall better MEPS performance, suggesting that individuals good at social processing are also distinguished by their capacity to constrain attention to an external task. Our results provide novel evidence that the capacity for SGT is implicated in the process by which solutions to social problems are generated, although optimal problem solving may be achieved by individuals who display a suitable balance between SGT and cognition derived from perceptual input.

The default modes of reading: modulation of posterior cingulate and medial prefrontal cortex connectivity associated with comprehension and task focus while reading

Reading is a fundamental human capacity and yet it can easily be derailed by the simple act of mind-wandering. A large-scale brain network, referred to as the default mode network (DMN), has been shown to be involved in both mind-wandering and reading, raising the question as to how the same neural system could be implicated in processes with both costs and benefits to narrative comprehension. Resting-state functional magnetic resonance imaging (rs-fMRI) was used to explore whether the intrinsic functional connectivity of the two key midline hubs of the DMN—the posterior cingulate cortex (PCC) and anterior medial prefrontal cortex (aMPFC)—was predictive of individual differences in reading comprehension and task focus recorded outside of the scanner. Worse comprehension was associated with greater functional connectivity between the PCC and a region of the ventral striatum. Better comprehension was associated with greater functional connectivity with a region of the right insula. By contrast reports of increasing task focus were associated with functional connectivity from the aMPFC to clusters in the PCC, the left parietal and temporal cortex, and the cerebellum. Our results suggest that the DMN has both costs (such as poor comprehension) and benefits to reading (such as an on-task focus) because its midline core can couple its activity with other regions to form distinct functional communities that allow seemingly opposing mental states to occur. This flexible coupling allows the DMN to participate in cognitive states that complement the act of reading as well as others that do not.

How self-generated thought shapes mood--the relation between mind-wandering and mood depends on the socio-temporal content of thoughts

Recent work has highlighted that the generation of thoughts unrelated to the current environment may be both a cause and a consequence of unhappiness. The current study used lag analysis to examine whether the relationship between self-generated thought and negative affect depends on the content of the thoughts themselves. We found that the emotional content could strongly predict subsequent mood (e.g. negative thoughts were associated with subsequent negative mood). However, this direct relationship was modulated by the socio-temporal content of the thoughts: thoughts that were past- and other-related were associated with subsequent negative mood, even if current thought content was positive. By contrast, future- and self-related thoughts preceded improvements of mood, even when current thought content was negative. These results highlight the important link between self-generated thought and mood and suggest that the socio-temporal content plays an important role in determining whether an individual's future affective state will be happy or sad.

Letting go of the present: mind-wandering is associated with reduced delay discounting

The capacity to self-generate mental content that is unrelated to the current environment is a fundamental characteristic of the mind, and the current experiment explored how this experience is related to the decisions that people make in daily life. We examined how task-unrelated thought (TUT) varies with the length of time participants are willing to wait for an economic reward, as measured using an inter-temporal discounting task. When participants performed a task requiring minimal attention, the greater the amount of time spent engaged in TUT the longer the individual was prepared to wait for an economic reward. These data indicate that self-generated thought engages processes associated with the successful management of long-term goals. Although immersion in the here and now is undeniably advantageous, under appropriate conditions the capacity to let go of the present and consider more pertinent personal goals may have its own rewards.