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Objectives: The aim of this study was to investigate factors associated with functioning in participants with and without borderline personality disorder (BPD). In particular, we were interested whether mentalizing and related social cognitive capacities, as factors of internal functioning, are important in predicting psychosocial functioning, in addition to other psychopathological and sociodemographic factors. Method: This is a cross‐sectional study with N = 53 right‐handed females with and without BPD, without significant differences in age, IQ, and socioeconomic status, who completed semi‐structured diagnostic and self‐report measures of social cognition. Mentalizing was assessed using the Reflective Functioning Scale based on transcribed Adult Attachment Interviews. A regularized regression with the elastic net penalty was deployed to investigate whether mentalizing and social cognition predict psychosocial functioning. Results: Borderline personality disorder symptom severity, sexual abuse trauma, and social and socio‐economic factors ranked as the most important variables in predicting psychosocial functioning, while reflective functioning (RF) was somewhat less important in the prediction, social cognitive functioning and sociodemographic variables were least important. Conclusions: Borderline personality disorder symptom severity was most important in determining functional impairment, alongside trauma related to sexual abuse as well as social and socio‐economic factors. These findings verify that BPD symptoms themselves most robustly predict functional impairment, followed by history of sexual abuse, then contextual factors (e.g. housing, financial, physical health), and then RF. These results lend marginal support to the conceptualization that mentalizing may enhance psychosocial functioning by facilitating social learning, but emphasize symptom reduction and stabilization of life context as key intervention targets. [ABSTRACT FROM AUTHOR]

Objective: This study examines the association between psychosocial risk and protective factors and a wide range of psychosocial outcomes including emotional, social, cognitive, and physical domains in childhood cancer survivors (CCS). Methods: CCS from the Dutch Childhood Cancer Survivor Study (DCCSS)‐LATER cohort (diagnosed 1963–2001) part 2 (age ≥ 18 years, diagnosed < 18 years, ≥ 5 years since diagnosis) completed questionnaires on psychosocial risk and protective factors (Benefit and Burden Scale, Illness Cognition Questionnaire, Rosenberg Self‐Esteem Scale, and Impact of Cancer Scale), and psychosocial outcomes (Hospital Anxiety and Depression Scale, Self‐Rating Scale for Post‐Traumatic Stress Disorder, TNO‐AZL Questionnaire for Adult Health‐Related Quality of Life, and Short Form‐36). Associations were assessed with regression analysis, adjusting for attained age, sex, number of health conditions, and time since diagnosis, while correcting for multiple testing (p < 0.004). Results: A total of 1382 CCS participated, all diagnosed ≥ 15 years ago. The mean age of participating CCS was 36 years, and 51% were female. Perceived benefit and burden, acceptance, and helplessness, self‐esteem and social support were associated with the psychosocial outcomes. In the models including all psychosocial factors, most associations with psychosocial outcomes were seen for self‐esteem (10×), and perceived burden (9×). Self‐esteem (all β ≤ 0.47) and perceived burden (all β ≤ 0.38) demonstrated strongest associations of medium/large size. Conclusions: Perceptions of childhood cancer, illness cognitions, self‐esteem, and social support play a role in explaining psychosocial functioning in CCS, outweighing the influence of socio‐demographic and medical variables. Addressing negative perceptions and reducing feelings of helplessness, while promoting acceptance, self‐esteem, and social support, could provide intervention targets for CCS who encounter psychosocial challenges. [ABSTRACT FROM AUTHOR]

Objective: To describe the characteristics of psychogenic non‐epileptic (functional) seizures (PNES) in adults with epilepsy and intellectual disability (ID) and to establish differences and risk factors regarding psychosocial functioning between individuals with and without PNES. Methods: Adults with ID and epilepsy living in epilepsy care facilities in The Netherlands were screened for PNES by a neurologist. A control group consisting of people with epilepsy and ID, without PNES, was matched according to age, sex, and level of ID. Objective data were retrieved retrospectively from clinical notes of the resident. Standardized questionnaires and tests, adjusted for people with ID, were obtained from participants and their nursing staff. Differences were analyzed using paired t tests, Wilcoxon signed‐rank tests, or McNemar's tests, appropriate for matched case–control studies. Conditional logistic regression identified PNES risk factors. Results: Five hundred forty individuals were screened, of which 42 had PNES (point prevalence 7.8%). In total, 35 cases and 35 controls gave consent. Proxy reports indicated that PNES impacted daily life in 79% by adjusting the individual's schedule, and caused minor injuries in one‐third. Those with PNES were mainly female (69%); had a mild (46%) or moderate (37%) level of ID; showed more symptoms of depression (p =.024), anxiety (p =.030), self‐injurious behavior (p =.015); and experienced more negative life events (p <.001). Clinically relevant predictors of PNES were the number of negative life events (odds ratio [OR] 1.71, 95% confidence interval [CI] 1.12–2.53) and self‐injurious behaviors (OR 5.27, 95% CI.97–28.81). Significance: Previously, PNES in individuals with ID and epilepsy were described mainly as a reinforced behavioral pattern, due to limited associations with psychiatric disorders. Our results demonstrate that this population does show individual psychosocial vulnerabilities when measured with instruments adjusted for this population, as indicated by proxy reports from daily caregivers. Viewing PNES as an involuntary response, especially for stress‐prone individuals with ID, could reduce stigma and improve treatment. [ABSTRACT FROM AUTHOR]

Aim: Schizophrenia is a leading cause of disability worldwide; early detection and intervention are critical. Early in their illness, individuals at clinical high‐risk (CHR) for psychosis have subthreshold psychotic symptoms that are often derogatory and self‐directed. We hypothesized that CHR participants with negative self‐reference (NSR) as a component of subthreshold psychosis would also have higher levels of social anxiety and depression, lower self‐esteem and lower social/role/global functioning as compared with CHR participants without NSR. Methods: One hundred and sixty‐eight participants from the National Institute of Mental Health (NIMH) funded Regroup Cognitive Behavioural Social Skills Training (CBSST) study were included. Clinical vignettes that included the Scale of Psychosis‐Risk Symptoms were coded categorically to indicate whether NSR was present. t‐tests were used to determine the association between NSR, symptom, and functional measures. Results: Participants with NSR demonstrated significantly more social interaction anxiety (p <.001), negative beliefs about the self (p ≤.001), defeatist beliefs (p <.05), depressive symptoms (p <.05) and positive symptoms (p <.005). There were no significant differences in social self‐efficacy, positive or negative beliefs about others, positive beliefs about the self or psychosocial functioning between the two groups. Conclusions: Clinically significant differences were found between CHR participants with and without NSR, suggesting that this may be a useful factor to identify and address. Follow‐up studies are needed to determine whether NSR responds to CBSST and whether or not its resolution would be associated with improvement in other symptom domains. [ABSTRACT FROM AUTHOR]

Background: Lifestyle factors are being increasingly studied in bipolar disorder (BD) due to their possible effects on both course of disease and physical health. The aim of this study was to jointly describe and explore the interrelations between diet patterns, exercise, pharmacological treatment with course of disease and metabolic profile in BD. Methods: The sample consisted of 66 euthymic or mild depressive individuals with BD. Clinical and metabolic outcomes were assessed, as well as pharmacological treatment or lifestyle habits (diet and exercise). Correlations were explored for different interrelations and a factor analysis of dietary patterns was performed. Results: Adherence to the Mediterranean diet was low, seen in 37.9% of the patients and was positively associated with perceived quality of life. The amount of exercise was negatively associated with cholesterol levels, with 32.8% of participants rated as low active by International Physical Activity Questionnaire. There was a high prevalence of obesity (40.6%) and metabolic syndrome (29.7%). Users of lithium showed the best metabolic profile. Interestingly, three dietary patterns were identified: "vegetarian," "omnivore" and "Western." The key finding was the overall positive impact of the "vegetarian" pattern in BD, which was associated with reduced depression scores, better psychosocial functioning, and perceived quality of life, decreased body mass index, cholesterol, LDL and diastolic blood pressure. Nuts consumption was associated with a better metabolic profile. Conclusions: A vegetarian diet pattern was associated with both, better clinical and metabolic parameters, in patients with BD. Future studies should prioritize prospective and randomized designs to determine causal relationships, and potentially inform clinical recommendations. [ABSTRACT FROM AUTHOR]

ABSTRACT Severe mental illnesses (SMIs) represent a significant public health challenge with substantial personal, economic and societal burdens. Despite treatment advances, recovery outcomes for SMI patients remain variable. This study aimed to investigate the influence of personal and psychosocial factors on recovery among SMI patients in community health settings. This cross‐sectional study was conducted in 23 community health service centres in Nanjing, China. We recruited 924 participants diagnosed with SMIs, using a random sampling method. The relationships between individual, psychosocial factors and patients' recovery status were analysed by multiple linear regression. The mediation effect of medication adherence was further tested by the Sobel test with bootstrapping. The mean score of the Morningside Rehabilitation Status Scale (MRSS) of 924 patients with SMIs was 49.82 ± 41.52. The main influencing personal factors of recovery status were age, marital status, education, average annual income and duration of illness. Patients who were accepted by their families tended to have better recovery outcomes, while stigma and social impairment may hinder recovery. Medication adherence played a mediating role between psychosocial factors and recovery status. This study highlights the crucial role of psychosocial factors in the treatment and recovery of SMI patients. Furthermore, medication adherence emerged as a mediating factor. Implementing targeted interventions and policies addressing identified psychosocial barriers can offer promising avenues for improving recovery outcomes for SMI patients in community settings. [ABSTRACT FROM AUTHOR]

Introduction Material and Methods Results Conclusions Uterus transplant (UTx) has emerged as a groundbreaking solution for individuals with uterine factor infertility (UFI). This study is the first in Australia to explore the psychosocial functioning of potential recipients assessed for the nation's initial UTx clinical trial and to compare their psychological profiles with those from international UTx trials.This is a mixed methods prospective study incorporating standardized psychological measures and semi‐structured interviews. Conducted at a tertiary hospital in Sydney, Australia, the study involved 10 female Australian UTx potential recipients with UFI undergoing assessment for UTx surgery. Participants underwent comprehensive psychological evaluation using validated measures and in‐depth semi‐structured interviews. Quantitative measurement tools included the Hospital Anxiety and Depression Scale, Short Form‐36 Health Survey, Fertility Quality of Life, and the Stanford Integrated Psychosocial Assessment for Transplantation. Thematic analysis was conducted on qualitative data from semi‐structured interviews.The Australian UTx potential recipients reported significantly higher Short Form‐36 (SF‐36) scores compared to the Australian general population in general health (p < 0.04), bodily pain (p < 0.02), social functioning (p < 0.02), and emotional well‐being (p < 0.01). Compared with international UTx cohorts, the Australian UTx group showed comparable SF‐36 outcomes, with minor variations observed for general health and physical function domains. Hospital Anxiety and Depression Scale scores revealed lower anxiety, but slightly higher depression levels compared to international UTx trial cohorts. Fertility quality‐of‐life scores were significantly higher in the Australian UTx group compared to women experiencing primary infertility across four domains (p < 0.001). Thematic analysis of interviews highlighted the complex emotional impact of infertility, strong family and social support, and the perception of UTx as a transformative opportunity to achieve wholeness and motherhood.UTx represents a novel treatment option for women with UFI. This is the first qualitative study in Australia, it demonstrates the connection between women with UFI and their motivations for parenthood. These findings highlight the importance of tailored psychological assessments and establish a foundation for future research exploring the psychological characteristics of patient candidacy for UTxs. [ABSTRACT FROM AUTHOR]

Objective: Research suggests that identity functioning (i.e., sense of self) issues may be a core feature of anorexia nervosa (AN). We aimed to investigate differences in identity functioning among women with AN at varying illness and recovery stages, and women with no history of eating disorders (non‐ED controls). It was hypothesized that those with current AN (AN‐C), weight‐restored (AN‐WR), and partial recovered individuals (AN‐PR) would show poorer identity functioning than fully recovered individuals (AN‐FR) and non‐ED controls. Method: Women (334) with AN‐C (n = 74), AN‐WR (n = 90), AN‐PR (n = 19), AN‐FR (n = 22), and non‐ED controls (n = 129) completed online self‐report measures of identity functioning and ED symptom severity. Results: The AN‐C group showed significantly poorer overall identity functioning, poorer consolidated identity, and significantly worse disturbed and lack of identity, than the AN‐PR, AN‐FR, and non‐ED Control groups. The AN‐WR group showed significantly poorer overall identity function, and worse lack of identity, than the AN‐FR and non‐ED Controls, and poorer consolidated identity and disturbed identity than non‐ED Controls. Identity scores did not significantly differ between AN‐PR, AN‐FR, and non‐ED Controls. Discussion: Differences in identity functioning are identifiable among individuals at different AN recovery stages, and thus may represent an important state‐based feature of AN, making it an important area of consideration in treatment. [ABSTRACT FROM AUTHOR]

Gender‐affirming hormone therapy (GAHT) is used by many transgender and gender‐diverse adults to align physical characteristics with their gender identity, reduce gender incongruence and improve psychological functioning. This narrative review provides an overview of the initiation and monitoring of GAHT in an Australian context. Trans individuals treated with testosterone typically receive standard testosterone doses and formulations recommended for cisgender men, whereas those receiving estradiol GAHT are typically treated with estradiol in combination with an anti‐androgen in those without orchidectomy. Proactive monitoring and mitigation of cardiovascular risk factors is pertinent in all transgender and gender‐diverse adults and bone health is an important consideration in those using estradiol GAHT. [ABSTRACT FROM AUTHOR]

Background: Neurodevelopmental conditions frequently co‐occur. The aim of this paper was to determine whether there is a cumulative association between (1) the number of neurodevelopmental conditions, specifically hyperkinetic disorder (hereafter referred to as attention deficit hyperactivity disorder), autism spectrum disorder (hereafter referred to as autism) and intellectual disability, and (2) behavioural and socio‐emotional problems and the level of clinician‐rated functioning for young males and females. Methods: In this cross‐sectional study, diagnostic information, caregiver‐rated behavioural and socio‐emotional data (as conceptualised by the Strengths and Difficulties Questionnaire) and clinician‐rated functioning scores (as conceptualised by the Children's Global Assessment Scale) were extracted from electronic patient records for 2768 young people aged 3–17 years (mean = 11.55, SD = 3.46). All data were extracted at baseline, that is, at the time the young person was diagnosed with attention deficit hyperactivity disorder, autism and/or an intellectual disability. Ordinal regression analyses tested associations between the number of neurodevelopmental conditions met (i.e. 1, 2 or 3) and behavioural and socio‐emotional outcomes and functioning. Results: After controlling for age and biological sex, the number of neurodevelopmental conditions was associated with higher levels of inattention/hyperactivity and peer problems, lower levels of prosocial behaviour and poorer clinician‐rated functioning. Although these findings were consistent for males, a cumulative association was not identified for females, except for clinician‐rated functioning. Conclusions: For young people, the presence of multiple neurodevelopmental conditions may have a cumulative impact across domains, but this may differ between males and females. [ABSTRACT FROM AUTHOR]

Aim: Recently, efforts have been made to use and report person‐reported outcomes (PROs) in randomised clinical trials (RCTs). Here, we aim to (1) assess the status of inclusion of PROs in registered RCTs over 5 years in people with type 1 or 2 diabetes, and (2) map the PRO measures (PROMs) onto predefined domains. Methods: The largest trial registries (Clinicatrials.gov, International Clinical Trial Platform and ISRCTN) were systematically searched for RCTs in people with type 1 and/or type 2 diabetes of all ages between 2018 and 2023. Coding of PROs comprised: (1) PRO measure(s) included yes or no; if yes: (2) PRO(s) as primary outcome yes or no; and (3) mapping PROMs onto predefined PRO domains and per type of intervention. Results: N = 1543 trials met our inclusion criteria, of which n = 673 (44%) included PROs, assessed by 545 different measures. Twenty per cent of drug trials (n = 112) and 71% of behavioural interventions (n = 405) included PROs. In 149 trials (9.6%), a PRO was the primary outcome. The psychological functioning domain was most often assessed across all trials (21.6%), specifically in behavioural (44.8%) and medical device interventions (29.7%). In drug trials, the physical functioning and functional health domain was most included (9%). Across all trials, the social and family functioning domain was least assessed (3%). Conclusions: We noticed an increase in the inclusion of PROs in diabetes RCTs. However, PROs are rarely included as primary outcomes in the majority of studies, particularly in drug trials. The heterogeneity of PROMs used in RCTs underscores the need for standardisation of PROs. [ABSTRACT FROM AUTHOR]

Background: Parental substance misuse is a pervasive risk factor for a range of detrimental outcomes for children across the life course. While a variety of interventions have been developed for this population, the existing evidence‐base requires consolidation and consideration of the comparative effectiveness of different interventions to facilitate evidence‐informed decisions between different intervention approaches. Objectives: This review aimed to use network meta‐analysis to synthesise the comparative effectiveness of psychosocial, legal, and pharmacological interventions for improving outcomes for children with substance misusing parents. Network meta‐analysis was not possible; however, we synthesised the effects of a broad range of interventions on child psychosocial outcomes. Another aim was to examine potential moderators of the effects, yet this was also not possible due to data limitations. A secondary objective was to qualitatively synthesise economic, treatment completion, and treatment acceptability information for included studies. Search Methods: Searches were performed in November 2020 and again in April 2021. Encompassing multiple disciplines, we searched 34 databases, 58 grey literature repositories, and 10 trial registers. Supplementary hand searches were conducted on 11 journals, along with harvesting the references of all included studies and existing reviews, and forward citation searching each report of all included studies. Study authors were contacted to obtain missing data. Selection Criteria: Eligible studies included randomised and quasi‐experimental evaluations of psychosocial, pharmacological, and/or legal interventions using either a placebo, no treatment, waitlist control, treatment‐as‐usual, or alternative treatment as a comparison condition. Study participants needed to be comprised of families with children under the age of 18 with one or more currently substance‐misusing parents (or caregivers). Studies were required to evaluate the eligible intervention using a child‐focused psychosocial outcome. If reported in eligible studies, the following secondary outcomes were also synthesised in the review: cost‐effectiveness, treatment completion, length of time in treatment and acceptability of treatment (e.g. participant perspectives of the intervention). There were no restrictions placed on publication status or geographic location, however only research written in English was included. Data Collection and Analysis: Standard methodological procedures were followed across all stages of the review, as guided by the published protocol for the review (Eggins et al. 2020). Due to the inability to conduct network meta‐analyses, random effects pairwise meta‐analyses with inverse variance were used to synthesise effects when two or more studies with conceptually similar interventions and outcomes were available. Results of the meta‐analyses are displayed in forest plots, and separate analyses are provided for conceptually distinct outcomes and time‐points of measurement. Sensitivity analyses are used to explore possible sources of heterogeneity in the absence of sufficient studies to conduct subgroup analyses. Main Results: 99 studies (reported in 231 documents) met review inclusion criteria, encompassing 22,213 participants. Most studies were conducted in the United States (k = 76), almost half were randomised controlled trials (k = 46), and the most common comparator was treatment‐as‐usual (k = 50). Interventions were evaluated using a large range of child psychosocial outcomes which broadly fell under: (a) child welfare; (b) child development; (c) child emotional and behavioural; and (d) educational domains. Intervention models were rarely only legal or pharmacological in nature, with most studies evaluating integrated psychosocial treatments with either pharmacology, coordinated health care, case‐management, and/or judicial or child welfare oversight and coordination. Thirty‐six meta‐analyses and 227 single effect sizes were used to appraise the effectiveness of included interventions, based on 68 studies with sufficient data for effect size calculation. The size and direction of the effects varied across interventions, type of outcomes, and time‐point of measurement. Twenty‐seven meta‐analyses and 186 single effect sizes suggested null effects. Only five single effect size estimates based on three studies indicated negative effects including: higher depressive and somatisation symptoms (parent‐report), hopelessness (child‐report), educational achievement difficulties (parent‐report), and substantiated child protection reports for those engaged with interventions versus treatment‐as‐usual or no treatment. Nine meta‐analyses and 36 single study effect estimates suggest that psychosocial, pharmacological and/or legal interventions have a positive effect on a range of specific child welfare, developmental, and emotional/behavioural outcomes for children. The risk of bias varied across domains and studies, which further lowers confidence in the results. Based on a subset of included studies, treatment completion tends to vary, yet cost‐benefits can be achieved when intervening with children whose parents misuse substances. Authors' Conclusions: Despite a large body of evaluation evidence, disparate outcomes, and missing data precluded analyses to formally examine the comparative effectiveness of psychosocial, legal, and pharmacological interventions for improving outcomes for children with substance misusing parents. The large amount of unreported (missing) data meant that many effect estimates were underpowered due to single studies and small sample sizes. The review findings suggest that interventions for families affected by parental substance misuse can be effective when they holistically address multiple domains such as parent wellbeing/mental health, parenting, children's wellbeing, and/or other factors impacting family wellbeing (e.g. housing). [ABSTRACT FROM AUTHOR]

Background: The number of people fleeing persecution and regional conflicts is rising. Western countries have applied increasingly stringent measures to discourage those seeking asylum from entering their country, amongst them, to confine asylum seekers in detention facilities. Clinicians have expressed concerns over the mental health impact of detention on asylum seekers, a population already burdened with trauma, advocating against such practices. Objectives: The main objective of this review is to assess evidence about the effects of detention on the mental and physical health and social functioning of asylum seekers. Search methods: Relevant literature was identified through electronic searches of bibliographic databases, internet search engines, hand searching of core journals and citation tracking of included studies and relevant reviews. Searches were performed up to November 2023. Selection criteria: Studies comparing detained asylum‐seekers with non‐detained asylum seekers were included. Qualitative approaches were excluded. Data collection and analysis: Of 22,226 potential studies, 14 met the inclusion criteria. These studies, from 4 countries, involving a total of 13 asylum‐seeker populations. Six studies were used in the data synthesis, all of which reported only mental health outcomes. Eight studies had a critical risk of bias. Meta‐analyses, inverse variance weighted using random effects statistical models, were conducted on post‐traumatic stress disorder (PTSD), depression, and anxiety. Main results: A total of 27,797 asylum seekers were analysed. Four studies provided data while the detained asylum seekers were still detained, and two studies after release. All outcomes are reported such that a positive effect size favours better outcomes for the non‐detained asylum seekers. The weighted average SMD while detained is 0.45 [95% CI 0.19, 0.71] for PTSD and after release 0.91 [95% CI 0.24, 1.57]; for anxiety 0.42 [95% CI 0.18, 0.66] and for depression 0.68 [95% CI 0.10, 1.26] both while detained. Based on single‐study data, the SMD was 0.60 [95% CI 0.02, 1.17] for depression and 0.76 [95% CI 0.17, 1.34] for anxiety, both after release. Three studies (one study each) reported outcomes related to psychological distress, self‐harm and social well being. Psychological distress favoured the detained but was not significant; whereas both effect sizes on self‐harm and social wellbeing indicated highly negative impacts of detention; in particular, the impact on self‐harm was extremely high. The OR of self‐harm was reported separately for asylum seekers detained in three types of detention: Manus Island, Nauru and onshore detention. The ORs were in the range 12.18 to 74.44; all were significant. Authors' conclusions: Despite similar post‐migration adversities amongst comparison groups, findings suggest an independent adverse impact of detention on asylum seekers' mental health, with the magnitude of the effect sizes lying in an important clinical range. These effects persisted beyond release into the community. While based on limited evidence, this review supports concerns regarding the detrimental impact of detention on the mental health of already traumatised asylum seekers. Further research is warranted to comprehensively explore these effects. Detention of asylum seekers, already grappling with significant trauma, appears to exacerbate mental health challenges. Policymakers and practitioners should consider these findings in shaping immigration and asylum policies, with a focus on minimising harm to vulnerable populations. [ABSTRACT FROM AUTHOR]

Background: Functional recovery remains a core clinical objective for patients with bipolar disorder (BD). Sociodemographic, clinical, and neurocognitive variables are associated with long‐term functional impairment, yet the impact of sex differences is unclear. Functional remediation (FR) is a validated intervention aimed at achieving functional recovery in BD. The present study assessed the effect of sex differences of FR on psychosocial functioning at post‐treatment (6‐months) and 12‐month follow‐up (FUP). To the best of our knowledge, this is the first study to explore the role of sex as a factor in the efficacy of FR. Methods: 157 participants with BD were randomly assigned to either FR (N = 77) or treatment as usual group (80). Clinical, sociodemographic, neuropsychological, and functional data were obtained using a comprehensive assessment battery. Sex differences were explored via a general linear model (GLM) for repeated measures to compare the effect of sex on the intervention over time (6 months and FUP). Results: Results demonstrated that FR benefits both sexes, males (p = 0.001; d' = 0.88) and females (p = 0.04; d' = 0.57), at 6 months suggesting a generalized functional improvement. Conversely, at 12‐month FUP sex differences were observed only in males (p = 0.005; d' = 0.68). Conclusions: FR is a beneficial intervention for males and females after treatment, suggesting that there are no relevant distinct needs. Females may benefit from ongoing psychosocial functioning booster sessions after the intervention to maintain original improvements. Future research exploring sex differences could help to identify strategies to offer personalized FR intervention approaches in individuals with BD. [ABSTRACT FROM AUTHOR]

Background: Psychosocial rehabilitation in forensic psychiatric services requires sound measurement of patient and staff perceptions of psychosocial function. The recommended World Health Organisation Disability Assessment Schedule 2.0 (WHODAS), designed for this, has not been examined with offender patients. Aims: To examine patient and staff WHODAS ratings of secure hospital inpatients with psychosis, any differences between them and explore associations with other clinical factors. Methods: Seventy‐three patients self‐rated on the WHODAS after 3 months as inpatients. An occupational therapist interviewed the patient's primary nurse and care team at about the same time (staff ratings). Scores were calculated according to the WHODAS manual. WHODAS scores and interview‐rated symptom severity, cognitive measures, daily antipsychotic dose and duration of care were compared. Results: Patient ratings indicated less disability than staff ratings for total score and for the domains of understanding and communicating, getting along and life activities. Self‐care and participation ratings were similar. Patients were more likely to rate themselves as disabled in getting around (mobility). Only one‐fifth of patient‐ and staff‐ ratings (16, 22%) were similar, while for nearly a third of the patients (23, 32%) self‐ratings were higher than staff ratings. More severe positive symptoms were associated with higher self‐rated WHODAS disability after accounting for treatment duration, negative symptoms, cognitive score and antipsychotic dose. No variable accounted for the staff/patient differences in ratings. Conclusion: Our mean WHODAS score findings echoed those in other patient samples—of patient underestimation of disability, linked to severity of symptoms. In this study using the WHODAS for the first time in a forensic mental health secure inpatient service, however, we found that, by comparing individuals, half of the patients reported equivalent or greater disability than did staff. Future research should focus on elucidating from patients what contributes to their self‐ratings. Understanding their thought processes in rating may enhance rehabilitation planning. [ABSTRACT FROM AUTHOR]

Diabetes is unique among chronic diseases because clinical outcomes are intimately tied to how the person living with diabetes reacts to and implements treatment recommendations. It is further characterised by widespread social stigma, judgement and paternalism. This physical, social and psychological burden collectively influences self‐management behaviours. It is widely recognised that the individual's perspective about the impact of trying to manage the disease and the burden that self‐management confers must be addressed to achieve optimal health outcomes. Standardised, rigorous assessment of mental and behavioural health status, in interaction with physical health outcomes is crucial to aid understanding of person‐reported outcomes (PROs). Whilst tempting to conceptualise PROs as an issue of perceived quality of life (QoL), in fact health‐related QoL is multi‐dimensional and covers indicators of physical or functional health status, psychological and social well‐being. This complexity is illuminated by the large number of person reported outcome measures (PROMs) that have been developed across multiple psychosocial domains. Often measures are used inappropriately or because they have been used in the scientific literature rather than based on methodological or outcome assessment rigour. Given the broad nature of psychosocial functioning/mental health, it is important to broadly define PROs that are evaluated in the context of therapeutic interventions, real‐life and observational studies. This report summarises the central themes and lessons derived in the assessment and use of PROMs amongst adults with diabetes. Effective assessment of PROMs routinely in clinical research is crucial to understanding the true impact of any intervention. Selecting appropriate measures, relevant to the specific factors of PROs important in the research study will provide valuable data alongside physical health data. [ABSTRACT FROM AUTHOR]

Background: Tooth loss has been associated with cognitive decline, but the underlying mechanisms involving speech and psychosocial impairment remain unclear. Objectives: To investigate the impact of tooth loss‐related speech and psychosocial impairment on cognitive function in Hong Kong's older population. Methods: Seventy‐six Cantonese‐speaking participants between the ages of 51–92 were classified into three groups: patients with complete dentures (CD), partially edentulous patients with less than 10 occluding tooth pairs (OU <10), and at least 10 occluding tooth pairs (OU ≥10). Cognitive function was assessed using the Montreal Cognitive Assessment Hong Kong Version, One‐minute Verbal Fluency Task and Hayling Sentence Completion Test. Objective and subjective speech assessments were carried out using artificial intelligence speech recognition algorithm and a self‐designed speech questionnaire. The impact of tooth loss on psychosocial condition was evaluated by the Reading the Mind in the Eyes Test and a self‐designed questionnaire. Statistical analyses (one‐way ANOVA, ANCOVA, Kruskal–Wallis test, Spearman correlation test) were performed. Results: Tooth loss was significantly associated with lower cognitive function (p =.008), speech accuracy (p =.018) and verbal fluency (p =.001). Correlations were found between cognitive function and speech accuracy (p <.0001). No significant difference in tooth loss‐related psychosocial impact was found between the three groups. Conclusion: While warranting larger sample sizes, this pilot study highlights the need for further research on the role of speech in the association between tooth loss and cognitive function. The potential cognitive impact of tooth retention, together with its known biological and proprioceptive benefits, supports the preservation of the natural dentition. [ABSTRACT FROM AUTHOR]

Objectives: To examine the reliability and validity of a semi‐structured interview assessing the features of the DSM‐5 mixed features specifier. Our goal was to develop an instrument that could be used for both diagnostic and severity measurement purposes. Methods: Four hundred fifty‐nine psychiatric patients in a depressive episode were interviewed by a trained diagnostic rater who administered semi‐structured interviews including the DSM‐5 Mixed Features Specifier Interview (DMSI). We examined the inter‐rater reliability and psychometric properties of the DMSI. The patients were rated on clinician rating scales of depression, anxiety, and irritability, and measures of psychosocial functioning, suicidality, and family history of bipolar disorder. Results: The DMSI had excellent joint‐interview interrater reliability. More than twice as many patients met the DSM‐5 mixed features specifier criteria during the week before the assessment than for the majority of the episode (9.4% vs. 3.9%). DMSI total scores were more highly correlated with a clinician‐rated measure of manic symptoms than with measures of depression and anxiety. More patients with bipolar depression met the mixed features specifier than patients with MDD. Amongst patients with MDD, those with mixed features more frequently had a family history of bipolar disorder, were more frequently diagnosed with anxiety disorders, attention deficit disorder, and borderline personality disorder, more frequently had attempted suicide, and were more severely depressed, anxious, and irritable. Conclusion: The DMSI is a reliable and valid measure of the presence of the DSM‐5 mixed features specifier in depressed patients as well as the severity of the features of the specifier. [ABSTRACT FROM AUTHOR]

Emerging adulthood is an important developmental phase often accompanied by peaks in loneliness, social anxiety, and depression. However, knowledge is lacking on how the relationships between emotional loneliness, social loneliness, social isolation, social anxiety and depression evolve over time. Gaining insight in these temporal relations is crucial for our understanding of how these problems arise and maintain each other across time. Young adults from a university sample (N = 1,357; M = 23.60 years, SD = 6.30) filled out questionnaires on emotional and social loneliness, social isolation, depressive and social anxiety symptoms at three time points within a 3‐year period. Random intercept cross‐lagged panel models were used to disentangle reciprocal and prospective associations of loneliness subtypes, social isolation, depressive and social anxiety symptoms across time. Results showed that on the within‐person level, increases in emotional and social loneliness as well as social isolation predicted higher depression levels on later timepoints. Increases in depressive symptoms also predicted increases in subsequent social loneliness, but not in emotional loneliness. Finally, increases in depressive symptoms predicted increases in social isolation. There were no significant temporal relations between loneliness and social isolation on the one hand and social anxiety symptoms on the other hand. Social distancing imposed by COVID‐19 related government restrictions may have impacted the current results. The findings suggest that emotional and social loneliness precede development of depressive symptoms, which in turn precedes development of social loneliness and social isolation, indicating a potential vicious cycle of social loneliness, social isolation and depressive symptoms in emerging adulthood. Social anxiety did not precede nor follow loneliness, depressive symptoms, or social isolation. The current study sheds more light on the temporal order of loneliness and psychopathological symptoms and hereby assists in identifying times where prevention and intervention efforts may be especially helpful to counter development of depression and loneliness. [ABSTRACT FROM AUTHOR]

Background: We examined the implementation and potential effectiveness of a school‐based targeted prevention programme addressing behaviour problems, adapted for children with mild intellectual disabilities or borderline intellectual functioning. Method: Thirteen children participated. The intervention was implemented in schools. We examined intervention dosage, reach, responsiveness, satisfaction, and comprehension, using questionnaires completed by children and trainers. We assessed child‐ and teacher‐reported behaviour problems before and after the intervention. Results: Trainers selected both children who did and did not meet the intervention eligibility criteria, suggesting problems in intervention reach. Intervention dosage, responsiveness, satisfaction, and comprehension were satisfactory. There were group‐level behaviour problem decreases (i.e., Cohen's d). Individual‐level behaviour problem changes (i.e., Reliable Change Indices) showed large heterogeneity and little reliable change. Conclusions: The results provide initial evidence that the intervention has potential for successful implementation in schools, but the current evidence for intervention effectiveness is inconclusive. [ABSTRACT FROM AUTHOR]

Workplace learning and development is crucial for sustained employability, especially for people with limited work capacity (LWC). We explored the development in cognitive functioning and work behaviour of people with LWC and to which extent this is moderated by workplace acceptance and support. As suggested in literature, acceptance and support concern pre‐conditions for development. Therefore, we expected them to influence the development of our target group. In total, 182 people with LWC and 172 workplace mentors provided data on dimensions of cognitive functioning and work behaviour on three time‐points over 4 months. Furthermore, people with LWC provided data on workplace acceptance and support. Results showed significant development over time for both, self‐ and observer‐rated cognitive functioning, such as planning and organising, learning and memory, problem solving, and for self‐rated adaptability and concentration. Development over time emerged for the self‐rated work pace, a work behaviour dimension. Moreover, the growth curves on self‐rated variables such as learning and memory, work accuracy, social behaviour and work pace were moderated by workplace acceptance and support. This study provides initial insight into growth patterns of cognitive functioning and work behaviour of people with LWC and illustrates the relevance of a supportive climate for development. [ABSTRACT FROM AUTHOR]

Background/Objectives: The Skindex‐29 and Skindex‐Teen assess dermatology‐related quality of life among adults and adolescents, respectively. This study directly compared the same adolescents' responses to the Skindex‐29 relative to Skindex‐Teen in a predominantly American Indian and/or Alaska Native population. This population is underrepresented in medical research. Although skin‐related quality‐of‐life issues are widespread, American Indian and/or Alaska Native adolescents are not well‐represented in related studies. Methods: Data were collected in‐person by self‐report survey at two regional powwows in Denver, Colorado in 2021 and 2022. Respondents completed the full Skindex‐29 and Skindex‐Teen (40 unique items total). Results: Eighty‐six adolescents, 12–17 years old, completed the survey. The majority (70.9%, 61/86) of respondents self‐identified as American Indian and/or Alaska Native. Analyses were conducted with all respondent survey data. Nearly two‐thirds (64.0%, 55/86) of our respondents had a Skindex‐29 score that revealed their quality of life was impaired at least mildly by skin disease. The Skindex‐29 and Skindex‐Teen demonstrated good reliability; there was substantial concordance between responses to the two measures (r values ranged from 0.88 to 0.97 for similar subscales). Compared to younger adolescents (aged 12–14), older adolescents (aged 15–17) reported worse dermatology‐related quality of life and emotional toll based on higher Skindex‐29 total, Skindex‐Teen total, Skindex‐29 Emotional subscale, and Skindex‐Teen Psychosocial Functioning subscale scores. Conclusions: American Indian and/or Alaska Native adolescents suffer from skin‐related quality‐of‐life issues. The Skindex‐Teen and Skindex‐29 generated similar information regarding quality of life in young patients with skin disease. While the Skindex‐Teen may be slightly more relevant to adolescents, these surveys were highly concordant. Both the Skindex‐Teen and Skindex‐29 exhibited frequent "never" responses to questions about impact of skin conditions on relationships with others and tendencies to stay home. Thus, careful attention should be paid to such questions to ensure their relevance to adolescents. [ABSTRACT FROM AUTHOR]

Background: This study examines the effect of a Theory of Mind (ToM) intervention on ToM abilities and social–emotional functioning in adolescents with developmental language disorder (DLD) or who are deaf/hard of hearing (D/HH). It emphasizes the importance of self‐reflection and measurement for personal growth. The research design incorporates both subjective and objective measures to evaluate the intervention's efficacy. Aims: To investigate the impact of the ToM intervention on ToM abilities and social–emotional functioning in adolescents with DLD or who are D/HH. It hypothesizes that participants in the intervention groups will show improved ToM and social–emotional functioning compared with those in the control groups. Methods & Procedures: Adolescents with DLD or who are D/HH were recruited through collaboration with educational institutions. The study utilized a pre‐/post‐test design, assigning participants to either the intervention or the control group. The ToM intervention involved targeted activities to enhance ToM abilities. ToM abilities and social–emotional functioning were assessed using standardized tests and self‐report questionnaires. Statistical analyses compared outcomes between the intervention and no intervention groups. Outcomes & Results: The findings reveal subjective improvements in social–emotional functioning among the D/HH intervention group. However, no significant effects on objective ToM measures were observed. These results highlight the need for further investigation and refinement of interventions in these areas. Future research should focus on improving intervention strategies and exploring additional objective measures to gain a comprehensive understanding of the intervention's impact on ToM and social–emotional functioning in this population. Conclusions & Implications: The ToM intervention shows subjective benefits in improving social–emotional functioning among D/HH adolescents. However, it does not yield significant effects on objective ToM measures. These findings emphasize the ongoing need to refine interventions targeting ToM abilities and social–emotional functioning in this population. Future studies should explore alternative strategies and incorporate additional objective measures to enhance understanding and outcomes. WHAT THIS PAPER ADDS: What is already known on this subject: Before this study, it was known that ToM interventions have the potential to enhance ToM abilities. However, the specific effects of such interventions on subjective and objective measures for ToM and social–emotional functioning in adolescents with DLD or who are D/HH remained unclear, necessitating further research. What this paper adds to the existing knowledge: This study adds to the existing knowledge by demonstrating subjective improvements in social–emotional functioning among adolescents who are D/HH and underwent a ToM intervention. However, no significant effects on objective ToM measures were observed. These findings highlight the need for refining interventions and exploring additional measures to better understand the intervention's impact. What are the potential or actual clinical implications of this work?: The subjective improvements in social–emotional functioning observed in this study have important clinical implications. They suggest that ToM interventions can positively impact the social well‐being of adolescents who are D/HH. However, the lack of significant effects on objective ToM measures emphasizes the need for further research and intervention refinement to address specific areas of improvement in this population. [ABSTRACT FROM AUTHOR]

Children whose families experience socioeconomic disadvantage are at risk for poor sustained attention, a foundational skill related to goal‐oriented behaviour, self‐regulation and kindergarten readiness. Maternal parenting behaviours and parenting stress are theorised developmental pathways linking socioeconomic status (SES) to children's sustained attention. However, research has yet to empirically test for these indirect pathways, thus limiting the relevance of extant findings to inform targets of parent‐mediated programmes addressing attentional disparities at school entry for low‐income children. Using a sample of mostly low‐income children from the Future of Families and Child Wellbeing Study (N = 2214) and the process of parenting model, this study tested whether maternal parenting stress, harsh parenting and cognitive stimulation uniquely explained associations between SES and child sustained attention at age 5 years. Results from structural equation modelling revealed that SES was positively and directly associated with child sustained attention. Some of these effects were indirectly transmitted through the pathway of maternal cognitive stimulation; however, neither harsh parenting nor parenting stress helped to explain the relationship between SES and child sustained attention. Implications of the findings are explored in the context of early childhood prevention and promotion programmes serving low‐income families. Highlights: This study explores the direct and indirect paths of family SES on child sustained attention through the pathways of maternal cognitive stimulation, harsh parenting and parenting stress amongst socioeconomically disadvantaged children.Results from SEM revealed that SES was positively and directly associated with child‐sustained attention and some of these effects were indirectly transmitted through the pathway of maternal cognitive stimulation.Cognitive stimulation is a crucial pathway through which SES may promote or impede the development of children's sustained attention skills. [ABSTRACT FROM AUTHOR]

Summary Many individuals with serious mental illness (i.e. schizophrenia spectrum, bipolar or major depressive disorders, with serious functional impairments) have insomnia symptoms. Insomnia is a common reason for mental health referrals in the Veterans Health Administration. The primary aim of this study was to explore the costs (what participants lose or what trade‐offs they make due to insomnia) and consequences (how insomnia impacts functioning) of insomnia for veterans with serious mental illness. Semi‐structured interviews of 20 veterans with insomnia and serious mental illness were collected as data using an inductive phenomenological approach. Two main themes were identified: Sleep Affects Mental Health and Functioning; and Compromising to Cope. Results illuminate pathways by which sleep effort destabilizes functional recovery, and illustrate how sleep has multiplicative positive impacts on functioning and mood. Researchers and clinicians alike must explore supporting people with serious mental illness in replacing sleep effort with the recovery of meaningful identity‐driven, values‐based experiences formerly conceded due to serious mental illness, insomnia or both. [ABSTRACT FROM AUTHOR]

Introduction: Web‐based guided self‐help cognitive behavioral therapy‐enhanced (CBT‐E) is a 12‐weeks, 12‐sessions, digitalized version of part II of the self‐help book Overcoming Binge Eating. This intervention is effective when offered under controlled circumstances in a randomized‐controlled‐trial. It is unknown how patients with binge‐eating disorder (BED) respond to this intervention when offered in real‐world clinical‐settings. The aim of this study is to examine post‐intervention effectiveness of guided self‐help CBT‐E for BED in real‐world settings. Method: The present study used a cohort‐design examining the effectiveness of web‐based guided self‐help CBT‐E according to an intention‐to‐treat (ITT) analysis. BED patients (n = 278) were assessed pre‐ and post‐intervention. The primary outcome was reduction in binge‐eating episodes. Other outcomes were full‐recovery (EDE‐Q score <2.77 and abstinence from binge‐eating episodes), impaired psychosocial functioning, defined as secondary impairment, and general psychopathology post‐intervention. Results: The number of binge‐eating episodes reduced by an average of 16 binge‐eating episodes per 4 weeks pre‐intervention to five binge‐eating episodes during the last 4 weeks of treatment. Abstinence from binge eating was reported by 30%, and 28% reported full recovery. Effect sizes (Cohen's d) were large (d ≥ 1.0) for all outcome measures. There were no differences in outcomes between the ITT and the completers sample. Discussion: Guided self‐help CBT‐E is associated with significant improvements. The effects of guided self‐help CBT‐E offered in a real‐world‐setting are comparable to self‐help CBT‐E offered in a randomized‐controlled‐trial. However, it should be noted that comparisons with randomized‐controlled‐trials requires caution. Longer‐term follow‐up data are necessary to measure persistence of treatment benefits. Public Significance: Offering CBT‐E as a web‐based guided self‐help intervention has several benefits for patients with BED. Guided self‐help CBT‐E is associated with significant improvements on the short term when offered in real‐world clinical settings. [ABSTRACT FROM AUTHOR]

Introduction: The aim of this study was to explore how resilience is manifested in the experiences of emerging adults who were subjected to bullying victimization in school and have high levels of psychological functioning in emerging adulthood. Methods: Fifteen Swedish emerging adults (Mage = 29.13, SD = 0.52) who, despite experiences of bullying victimization at age 10, had high levels of psychological functioning as emerging adults were interviewed. The interviews focused on experiences of bullying victimization and the long‐term outcomes of these experiences. Qualitative methods were used in the analysis, with a specific focus on resilience. Results/Conclusion: The findings illustrate how long‐term outcomes of bullying victimization in school, in relation to resilience, comprise a dynamic process between personal agency and social resources in the environmental context. [ABSTRACT FROM AUTHOR]

Introduction: Many people experience persistent symptoms for more than 12 weeks following SARS‐CoV‐2 infection, which is known as post‐COVID‐19 condition (PCS) or Long COVID (LC). PCS can impair people's quality of life and daily functioning. However, there is a lack of in‐depth research exploring the PCS patient journey, as well as gendered aspects of patients' experiences. Methods: Nineteen semi‐structured qualitative interviews were conducted with people living with PCS in the United Kingdom (13 women, 6 men). Interviews were transcribed verbatim and analysed inductively using reflexive thematic analysis. Results: Five main themes were identified: 'Symptom dismissal', 'Lack of information and support', 'Life before and after Long COVID', 'Psychological impact' and 'Acceptance'. A shift overtime to self‐management of symptoms was evident. These themes represent different stages of patients' PCS journey. Narratives indicated that women highlighted dismissal by healthcare professionals (HCPs), which was not as prominent in men's narratives. In addition, women went into more detail about the psychological impact of PCS compared to men. Conclusion: Women with PCS reported symptom dismissal by HCPs, which may have delayed their diagnosis and negatively affected their well‐being. We were not able to explore the experiences of people from non‐conforming gender groups. Raising awareness of these issues among HCPs, particularly general practitioners, could improve patient care in PCS. Patient or Public Contribution: Patient and public involvement consisted of people who took part in the interviews and commented on the themes' interpretation and study conclusions. [ABSTRACT FROM AUTHOR]

Perceiving partner emotions accurately is relevant for relationship functioning and may relate to perceivers' attachment orientations. Here we tested whether attachment anxiety and avoidance affect the perception of a hard and a flat partner emotion which can signal a relationship threat, that is, irritation and indifference towards the partner, and of general affective valence. We assessed whether individuals (1) over‐ or underestimate (directional bias) and (2) track changes (tracking accuracy) in their partner's emotions. Ninety‐four couples reported on their own emotions and their perception of their partner's emotions multiple times per day during 1 week. Results revealed that more avoidantly attached men less accurately tracked changes in partner irritation and more anxiously attached men less accurately tracked changes in partner affective valence. No other significant associations of attachment with tracking accuracy nor with directional bias were found. Overall, the findings suggest no robust relation between attachment insecurity and perception of partner irritation, indifference and affective valence in everyday life. [ABSTRACT FROM AUTHOR]

Background: Bipolar depression is the major cause of morbidity in patients with bipolar disorder. It affects psychosocial functioning and markedly impairs occupational productivity. Anhedonia is one of the most debilitating symptoms of depression contributing to treatment resistance. It correlates with suicidality, low quality of life, social withdrawal, and poor treatment response. Currently, there is no approved treatment specifically targeting anhedonia. Emerging evidence suggests that ketamine possesses anti‐anhedonic properties in individuals with depression. Objectives: The aim of this naturalistic open‐label study was to investigate the effect of add‐on ketamine treatment on anhedonia in treatment resistant bipolar depression. Methods: Our main interest was the change in patient‐reported (Snaith‐Hamilton Pleasure Scale) and rater‐based anhedonia measure (Montgomery–Åsberg Depression Rating Scale‐anhedonia subscale). The secondary aim was to analyze the score change in three Inventory of Depressive Symptomatology‐Self Report (IDS‐SR) domains: mood/cognition, anxiety/somatic, and sleep. Patients underwent assessments at several time points, including baseline, after the third, fifth, and seventh ketamine infusions. Additionally, a follow‐up assessment was conducted 1 week following the final ketamine administration. Results: We found improvement in anhedonia symptoms according to both patient‐reported and rater‐based measures. The improvement in IDS‐SR domains was most prominent in anxiety/somatic factor and mood/cognition factor, improvement in sleep factor was not observed. No serious adverse events occurred. Conclusion: Add‐on ketamine seems to be a good choice for the treatment of anhedonia in treatment resistant bipolar depression. It also showed a good effect in reducing symptoms of anxiety in this group of patients. Considering unmet needs and the detrimental effect of anhedonia and anxiety, more studies are needed on ketamine treatment in resistant bipolar depression. [ABSTRACT FROM AUTHOR]

Background: Static and dynamic balance skills can be related to the activities of daily living (ADL) in children with non‐syndromic intellectual disabilities, and the type of balance skills affecting ADL can differ depending on the domain of ADL (self‐care, mobility, and social function). Methods: The ADL capabilities of 66 children with intellectual disabilities were assessed using the Pediatric Evaluation of Disability Inventory (PEDI) and were examined in relation to static and dynamic balance skills. Results: Significant positive correlations were found between the one‐leg standing and PEDI (r =.841 for self‐care, r =.700 for mobility, and r =.760 for social function). Our analysis showed that static balance skills affected self‐care, dynamic balance skills affected mobility, and intelligence quotient affected social function. Conclusions: Improving balance skills is important for enhancing ADL capabilities, and the type of balance skills that need enhancement vary based on the domain of ADL. [ABSTRACT FROM AUTHOR]

Overuse injuries, which have a high prevalence in sport, are suggested to result in different affective responses in comparison to traumatic injuries. Affects may also reciprocally act as risk factors for overuse injury. The aim of this study was to examine the associations between overuse injury and affects within a longitudinal follow‐up design. Competitive athletes (N = 149) of various sports and levels of competition completed the Positive and Negative Affect Schedule (PANAS) and the Oslo Sports Trauma Research Centre Overuse injury questionnaire (OSTRC‐O) once a week over 10 consecutive weeks. Bivariate unconditional latent curve model analyses with structured residuals were performed to evaluate the associations within and across weeks between OSTRC‐O severity score and affects. Results indicated that OSTRC‐O severity score and positive affects (PA) had a statistically significant negative within‐week relation (r = −24.51, 95% CI = [−33.9, −15.1], p < 0.001). Higher scores of overuse injury were significantly related to lower levels of PA across weeks (ß = −0.02, 95% CI = [−0.04, −0.001], p = 0.044), while the reciprocal effect of PA on overuse injury was not significant (ß = −0.13, 95% CI = [−0.52, 0.26], p = 0.51). No statistically significant association was observed between OSTRC‐O severity score and negative affects, neither within nor across weeks. Our findings suggest that overuse injury may have adverse psychological consequences on the long run through lessened PA and address the need for providing sustainable psychological support focusing upon such PA when working with athletes experiencing overuse injury. [ABSTRACT FROM AUTHOR]

Background and purpose: Dysphagia is associated with poor outcome, higher mortality, reduced quality of life, and social isolation. We investigate the relationship between swallowing impairment and symptoms of anxiety and depression after ischemic stroke. Methods: Consecutive patients with ischemic stroke participating in the prospective STROKE‐CARD Registry study from 2020 to 2022 were assessed for dysphagia on hospital admission (clinical swallowing assessment) and for persistence until discharge and 3‐month follow‐up (SINGER Independency Index). Anxiety and depression symptoms were recorded using Beck Depression Inventory (BDI) and Hospital Anxiety and Depression Scale (HADS) at 3‐month follow‐up. Results: Of 648 patients, 19.3% had dysphagia on admission, persisting in 14.8% at discharge and 6.8% at 3‐month follow‐up. With the presence or duration of dysphagia (no dysphagia, dysphagia at baseline, at discharge, at 3 months), score (mean ± SD) increased on the BDI (7.9 ± 6.7, 12.5 ± 8.7, 13.5 ± 9.0, 16.5 ± 10.2), HADS‐D (4.4 ± 3.7, 7.1 ± 4.2, 7.7 ± 4.4, 9.8 ± 4.3), and HADS‐A (4.4 ± 3.5, 5.4 ± 3.6, 6.0 ± 3.6, 7.0 ± 3.6). In linear regression analysis adjusting for age, sex, diabetes, dementia, and either functional disability or stroke severity, BDI and HADS‐D scores were significantly higher in patients with dysphagia across all points in time (admission, discharge, 3‐month follow‐up). An independent association with HADS‐A scores was only evident in patients with persisting dysphagia after 3 months. Patients with dysphagia were more likely to receive antidepressants, antipsychotics, or benzodiazepines at discharge and 3‐month follow‐up. Conclusions: Dysphagia after stroke is common and severely affects psychosocial functioning of individuals. Our results highlight swallowing impairment as an independent predictor for poststroke depressive and, to a lesser extent, anxiety symptoms. [ABSTRACT FROM AUTHOR]

Aims: Maternal caregiver involvement is strongly associated with psychosocial and glycemic outcomes amongst adolescents with type 1 diabetes (T1D); however, previous studies have lacked detailed, objective examinations of caregiver involvement. We examined the relationship between observed parenting behaviors and psychosocial and glycemic outcomes amongst youth with T1D. Methods: Data collected from adolescents with T1D (age 11‐17) and their female caregivers as a part of a randomized controlled trial were analyzed. These included structured, observation‐based scores of adolescent‐caregiver dyads engaged in videotaped interactions and selected psychosocial and glycemic outcome measures. Results: In adjusted analyses, higher levels of intrusive parenting behaviors during observed interactions were associated with higher diabetes distress in adolescents, but no difference in HbA1c. Associations between intrusive parenting behaviors and psychosocial outcomes were stronger for females compared to males for both diabetes distress and quality of life. Similarly, associations between collaborative parenting behaviors and quality of life were stronger for female adolescents than males. No associations were observed between collaborative parenting behaviors and glycemic outcomes. Consistent with previous work, we noted higher levels of adolescent‐reported family conflict were associated with lower adolescent quality of life and higher diabetes distress with no significant difference between male and female adolescents. Conclusion: These findings indicate that high levels of intrusive parenting behaviors, such as lecturing or over‐controlling behaviors, are associated with lower levels of adolescent well‐being, particularly among adolescent girls. This work suggests that interventions to reduce intrusive parenting by maternal caregivers could result in improved psychosocial outcomes for adolescents with T1D. [ABSTRACT FROM AUTHOR]

Aims: Both parent and adolescent involvement in type 1 diabetes management are critical during adolescence. The current study sought to understand the factors associated with parent and adolescent satisfaction with their own and one another's involvement in diabetes management. Methods: Cross‐sectional baseline data from 157 parent‐adolescent dyads enrolled in an RCT were used. Adolescent ages ranged from 12 to 19 (Mage = 14.7, SD = 1.89) and were balanced by gender (50.3% male). Paired t‐tests examined concordance between parent and adolescent satisfaction, bivariate correlations identified correlates, and regressions examined unique associations. Results: Roughly, 43% of adolescents and 29% of parents were very satisfied with adolescent involvement in diabetes management, whereas 71% of adolescents and 26.1% of parents were very satisfied with parent involvement. Indicators of better glycaemic health (via higher percent time‐in‐range and lower HbA1c and percent time in hyperglycaemia) and psychosocial functioning (less diabetes distress and depression) were correlated with higher satisfaction. Parent satisfaction with adolescent involvement was higher among older adolescents (R = 0.198, p = 0.013). Non‐Hispanic white youth were more satisfied with their own involvement than youth of colour (t(149) = −2.783, p = 0.003). Both percent time‐in‐range and one's own diabetes distress uniquely related to parent and adolescent satisfaction with adolescent involvement. Conversely, parent satisfaction with their own involvement was only uniquely associated with parent diabetes distress. Conclusion: Both adolescent and parents' satisfaction with adolescents' involvement in self‐management are indicators of both glycaemic control and psychosocial well‐being, whereas parents' self‐evaluations are more closely tied to diabetes‐specific distress. [ABSTRACT FROM AUTHOR]

Shift‐&‐persist (S&P) coping has been shown to buffer against the effects of discrimination on psychosocial functioning in racially and ethnically minoritized youth. However, existing measures of S&P refer broadly to coping with stress and are not specifically tailored to the type of stressor individuals are coping with (e.g., discrimination). The current study evaluated the measurement properties, utility, and validity of a discrimination‐specific adapted measure of S&P relative to an existing, general measure among a sample of 327 minoritized youth (Mage = 18.80, SD = 1.28, 78.6% female, 50.5% Black) recruited from a large public minority‐serving institution in the southeastern United States. Contrary to our hypotheses, when the item stem was changed to refer to coping specifically with discrimination, the measurement properties of a validated S&P scale (Lam et al., 2018) were worse relative to the original measure. Overall, the general S&P measure produced larger main effects and explained two times more variance in depressive symptoms than discrimination‐specific S&P. Findings do not rule out the idea that context‐specific measures may better characterize coping with discrimination experiences than 'trait‐like' general coping measures. However, results highlight that small adaptations to current measures may not be sufficient and may compromise predictive validity. Coping with discrimination measurement recommendations is discussed. [ABSTRACT FROM AUTHOR]

Functional analysis (FA) methodology has been deemed the best practice in the field of applied behavior analysis. The data collected in an FA allows behavior analysts to develop the most effective and ethical behavior interventions. With the diagnosis for individuals with autism on the rise along with the forecast of adults who will need support, it may be time to take stock of the available literature. The purpose of this review was to evaluate the behavior analytic research over the last 25 years (1997–2022) on FA and treatment for adults who engage in severe problem behavior. Utilizing specific inclusion and exclusion criteria resulted in the identification of 28 articles. These articles were examined across participant characteristics, target behavior, FA type, FA settings, interventions, generalization, and maintenance. Implications on adult FA and treatment are discussed along with recommendations for practitioners who desire to support this population. [ABSTRACT FROM AUTHOR]

Background: Conduct disorder (CD) and oppositional defiant disorder (ODD) both convey a high risk for maladjustment later in life and are understudied in girls. Here, we aimed at confirming the efficacy of START NOW, a cognitive‐behavioral, dialectical behavior therapy‐oriented skills training program aiming to enhance emotion regulation skills, interpersonal and psychosocial adjustment, adapted for female adolescents with CD or ODD. Methods: A total of 127 girls were included in this prospective, cluster randomized, multi‐center, parallel group, quasi‐randomized, controlled phase III trial, which tested the efficacy of START NOW (n = 72) compared with standard care (treatment as usual, TAU, n = 55). All female adolescents had a clinical diagnosis of CD or ODD, were 15.6 (±1.5) years on average (range: 12–20 years), and were institutionalized in youth welfare institutions. The two primary endpoints were the change in number of CD/ODD symptoms between (1) baseline (T1) and post‐treatment (T3), and (2) between T1 and 12‐week follow‐up (T4). Results: Both treatment groups showed reduced CD/ODD symptoms at T3 compared with T1 (95% CI: START NOW = −4.87, −2.49; TAU = −4.94, −2.30). There was no significant mean difference in CD/ODD symptom reduction from T1 to T3 between START NOW and TAU (−0.056; 95% CI = −1.860, 1.749; Hedge's g = −0.011). However, the START NOW group showed greater mean symptom reduction from T1 to T4 (−2.326; 95% CI = −4.274, −0.378; Hedge's g = −0.563). Additionally, secondary endpoint results revealed a reduction in staff reported aggression and parent‐reported irritability at post assessment. Conclusions: Although START NOW did not result in greater symptom reduction from baseline to post‐treatment compared with TAU, the START NOW group showed greater symptom reduction from baseline to follow‐up with a medium effect size, which indicates a clinically meaningful delayed treatment effect. [ABSTRACT FROM AUTHOR]

Objectives: Identification of clinically significant irritability in preschool age is important to implement effective interventions. However, varying informant and measurement methods display distinct patterns. These patterns are associated with concurrent and future mental health concerns. Patterns across multi‐informant methods in early‐childhood irritability may have clinical utility, identifying risk for impaired psychosocial functioning. Methods: Using data from the Multidimensional Assessment of Preschoolers Study (N = 425), latent profile analysis identified irritability patterns through the parent‐reported Multidimensional Assessment Profile Scales–Temper Loss (MAPS‐TL), parent‐reported interviewer‐rated Preschool Age Psychiatric Assessment (PAPA), and observer‐rated Disruptive Behavior Diagnostic Observation Schedule (DB‐DOS). These profiles were characterized on protective factors, global functioning, and mental health syndromes, concurrently and at early school age and preadolescent follow‐up. Results: Fit indices favored a five‐class model: Low All, High Observation with Examiner (high DB‐DOS Examiner Context), High All, High Parent Report (high MAPS‐TL/PAPA), and Very High Parent Report (very high MAPS‐TL/PAPA). Whereas Low All and High Observation with Examiner exhibited strong psychosocial functioning, remaining profiles showed impaired psychosocial functioning, with the Very High Parent Report group showing higher impairment at follow‐ups, ds = 0.37–1.25. Conclusions: Multi‐informant measurements of irritability may have utility for clinical prediction, and future studies should test utility for diagnostic precision. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to evaluate the efficacy of Group social skills interventions (GSSIs) versus any comparator on social functioning in children aged 5–12 years with acquired brain injury or cerebral palsy. Background: GSSIs are an evidence‐based approach to foster social skills development in children with autism spectrum disorder. Currently, limited literature exploring GSSIs in children with acquired brain injury and cerebral palsy is available. Results: MEDLINE, SCOPUS, Embase, CINAHL, Cochrane Library, PsycINFO, clinicaltrials.gov, ICTRP and ProQuest Dissertations and Theses were systematically searched. Study screening, risk‐of‐bias, Grading of Recommendations Assessment, Development and Evaluation and data extraction were performed in duplicate. Six studies were included in the narrative synthesis (one randomised controlled trial and five nonrandomised studies). Results indicate that GSSIs may increase children's social skills as measured on the Social Skills Rating System and Social Skills Questionnaire. Very low certainty evidence was found for improvements in social functioning and competence. Conclusions: There is low certainty evidence that participation in GSSI may lead to gains in social functioning for children with acquired brain injury or cerebral palsy. Given the certainty of the evidence, these results must be interpreted with caution. Only one randomised controlled trial of GSSIs for children with acquired brain injury was identified, underscoring the need for additional high‐quality studies. [ABSTRACT FROM AUTHOR]

There is evidence of weak self‐processing in autism spectrum disorder (ASD), including diminished self‐reference effects (SREs) in memory. Because smaller SREs in older ASD children and adults are sometimes associated with worse social functioning, we examined this relation for the first time in ASD preschoolers (n = 21). Following a self‐performed task, children completed tests of self/other source memory, verbal ability, imitation and mentalizing. Although the ASD children were outperformed on the socio‐cognitive measures by non‐autistic preschoolers (n = 20), they still showed a significant SRE. Moreover, the SRE, but not the socio‐cognitive variables, was a significant predictor of children's social functioning as rated by parents. Larger SREs were linked with better social functioning, while children with stronger autism traits showed no memory advantage for information encoded self‐referentially. These findings support previous research showing that self‐processing impairments in ASD are mainly apparent for individuals with greater social difficulties. [ABSTRACT FROM AUTHOR]

This paper attempts to formulate a generic model of living and social system at all levels with three parts. The first is the Dynamics of Life diagram, which follows flows of energy, matter and information through the system. A rule set controls how the parts co‐operate to maintain internal and external processes. As a system acts, it creates the space for a shadow system that opposes it. Unmanaged entropy is expelled or remains as a toxic element. The second is the Tree of Life that outlines the levels of functioning in a human being from biological to psychological to social. Each level manifests the flows as in the Dynamics of Life diagram. The third explores the processes of living and social systems through time and borrows heavily from Holling and Gunderson's Adaptive Cycle. The three parts present an integrated overview of the functioning of living and social systems. [ABSTRACT FROM AUTHOR]

Purpose: In patients with urologic chronic pelvic pain syndrome (UCPPS), the presence of widespread pain appears to identify a distinct phenotype, with a different symptom trajectory and potentially different response to treatment than patients with pelvic pain only. Materials and Methods: A 76‐site body map was administered four times, at weekly intervals, to 568 male and female UCPPS participants in the MAPP Network protocol. The 76 sites were classified into 13 regions (1 pelvic region and 12 nonpelvic regions). The degree of widespread pain was scored from 0 to 12 based on the number of reported nonpelvic pain regions. This continuous body map score was regressed over other measures of widespread pain, with UCPPS symptom severity, and with psychosocial variables to measure level of association. These models were repeated using an updated body map score (0–12) that incorporated a threshold of pain ≥ 4 at each site. Results: Body map scores showed limited variability over the 4 weekly assessments, indicating that a single baseline assessment was sufficient. The widespread pain score correlated highly with other measures of widespread pain and correlated with worsened UCPPS symptom severity and psychosocial functioning. Incorporating a pain severity threshold ≥4 resulted in only marginal increases in these correlations. Conclusions: These results support the use of this 13‐region body map in the baseline clinical assessment of UCPPS patients. It provides reliable data about the presence of widespread pain and does not require measurement of pain severity, making it relatively simple to use for clinical purposes. [ABSTRACT FROM AUTHOR]

Objective: To describe the impact of migraine on functioning based on comprehensive data collection, analysis, and reporting of patients' experiences. Background: Qualitative research conducted to understand patients' perspectives on living with migraine has often focused on narrow topics or specific groups of patients or has been selectively reported. Methods: Qualitative interviews with 71 participants were conducted during two concept elicitation studies as part of the Migraine Clinical Outcome Assessment System (MiCOAS) project, an FDA grant‐funded program designed to develop a core set of patient‐centered outcome measures for migraine clinical trials. Participants self‐reported being diagnosed with migraine by a healthcare professional and participated in semi‐structured qualitative interviews about their experiences with the symptoms and impacts of migraine. Interview transcripts were coded to identify and define concepts, which were then grouped into broad domains based on conceptual similarities. Results: A total of 66 concepts were identified: 12 for physical functioning, 16 for cognitive functioning, 10 for social role functioning, 19 for emotional and psychological functioning, and 9 related to migraine management. Participants described a complex and varied relationship between migraine attack symptoms and impacts on functioning. Impacts from migraine were further influenced by numerous contextual factors, such as people's individual social environments and the level of day‐to‐day demand for functioning they face. Conclusion: Findings showed that migraine impacted individual functioning in multiple ways and the nature of these impacts was dependent on social‐contextual factors. The results are being used in the development of core measures designed to improve our understanding of the burden of migraine and the efficacy of migraine therapies. The results also offer new insights and raise new questions about migraine experience that can be used to guide future research. [ABSTRACT FROM AUTHOR]

Objective: Limited research has characterized cancer‐related stress (CRS) among families of childhood cancer survivors. We examined the prevalence of CRS among survivors and caregivers, as well as its association with health risk perceptions (i.e., prognosis, risk for diminished quality of life) and views of survivor quality of life (QoL). Methods: At five years post‐diagnosis or relapse, survivors (n = 100; Mage = 15.84 years; 89% White), mothers (n = 127), and fathers (n = 59) reported their CRS. Perceived prognosis and risk for diminished QoL were rated on a 0%–100% visual analogue scale, while the PedsQL assessed QoL. Results: CRS was low (M = 1.6–1.8, scale: 1–4); mothers reported greater stress than survivors, p = 0.038, d = 0.25. There was an indirect effect of survivors' perceived prognosis on their QoL through CRS, CI = 0.04 to 0.25, R2 = 0.32. Among mothers, there was an indirect effect of perceived prognosis/risk for diminished QoL on their reports of survivor QoL through CRS, CI = 0.03 to 0.23 and −0.15 to −0.03, R2 = 0.28 and 0.32, respectively. There were no indirect effects among fathers. Conclusions: CRS may be an important, modifiable factor that could improve survivors' QoL. Research is needed to examine how CRS changes over time to assess the utility of interventions among female survivors, mothers, and those with lower prognosis estimates. [ABSTRACT FROM AUTHOR]

This pilot study aimed to test a comprehensive experience sampling method (ESM) protocol for investigating the relationship between stress and personality functioning (PF) in the daily lives of outpatients diagnosed with borderline personality disorder (BPD). Participants (N = 22) responded to a 32‐item ESM questionnaire 10 times a day for 1 week while wearing two stress detection devices. Results showed that the protocol was feasible. There was a high level of compliance (i.e. average of 85%), and no serious adverse events. The main indices, that is, Stress and PF, demonstrated acceptable to excellent internal consistency and provisional evidence for their validity. We found that 64% of the variability in PF was due to within‐subject differences. Mixed modelling showed that the momentary changes in stress (p <.001) and body position (i.e. active vs passive; p <.001) explained an estimated 46% of this within‐subject variance. We found no significant within‐subject effects when we used parameters of autonomic nervous system (ANS)–activity as predictors. Data loss during recording and artefact detection of electrophysiological data were substantial but not related to momentary changes in PF. The preliminary findings suggest that PF is a volatile aspect of personality pathology and that there is a strong, concurrent relationship between stress and PF in daily life. This pilot study constitutes the first demonstration of PF fluctuations within a clinical sample and initiates an examination of their association with ANS activity. [ABSTRACT FROM AUTHOR]

Background: Transferring from paediatric to adult care can be challenging. Adolescents and young adults (AYAs) with chronic health conditions need to develop a specific set of skills to ensure lifelong medical follow‐up due to the chronicity of their condition. The Transition Readiness Assessment Questionnaire—French version (TRAQ‐FR) is a 19‐item questionnaire measuring such skills. The aims of the study were to (1) describe participant characteristics and (2) identify constructs related to, and predictors of, having learned domain‐specific transition readiness skills. Methods: Participants included 216 AYAs aged 14–20 years (M = 15.93; SD = 1.35; 54.1% male) recruited from five outpatient clinics in a Canadian tertiary hospital. AYAs completed the TRAQ‐FR, the Pediatric Quality of Life Inventory 4.0 (PedsQL) and a sociodemographic questionnaire. Descriptive, bivariate and binary logistic regression analyses were conducted. Results: Overall, participants reported significantly higher scores on the Talking with Providers, Managing Daily Activities and Managing Medications subscales than on the Appointment Keeping and Tracking Health Issues subscales (F[41075] = 168.970, p <.001). At the item level, median scores (on a 5‐point Likert scale) suggest that AYAs had begun practising five of the 19 skills (median scores ≥4; 'Yes, I have started doing this'), while a median score of 1 ('No, I don't know how') was found for one item ('Do you get financial help with school or work?'). At the subscale level, TRAQ‐FR skills and skill gaps were related to AYAs' age, sex and PedsQL scores (ps <.05). Conclusion: Older and female AYAs were more likely to have begun practising specific TRAQ‐FR subscale skills. Better psychosocial functioning was also related to having learned specific transition readiness skills. AYAs show several gaps in transition readiness. Targeted intervention in transition readiness skill development could take into account AYAs' age, sex and psychosocial functioning for a successful transfer to adult care. [ABSTRACT FROM AUTHOR]

Background: Dermatological conditions are common in childhood and, in their more severe forms, can cause pain, disability and social marginalisation. Despite attachment being a known factor contributing to psychological and physiological development in childhood and several adult studies showing associations between attachment and dermatology outcomes (Tomas‐Aragones, 2018), attachment in young dermatology patients has not been investigated. Objectives: This study examined if (1) 8–16‐year‐olds with chronic dermatological conditions were more likely to show attachment insecurity than general population peers; (2) attachment style was linked to psychological functioning; and (3) facial involvement was associated with attachment insecurity. Method: One hundred and twenty‐two 8–16‐year‐olds attending a specialist paediatric dermatological service were compared on the Child Attachment Interview (CAI) to general population data. The Strengths and Difficulties Questionnaire (SDQ) was used to measure psychosocial functioning. Results: The dermatology group was significantly more likely to be insecurely attached than their general population peers (χ2[1] = 4.76, p <.05). The secure group self‐reported significantly better psychological functioning on all indices compared with the insecure group (Total Difficulties: F[1,89] = 15.30, p <.001). There were no significant differences between secure and insecure groups on parent‐reported psychological measures (Total Difficulties: F[1,94] = 0.67, p =.42). Children with facial involvement were not significantly more likely to be insecurely attached. Conclusions: Increased risk of attachment insecurity, particularly in the anxious pre‐occupied category, as well as an association between attachment and psychosocial functioning resonated with adult studies suggesting that further research about the role of attachment with young dermatology patients is warranted. [ABSTRACT FROM AUTHOR]

Background: Children with loss of control (LOC) eating and overweight/obesity have relative deficiencies in trait‐level working memory (WM), which may limit adaptive responding to intra‐ and extra‐personal cues related to eating. Understanding of how WM performance relates to eating behavior in real‐time is currently limited. Methods: We studied 32 youth (ages 10–17 years) with LOC eating and overweight/obesity (LOC‐OW; n = 9), overweight/obesity only (OW; n = 16), and non‐overweight status (NW; n = 7). Youth completed spatial and numerical WM tasks requiring varying degrees of cognitive effort and reported on their eating behavior daily for 14 days via smartphone‐based ecological momentary assessment. Linear mixed effects models estimated group‐level differences in WM performance, as well as associations between contemporaneously completed measures of WM and dysregulated eating. Results: LOC‐OW were less accurate on numerical WM tasks compared to OW and NW (ps <.01); groups did not differ on spatial task accuracy (p =.41). Adjusting for between‐subject effects (reflecting differences between individuals in their mean WM performance and its association with eating behavior), within‐subject effects (reflecting variations in moment‐to‐moment associations) revealed that more accurate responding on the less demanding numerical WM task, compared to one's own average, was associated with greater overeating severity across the full sample (p =.013). There were no associations between WM performance and LOC eating severity (ps >.05). Conclusions: Youth with LOC eating and overweight/obesity demonstrated difficulties mentally retaining and manipulating numerical information in daily life, replicating prior laboratory‐based research. Overeating may be related to improved WM, regardless of LOC status, but temporality and causality should be further explored. Public significance statement: Our findings suggest that youth with loss of control eating and overweight/obesity may experience difficulties mentally retaining and manipulating numerical information in daily life relative to their peers with overweight/obesity and normal‐weight status, which may contribute to the maintenance of dysregulated eating and/or elevated body weight. However, it is unclear whether these individual differences are related to eating behavior on a moment‐to‐moment basis. [ABSTRACT FROM AUTHOR]