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BACKGROUND: There is growing interest in using personalized mental health care to treat disorders like depression and anxiety to improve treatment engagement and efficacy. This randomized controlled trial will compare a traditional symptom severity decision-making algorithm to a novel multivariate decision-making algorithm for triage to and adaptation of mental health care. The stratified levels of care include a self-guided online wellness program, coach-guided online cognitive behavioral therapy, and clinician-delivered psychotherapy with or without pharmacotherapy. The novel multivariate algorithm will be comprised of baseline (for triage and adaptation) and time-varying variables (for adaptation) in four areas: social determinants of mental health, early adversity and life stressors, predisposing, enabling, and need influences on health service use, and comprehensive mental health status. The overarching goal is to evaluate whether the multivariate algorithm improves adherence to treatment, symptoms, and functioning above and beyond the symptom-based algorithm. METHODS/DESIGN: This trial will recruit a total of 1000 participants over the course of 5 years in the greater Los Angeles Metropolitan Area. Participants will be recruited from a highly diverse sample of community college students. For the symptom severity approach, initial triaging to level of care will be based on symptom severity, whereas for the multivariate approach, the triaging will be based on a comprehensive set of baseline measures. After the initial triaging, level of care will be adapted throughout the duration of the treatment, utilizing either symptom severity or multivariate statistical approaches. Participants will complete computerized assessments and self-report questionnaires at baseline and up to 40 weeks. The multivariate decision-making algorithm will be updated annually to improve predictive outcomes. DISCUSSION: Results will provide a comparison on the traditional symptom severity decision-making and the novel multivariate decision-making with respect to treatment adherence, symptom improvement, and functional recovery. Moreover, the developed multivariate decision-making algorithms may be used as a template in other community college settings. Ultimately, findings will inform the practice of level of care triage and adaptation in psychological treatments, as well as the use of personalized mental health care broadly. TRIAL REGISTRATION: ClinicalTrials.gov NCT05591937, submitted August 2022, published October 2022.

Limited research has examined a comprehensive set of predictors when evaluating discharge placement decisions for infants exposed to substances prenatally. Using a previously validated medical record data extraction tool, the current study examined prenatal substance exposure, infant intervention (i.e., pharmacologic, or non-pharmacologic), and demographic factors (e.g., race and ethnicity and rurality) as predictors of associations with discharge placement in a sample from a resource-poor state (N = 136; 69.9% Non-Hispanic White). Latent class analysis (LCA) was used to examine whether different classes emerged and how classes were differentially related to discharge placement decisions. Logistic regressions were used to determine whether each predictor was uniquely associated with placement decisions. Results of the LCA yielded a two-class solution comprised of (1) a Low Withdrawal Risk class, characterized by prenatal exposure to substances with low risk for neonatal abstinence syndrome (NAS) and non-pharmacologic intervention, and (2) a High Withdrawal Risk class, characterized by a high risk of NAS and pharmacologic intervention. Classes were not related to discharge placement decisions. Logistic regressions demonstrated that meth/amphetamine use during pregnancy was associated with greater odds of out of home placement above other substance types. Future research should replicate and continue examining the clinical utility of these classes. [ABSTRACT FROM AUTHOR]

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Scant research has investigated emotion regulation strategies in somatization disorder, despite its high comorbidity with depression and the growing interest in this topic in depression. The present study investigated emotion regulation strategies in patients with major depression and somatization disorder using clinical samples to examine common vulnerability factors and to provide evidence for difficulties in emotion regulation as transdiagnostic factors in these disorders. Patients with major depressive disorder (n = 30) and patients with somatization disorder (n = 30) completed measures of putatively adaptive and maladaptive emotion regulation strategy use. Patients with somatization disorder showed higher scores on measures of regulatory strategies, as measured by the sum of adaptive strategies in the Cognitive Emotion Regulation Questionnaire as well as the following subscales: positive refocusing, positive reappraisal, and refocusing on a plan. After controlling for levels of current depression, the significant effects remained for positive refocusing. Depression symptom severity was significantly and negatively correlated with most adaptive strategies and positively correlated with most maladaptive strategies. The current results provide preliminary data for a similar pattern of adaptive and maladaptive emotion regulation strategies usage in these two disorders. The results also contribute to theories of psychopathology and our understanding of critical cognitive and emotional processes. [ABSTRACT FROM AUTHOR]

Depression is a serious mental disorder that is highly prevalent among Canadians. Stigma associated with depression is a key barrier in preventing depressed individuals from seeking psychological services. This type of help-seeking behavior is especially low in Asian individuals, which can be accounted for by the stigmatization of depression in this population. However, little research has been conducted on depression stigma in East Asian Canadians; specifically, those who are Chinese, Korean, and Japanese. Furthermore, no research has directly investigated self-stigma for depression in this population. The present study hypothesized that Asian Canadians would exhibit higher self-stigma for depression than Caucasian Canadians. To assess for this hypothesis, the present study recruited Asian and Caucasian undergraduate students and employed several surveys assessing depression stigma. Consistent with previous literature, the analyses revealed that the Asian participants had higher scores on some measures of social stigma, including attributions of blame, fear, and dangerousness towards a depressed individual. The present study indicated that Asian participants exhibited higher self-stigma, including an overall lower level of self-respect. However, there were no differences on any other stigma inventories. Possible explanations, limitations and future directions are discussed. [ABSTRACT FROM AUTHOR]

Over the past few decades of psychological research, there has been an important increase in both the application of multidisciplinary or collaborative science and in training and research that emphasizes social justice and cultural humility. In the current article, we report on the use of the "Paper Chase" as a team science training and research experience that also facilitates cultural humility in research and when working in teams. The Paper Chase is a synchronous writing exercise originally conceptualized by a cohort of health service psychology interns to reduce lag time between article writing and submission (Schaumberg et al., 2015). The Paper Chase involves a group of trainees coming together for a predetermined amount of time (e.g., 9 or more hours) with the aim of writing and submitting a full article for publication. In the current article, we extend a previous report on the Paper Chase by formally linking the training experience to the four phases of team science: development, conceptualization, implementation, and translation. We also discuss ways in which the Paper Chase as a training experience can promote cultural humility. Finally, we provide updated recommendations for successfully completing a Paper Chase project. Overall, the authors of this article who were predoctoral psychology interns across two recent cohorts at one academic medical center reported positive experiences from the Paper Chase. In addition, the present study suggests that the Paper Chase can be used as one activity that facilitates critical training in team science. [ABSTRACT FROM AUTHOR]