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OBJECTIVE: To evaluate the role of psychosocial well-being on perioperative pain and opioid use among patients with cleft lip and palate (CLP) undergoing alveolar bone grafting (ABG). DESIGN: Retrospective review. SETTING: Tertiary level craniofacial clinic. PARTICIPANTS: 34 patients with CLP (median age: 11.7 years), including 25 (73.5%) unilateral CLP and 9 (26.5%) bilateral CLP, who underwent ABG from 2015 to 2022. INTERVENTIONS: ABG using iliac crest bone graft. Patients were prospectively administered four patient-reported psychosocial instruments from the Patient-Reported Outcomes Measurement Information System. MAIN OUTCOME MEASURES: Perioperative opioid use in morphine equivalent dosage/kilogram, patient-reported pain scores, and length of hospital stay after ABG. RESULTS: Patient-reported anxiety (r = 0.41, p = 0.02) and depressive symptoms (r = 0.35, p = 0.04) correlated to higher perioperative opioid usage. Multivariable regression models including psychosocial scores, total acetaminophen usage, length of surgery, and other simultaneous surgeries were developed for total opioid usage, patient-reported pain, and length of hospital stay. Patient-reported anxiety was independently predictive of higher perioperative opioid use (β=0.36, p = 0.01) and higher pain scores (β=0.39, p = 0.02), but not length of hospital stay. CONCLUSIONS: We identified an association for patient-reported anxiety and perioperative opioid use and pain in a CLP cohort undergoing ABG. Future considerations in preoperative patient and family consultation may be indicated in patients self-reporting higher anxiety in an effort to minimize perioperative opioid usage.

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]

Background: Recovery from psychopathology in patients with personality disorder (PD) after the therapeutic intervention is not necessarily accompanied by an increase in their quality of life. This phenomenon can be understood from a bifactorial model of affect and challenges our therapeutic design to focus on recovery. Method: In a sample of severe PD, we evaluate emotional and clinical variables before (N = 414) and after (N = 247) a 6-month intervention program. Results: The level of emotion intensity influences the association between positive and negative affect (PA and NA; p < .0001). Patients with a "self-constructive" affective profile improve more in PA than in NA ( p = .008). Conclusions: The specific promotion of PA, applied in a phase in which the person experiences less negative emotional reactivity, could improve satisfaction with life and psychosocial functioning of PD patients. [ABSTRACT FROM AUTHOR]

Objective: Psychiatric disorders have been linked to poor social functioning, including deficits in relationship satisfaction. Treatments have shown strong effectiveness in reducing clinical symptoms for a range of disorders, though less is known of the effects disorder-focused treatments have on relationship satisfaction. Methods: The present study describes a systematic review that was conducted to determine the efficacy of treatments for specific psychiatric disorders in improving relationship satisfaction. Surprisingly, only seventeen studies were identified and included in the review. Results: We found that a majority of these studies reported modest improvement in relationship satisfaction among people who completed treatment. However, studies were severely hampered by methodological limitations, and all therapy-related improvements could be attributable to placebo effects or the passage of time. Conclusion: Important gaps in the literature were found that future research should seek to address to maximize treatment outcomes and psychosocial functioning. [ABSTRACT FROM AUTHOR]

Developmental science aims to explain development across the lifespan. Jerome Kagan observed that the same behavior can occur for different reasons, and differing behaviors can occur for the same reason. To help account for persistence, desistence, and transformation of behavior across development, Kagan introduced various types of continuity and discontinuity of forms and functions of behavior. This framework provides opportunities for identifying explanatory mechanisms in behavior development. However, misconceptions remain in applying the concepts that Kagan introduced. Much of the literature assumes developmental continuity in constructs without examining whether assumptions are supported, leading to faulty developmental inferences. For instance, the use of the same measure across time to assess development assumes that the behavior occurs for the same reason across time (homotypic continuity). In addition, just because one behavior predicts a different behavior at a later time does not necessarily indicate that age-differing behaviors occur for the same reason (heterotypic continuity). This review aims to advance conceptualizations of continuity and discontinuity from a contemporary perspective with aims to improve mechanistic understanding of behavior development across the lifespan. To better align behaviors, functions, and mechanisms, research should (a) examine (dis)continuity of individual behaviors rather than merely syndromes, (b) identify the function(s) of the given behavior(s), and (c) identify the cognitive and biological processes that underlie the behavior–function pairs. Incorporating examples from research on development of humans and nonhuman animals, I discuss challenges from work that has followed Kagan's ideas and ways to advance understanding of continuity and discontinuity across development. Public Significance Statement: Research in developmental science has paid insufficient attention to types of developmental continuity and discontinuity. To advance understanding of development across the lifespan, research should (a) examine (dis)continuity of individual behaviors rather than merely syndromes, (b) identify the function(s) of the given behavior(s), and (c) identify the cognitive and biological processes that underlie the behavior–function pairs. [ABSTRACT FROM AUTHOR]

Cultural identity formation is a complex developmental task that influences adolescents' adjustment. However, less is known about individual variations in trajectories of cultural identity processes and how they relate to youth psychosocial outcomes. Using a person-centered approach, this study investigated patterns of change over a year in cultural identity exploration and resolution, respectively, among ethnically diverse adolescents in Italy. The sample included 173 high school students (Mage = 15 yrs, SD = 0.62, range = 14–17; 58.4% female; 26% immigrant background) who had participated in the Identity Project, a school-based intervention targeting ethnic-racial identity development. Longitudinal latent profile analysis revealed only one profile of change for exploration, whereas four unique profiles for resolution emerged ("stable low," "stable average," "increase low-to-average," "increase high-to-higher"). Overall, youth in the resolution-increase profiles reported the best outcomes. The findings highlight the heterogeneity of adolescents' resolution trajectories and the benefits of an increased sense of clarity concerning one's cultural identity for positive psychosocial functioning. [ABSTRACT FROM AUTHOR]

Objectives: Playfulness describes individual differences in (re)framing situations in a way that they are experienced as interesting, intellectually stimulating, or entertaining. We extended the study of playfulness to groups of middle- and higher age and examined the relations of four facets of playfulness (Other-directed, Lighthearted, Intellectual, and Whimsical) to indicators of positive psychological functioning. Method: We collected self-report data from 210 participants aged between 50 and 98 years. Results: The playfulness expressions in this age group were comparable to younger adults. We found that playfulness relates to life satisfaction, the PERMA domains of well-being, and character strengths with small-to-medium correlation effect sizes. The OLIW facets showed differential associations, with regression analyses revealing that particularly Other-directed is positively associated with positive psychological functioning. Conclusion: Our findings highlight the importance of playful relationships across the lifespan. We discuss the findings regarding the role of playfulness for healthy aging. [ABSTRACT FROM AUTHOR]

Objective: Weight-control compensatory behaviors appear to be a commonly utilized strategy for health management. Individuals engaging in such behaviors believe that the negative consequences from unhealthy behaviors will be neutralized by the positive consequences of healthy behaviors. Existing research has not reached a consensus on whether such behaviors are beneficial to health. This review aims to (1) summarize the patterns of weight-control compensatory health behaviors in different populations, (2) highlight correlates, predictors, and consequences of compensatory health behaviors, and (3) identify gaps for future research. Method: This review identified existing literature using online databases, CINAHL and PubMed. Primary research articles published after 2000 with non-clinical participants of 12 years or older who engaged in compensatory behaviors for weight control purposes were selected. Descriptive statistics were extracted from 35 studies. Results: Different patterns for weight-control compensatory behaviors emerged between the female and male sexes. Meanwhile, no clear association of such behaviors was found across weight status. Studies reviewed also highlighted three main areas of compensatory behaviors for weight management, namely dietary behaviors, physical activity, and alcohol consumption. Weight-control compensatory behaviors had significant negative correlations with mental health indicators, such as psychosocial functioning, emotional differentiation ability, and body esteem. Conclusion: Weight-control compensatory behaviors may be a widely used weight management strategy and can be presented in diverse ways. Although believed to be promoting health, such behaviors appear to be associated with poor psychological well-being. This emerging topic warrants more in-depth investigation to establish the direction of causation. Future research may investigate the relationship between weight-control compensatory behaviors and various aspects of health over longer time periods, examine the engagement of multiple weight-control compensatory behaviors, and focus on high-risk populations. [ABSTRACT FROM AUTHOR]

Introduction: In this study, we mainly evaluated the associations of borderline personality disorder (BPD), neuroticism, and childhood trauma with the selfrated and clinician-rated overall functional impairment levels of adult euthymic patients with bipolar disorder-1 (BD-1). In addition, we compared patient and healthy control groups regarding the levels of of childhood trauma, neuroticism, BPD and functional impairment. Methods: In total, 90 euthymic BD-1 patients and 90 healthy controls were enrolled. The Childhood Trauma Questionnaire-Short Form, the neuroticism subscale of the Eysenck Personality Questionnaire Revised-Abbreviated Form, the Borderline Personality Questionnaire, the Functioning Assessment Short Test, and the Sheehan Disability Scale were administered to the participants. Results: The study revealed that the levels of BPD, neuroticism, emotional abuse, physical abuse, global childhood trauma, self-rated overall functional impairment, all the subdomains of self-rated functional impairment, clinician-rated overall functional impairment, and all the subdomains of clinician-rated functional impairment (except leisure time) were significantly higher in the patients than those in the healthy controls (p < 0.05). Clinician-rated functional impairment levels were significantly correlated with levels of BPD (r = 0.555, p<0.001), neuroticism (r = 0.429, p < 0.001), global childhood trauma (r = 0.391, p <0.001), and all subtypes of childhood trauma except sexual abuse. Self-rated functional impairment levels were significantly correlated with levels of neuroticism (r= 0.289, p = 0.006), physical neglect (r = 0.213, p = 0.044), and BPD (r = 0.557, p < 0.001). In the regression analyses, the self-rated overall functional impairment levels were only significantly associated with the BPD feature levels (b = 0.319, p < 0.001) and the clinician-rated overall functional impairment levels were only significantly associated with the BPD feature levels (b = 0.518, p < 0.001). Conclusion: The present study's findings suggest that BPD features should be addressed in psychosocial interventions aimed at ameliorating functional impairment in patients with BD-1. Only BPD features were associated with selfrated and clinician-rated overall functional impairment levels in the regression analyses in the BD-1 patients. Performing self-rated and clinician-rated functional impairment assessments in the same clinical trial may give rise to relevant findings in the future. [ABSTRACT FROM AUTHOR]

ObjectiveMethodsResultsConclusionThis study aimed to compare psychosocial outcomes and functional neuroimaging among youth with concussion, youth with anxiety, and age- and sex-matched controls.Using archival data from the Adolescent Brain Cognitive DevelopmentSM Study, we analyzed between-group differences in psychosocial outcomes measured by the Child Behavior Checklist’s internalizing and externalizing problem scales, and assessed brain function using resting-state fMRI network-region connectivity (specifically frontoparietal network (FPN) and default mode network (DMN) connectivity with the amygdala).Significant differences in psychosocial outcomes were found across all groups, with the anxiety group reporting the most internalizing problems, followed by the concussion group which significantly differed from controls. Additionally, FPN-amygdala connectivity was significantly reduced in the concussion group only; this reduced connectivity did not predict psychosocial outcomes across groups.This study provided preliminary findings that brain connectivity is reduced exclusively in individuals with concussion. Although disruptions were observed in the concussion group, further investigation is warranted to understand how disruptions may be associated with concussion symptoms. Studies that utilize well-defined control and study groups, and comprehensive cognitive and mental health measures will offer a deeper understanding of the relationship between brain function and psychosocial outcomes. [ABSTRACT FROM AUTHOR]

Limited research exists regarding the impact of the Ukrainian War on mental distress among refugees or the presentation of post-traumatic stress disorder (PTSD) as a co-morbidity. This study analyzes the mental distress experienced by displaced Ukrainian refugees, including exposure to war-related trauma, PTSD, psychological distress based on socio-demographic factors, prevalence of concurrent mental illnesses, and associated risk factors. Ukrainian refugees in Israel were included in the study shortly after their arrival. Participants completed questionnaires on socio-demographic information, exposure to war-related events, presence of PTSD, depression, anxiety, and current life satisfaction. The 128 participants reported an average of 6.4 traumatic events (SD = 2.97). Among them, 69.5% (n = 89) met the criteria for probable PTSD, 36.7% (N = 47) for depression, and 53.1% (N = 68) for anxiety. The "comorbidity" cohort, consisting of refugees with PTSD and depression/anxiety or both, included 65 participants (53.3%), the "only PTSD" group was 24 participants (19.7%), and 33 (27%) had "no probability". Women and those who had left family members behind were 2.9 and 3.2 times more likely to experience comorbidity, respectively. Refugees with comorbidity reported higher distress and functional impairments compared to the "only PTSD" group, and lower life satisfaction than those with "no probability". This study highlights the significant traumatology experienced by Ukrainian refugees, with attention to the unique impact of comorbidity on functional and subjective well-being among refugees. Therefore, a comprehensive approach is necessary to appropriately diagnose and support refugees, considering the interconnected impact of PTSD, anxiety, and depression. [ABSTRACT FROM AUTHOR]

A considerable proportion of patients with schizophrenia perform below population norms on standardized neuropsychological tests, and the performance of those performing within normal range is lower than predicted based on parental education. Cognitive impairment predates the onset of psychosis, is observed during symptom remission and in non-affected firstdegree relatives of patients. At the present time, cognitive deficits are regarded as key features of schizophrenia, important determinants of poor psychosocial outcome and targets for both pharmacological and non-pharmacological treatment strategies. A group of eight key opinion leaders reviewed and discussed latest advances in scientific research and current good clinical practices on assessment, management, and treatment of CIAS. In the present paper they summarize the current evidence, identify main gaps between current knowledge and mental health services clinical practice, and provide practical recommendations to reduce the gap. [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]

In the following we introduce a special issue of the journal Woman & Therapy, titled Women in Their 80s and 90s: Positively Vital. Our intent has been to provide a balance to the prevailing literature on older women which tends to present a negative view of the trials and tribulations of old age. We believe that this information is vital not just for old women but also for feminist psychologists who work with this population and for the world at large. [ABSTRACT FROM AUTHOR]

(1) Background: Prenatal depression, maternal anxiety, puerperal psychosis, and suicidal thoughts affect child welfare and development and maternal health and mortality. Women in low-income countries suffer maternal mental health issues in 25% of cases during pregnancy and 20% of cases thereafter. However, MMH screening, diagnosis, and reporting are lacking. The primary goals of the present study are twofold, as follows: firstly, to evaluate the importance of screening maternal mental health to alleviate perinatal depression and maternal anxiety, and, secondly, to analyze research patterns and propose novel approaches and procedures to bridge the current research gap and aid practitioners in enhancing the quality of care offered to women exhibiting symptoms of perinatal depression. (2) Methods: We conducted a bibliometric analysis to analyze the research topic, using the bibliometric tools Biblioshiny and VOSviewer, as well as the R statistical programming language. To accomplish our goal, we obtained a total of 243 documents from the Scopus and PubMed databases and conducted an analysis utilizing network, co-occurrence, and multiple correlation approaches. (3) Results: Most of the publications in the field were published between the years 2021 and 2024. The results of this study highlight the significance of shifting from conventional screening methods to digital ones for healthcare professionals to effectively manage the symptoms of maternal mental health associated with postpartum depression. Furthermore, the results of the present study suggest that digital screening can prevent maternal physical morbidity, contribute to psychosocial functioning, and enhance infant physical and cognitive health. (4) Conclusions: The research indicates that it is crucial to adopt and include a computerized screening practice to efficiently and immediately detect and clarify the signs of prenatal to neonatal depression. The introduction of digital screening has led to a decrease in scoring errors, an improvement in screening effectiveness, a decrease in administration times, the creation of clinical and patient reports, and the initiation of referrals for anxiety and depression therapy. [ABSTRACT FROM AUTHOR]

Simple Summary: This review explores the role of physiotherapy in early and traditional palliative care (PC) for cancer patients, focusing on its effects on patient-reported outcomes (PROMs) such as fatigue, pain, and quality of life (QoL). The findings suggest that certain physiotherapy interventions, like cognitive behavioral therapy (CBT) and massage, can improve these outcomes, while others show limited or no significant benefits. However, the overall quality of the studies reviewed was low, highlighting the need for more rigorous research in this area to better understand how physiotherapy can support patients in PC. Background: This review aims to explore the role of physiotherapy in early and traditional palliative care (PC) for oncology patients, focusing on its impact on six patient-reported outcomes (PROMs), namely fatigue, pain, cachexia, quality of life (QoL), physical functioning (PHF), and psychosocial functioning (PSF). The purpose is to assess the effectiveness of various physiotherapy interventions and identify gaps in the current research to understand their potential benefits in PC better. Methods: A systematic literature search was conducted across PubMed, Embase, and Web of Science, concluding on 21 December 2023. Two independent reviewers screened the articles for inclusion. The Cochrane Risk of Bias Tool 2 was employed to assess the risk of bias, while the GRADE approach was used to evaluate the certainty of the evidence. Results: Nine randomized controlled trials (RCTs) were included, with most showing a high risk of bias, particularly in outcome measurement and missing data. Cognitive behavioral therapy (CBT) was the only intervention that significantly reduced fatigue, enhanced PHF, and improved QoL and emotional functioning. Graded exercise therapy (GET) did not yield significant results. Combined interventions, such as education with problem-solving or nutritional counseling with physical activity, showed no significant effects. Massage significantly improved QoL and reduced pain, while physical application therapies were effective in pain reduction. Mindful breathing exercises (MBE) improved QoL but had a non-significant impact on appetite. The overall certainty of the evidence was low. Conclusions: Physiotherapy can positively influence PROMs in oncology PC; however, the low quality and high risk of bias in existing studies highlight the need for more rigorous research to confirm these findings and guide clinical practice. [ABSTRACT FROM AUTHOR]

The objective of this scoping review is to evaluate the effectiveness of mindfulness training in improving functioning in adolescents (aged 12–19 years) diagnosed with Attention Deficit Hyperactivity Disorder (ADHD). Previous research has demonstrated that psychological interventions improve functioning in a myriad of domains for individuals diagnosed with ADHD, such as attention training, interpersonal relationships, and social skills. Mindfulness-based interventions (MBI) are indicated as an intervention in attention training. It maybe argued that group based MBI programmes should begin early, for children and adolescents at a time that is critical in their development. Methods and reporting are in line with the PRISMA extension for scoping reviews, the protocol is preregistered in the (Open Science Framework register). The study outcomes included attention, impulsivity, and relationships of adolescents with ADHD. Findings demonstrated preliminary evidence for the use of group-based mindfulness interventions with adolescents continues to be nascent. Although studies reported positive results, the evidence of its effectiveness for adolescents with ADHD is inconclusive, due to limited studies available and the limitations of the study design. This scoping review provides a panorama of MBI for ADHD adolescents. Plain language summary: This review explores group mindfulness-based programmes for adolescents with attention deficit hyperactive disorders. It provides a useful summary for clinicians. [ABSTRACT FROM AUTHOR]

AbstractObjectives: The purpose is to examine the relationship between Adverse Childhood Experiences (ACEs), protective factors, and select maladaptive coping behaviors in postsecondary students. Participants: Undergraduate students attending Dalhousie University. Methods: An online anonymous survey was conducted. Zero order one-tailed correlations were computed to measure relationships between ACEs, levels of maladaptive coping behaviors and protective factors. A structural equation mediation model examined direct and indirect pathways between measures. Results: 42.5% of respondents (n = 327) reported ≥3ACEs. Higher ACEs were associated with higher expression of maladaptive coping behaviors. Respondents with high ACEs and low levels of protective factors reported lower levels of hope and forgiveness and higher levels of stress and rumination. Conclusion: Higher levels of protective factors were associated with lower levels of maladaptive coping behaviors in students with high ACEs. [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]

Objective Research indicates that perceived injustice significantly influences pain-related outcomes and is associated with delayed recovery in adults. This systematic review examines the relationship between perceived injustice and pain-related outcomes in children with pain conditions. Methods A search of published studies in English in PubMed, PsychInfo, and Cochrane Database of Systematic Reviews from database inception through December 2022 were performed. The search criteria focused on studies that measured perceived injustice and pain-related outcomes in children with pain conditions. Out of 56 articles screened, 8 met the inclusion criteria, providing data on 1240 children with pain conditions. Results The average age of participants across all studies was 14.12 years (SD = 2.25), with 68.2% being female. There was strong evidence that higher perceived injustice is associated with worse pain intensity, functional disability, mental health outcomes, and emotional, social, and school functioning. Conclusion The results of this study underscore how perceptions of injustice are associated various pain-related outcomes across different domains of children's lives. The findings highlight the need for screening and treatments targeting injustice appraisals in pediatric populations with pain conditions. The discussion addresses possible determinants and mechanisms of perceived injustice, along with implications for research and clinical practice. [ABSTRACT FROM AUTHOR]

Objectives: Anal incontinence (AI) is a distressing condition with grave impact on many aspects of life, including quality of life (QoL), social life and sexual activities. This study explored how AI and bowel symptoms impact QoL in a Norwegian population by (1) describing the psychosocial and sexual consequences of AI, and (2) investigating factors most often associated with AI-specific QoL. Materials and methods: A cross-sectional study among patients with AI referred to hospital outpatient clinics was conducted. A Norwegian version of ICIQ-B was used to measure bowel control, bowel symptoms, sexual impact, and impact on QoL. Results: A total of 208 persons with AI completed the questionnaire. The results demonstrated that these patients are overall embarrassed, make plans according to the bowels, ensure the presence of a nearby toilet, and many abstain from sexual activities. After adjusting for other variables included in a multivariable model, we found that having bowel accidents on one's mind had the greatest relative impact on QoL, followed by lower bowel control, using more medications to stop bowels, having more pain/soreness around the back passage, lower age, and more straining to open the bowels. Conclusions: AI has substantial consequences for the psychosocial function and sexual activities of persons with AI. This study indicates that worrying about potential faecal accidents and the social stigma associated with this have greater impact on QoL than actual bowel leakages. Future studies should therefore focus on the emotional burden, patient coping, and health education related to bowel function and AI. [ABSTRACT FROM AUTHOR]

The Career Identity Development Inventory (CIDI) was designed to be used at the person level to assign individuals in a career identity status that would indicate how they approached a career identity crisis and identify developmental needs to resolve career identity concerns. However, given that CIDI has not been tested using a person-centered approach, the first aim of this study was to demonstrate whether and how CIDI can be used to determine individuals' career identity statuses that are theoretically informed by Marcia's identity status paradigm and neo-Eriksonian identity literature. Using a sample of 410 US college graduates, we identified, through a cluster analytic approach, eight groups of distinct career identity profiles, from which four groups resembled Marcia's identity statuses and four other groups were unique variants of identity statuses that extended this paradigm and illustrated a more gradual process of career identity development. This person-centered approach enabled us to subsequently provide evidence of the criterion validity of CIDI, which was the second aim of this study. We examined how the eight career identity statuses derived from the cluster analysis differed according to validation-criterion variables and found that individuals assigned to statuses characterized by high levels of career identity commitments tended to have better career and psychosocial functioning than individuals assigned to statuses characterized by low levels of career identity commitments. Implications along with directions for future research are discussed with respect to developmental challenges associated with career exploration and critical processes of forming a constructed career identity. [ABSTRACT FROM AUTHOR]

Objective: Sickle cell disease (SCD), the most common inherited blood disorder in the United States, is associated with severe psychoneurological symptoms. While epigenetic age acceleration has been linked to psychoneurological symptom burden in other diseases, this connection is unexplored in SCD. This study aimed to assess the association between epigenetic age acceleration and psychoneurological symptom burden in SCD. Methods: In this cross-sectional study, emotional impact, pain impact, sleep impact, social functioning, and cognitive function were assessed in 87 adults living with SCD. DNA methylation data were generated from blood specimens and used to calculate epigenetic age using five clocks (Horvath, Hannum, PhenoAge, GrimAge, & DunedinPACE). Associations between epigenetic age acceleration and symptoms were assessed. Results: The sample (N = 87) had a mean (SD) chronologic age was 30.6 (8.1) years. Epigenetic age acceleration was associated with several symptom outcomes. GrimAge age acceleration (β = −0.49, p =.03) and increased DunedinPACE (β = −2.23, p =.004) were associated with worse emotional impact scores. PhenoAge (β = −0.32, p =.04) and the GrimAge (β = −0.48, p =.05) age acceleration were associated with worse pain impact scores. Increased DunedinPACE (β = −2.07 p =.04) were associated with worse sleep impact scores. Increased DunedinPACE (β = −2.87, p =.005) was associated with worse social functioning scores. We did not find associations between epigenetic age acceleration and cognitive function in this sample. Conclusion: Epigenetic age acceleration was associated with worse symptom experiences, suggesting the potential for epigenetic age acceleration as a biomarker to aid in risk stratification or targets for intervention to mitigate symptom burden in SCD. [ABSTRACT FROM AUTHOR]

Although parental psychological control has been well-documented as a significant predictor of social anxiety among adolescents, few studies examine how changes in parental psychological control and adolescent social anxiety are reciprocally related at the within-person level, especially in Chinese culture. This longitudinal study examined reciprocal relations between parental psychological control and social anxiety, and the potential mediating role of self-concept clarity, by disentangling between- and within-person effects. A total of 4731 students (44.9% girls; Mage = 10.91 years, SD = 0.72) participated in a four-wave longitudinal study with 6-month intervals. Results from random intercept cross-lagged panel modeling indicated that parental psychological control directly predicted social anxiety, and vice versa. Parental psychological control indirectly predicted social anxiety via self-concept clarity, and social anxiety also indirectly predicted parental psychological control via self-concept clarity. These findings reveal a vicious cycle of mutual influence between parental psychological control and adolescent social anxiety in Chinese youth, and highlight the crucial role of self-concept clarity in the interplay between parenting and adolescent social functioning. [ABSTRACT FROM AUTHOR]

Accuracy and assumed similarity are the most central topics in the research area of interpersonal perception. These two interpersonal perceptual tendencies have been demonstrated to have beneficial effects on adults' psychological functioning independently. However, how and why they influence adolescent psychological adjustment is less well-understood. The present research aimed to examine the mediating role of peer relationships in the association between these two interpersonal perceptual tendencies and psychological adjustment in adolescents. In the first study, a sample of adolescents in their first year of college (N = 93, 63% girls, Mage = 17.45 years, SD = 0.52) were recruited from a university located in Eastern China. They completed the likableness ratings of Anderson's 200 adjectives. The top 10 personality traits with the lowest and highest likableness values were selected to measure adolescents' personality profiles. In the second study, a round-robin design in a real-life setting, a sample of Chinese adolescents in grades six to nine were recruited from two middle schools (N = 337, Ndyads = 918, 47% girls, Mage = 13.76, SD = 1.15). They were requested to rate themselves and their peers within the same group on various factors. Results revealed that adolescents could form an accurate perception of their peers' personalities and concurrently assume that their peers' personalities are similar to their own. More importantly, accurate interpersonal perception and a biased tendency towards assumed similarity could, directly and indirectly, benefit adolescent psychological adjustment through peer relationships. [ABSTRACT FROM AUTHOR]

Social competence is crucial to functioning in youth with chronic medical conditions. Developmentally sensitive measures of social functioning in this population can aid clinicians in identifying skill deficits and informing treatment interventions that improve social competence. The study explored the psychometric properties of a proposed social functioning measure utilizing data obtained from a clinical sample of chronically ill adolescents enrolled in an evidence-based manualized psychosocial treatment program. Initial exploratory findings support the potential for the SDI to be a valid, reliable, and clinically sensitive measure of adolescent social functioning in teens experiencing functional disability associated with their chronic health conditions. [ABSTRACT FROM AUTHOR]

Racial disparities in diagnosis, treatment, and outcome have been well-established for people with schizophrenia. While cognitive remediation treatments have been shown to produce mild to moderate improvements in cognition for people with schizophrenia, few studies have examined racial/ethnic differences in treatment response. This study employed a secondary analysis of data from two randomized, single-blind controlled trials (N = 119) investigating the efficacy of two forms of cognitive training, to explore potential racial/ethnic differences in targeted outcomes. Given the extant literature, we predicted that racial/ethnic minorities would (1) drop out of the study at higher rates, (2) display greater levels of functional and cognitive impairment prior to treatment, and (3) display lower levels of improvement in cognitive and functioning outcomes following treatment. Our study revealed largely negative findings: white vs. non-white groups showed similar treatment drop-out rates, similar levels of cognitive impairment and symptom severity at study baseline and showed similar responses to cognitive training, with the exception of working memory in which participants' racial/ethnic minority status predicted significantly greater improvement in response to cognitive training. These findings suggest that cognitive remediation treatments are effective at addressing cognitive deficits in racial/ethnic minorities and supports cognitive remediation as a treatment which may help address racial/ethnic disparities in cognition. Given the scant research literature, future analyses should look at race as a potential mediator of treatment in a variety of evidence-based psychosocial treatments. [ABSTRACT FROM AUTHOR]

Bipolar disorder (BD)1 implies impairments in executive functions during euthymia that interfere in psychosocial functioning. Virtual reality assessments may confer advantages respect to traditional assessments in terms of efficiency and ecological validity. The aim of this study was to validate a novel Virtual Cooking Task (VCT) for executive functions assessment in euthymic patients with BD. This is a cross-sectional study in which a group of BD patients (n = 42) and healthy controls (n = 42) were assessed with the VCT and a battery of computerized standard tasks (CST). Additionally, the influence on psychosocial functioning of both forms of assessment, measured with the FAST, was investigated to check ecological validity. In BD group significant impairments in interference, working memory and sustained attention were found in CST and VCT respect to controls. However, deficits in planning and problem-solving were also revealed with the VCT. With respect to psychosocial functioning, only VCT variables were able to predict FAST scores at the assessment time. The VCT showed a greater sensitivity than CST to assess executive functions and real-life functioning in BD. This provides evidence about the opportunity to design novel cognitive assessments for diagnostic and therapeutic purposes in BD. • Patients with BD may have impairments in executive functions even during euthymia that can affect psychosocial functioning. • The Virtual Cooking Task is an immersive virtual task to assess executive functioning from an ecological perspective. • When compared to traditional assessment, the Virtual Cooking Task was able to detect impairments in planning, problem solving and switching task with a greater sensitivity in euthymic patients with BD respect to controls. • Executive performance in the Virtual Cooking Task predicted psychosocial functioning in patients with BD at the assessment time. [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]

* OBJECTIVES: The primary objective was to compare sensory processing measures in people attending specialist orthopaedic consultation for management of persistent shoulder pain with control participants. The secondary objective was to compare the groups' sociodemographic, clinical, general health and lifestyle, and psychological characteristics. * DESIGN: Observational cross-sectional. * METHODS: Participants with shoulder pain for ≥3 months, who attended a public hospital orthopaedic department (n = 119), and community participants without shoulder pain (n = 44) underwent a standardized quantitative sensory testing protocol, measuring pressure pain threshold, temporal summation, and conditioned pain modulation. Sociodemographic, clinical, general health and lifestyle, and psychological characteristics were also collected. * RESULTS: Participants with shoulder pain had significantly lower pressure pain thresholds at all sites (ie, local and widespread mechanical hyperalgesia) and significantly decreased conditioned pain modulation effect (ie, descending inhibition of nociception) than control participants. There was no significant difference between groups for temporal summation. Participants with shoulder pain had decreased general health and function, less healthy lifestyles, and poorer psychological health compared with controls. * CONCLUSION: People referred to specialist orthopaedic care for management of persistent shoulder pain had clinical signs of altered sensory processing and poor health outcomes. [ABSTRACT FROM AUTHOR]

Purpose: To examine the feasibility and acceptability of progressive whole-body resistance training with social support reinforcement for older adults living alone. Method: This mixed methods single-group pilot study examined an intervention provided over 3 nonconsecutive days per week for 12 weeks. We evaluated quantitative data on recruitment, uptake, retention, and adherence, and measured pretest and posttest outcome scores on body composition, physical function, and psychosocial health. We conducted a focus group interview to collect qualitative data on participants' perspectives. Results: Seven participants (five women and two men) completed the program (attendance rate = 88.9%). Physical function and psychosocial health improved, but soft lean and skeletal muscle mass decreased. Five themes emerged from the qualitative data. Conclusion: Results support the feasibility and benefits of this intervention program for older adults living alone despite challenges with recruitment and uptake. [Journal of Gerontological Nursing, 50(10), 34–41.] [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]

Hypertensive disorders of pregnancy (HDP), such as preeclampsia and eclampsia, present significant risks to maternal and fetal health. While immediate complications are well-documented, emerging research highlights potential neurocognitive impacts on both mothers and their offspring. This narrative review synthesizes evidence on these neurocognitive outcomes associated with HDP, focusing on preeclampsia and eclampsia. A literature search was conducted for studies published from 2000 to February 2024. Maternal outcomes, including memory, executive function, and psychosocial well-being, were assessed across 11 studies, while fetal and neonatal neurocognitive outcomes were explored in five studies. Consistent findings indicate that preeclampsia and eclampsia are linked to impairments in maternal cognitive functions and psychosocial health. Offspring exposed to these conditions in utero also show cognitive deficits and alterations in brain connectivity. Contributing factors include placental dysfunction, altered angiokine levels, maternal stress, and socioeconomic variables. To mitigate these impacts, future research should focus on clarifying the underlying mechanisms and developing early interventions. This review emphasizes the necessity of multidisciplinary approaches to improve neurocognitive outcomes for both mothers and their children affected by preeclampsia and eclampsia. [ABSTRACT FROM AUTHOR]

Introduction: In addition to physical symptoms such as dyspnea, fatigue, post-exertional malaise, and pain, a subgroup of patients with Post-COVID-19 syndrome (Post-Acute Sequelae of COVID-19, PASC) suffers from mental illnesses such as anxiety, depression, and neurocognitive impairments. To date, there are no causal treatments available for PASC. While initial studies show that psychotherapy improves psychological symptoms, PASC-related fatigue, and psychosocial functioning, further research is needed to evaluate the effectiveness of psychotherapeutic treatment for PASC. Methods and analysis: This study presents a non-randomized controlled trial aimed at evaluating the effectiveness of a five-week multimodal inpatient psychosomatic treatment program for individuals experiencing PASC symptoms and comorbid mental illness. A total of 118 patients presented at the Post-COVID Center at the Universitätsklinikum Erlangen will be assigned to the intervention group receiving inpatient psychosomatic treatment or the control group receiving treatment as usual. The inclusion criteria for the intervention group are a diagnosis of PASC and at least one condition of mental distress and problems with coping with illness. The primary objective of the intervention is to reduce mental ailments, including depression and anxiety, as well as neurocognitive deficits, and to address PASC symptoms such as fatigue and pain. The core elements of the treatment are psychotherapy in individual and group settings, medical treatment, neurocognitive training, and physical therapy, adapted to the individual's capacity and oriented towards the concept of pacing. After enrollment, participants will undergo a 6-month follow-up to assess long-term results and the sustainability of the intervention effects. Discussion: This study examines the effectiveness of inpatient psychotherapeutic treatment in PASC patients with comorbid mental illness in comparison with a control group based on treatment as usual. The results of the study can contribute to the development of evidence-based interventions to address the complex needs of patients with PASC and comorbid mental illness. Trial registration: German Clinical Trial Register (DRKS), retrospectively registered 15.02.2024 DRKSID DRKS00033562. [ABSTRACT FROM AUTHOR]

Aim: To review the international evidence base on interventions to support the mental health of family carers of children with brain injuries in low and middle income countries (LMIC). Methods: Searches were conducted with five electronic databases (Pubmed, Web of Science, Embase, PsycINFO, CINAHL) using search terms related to "family carers", "brain injury", "children" and "low and middle income countries". Studies were independently screened using predetermined eligibility criteria by two authors. Data were extracted from included studies using standardised data extraction and quality appraisal tools. These data were then subjected to narrative synthesis. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines were used to govern the review process. Findings: One study met our inclusion criteria and described an acquired brain injury called nodding syndrome which occurs in Sub-Saharan Africa. The study was conducted in Ghana and provided group-based psychotherapy to carers and their children. As such we found no study which sought to solely support the mental health of family carers. Conclusions: There has been a lack of focus in the literature on the mental health of family carers of children with brain injuries in LMIC. Considering the vital importance of caregivers in supporting their children it is imperative that service providers and researchers devise programmes to better meet their needs. The mental health of family carers should be better supported to improve their overall wellbeing, which will in turn improve the wellbeing of their children. [ABSTRACT FROM AUTHOR]

Background: The PedsQL™ 4.0 Generic Core Scales (GSC) have been translated into over 60 languages, but use in the sub-Saharan African region is limited. This study aimed to cross-culturally adapt and validate the PedsQL™ 4.0 GCS child self-report and teen self-report versions into the Chichewa language for Malawi. Methods: The English (USA) versions were adapted (translation, back translation and cognitive interviews to evaluate conceptual equivalence) into Chichewa. We recruited 289 children (8–17 years) in Blantyre, Malawi. Classical psychometrics at the item level (missing data, endorsement frequencies, item redundancy) and scale level (internal consistency, convergent, discriminant and known groups validity) was used to evaluate the new Chichewa versions. Results: Six items were found to need cultural adaptation for Malawi. There were problems with missing data (< 5%) and adjacent endorsement frequency (< 10%) among younger children. Internal consistency reliability was acceptable (Cronbach α > 0.7). Convergent validity was generally strong (correlations > 0.4). Discriminant validity (p > 0.05) was evident with respect to gender and age, but not for school grade (p < 0.05). Effect sizes indicating known groups validity were in the expected direction but of variable magnitude. Conclusion: We have successfully adapted the PedsQL™ 4.0 GCS child self-report and teen self-report into Chichewa for use in Malawi. Many aspects of the psychometric evaluation were promising, though some elements were more mixed and we have not yet been able to evaluate test-retest reliability or responsiveness. We suggest that the PedsQL™4.0 GCS child and teen self-reports should be used with caution among children and adolescents in Malawi. [ABSTRACT FROM AUTHOR]

Background: Digital mental health interventions for smartphones, such as the World Health Organization (WHO) Step-by-Step (SbS) program, are potentially scalable solutions to improve access to mental health and psychosocial support in refugee populations. Our study objective was to evaluate the effectiveness of SbS as self-guided intervention with optional message-based contact-on-demand (COD) support on reducing psychological distress, functional impairment, symptoms of posttraumatic stress disorder (PTSD), and self-identified problems in a sample of Syrian refugees residing in Egypt. Methods and findings: We conducted a 2-arm pragmatic randomized controlled trial. A total of 538 Syrians residing in Egypt with elevated levels of psychological distress (Kessler Psychological Distress Scale; K10 > 15) and reduced psychosocial functioning (WHODAS 2.0 > 16) were randomized into SbS + CAU (N = 266) or CAU only (N = 272). Primary outcomes were psychological distress (Hopkins Symptom Checklist 25) and impaired functioning (WHO Disability Assessment Schedule 2.0) at 3-month follow-up. Secondary outcomes were symptoms of PTSD (PTSD Checklist for DSM-5 short form, PCL-5 short) and self-identified problems (Psychological Outcomes Profiles Scale, PSYCHLOPS). Intention-to-treat (ITT) analyses showed significant but small effects of condition on psychological distress (mean difference: −0.15; 95% CI: −0.28, −0.02; p =.02) and functioning (mean difference: −2.04; 95% CI: −3.87, −0.22; p =.02) at 3-month follow-up. There were no significant differences between groups on symptoms of PTSD and self-identified problems. Remission rates did not differ between conditions on any of the outcomes. COD was used by 9.4% of participants for a median of 1 contact per person. The main limitations are high intervention dropout and low utilization of COD support. Conclusions: The trial provides a real-world implementation case, showing small positive effects of a digital, potentially scalable and self-guided mental health intervention for Syrian refugees in Egypt in reducing psychological distress and improving overall functioning. Further user-centered adaptations are required to improve adherence and effectiveness while maintaining scalability. Trial registration: German Register for Clinical Studies DRKS00023505. Sebastian Burchert and colleagues examine if digital self-help interventions for refugee populations may be a scalable approach to complement local healthcare systems. Author summary: Why was this study done?: Syrians are the largest forcibly displaced population worldwide. Host countries like Egypt struggle to provide mental health and psychosocial support at scale for refugee populations. Digital self-help interventions may be a highly scalable approach to strengthening local healthcare systems. What did the researchers do and find?: We tested a smartphone app offering a self-help intervention in displaced people from Syria residing in Egypt who reported elevated levels of psychological distress and problems with daily functioning. A total of 538 participants were randomly assigned to either use the app or to a control group receiving usual care and basic information only. Participants who used the app showed stronger improvements in psychological distress and daily functioning compared to the control group. However, many participants did not complete the app-based intervention and dropped out of the study early. What do these findings mean?: The app was found to improve psychological distress and functioning in study participants. This self-help approach can be made available to many people, offering a potentially scalable solution to mental health support. The large number of participants who dropped out of the study indicates that the approach may only be relevant or helpful for some, and the results should be interpreted with this limitation in mind. [ABSTRACT FROM AUTHOR]

AbstractObjective: Hoarding disorder is a chronic and progressive psychiatric disorder that often begins in adolescence and early adulthood. The purpose of this study was to investigate the impact of hoarding severity on college students’ psychosocial functioning and possible methods of early intervention. Participants: Undergraduate students (N = 363) at a large public university in the United States. Methods: Participants completed a self-report battery that included their parental history of clutter, perceptions about possible interventions for clutter, and standardized measures of hoarding severity, psychiatric symptoms, and psychosocial functioning. Results: Hoarding symptom severity predicted significant unique variance in emotional support and companionship, even when controlling for comorbid psychiatric symptoms. The main reasons endorsed by participants for disorganization of their objects despite adequate storage space were “lack of time” (37%), “easily distracted” (26%), and “procrastination” (34%). Conclusions: Emerging adults may benefit from early intervention focused on time management, attentional control, and consistent motivation. [ABSTRACT FROM AUTHOR]

While mental disorders have been broadly researched in people with intellectual disabilities (ID), comparatively less attention has been given to the conceptualisation of good mental health for this population. To capture existing concepts, definitions and measurement approaches of good mental health a systematic literature review was conducted following PRISMA guidelines. The search was carried out in eleven databases, using various synonyms of (i) intellectual disability, (ii) mental health, (iii) wellbeing, (iv) definition, and (v) assessment. A total of 2,046 datasets were identified, of which 37 met the inclusion criteria and were analysed using reflexive thematic analysis and content analysis. Results show four main themes: (1) environment, (2) absence of mental illness, (3) physical health, and (4) psychosocial functioning. The fourth was the most dominant theme and was further divided into five sub-themes: (1) emotionality, (2) interpersonal relations, (3) realise own potential, (4) personal resources, and (5) overall appraisal of life. Our findings reveal different conceptualisations of wellbeing, which is a vital part of good mental health, but highlight a notable research gap in the actual definition and conceptualisation of good mental health for people with ID. [ABSTRACT FROM AUTHOR]

Depersonalization/derealization disorder (DPD) is a prevalent yet inadequately understood clinical condition characterized by a recurrent or persistent sense of unreality. This study aims to provide insight into DPD through descriptive and comparative analyses involving a large group of Chinese participants. The socio-demographic details (age, gender proportion, education, occupational status, marital status), depersonalized and dissociative symptom characteristics (symptomatic factors or subscales of the Cambridge Depersonalization Scale and the Dissociative Experiences Scale), development trajectory (age of onset, potential precipitating factors, course characteristics), treatment history (duration of delayed healthcare attendance, duration of delayed diagnosis, previous diagnoses), and adverse childhood experiences of the DPD patients are presented. Comparisons of anxiety and depressive symptoms, alongside psychosocial functioning, between DPD participants and those diagnosed with generalized anxiety disorder, bipolar disorders, and major depressive disorder were conducted. The analysis highlights a higher male preponderance and early onset of DPD, symptomatology marked by derealization, notable impairment in psychosocial functioning, and prolonged periods of delayed healthcare attendance and diagnosis associated with symptom severity. Furthermore, noteworthy relationships between adverse childhood experiences and symptom levels were identified. The findings substantiate the view that DPD is a serious but neglected mental disorder, urging initiatives to improve the current condition of DPD patients. [ABSTRACT FROM AUTHOR]

Eating disorders can significantly impact the psychosocial functioning and physical health of adolescents. Early and effective treatment is crucial to prevent long-lasting and potentially devastating adverse effects. The National Institute for Health and Care Excellence has recommended cognitive behaviour therapy (CBT) for eating disorders in adolescents when family therapy is unacceptable, contraindicated, or ineffective. This recommendation was primarily based on the review of promising results from the enhanced version of CBT (CBT-E) adapted for adolescents with eating disorders aged between 12 and 19 years. A non-randomized effectiveness trial has also shown that CBT-E achieved a similar outcome to family-based treatment (FBT) at 6- and 12-months. CBT-E has several advantages. It is acceptable to young people, and its collaborative nature suits ambivalent young patients who may be particularly concerned about control issues. The transdiagnostic scope of the treatment is an advantage as it can treat the full range of disorders that occur in adolescent patients. It is an individual one-on-one treatment that does not necessitate the full involvement of the family. This approach is particularly beneficial for families that can only provide limited support. Future challenges include clarifying the relative efficacy of CBT-E and family therapy for the treatment of adolescent patients with eating disorders in a randomized control trial and increasing its effectiveness, identifying the reasons for the lack of response, and modifying the treatment accordingly. [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]

Background: Premenstrual dysphoric disorder (PMDD) represents a significant psychiatric condition affecting women of reproductive age. It is characterized by cyclical emotional and physical symptoms that considerably impair psychosocial functioning. This study aims to investigate the prevalence of PMDD among adult working women and identify associated etiological factors. Methods: From January 2022 to March 2022, a crosssectional study utilizing cluster sampling methodology was conducted to investigate the prevalence of PMDD among adult working women in six communities in Hangzhou (China). A total of 1710 participants were selected for research through a questionnaire-based survey. To elucidate the factors associated with PMDD, logistic regression analysis was employed. Results: Among 1710 working women, 52 had PMDD, representing an incidence of 3.04%. Age (odds ratio (OR) = 3.196, p = 0.002), age at menarche (OR = 0.362, p = 0.011), income (OR = 0.449, p = 0.043), menstrual cycle (OR = 2.352, p = 0.022), menstrual symptoms (OR = 0.317, p = 0.003), physical activity (OR = 2.234, p = 0.028), and caffeine intake (OR = 2.318, p = 0.022) were independent influencing factors of PMDD in adult working women. Conclusions: The study highlights that PMDD, which has a prevalence of 3.04% in the surveyed population, is a notable concern among adult working women. Key factors, such as age, age at menarche, income level, menstrual cycle characteristics, menstrual symptom presence, physical activity, and caffeine intake, significantly contribute to the likelihood of developing PMDD. These findings underscore the importance of recognizing and monitoring the above risk factors by clinicians to identify and manage PMDD in working women. [ABSTRACT FROM AUTHOR]

This study explored the associations between Adverse Childhood Experiences (ACEs) and functioning across several school readiness domains among preschoolers with disruptive behavior problems. The sample included 115 children (Mage= 5.18, 67.8% male; 32.2% female) from a large, urban, high-poverty community, with predominantly Black families, who were about to enroll in a summer treatment program prior to kindergarten. As part of pre-treatment assessments, caregivers completed interviews and questionnaires about adverse experiences and stressors in their children's lives. Children's behavioral, academic, and social functioning were also assessed at this time. We identified exposure to ACEs using multimodal parent reports. A path analysis was conducted between preschoolers' exposures to ACEs and their school readiness, covarying outcomes with one another to isolate the effect of ACEs. Our findings indicate a dose-effect, such that exposure to a higher number of ACEs is significantly associated with more severe disruptive behaviors, internalizing problems, and global impairment in the child's functioning. However, there were no significant associations between total number of ACEs and academic or social functioning. Notably, the prevalence of ACEs among this sample of preschoolers living in highly under-resourced communities was strikingly higher than national samples, with 93.9% of parents reporting exposure to at least one ACE by age 5, compared to 19–26% in a nationally samples; moreover, 62.6% experienced 3 or more ACEs, compared to 5.35% in same-aged samples (Briggs-Gowan et al., 2010; Jackson et al., 2021). Our study contributes to the growing literature on the importance of recognizing the heightened risk of early and compounding adversity in school readiness outcomes for young children with special needs. Implications for early intervention timing and the need to consider readiness for preschool are discussed. Study Highlights: We investigate associations between adversity and school readiness in preschoolers with disruptive behaviors living in a low income community. We identify exposure to ACEs using multimodal parent report from clinical interviews and surveys. We find that 94% of participants had experienced at least 1 ACE and 49% had experienced 4 or more. We find a dose effect between number of ACEs and severity of disruptive and internalizing problems, and global impairment. [ABSTRACT FROM AUTHOR]

Parent-child interactions, which substantially impact children's psychosocial functioning, can be affected by caregiver adversity exposure. Considering that caregivers and their children often have divergent perspectives on their interactions, the current study included maternal- and child-reports of parenting practices and parent-child communication as indicators in a latent profile analysis. This study included 263 dyads comprised of children aged 8–17 (MAge = 12.13, SD = 2.77; 88.2% Black) and their female caregivers (MAge = 36.43, SD = 7.89; 82.9% Black) who were recruited based on caregivers' differing experiences with the SAVA syndemic (i.e., potentially harmful substance use, intimate partner violence (IPV), HIV, or none of these adversities). After identifying empirically-derived profiles of maternal-child interactions, we examined associations between these established profiles and children's external resilience resources. A three-class model emerged as the best fit: Concordant: Child/Mother Positive (C-PP; 73.4%), Discordant: Child Very Negative/Mother Slightly Negative (D-CN; 13.1%), and Discordant: Child Positive/Mother Negative (D-CP; 11.8%). Caregiver endorsement of SAVA syndemics did not predict class membership. Dyads with older children were more likely to be in the D-CN class, and dyads reporting lower SES were more likely to be in the D-CP class. Compared to children in the D-CN class, children in the C-PP class reported significantly higher resilience in school (Est. = −0.42, p = 0.006), community (Est. = −0.51, p = 0.001), and peer (Est. = −0.37, p = 0.004) contexts. No other class differences emerged. Findings highlight the importance of positive and consistent maternal-child interactions, which may help youth access a network of resilience resources that can promote healthy development and bolster well-being. Highlights: Most mother-child dyads agreed that their interactions, which included parenting practices and communication, were positive. When mothers and children agreed that their interactions were positive, children reported higher external resilience resources. Maternal SAVA (substance abuse, violence, AIDS/HIV) did not affect whether mother-child reports of parenting were concordant/positive. Older children were more likely to be in dyads with very negative child perspectives on parenting and slightly negative maternal perspectives. Mothers with lower SES were more likely to report negative views of their parenting, despite their children holding positive perspectives. [ABSTRACT FROM AUTHOR]

Weight stigma is described as prejudice and discrimination concerning body weight. People stigmatized by their body weight report worse physical and mental health and, consequently, poor psychosocial functioning. Research has shown a high prevalence of weight stigma among health professionals. However, less is known about weight stigma among healthcare undergraduate students. In this vignette study, we assessed weight stigma in 217 healthcare students, who filled sociodemographic and weight stigma measures, and read one of three vignettes at random, each one with a hypothetical patient which differs only in terms of body weight (underweight, healthy weight, and overweight). Then, participants answered ten questions/statements about patient characteristics described in the vignette to assess the influence of body weight on stigmatizing beliefs. Weight stigma was found in 39.44% of healthcare students. Moreover, weight stigma was higher among men, healthy weight people, and Physical Therapy students. This experimental study showed more negative attitudes in participants exposed to the patient with overweight and underweight vignettes compared to those exposed to the healthy weight patient vignette. Due to the known impacts of weight stigma, efforts are needed to address this issue during the training of healthcare undergraduate students. [ABSTRACT FROM AUTHOR]

The consequences of inflammatory bowel disease (IBD) in children are connected to possible detrimental impacts on growth, development, psychosocial function, and general well-being. Therefore, the primary management plan in pediatric IBD is to achieve the long-term control of intestinal inflammation while also monitoring potential disease complications and therapeutic adverse effects, where nutritional management is of utmost importance. This review explores the role of dietary supplements as concentrated sources of nutrients with nutritional and/or physiological effects on children with IBD. While dietary supplements are commonly used in pediatric IBD management, their efficacy and, for some of them, safety remain subjects of debate. We provide an overview of the types of dietary supplements available and their potential benefits and risks in pediatric IBD patients. Additionally, we discuss the evidence supporting the use of specific supplements, their mechanisms of action, and considerations for clinical practice. Understanding the role of dietary supplements in pediatric IBD management is crucial for optimizing patient care and outcomes. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to examine longitudinal associations of workplace effort and reward with changes in cognitive function among United States workers. Methods: Data from the national, population-based Midlife in the United States (MIDUS) study with a 9-year follow-up were used. Validated workplace effort and reward scales were measured at baseline, and cognitive outcomes (including composite cognition, episodic memory, and executive functioning) were measured with the Brief Test of Adult Cognition by Telephone (BTACT) at baseline and follow-up. Multivariable linear regression analyses based on generalized estimating equations (GEE) examined the longitudinal associations under study. Results: Among this worker sample of 1,399, after accounting for demographics, socioeconomics, lifestyle behaviors, health conditions, and job control, high reward at baseline was associated with increased composite cognition (regression coefficient: 0.118 [95% CI: 0.049, 0.187]), episodic memory (0.106 [0.024, 0.188]), and executive functioning (0.123 [0.055, 0.191]) during follow-up. The joint exposure of 'high effort and high reward' was also associated with increased composite cognition (0.130 [0.030, 0.231]), episodic memory (0.131 [0.012, 0.250]), and executive functioning (0.117 [0.017, 0.216]), while the combination of 'low effort and high reward' was associated with increased composite cognition (0.106 [0.009, 0.204]) and executive functioning (0.139 [0.042, 0.235]). Conclusion: Findings suggest that workplace high reward is related to improved cognitive scores among United States workers. Future research should investigate larger cohorts over longer timespans and expand into disease outcomes such as dementia. If these findings emerge as causal, relevant workplace rewards to promote worker cognitive health should be considered. [ABSTRACT FROM AUTHOR]