American Psychiatric Association Research Articles

Development of an experimental oculographic test battery as part of a software and hardware complex for diagnosing the tendency to computer gaming addiction

Currently, the problem of determining the state of the individual in the «norm-pathology» continuum for non-chemical addictions remains relevant. Our analysis of diagnostic materials allows us to conclude that the vast majority of methods for diagnosing computer gaming addiction are foreign clinical scales translated into Russian, built on the basis of the clinical criteria of the American Psychiatric Association. In connection with this fact, as well as the rapid development of society and the digitalization the practical psychology are needed to modern and effective psychodiagnostic techniques.The research was carried out with the financial support of the Federal State Budgetary Institution «Fund for Assistance to the Development of Small Innovative Enterprises in the Scientific and Technical Sphere» (Innovation Promotion Fund) within the framework of the implementation of innovation project.Purpose of the study - to develop an experimental oculographic test battery for diagnosing computer gaming addiction.Methods. In the empirical research of the first stage of work we used the following methods: clinical conversation; psychodiagnostic methods: method of multilateral personality research by S. Hathaway, J. McKinley (adapted by F.B. Berezina, M.P. Miroshnikova), style of self-regulation of behavior by V.I. Morosanova, questionnaire of volitional self-control by A.G. Zverkova, E.V. Eidman, Distress, Depression, Anxiety and Somatization Questionnaire by B. Terluin (adapted by A.B. Smulevich). To assess oculomotor reactions (fixation duration, number of fixations), we used the GP3 Gazepoint remote software and hardware system for assessing oculomotor reactions.We used the Spearman rank correlation coefficient (p ≤ 0.05) for study the relationships between the structural-dynamic parameters of oculomotor reactions and the personal characteristics of respondents.Results. During the first stage of the work, we obtained the following scientific results: requirements for digital images that make up visual stimuli, and for the visual stimuli themselves have been formulated; stimulus images have been developed to assess the tendency to computer gaming addiction; we was carried out a comparative analysis and studied the relationship between the structural and dynamic parameters of oculomotor reactions and the personal characteristics of respondents; we has been developed the experimental oculographic test battery to diagnose computer gaming addiction.Conclusion. Requirements for visual stimuluses will become part of the guidelines to the oculographic test battery, which will be developed in the second stage of work. Comparative analysis made it possible to identify the most effective visual stimulus that we included in the experimental oculographic test battery.

It doesn't need to be so stressful!

The rapid development of the online delivery in higher education has resulted in a proliferation of research. Key in this work are two critical streams: how to support diverse students in online learning spaces, and the need for greater theorisation to guide educators on the optimal design of such pedagogies. In this study we bring these two streams together by harnessing the lens of self-determination theory (SDT) to explore the experiences of medical students with Attention Deficit Hyperactivity Disorder (ADHD) in their online learning experiences. In doing so, we contribute key theoretical and practical knowledge on supporting innovative, inclusive online learning spaces for our increasingly diverse student cohorts. ADHD is a neurodevelopmental disorder characterised by persistent patterns of inattention, hyperactivity, and impulsivity (American Psychiatric Association, 2022). Studies indicate that the prevalence of ADHD in higher education settings is significant, and medical students are not exempt from this trend with self-reported prevalence suggests it could be as high as 24% (Emmers et al., 2017; Njuwa et al., 2020; Sedgwick-Müller et al., 2022). The nature of medical education, characterised by heavy workloads, time pressures, and complex material, can further pose unique challenges for individuals with ADHD affecting academic performance, professionalism and overall well-being (Im & Tamarelli, 2023). The literature implies that motivational alterations, particularly focusing on internal motivations, exist in people with ADHD, acting as mediators between environmental and social contexts and outcomes including behaviour and performance. Thus, what is the key in this issue is how students are supported to develop and enact their SDT to foster optimal engagement and ultimately their well-being and inclusion (Morsink et al., 2022). In this presentation we will present our findings of semi-structured interviews with medical students diagnosed with ADHD (n=10). Specifically, our study will organise results in relation to the three dimensions of SDT including: student autonomy, competence and relatedness. Findings include the students’ perceptions of the challenges related to flexible delivery, and how greater choice also at times led to barriers around their study decision-making (e.g., to attend lectures, to study asynchronously). Through our presentation we will further provide recommendations on strategies to create inclusive, autonomy-supportive online learning spaces for ADHD students in higher education settings.

A Narrative Review of the Digital Equity Gap of Apps for Cigarette Smoking Cessation for Persons Living in the Hispanosphere

Abstract Purpose of Review The Hispanosphere is a vast region of the world that has received little attention in the digital health literature. No study to date has examined the availability and quality of publicly available mobile applications (apps) for cigarette smoking cessation in this region. Three coders utilized the American Psychiatry Association (APA)’s Brief App Evaluation Model Screener (Brief-AEM Screener) to evaluate the quality of the label and public-facing screens of smoking cessation apps in Spanish. Availability of apps in the Hispanosphere was compared to availability of apps in the Anglosphere. Recent Findings We identified and reviewed 19 apps in Spanish in Google Play. The median score using the Brief-AEM Screener was 63 out of 100 suggesting generally acceptable app quality and features according to the quality standards for digital health tools proposed by the APA. However, we found (1) notable inaccurate and misleading labelling claims, (2) poor grammar or incomplete translations, and (3) a lack of cultural and linguistic adaptation to countries in the Hispanosphere. Our comparison of smoking cessation apps between the Hispanosphere and the Anglosphere suggested that there is a large digital equity gap between these two regions, with a four to sevenfold gap in app availability. Summary There is a relative shortage of quality and quantity of digital health apps for smoking cessation in the Hispanosphere. To ensure the cultural appropriateness of those digital interventions, it is essential that developers of digital health tools establish community partners in the region prior to developing apps for smoking cessation.

In Case You Haven't Heard…

As the nation “falls back” to standard time, Americans are twice as likely to say their mood declines in the winter (41%) as they are to say it improves (22%), according to the latest Healthy Minds Monthly Poll from the American Psychiatric Association (APA). However, when spring comes around, 61% of respondents reported feeling better, an APA news release stated. When asked about what behaviors and feelings they noticed during the winter, Americans reported sleeping more (41%), feeling fatigued (28%), feeling depressed (27%), feeling moody (23%), losing interest in things they like (20%), eating more sweets (21%), and problems sleeping (14%). When asked to select which activities were most likely to boost their mood in the winter, those polled were most likely to select eating good food (46%); reading, watching TV or engaging in other indoor habits (42%); or spending time with family and friends at the holidays (40%). When asked which activities helped them cope with winter weather, respondents were most likely to select talking with friends and family (46%), sleeping more (35%), and going outside (35%). Generally, women reported more behavioral changes related to the change of season, such as feeling moody, and were less likely to report feeling happier (15% of women versus 21% of men).

The American Psychiatric Association Practice Guideline for the Treatment of Patients With Borderline Personality Disorder.

The American Psychiatric Association Practice Guideline for the Treatment of Patients With Borderline Personality Disorder.

Mokken scale analysis of the Internet Gaming Disorder Scale–Short-Form and the Gaming Disorder Test

In recent years, research on disordered gaming has grown substantially with researchers developing different psychometric tools for assessing it. Two of the most prominent assessment tools are the Internet Gaming Disorder Scale–Short-Form (IGDS9-SF) and the Gaming Disorder Test (GDT), which evaluate disordered gaming under the American Psychiatric Association (APA) and the World Health Organization (WHO) frameworks, respectively. The main aim of this study was to assess and compare the scalability, reliability, and validity of both scales to determine if they effectively assess disordered gaming in a normative sample, through the Mokken Scale Analysis (MSA). A sample of 605 participants (42.31 % female, meanage = 23.98 years, SD = 9.21 years) was recruited for the present study. Results showed that both the IGDS9-SF and GDT were unidimensional, with all items presenting latent monotonicity fitting in the Monotone Homogeneity Model (MHM). Item characteristic curves did not intersect and presented with adequate fit in the Double Monotonicity Model (DMM). These findings further support the psychometric adequacy of the IGDS9-SF and GDT, attesting to their suitability to assess disordered gaming.

Pharmacotherapy for complex substance use disorders: a practical guide by Thanh Thuy Truong, Benjamin Li, Daryl Shorter, Nidal Moukaddam, Thomas R. Kosten, American Psychiatric Association Publishing, 2023

Pharmacotherapy for complex substance use disorders: a practical guide by Thanh Thuy Truong, Benjamin Li, Daryl Shorter, Nidal Moukaddam, Thomas R. Kosten, American Psychiatric Association Publishing, 2023

Management of eating and feeding disorders

The World Health Organization and the American Psychiatric Association have identified eating disorders. This is the most common disease in the world. According to a systematic review, the prevalence of eating and feeding disorders was 3.5% between 2000 and 2006 and increased between 2013 and 2017 to 7.8 percent. Approximately 28.8 million people will suffer from this disease in USA. Eating and feeding disorders can be lifelong issue. These disorders are more common among women. Anorexia nervosa, effects on systemic as well as general oral and dental health.

Post-Traumatic Stress Disorder (PTSD) in Trauma Patients.

Post-traumatic stress disorder (PTSD) was first introduced as a diagnosis by the American Psychiatric Association in 1980. This diagnosis, included in the 3rd edition of the Diagnostic and Statistical Manual of the American Psychiatric Association (DSM-III), was to be considered after someone was exposed to a traumatic event "outside the range of usual human experience and would be markedly distressing to almost anyone." Since then, trauma survivors have been identified as being at risk for the development of post-traumatic stress symptom (PTSS) and post-traumatic stress disorder (PTSD). Despite the recognition of this fact, the screening, recognition, and diagnosis of PTSD in these at-risk populations are inconsistent. In the following review, which is designed for the clinician who is unfamiliar with PTSD and its recognition, diagnosis, and treatment, we introduce the problem in the trauma patient and define its scope. In addition, we discuss the diagnosis of PTSD in trauma patients, special considerations relating to these patient populations, treatment options, and explore future directions for how best to define, study, recognize, and treat this challenging and potentially devastating condition.

The Underuse of Clozapine and Long-Acting Injectable Antipsychotics.

Schizophrenia is among the most devastating and costly human diseases. The public face of the failure to appropriately treat schizophrenia includes approximately 100,000 homeless individuals with schizophrenia and related psychoses and 200,000 incarcerated individuals with similar diagnoses. Clozapine and long-acting injectable antipsychotics are among the most effective treatments, but both are markedly underused. The following organizations should take responsibility for fixing this problem: National Institute of Mental Health, Patient-Centered Outcomes Research Institute, Substance Abuse and Mental Health Services Administration, Centers for Medicare and Medicaid Services, U.S. Food and Drug Administration, American Psychiatric Association, and patient and family advocacy groups.

Validating the Motives for Online Gaming Questionnaire (MOGQ) within the WHO and APA gaming disorder symptoms frameworks

The increasing interest in digital games and the reasons behind their popularity worldwide warrants further psychometric investigation of motivation factors for engagement in digital games. The present study aimed to validate the Motives for Online Gaming Questionnaire (MOGQ) in a Swedish sample and compare the associations between the seven motivational factors and gaming disorder symptoms across the American Psychiatric Association and World Health Organization diagnostic frameworks. Furthermore, considering the utility of more concise psychological measures, a 14-item version of the MOGQ was developed (MOGQ-14). A sample of 678 Swedish video game players (68.4% men, 29.7% women, and 1.9% other, Mage = 29.5 years, range 15–66) were included in the analyses after participating in an online survey. The analyses revealed that the Swedish version of the MOGQ had good psychometric properties. All MOGQ factors showed good reliability (McDonald's omega), and all intercorrelations among the MOGQ dimensions were consistent with previous findings. The results showed that, on average, men reported higher gaming motivations concerning competition than women. The relationships between six gaming motivation factors (social, escape, competition, coping, skill development, fantasy) and gaming disorder symptoms were consistent with previous research. Findings indicated that the relationship between motivations (escape and recreation) and gaming disorder symptoms varied across APA and WHO diagnostic frameworks, depending on the motivation scale used (MOGQ or MOGQ-14). Recreation significantly differed in its relationship with symptoms when using MOGQ, and the MOGQ-14 showed larger effect sizes in the WHO framework for escape and recreation motivations.

Major considerations in neurotic skin excoriations and psychiatric disorders: a systematic review

Introduction: Among psychiatric dermatoses, neurotic excoriation is characterized by the patient's confession of causing lesions on the skin itself, without presenting a basic dermatological disease. The theme has been gaining prominence since the incorporation of the diagnosis in the American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders (DSM-5, APA 2014). Objective: The present study addressed the main clinical findings in research studies on neurotic excoriation, in addition to valuing the importance of psychological aspects in etiopathogenesis. Methods: The research and development of the work were carried out from June to July 2024 in the Scopus, PubMed, Science Direct, and Scielo databases, using the main scientific articles on nutrigenomics, and following the PRISMA rules. The quality of the studies was based on the GRADE and AMSTAR-2 instruments, and the risk of bias by the Cochrane instrument (Funnel Plot). Results and Conclusion: 18 studies were included out of a total of 115. According to the GRADE instrument, most studies presented homogeneity in their results, with X2=89.5%>50%. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 26 studies with a high risk of bias and 25 studies that did not meet the GRADE and AMSTAR-2 criteria. it was found that the subject has been scarcely addressed in the literature since not all cases are diagnosed and this pathology has more than one denomination (excoriation disorder, pathological palpation of the skin, neurodermatitis, dermatothilomania, and psychogenic excoriation). Therefore, the present study addressed the main clinical findings in research studies, through a systematic review, on neurotic excoriation, in addition to valuing the importance of psychological aspects in etiopathogenesis.

Grief and prolonged grief disorder by CFReynolds III , S Cozza, PK Maciejewski, HG Prigerson, K Shear, NM Simon and S Zisook. 2024 American Psychiatric Association. ISBN: 978-1-61537-463-2

Grief and prolonged grief disorder by CFReynolds III , S Cozza, PK Maciejewski, HG Prigerson, K Shear, NM Simon and S Zisook. 2024 American Psychiatric Association. ISBN: 978-1-61537-463-2

Intensive Group Behavioral Treatment for Older Youth With Selective Mutism: An Open Trial

Selective mutism (SM) is an anxiety disorder characterized by an inability to speak in social situations, despite comfortably speaking in familiar situations (American Psychiatric Association, 2022). To date, research has demonstrated the effectiveness of cognitive-behavioral therapy (CBT) models, including both weekly CBT and intensive group behavioral treatment for younger children with SM (Cohan et al., 2006; Cornacchio et al., 2019; Haggerty et al., 2022; Oerbeck et al., 2018). However, no research has examined treatment options for older youth with SM. The present study sought to examine effectiveness of an intensive group behavioral treatment (IGBT) for older youth with SM by examining pretreatment to follow-up differences on primary (SM symptoms) and secondary outcomes (self-efficacy and social skills). Sixteen youth, ages 10–17, with a primary diagnosis of SM engaged in a 5-day IGBT. Results indicated statistically significant reductions in parent- and self-reported SM symptoms from pretreatment to follow-up (2 months and 5 months into the following school year), as well as statistically significant improvements in self-reported self-efficacy and social skills from pretreatment to follow-up. These findings provide empirical support for the preliminary effectiveness of IGBT for older youth with SM and reveal information about the unique clinical profile of this subset of the population.

Efficacy of continuous glucose monitoring for finding unusual causes of hyperglycemia: a clinical case

Diabetes is a chronic condition that requires constant blood glucose self-monitoring. The carbohydrate metabolism compensation is usually assessed by the level of glycated hemoglobin. But it does not always help reveal the true cause of poor glycemic control. The devices for continuous glucose monitoring allows to assess blood glucose level in real time and find unusual causes of hyper- and hypoglycemia. Achieving target glycemic levels is influen­ced by many factors: age of patients, duration of diabetes, eating habits and eating disorders, level of education, patient’s understan­ding of the diabetes course. One of the reasons for not reaching the target levels of glycemia can be hyperphagic eating disorders, such as night eating syndrome. According to the American Psychiatric Association classification, night eating syndrome belongs to the category of “Other specified eating disorders”. Diagnostic criteria in this syndrome include consumption of > 25 % of food from the daily diet after dinner or at least 2 cases per week of food consumption at night; awareness of these episodes; and at least 3 of the following: morning anorexia, uncontrollable desire to eat between dinner and sleep or at night, conviction that eating will help you fall asleep or return to sleep, insomnia and/or bad mood in the morning. The prevalence of night eating syndrome in the general population is 1.1 %, and in those who refer to metabolic surgery specialists, it is 2–20 %. The presence of night eating syndrome in diabetes adversely affects metabolic control and complicates the management of these patients, in particular, they have higher levels of HbA1c, blood pressure and body mass index compared to individuals without such eating disorder. In this case report, we describe a patient with poor glycemic control who used continuous glucose monitor and was diagnosed with night eating syndrome that helped change management and achieve normoglycemia in the evening and nighttime.

Most adults would seek MH care if advised by faith leader

Most adults have said they believe that their faith or spirituality is important for their mental wellness, according to a survey released by the American Psychiatric Association (APA) assessing the relationship between faith and mental health. Additionally, a majority of the individuals who responded to the poll would pursue mental health care if it were recommended by their faith leader.

Coming Up…

The American Psychiatric Association is holding The APA 2024 Mental Health Services Conference Sept. 26–28 in Baltimore. For more information, visit https://www.xpressreg.net/register/MHSC0924.

A - 67 A Critical Analysis of EEG Neurofeedback Training Efficacy in Historically Disadvantaged Communities

Abstract Objective Electroencephalogram neurofeedback training (EEG-NFT) is gaining popularity as a way of supporting emotional regulation following traumatic brain injury (TBI; Dehghani et al., 2023; Bezmaternykh et al., 2021; Rajeswaran and Bennett, 2019), as well as mental disorders defined in the DSM-5-TR (American Psychiatric Association [APA], 2022; Deiber et al., 2021; Micoulaud-Franchi et al., 2021; Neurofeedback Collaborative Group, 2023). EEG-NFT can extend well beyond TBIs and mental health disorders, especially in marginalized individuals facing ongoing trauma due to discrimination, hate crimes, and chronic stress as a result of frequent micro- and macroaggressions (Choi et al., 2022; Majeno et al., 2021; Moody and Lewis, 2019). One area not explored is the efficacy of EEG-NFT for individuals who have experienced racial or gender discrimination, especially if they are receiving training while continuing to experience microaggressions during the course of treatment. The authors commenced a review to determine (1) how often demographic data is shared in EEG-NFT research, (2) how frequently individuals who experience stigma enroll in neurofeedback, and (3) the efficacy of EEG-NFT specifically on marginalized individuals. Method Literature Review. Results Current literature reveals a deficiency in research amongst marginalized populations. Conclusions EEG-NFT shows promising results in emotional regulation for various mental disorders and TBIs, but there remains a significant gap in understanding its effectiveness for marginalized populations. The authors are moving forward with a detailed study, starting with an IRB proposal at Antioch University New England, to explore the efficacy of EEG-NFT in these underrepresented groups and plan to present preliminary results later this year.

Fifty Years of Psychiatric Classification and Epidemiology Interactions: What is a Mental Disorder?

Psychiatric clinical diagnostic formulation has evolved over time. The changes alter our understanding and our ability to provide a public health perspective on the epidemiology of mental disorders in large populations. Epidemiology is an important perspective and set of tools to assess prevalence, treated prevalence, untreated prevalence, individual risks for mental disorders, and possible links to the etiology of disorders by following the trails of environmental exposures, biological measures, interpersonal dynamics, and genetic risk factors. As communities develop health-care services to treat individuals with mental disorders, knowledge about their prevalence and treatment requirements is also important. Since severe mental disorders may require institutional care, the diagnostic criteria used may either protect an individual’s liability for dangerous behavior (i.e. the insanity defense) or be used to control political and social dissidents. The criteria may also be used to determine evidence-based treatment options and eligibility for disability benefits. In this paper, using my vantage points as a physician scientist and public health officer, with leadership positions in national federal and professional mental health organizations, I address the developments in these areas over the past 50 years that have influenced institutional positions in the U.S. National Institute of Mental Health, the World Health Organization, the American Psychiatric Association, and the Center for the Study of Traumatic Stress. These perspectives may aid the next generation of investigators to advance the epidemiological and mental disorder classification scientific fields.

Prazosin Treatment of Sleep Problems in Youth with PTSD

Post traumatic stress disorder (PTSD) is a condition characterized by reexperiencing symptoms, persistent avoidance, negative alterations in cognition and mood, and changes in arousal and reactivity in response to a traumatic event (American Psychiatric Association, 2013). The pathophysiology of PTSD is not fully understood but likely related to dysregulation of fear‐processing. Currently, the gold standard of treatment is trauma‐focused cognitive behavioral therapy (TF‐CBT). SSRIs are the only FDA‐approved pharmacologic treatments for PTSD in adults and there are no FDA approved medications to treat pediatric PTSD. Unlike studies in adults, double‐blinded randomized control trials (RCTs) did not show any efficacy for SSRIs in pediatric patients diagnosed with PTSD (Hudson et al., 2021). While estimates of pediatric PTSD prevalence varies, the prevalence of PTSD at age 18 is 7.8% (Rolling et al., 2023). Sleep disturbances such as insomnia, night‐time awakenings, and nightmares often persist despite treatment with TF‐CBT or SSRIs. Left untreated, sleep disturbances are predictive of PTSD persistence and comorbid psychiatric complications (Rolling et al., 2023). There is evidence supporting the use of the medication prazosin in alleviating pediatric PTSD sleep disturbances including nightmares and insomnia. Anywhere from 20–80% of children with PTSD report nightmares compared to a prevalence of 10–20% in the general pediatric population (Kovachy et al., 2013). There is a growing need for pharmacologic therapy given the paucity of providers trained in TF‐CBT and a need for symptomatic management. In this review, we will examine sleep disturbances in pediatric PTSD patients and discuss the feasibility of prazosin as an adjunct treatment option.