Clinical Psychology Research Articles

Forensic Psychology is Different: Supervision Approaches in Forensic Assessment

ABSTRACT Supervision and the supervisory role are essential aspects of clinical training and represent a distinct area of competency within clinical psychology. While guidance documents exist for clinical supervision, there is limited guidance regarding forensic assessment supervision, despite the recognition of forensic psychology as a specialty warranting its own set of unique principles and specialty-specific competencies. Although there is substantial overlap between clinical and forensic assessment supervision, significant differences also exist which can have a great impact on the nature of forensic assessment supervision. This article uses established principles, training, and practice considerations within the field of forensic psychology to highlight the core distinctions between clinical and forensic assessment supervision.

The screening accuracy of the Edinburgh Postnatal Depression Scale (EPDS) to detect perinatal depression with and without the self-harm item in pregnant and postpartum women

Background This study aims to examine whether the Edinburgh Postnatal Depression Scale (EPDS), excluding the self-harm item (EPDS-9), performs as effectively as the full EPDS in identifying depression among perinatal women. Methods A total of 3571 pregnant women and 3850 postpartum women participated in this observational study. Participants who scored ≥ 9 on the EPDS underwent further diagnostic evaluations by a clinical psychologist and/or psychiatrist. Results The EPDS-9 and full EPDS demonstrated a near-perfect correlation in both the antepartum (r = 0.996) and postpartum (r = 0.998) cohorts. EPDS-9 showed exceptional precision in identifying depression as screened by the full EPDS at cutoff points ranging 9–14, with areas under the curve ≥0.998. The sensitivity of EPDS-9 and full EPDS to detect depression that requires psychotropic medications was poor. The highest accuracy for both versions was at a cutoff score of 9: sensitivity of 0.579 for the full EPDS and 0.526 for the EPDS-9. At the cutoff point of 9, EPDS-9 performed adequately in predicting the response of the participants to the self-harm item. Conclusion The EPDS-9 represents a solid and effective replacement for the full EPDS in clinical settings. If the presence of suicidal thoughts needs to be assessed, specialized scales should be used.

Testing the validity of the broaden-and build theory of positive emotions: a network analytic approach.

The Broaden-and-Build Theory of positive emotions is one of the best known and applied theories in Positive Psychology. It argues that positive emotions initiate an upward movement by opening up the mind and broadening thoughts and thus represents a counter model to the vicious circle-models of clinical psychology. The number of studies directly testing this theory in all components is scarce, ambiguities in the model impede clear inference. To draw a conclusive picture on within-model processes, we applied network modeling on the components of the theory across two studies (N 1 = 312; N 2 = 302). In both studies, the positive relationship between positive emotions, resources and life outcomes is well-supported, yet the role of broadening, as an intermediary component within these is questioned. As the broadening component consistently deviated from the model's predictions and thus did not contribute to the model as expected in either study, the validity of the Broaden-and-Build Theory in its current conceptualization is challenged, and our results point to the need to reassess the role of broadening.

Risk factors of PTSD and substance use disorders in clinical and counseling psychology doctoral students.

Risk factors of PTSD and substance use disorders in clinical and counseling psychology doctoral students.

Abstract B028: Beyond the diagnosis: A town hall event to explore black men’s journey with prostate cancer and sexuality

Abstract Introduction Prostate cancer (CaP) significantly impacts Black men, who face higher morbidity despite lower overall mortality. The disease and its treatments profoundly affect sexuality, relationships, and quality of life (QoL), necessitating robust support systems. Healthcare, spousal support, community involvement, and interactions with other survivors are crucial for enhancing survivors' self-esteem and daily functioning. Virtual town halls offer a platform to share trusted information and foster community support, overcoming geographic and structural barriers. This town hall event will explore Black CaP survivors' experiences, focusing on sexuality post-diagnosis and related medical and psychological needs. MethodsOn June 13, 2024, The University of Oklahoma and Stephenson Cancer Center will host the 5th town hall event (via Microsoft Teams) to address Black CaP survivors' sexual health concerns. Previous town halls averaged 70 attendees and covered various aspects of the CaP journey. This event will include storytelling and panel discussions, with presentations from two CaP survivors and their spouses on personal experiences and coping strategies. A urologic oncologist will discuss treatment advancements and early detection, while a clinical health psychologist will address psychological and emotional aspects of survivorship. Simultaneous watch parties will be held in Milledgeville, Georgia, and Dallas, Texas. Interactive Q&A sessions will allow participant engagement. Attendees will complete a post-event survey to assess the session's impact and collect clinical and sociodemographic data. Quantitative data will be analyzed using SPSS v28, and audio-recorded sessions will be transcribed and thematically analyzed using Nvivo. Results will be available by the end of June and presented at the conference. Expected Results Participants will gain a deeper understanding of the intersection between CaP and sexuality in Black men's health. Discussions will highlight the psychological impact of a cancer diagnosis, challenges in maintaining sexual health during and after treatment, and the role of mental health support. The town hall aims to emphasize the importance of a strong support system, providing valuable coping skills through shared experiences and expert insights. Topics will include the emotional and psychological impact of sexual health challenges, partner support, and the necessity of open communication with healthcare providers. The event seeks to improve CaP survivors' QoL by emphasizing continuous education and integrating sexual health into overall survivorship care. Conclusion This town hall event aims to bridge gaps in understanding and addressing Black CaP survivors' sexual health concerns. By fostering open dialogue and providing expert insights, we hope to improve these men's QoL and survivorship care, emphasizing mental health support, spousal support, and continuous education. Citation Format: Motolani Ogunsanya, Ernie Kaninjing, Parisa Ghasemi, Skyler Danker, Daniel Morton, Kathleen Dwyer, Mary Ellen Young, Folakemi T. Odedina, Yaw Nyame, Amy Siston, Jordan Neil, Adam C Alexander, Perry Cole, Patrick Beckford, Donald Reese, Thomas Mitchell, Everett Montgomery, Roland Odeleye, Darla E. Kendzor. Beyond the diagnosis: A town hall event to explore black men’s journey with prostate cancer and sexuality [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B028.

The mediating role of perceived stress in the association between family resilience and psychological distress among gynecological cancer patients: a cross-sectional study

BackgroundGynecological cancer patients face various stressors and suffer from severe psychological distress. The activation of family resilience supports patients to overcome daily stressors, yet the relationship between family resilience and psychological distress is poorly understood. The purpose of this study is to investigate the degree of psychological distress in patients diagnosed with gynecological cancer, and whether perceived stress mediate the relationship between family resilience and psychological distress.MethodsA cross-sectional study was undertaken on 358 gynecological cancer patients in China from September 2021 to November 2022. The participants completed surveys that included the Chinese Version of the Family Resilience Assessment Scale, the Perceived Stress Scale, the Hospital Anxiety and Depression Scale, the Distress Management Screening Measure, and socio-demographic questions. Using Pearson’s correlation analysis to investigate the association between variables, and the bias corrected bootstrapping method was utilized to establish perceived stress as a mediator.ResultsChinese patients with gynecological cancer experienced a moderate psychological distress. In addition, psychological distress exhibited a negative correlation with family resilience and a positive correlation with perceived stress in gynecological cancer patients (both P < 0.01). Perceived stress partially mediated the correlation between family resilience and psychological distress (β=-0.182; 95% CI: -0.224 to -0.140; P < 0.001). The total indirect effect value was − 0.182, and the total effect value was − 3.060.ConclusionsThe findings indicate that higher family resilience and lower perceived stress can reduce psychological distress in gynecological cancer patients, and family resilience also tends to reduce perceived stress in cancer patients. Clinical staff and psychologist should consciously cultivate patients’ family resilience to reduce psychological distress. Meanwhile, identifying potential mediators between family resilience and psychological distress are able to promote the development and assessment of interventions in the future.

Supplemental Material for Risk Factors of PTSD and Substance Use Disorders in Clinical and Counseling Psychology Doctoral Students

Supplemental Material for Risk Factors of PTSD and Substance Use Disorders in Clinical and Counseling Psychology Doctoral Students

Core Mental Health Clinician Capacity and Use Rates in the US Military

Active duty service members have higher mental health stress and cannot choose where to live. It is imperative to understand how geographic access may be associated with their ability to obtain mental health treatment and how the COVID-19 pandemic was associated with these patterns. To identify changes in the prevalence and intensity of mental health care use when service members experienced changes in core mental health clinician (defined to include psychiatrists, psychiatric nurse practitioners, clinical psychologists and social workers, and marriage and family therapists) capacity in their communities and whether patterns changed from before to after the onset of the COVID-19 pandemic. This retrospective cohort study of the active duty population between January 1, 2016, and December 31, 2022, was conducted using individual fixed-effects models to estimate changes in the probability of mental health care visits and visit volume when a person moved across communities with adequate core mental health clinician capacity (≥1 clinician/6000 beneficiaries), shortage areas (<1 clinician/6000 beneficiaries), and areas with 0 clinicians within a 30-minute drive time. All US active duty service members stationed in the continental US, Hawaii, and Alaska were included. Data were analyzed from January through July 2024. The first set of outcomes captured the probability of making at least 1 mental health care visit in a given quarter; the second set of outcomes captured the intensity of visits (ie, the number of visits log transformed). This study included 33 039 840 quarterly observations representing 2 461 911 unique active duty service members from the Army, Navy, Marines, and Air Force (1 959 110 observations among Asian or Pacific Islander [5.9%], 5 309 276 observations among Black [16.1%], 5 287 168 observations among Hispanic [16.0%], and 18 739 827 observations among White [56.7%] individuals; 27 473 563 observations among males [83.2%]; mean [SD] age, 28.20 [7.78] years). When an active duty service member moved from a community with adequate capacity at military treatment facilities to one with 0 clinicians within a 30-minute drive, the probability of a mental health visit to any clinician decreased by 1.13 percentage points (95% CI, -1.21 to -1.05 percentage points; equivalent to a 11.6% relative decrease) and the intensity of total visits was reduced by 7.7% (95% CI, -9.0% to -6.5%). The gap increased from before to after the onset of the COVID-19 pandemic, from 8.5% (equivalent to -0.82 percentage points [95% CI, -0.92 to -0.73 percentage points]) to 16.2% (equivalent to -1.58 percentage points [95% CI, -1.70 to -1.46 percentage points]) in the probability of visiting any clinician type for mental health. In this study, active duty personnel assigned to locations without core military mental health clinicians within a 30-minute drive time were less likely to obtain mental health care and had fewer mental health care visits than those in communities with adequate military mental health capacity even if there was adequate coverage from the civilian sector. The care disparity increased after the onset of the COVID-19 pandemic.

The development of a bullying victimisation scale: the experience of Pakistani adolescents

ABSTRACT This paper describes and evaluates the procedure for the development and validation of the bullying victimisation scale for Pakistani young people aged 12–18 years. During phase I, a total of 60 participants aged from 13 to 17 years were selected by using a multistage sampling strategy for item generation for bullying victimisation. In phase II, empirical validation was carried out by 10 experienced clinical psychologists for the cultural relevance of the scale. In phase III, a pilot study was carried out on 20 participants for testing the layout of the bullying victimisation scale (BVS). In the final phase, a total of 780 participants were selected through a multi-stage sampling within the age range of 12–18 years (M = 14.78, SD = 1.33) and were given a demographic Proforma, BVS, and School Children Problem Scale. Factor analysis identified a three-factor solution for bullying victimisation, consisting of emotional bullying, verbal bullying, and physical bullying. The current findings have implications for psychological and educational professionals for the identification and management of social and emotional problems in children resulting from bullying victimisation.

Co-Designing Digital Health Intervention for Monitoring Medication and Consultation Among Transgender People in Underserved Communities: Collaborative Approach.

In many parts of the world, men who have sex with men and transgender individuals face criminalization and discrimination. As a result, they are less likely to seek medical help, despite experiencing higher rates of HIV/AIDS, mental health issues, and other health problems. Reaching key populations (KPs) with essential testing, care, and treatment services can be challenging, as they often have a higher likelihood of contracting and spreading the virus. They have limited access to antiretroviral (ARV) therapy (ART) services, which means that KPs may continue to serve as reservoirs for new HIV infections if they do not receive effective HIV programming. This ongoing issue complicates efforts to control the epidemic. Therefore, modeling a digital health system to track ARV medication access and use is crucial. This paper advocates for the use of digital interventions to manage the health of KPs in underserved regions, using Nigeria as a case study. This study aims to assess digital health interventions for monitoring medication and consultations among transgender people in underserved communities. It also sought to determine whether a system exists that could support ART adherence in Nigeria. Additionally, the study evaluated design strategies to address privacy and confidentiality concerns, aiming to reduce nonadherence to ARV medications among KPs in Nigeria. A qualitative approach was adopted for this research, involving a thematic analysis of information collected from interviews with clinicians and other health practitioners who work directly with these communities, as well as from an interactive (virtual) workshop. The findings from the thematic analysis indicate a need to increase attendance at ART therapy sessions through the implementation of an intensive care web app. Unlike previous solutions, this study highlights the importance of incorporating a reminder feature that integrates with an in-app telemedicine consultancy platform. This platform would facilitate discussions about client challenges, such as adverse drug effects, counseling sessions with clinical psychologists, and the impact of identity discrimination on mental health. Other data-driven health needs identified in the study are unique drug request nodes, client-led viral load calculators, remote requests, and drug delivery features within the web app. Participants also emphasized the importance of monitoring medication compliance and incorporating user feedback mechanisms, such as ratings and encouragement symbols (eg, stars, checkmarks), to motivate adherence. The study concludes that technology-driven solutions could enhance ART adherence and reduce HIV transmission among transgender people. It also recommends that local governments and international organizations collaborate and invest in health management services that prioritize health needs over identity.

A - 87 Exploring the Utility of the Montreal Cognitive Assessment to Identify Neurocognitive Deficits among Adult Patients with Sickle Cell Disease

Abstract Objective Neurocognitive deficits associated with sickle cell disease (SCD) have been well established in the pediatric population but studies examining the adult neurocognitive profile are lacking. This study examined the utility of the Montreal Cognitive Assessment (MoCA) to screen patients for cognitive impairments within a multidisciplinary adult sickle cell clinic. Method Patients who presented to their scheduled appointment at the UCSF Benioff Children’s Hospital Oakland Adult Sickle Cell Clinic were provided psychoeducation and offered neurocognitive screening. Those that accepted completed a brief clinical interview and were screened with the MoCA by neuropsychology externs or a licensed clinical psychologist. Results A sample of 24 patients (M age = 37.63, age range = 18–75; female =58.33%) were screened with the MoCA. Of patients screened, 41.67% (n = 10) were identified as mildly impaired (M score = 22) and 16.67% (n = 4) were identified as moderately impaired (M score = 15.5), consistent with other studies in the literature. Overall MoCA score and the memory subdomain were both negatively correlated with increasing age (r = −0.15, p &amp;lt; 0.05 and r = −0.06, p &amp;lt; 0.05 respectively). Conclusions Utilizing the MoCA, our study demonstrates a notable prevalence of cognitive impairment identified in 58.43% of adult SCD patients, with a marked decline associated with advancing age. These findings suggest the MoCA’s utility; however, further research is needed to understand the validity of this measure in detecting the varying levels of cognitive impairment in adult SCD patients. Such measures could significantly enhance the care and quality of life for individuals with SCD and address age disparities in SCD, where resources for adult patients are much more limited.

Assessment of mood after severe acquired brain injury: Interviews with UK clinical psychologists and medical professionals.

Mood assessment is challenging when people have cognitive and receptive communication impairments after severe brain injury. This study explored how UK-based medical and psychology professionals working with people with severe cognitive and communication impairments after brain injury assess mood in this population. Following their participation in an online survey, professionals were invited to participate in individual semi-structured interviews. Interviews were analysed using thematic analysis to label explicit data (semantic themes) and implicit data (latent themes). Twenty-three clinical psychologists and nine medical professionals participated in online or in-person interviews. Both groups explicitly reported using a combination of collateral information, history, observations, and patient interviews when assessing mood in this population. Medical professionals did not routinely use standardised measures and clinical psychologists often adjusted them when they used them. The respondents discussed difficulties conceptualising depression after brain injury, the experience needed by the assessor, and the need for an individualised approach for this population. Clinical psychologists discussed the pressures of working in healthcare systems and medical professionals discussed how symptoms may influence prescription choices. Seven latent themes were labelled which highlighted additional challenges and complexities experienced by those assessing mood, beyond the actual assessment process itself. No 'gold standard' approach to assessing mood in those with cognitive and communication difficulties after severe brain injury was identified. There was overlap in assessment approaches but no clear consensus. Interviewees felt that mood assessment must be approached differently in this population and that self-report measures are not useful.

Exploring considerations of equality, diversity and inclusion in selection for a doctorate in clinical psychology programme: A qualitative study

Diverse and inclusive healthcare workforces are important to optimise patient access and outcomes. Various attempts have been made to promote equality, diversity and inclusion (EDI) in clinical psychology; however, clinical psychology doctoral training programmes (DClinPsy) frequently fail to reflect the population demographics of the communities that they serve within the make-up of their trainees. Some research indicates that the lack of diversity might be linked to potential biases within the selection process.This study seeks to qualitatively explore how application screeners and interview panellists for a DClinPsy programme consider EDI in the selection process. Content analysis of seven semi-structured interviews suggests that participants think broadly about EDI, considering differences between marginalised groups and the provision of equal access for members of these groups. Content analysis of discussions of protected characteristics suggests that, when considering EDI, race, sex, disability, sexual orientation, and socio-economic status prove more salient than other factors such as age, and religion or belief.Barriers and facilitators to accessing the DClinPsy are discussed. Participants discuss the perceived inadequacy of EDI training for their roles in selection, and conflicts related to different EDI measures such as positive action and standardisation. The findings are discussed with reference to existing literature. Future research should seek to examine the EDI training needs of those involved in the selection process and examine the efficacy of EDI initiatives to improve equity and inclusion for underrepresented groups.

Organizational factors associated with less use of restraints in older adults with dementia in acute care hospitals: A scoping review.

Dementia affects more than 55 million people worldwide. Use of restraints for hospitalized older adults with dementia is a social issue that should be addressed systematically and should not depend on the characteristics of nurses. This study reviewed the literature on organizational factors associated with reducing use of restraints in older adults with dementia admitted to acute care hospitals. A scoping review was performed. Three databases were searched for papers that met our eligibility criteria. Factors related to restraint reduction were extracted, and results were deduced. Through inductive analysis, subthemes were categorized according to similarities and differences, which were then integrated into broader themes. Sixteen studies were eligible for inclusion. The prevalence of restraints ranged from 5.1% to 80.0% depending on how the meaning of restraint was interpreted. The most common indications for restraints were history of falls and fall risk. Interdisciplinary screening for restraints was associated with reduced prevalence of restraints, with a 0.18-fold (confidence interval [CI]: 0.12-0.24) reduction through use of a restraint decision flowchart and a 0.76-fold (CI: 0.63-0.92) reduction through consultation with a psychiatrist. Interdisciplinary members included nurses, physicians, clinical psychologists, pharmacists, respiratory therapists, and therapists. Research is needed to introduce and develop an interdisciplinary restraint decision-making system and to test its effectiveness. Important factors in implementing alternatives to restraints are the harmful effects of restraints, expertise in dementia, regular education on alternative methods, an inpatient environment that ensures patient safety, and the development of human resources.

Altmetric coverage of health research in Ireland 2017-2023: a protocol for a cross-sectional analysis.

Scientific publications have been growing exponentially, contributing to an oversaturated information environment. Quantifying a research output's impact and reach cannot be solely measured by traditional metrics like citation counts as these have a lag time and are largely focused on an academic audience. There is increasing recognition to consider 'alternative metrics' or altmetrics to measure more immediate and broader impacts of research. Better understanding of altmetrics can help researchers better navigate evolving information environments and changing appetites for different types of research. Our study aims to: 1) analyse the amount and medium of Altmetric coverage of health research produced by Irish organisations (2017 - 2023), identifying changes over time and 2) investigate differences in the amount of coverage between clinical areas (e.g., nutrition vs. neurology). Using Altmetric institutional access, we will gather data on research outputs published 1 January 2017 through 31 December 2023 from active Irish organisations with Research Organisation Registry (ROR) IDs. Outputs will be deduplicated and stratified by their Australian and New Zealand Standard Research Classification relating to ≥1 field of health research: Biological Sciences, Biomedical and Clinical Sciences, Chemical Sciences, Health Sciences, and Psychology. We will clean data using R and perform descriptive analyses, establishing counts and frequencies of coverage by clinical area and medium (e.g., traditional news, X, etc.); data will be plotted on a yearly and quarterly basis where appropriate. Improved understanding of one's information environment can help researchers better navigate their local landscapes and identify pathways for more effective communication to the public. All R code will be made available open-source, allowing researchers to adapt it to evaluate their local landscapes.

Acceptance and Commitment Therapy for the Treatment of Postpartum Depression: A Case Study Approach

The prevalence of postpartum depression (PPD) has been linked to contradictory outcomes for mothers, infants, and mother-child relationships. Pakistan has the greatest prevalence percentage among the Asian countries which ranges from 28%-63% (Habiba et al., 2020). When it comes to treating postpartum depression, one of the best methods is Acceptance and Commitment Therapy. (Hayes et al., 2006). However, a large number of new mothers choose not to seek expert assistance, which highlights the need for new platforms to be developed in order to provide health care services in Pakistan. As noted by Waters et al. (2020) the primary goal of this research is to develop and evaluate the ACT for postpartum depression in postpartum women. This treatment approach addresses mood and anxiety problems related to perinatal diseases. Utilizing the single-case study design. Our main resource who woman who volunteered, from teenage mothers to women in their forties who give birth. The intervention protocols and the strategy were developed in close collaboration with seasoned clinical psychologists and psychiatrists who are experts in the sector. The program was conducted weekly for a minimum of 12 weeks, during which the technique and treatment plan were explained in full. Compiling the patient's progress report and compiling the data received during treatment were done using computation. At the conclusion of the session, there was a notable decline in the severity of anxiety and depression symptoms. The goal is to compile positive evidence supporting the feasibility, efficacy, and proof-of-concept of ACT in reducing depressive symptoms in the postpartum phase. The advantages and disadvantages of this format were examined, along with their prospective applications in clinical health care and future research.

Promoting Geropsychology: A Memorandum for Research, Policies, Education Programs, and Practices for Healthy Aging.

This viewpoint paper reports the state of the art at a global level on research, practice and assessment, policies, and training in the clinical psychology of aging and, more specifically, in geropsychology. The main sources of information were as follows: (1) the most recent reviews of the literature available in the scientific literature; (2) the resources on the internet referable to professional and academic associations dealing with the topic; and (3) the laws, policy initiatives, and funded programs that are aimed at the diffusion and applications of mental health in aging. The present study aims to provide an updated and comprehensive memorandum highlighting the importance of prioritizing mental health in older adults. It seeks to promote health in general and disease prevention strategies, ensuring equitable access to mental health services integrated into primary care and designed for aging. This paper also aims to shed light on the slow development process and lack of consolidation in the adaptation of academic training at master's and doctoral levels in most developed countries, despite the long-declared importance of enhancing resources for the promotion of geropsychology. The results of the present study are patchy. Although the importance of enhancing resources for the promotion of geropsychology has long been declared, the development process seems very slow, and the adaptation of academic training at master's and doctoral levels in most developed countries-those that, for demographic reasons and attitudes, should be more sensitive to the issue, does not yet seem to have consolidated. Collaboration among diverse professionals is crucial for providing integrated and comprehensive care to older adults that addresses their physical, psychological, and social needs.

Quality improvement project (QIP): evaluating a pilot suicide awareness, screening and signposting training intervention for dental care professionals in a dental teaching hospital and school

Scotland’s 2022 suicide prevention strategy recommends building skills and knowledge among healthcare staff who play a role in preventing suicide. A quality improvement project (QIP) in relation to this was...

Клинические особенности и коморбидные нейропсихиатрические состояния у педиатрических пациентов с тикозными расстройствами. Обзор.

INTRODUCTION. Tic disorders are a common neurological pathology among children and adolescents. Tic disorders and comorbid conditions affect patients' socialization, education, and emotional state. Social stigmatization and discrimination caused by tic disorders have an irreparable impact on personality development, making it necessary to raise awareness and understanding of these conditions. AIM. The objective of this study is to analyze the literature on the features of the etiology, diagnosis, and clinical manifestations of tic disorders and comorbid disorders. MATERIAL AND METHODS. An analysis of DSM-5-TR and ICD-11 criteria, as well as 28 international literature sources from the PubMed database, was performed. This analysis provided descriptions of the diagnostic criteria, etiology, and pathogenesis of tic disorders and comorbid disorders. Data on the clinical manifestations of comorbid disorders, differential diagnosis, and main treatment approaches were also presented. RESULTS AND DISCUSSION. The prevalence of tic disorders is about 1% of the population, with 1 in 5 schoolchildren experiencing tics during their development. Currently, the exact causes of tics are unknown; it is assumed that tic disorders is a multifactorial disease involving heredity, environmental factors, and immune-mediated mechanisms. Additionally, dysfunctions in the cortico-striato-thalamo-cortical circuits and neurotransmitter imbalances play significant roles. About 80% of patients with tics have comorbid neuropsychiatric disorders such as attention-deficit/hyperactivity disorder, obsessive-compulsive disorder, autism spectrum disorders, mixed anxiety-depressive disorders, and sleep disturbances, which in some cases present challenges in the differential diagnosis and treatment of these conditions. CONCLUSION. The high degree of comorbidity in tic disorders necessitates a multidisciplinary approach, involving neurologists, psychiatrists, clinical psychologists, and behavioral therapy specialists. This collaboration aims to achieve the maximum therapeutic effect and improve the quality of life for patients. KEYWORDS: tics, chronic tics, Tourette syndrome, Gilles de la Tourette Disorder

Clinical Education: Addressing Prior Trauma and Its Impacts in Medical Settings.

Prior trauma exposure significantly increases the risk of developing PTSD following medical stressors and may contribute to the development of medically induced PTSD. However, healthcare systems often overlook the interaction between prior trauma and current medical stressors, contributing to negative psychosocial and health-related outcomes for patients. Integration of both trauma-informed and trauma-focused practices into psychosocial programming in medical settings may be key to effectively addressing the needs of trauma-exposed patients. Yet, there is a lack of practical guidance on how clinical psychologists in medical settings can respond to trauma's effects in routine clinical practice. This paper aims to provide an overview of trauma-focused theory, assessment, and treatment considerations within medical settings, emphasizing the importance of incorporating trauma-focused intervention into integrated psychosocial programming to address prior trauma and its impacts on care in order to improve patient outcomes.