Distress Behavior Research Articles

Psychological Distress and Help-Seeking Facilitators in Quebec Men: Findings From a Province-Wide Survey

Introduction It has been well established that men are not inclined to seek psychosocial help. Although barriers preventing psychosocial help-seeking behaviors in men have been extensively documented, few studies have investigated perceived facilitators and preferences involved in these behaviors. Methods Based on an online survey of 2095 Quebec men, this descriptive study explores men’s psychological distress and help-seeking behaviors, perceptions of effective facilitators of help-seeking behaviors, and psychosocial intervention preferences. Results About 30% of the men surveyed presented some form of psychological distress, and very few had used psychosocial services in the last year. Most men did not have a preference regarding the gender of their therapist, although they reported favoring solution-focused interventions and appreciating a continuity in the therapeutic relationship. Men also highly rated the importance of free or low-cost services to facilitate help-seeking behaviors. Finally, they indicated a high probability of consulting, if their doctor would tell them to, or if they noticed that their situation affected on their children, or if they experienced suicidal ideation. Discussion Understanding what encourages men to seek help for mental health difficulties and their preferences in services and intervention may lead to greater service use and improved mental health.

Why do students in psychological distress not use psychological care?

It is well established that some students face psychological difficulties, such as feelings of distress, major depressive episodes, and/or suicidal risk. This study aimed to shed light on students' use of psychological care and the reasons for nonuse among students facing these troubles and, by controlling the socionormative context in which students were interviewed, the role of knowledge about these psychopathologies and the severity and comorbidity of their disorders. In total, 316 students previously diagnosed for distress, major depression, or suicidal thoughts or behaviors were interviewed by peers in a door-to-door procedure about their use of psychological care and the reasons for their nonuse. The results confirmed the low use rate of psychological care in this clinical population (i.e., 8.23%). Students' knowledge about these psychological troubles improved the use of psychological care, as well as the perception of a need for use if care was not used. However, better knowledge was also associated with greater perceptions of structural barriers (e.g., not knowing where to go). These results support the need for psychoeducational programs that deepen knowledge about psychopathologies and also facilitate access to psychological care services. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Understanding the interplay between lifestyle factors and emotional distress for hemorrhagic stroke survivors and their informal caregivers: Protocol for a mixed methods dyadic natural history study.

Emotional distress (depression, anxiety, and PTS) and unhealthy lifestyle factors (e.g., smoking, alcohol consumption, poor diet, limited physical activity, medication adherence) are common in hemorrhagic stroke (HS) survivors and may increase risk for recurrence, morbidity, and mortality. Emotional distress and unhealthy lifestyle factors tend to be interdependent between survivors and their informal caregivers (e.g., family and friends who provide unpaid care; together called dyads), such that one partner's lifestyle and coping behaviors influence the other's behaviors, yet no research has closely examined this relationship in HS dyads over time. We will conduct a mixed methods study to quantitatively and qualitatively understand the longitudinal relationship between emotional distress and lifestyle factors across time in this population (HS dyads) to identify treatment targets to prevent emotional distress chronicity and stroke recurrence. In aim 1, we will assess emotional distress (i.e., depression, anxiety, and PTS) and lifestyle factors (smoking, alcohol consumption, poor diet, limited physical activity medication adherence/blood pressure control) in dyads of survivors of HS and their caregivers (N = 80), at three separate time points (hospitalization in the Neuro-ICU, 1, and 3 months later). We hypothesize that 1) lifestyle factors and emotional distress will be interrelated within and across time for both survivors and caregivers, and 2) lifestyle factors and emotional distress will be interdependent between survivors and caregivers. We also aim to explore the nuanced interplay between lifestyle factors and emotional distress and gain in depth information on barriers and facilitators for a dyadic intervention to optimize lifestyle behaviors and emotional functioning in HS dyads. Eligible patients will be adults who have a caregiver also willing to participate. Patients will be referred for study participation by the nursing team who will ensure that they are cognitively able to meaningfully participate. Multilevel dyadic modeling (i.e., actor-partner interdependence model; APIM) with distinguishable dyads will be used to determine influences of these factors onto each other over time. In Aim 2, we will conduct live video qualitative dyadic interviews (N = 20 or until theme saturation) at all time points from the same participants with and without emotional distress and at least one lifestyle risk factor, to understand the nuanced relationships between emotional distress and lifestyle behaviors, and barriers and facilitators to engagement in a skills-based psychosocial intervention. Interviews will be analyzed using inductive and deductive approaches. The present study is currently ongoing. So far, we enrolled 2 participants. Recruitment will end October 2022 with plans to analyze data by December 2022. The findings from this study will be used to further develop psychosocial interventions and inform novel treatments for survivors of HS and their informal caregivers.

Intergenerational trauma: Parental PTSD and parent-reported child abuse subtypes differentially relate to admission characteristics in the autism inpatient collection.

Autistic youth experience high rates of maltreatment. Little research has considered how distinct abuse dimensions differentially relate to meaningful outcomes, nor taken an intergenerational approach to consider how caregiver trauma and child maltreatment are related. This study sought to identify how parent-reported child abuse subtypes and parent posttraumatic stress disorder (PTSD) relate to each other and to admission characteristics upon inpatient service entry. Autistic youth (N=527; 79% White, 21.3% girls, mean age=12.94 years) participated in the autism inpatient collection. Parents reported on child abuse subtypes (physical, sexual, emotional) and their own PTSD, child behavior and emergency services, and parenting stress. Youth of parents with PTSD were nearly three times more likely to have parent-reported physical and emotional abuse. Autistic girls were more likely to experience parent-reported sexual abuse and a higher number of subtypes. Lower income related to higher rates of parent-reported child emotional abuse and parent PTSD. Emotional abuse associated with child behavior whereas both child physical and emotional abuse related to emergency services. Reported parent PTSD associated with child behavior and parental distress. When considered jointly, parent PTSD and number of parent-reported child abuse subtypes differentially related to child behavior and interacted to predict psychiatric hospitalizations. Intergenerational continuity of trauma is important to consider among autistic youth, and both parent-reported child abuse and parent PTSD relate to admission characteristics. Critical limitations include reliance on binary parent reports of child abuse and parent PTSD and the low representation of youth of minoritized identities. Implications for trauma-informed care are discussed. LAY SUMMARY: Autistic youth whose parents had reported posttraumatic stress disorder (PTSD) were nearly three times more likely to have experienced parent-reported physical and emotional abuse. Parent-reported child emotional abuse uniquely related to child behavioral concerns whereas both physical and emotional abuse related to higher emergency services. Parent PTSD also related to admission characteristics, showing that intergenerational continuity of trauma is critical to consider for understanding child maltreatment among autistic youth.

Parental Distress: A Result of Functional and Behavioral Difficulties in Children with Cerebral palsy

Background: Children with cerebral palsy (CP) may have risk factors of Functional and Behavioral difficulties. Aims: To Determine the parental distress as a result of functional and behavioral difficulties of children with C.P. Methodology: The population was based in Pakistan, cross-sectional survey was conducted in which caregivers of 40 children with CP aged 3-8 Years were involved by online “ Survey System” software and completed the Agitated Behavior Scale(ABS), The Gillette Functional Assessment Questionnaire and Parental Stress Scale to determine the child’s behavior, functional difficulties, and parental distress. Correlation paired 2-tail and Linear regression was used to analyze the data. Data were analyzed using IBM SPSS 20.Results: The demographic data (Age and Gender),non-significant regression equation f=2 (37), P > 0.01 with an Power calculation r2 = 0.45. Functional difficulties (F.A and L. A), not-significant regression equation was found df=4(35) , P > 0.01 with an Power calculation r2 = 0.07 while, not-significant regression equation was found df=5(34) , P > 0.01 with an Power calculation r2 = 0.03 and findings indicate that parental distress has no statistically significant relationship (|r| n=40, p> 0.05) to Functional Abilities , Locomotors Abilities and Behavior Difficulties. Conclusion and Implications: Evidence shows that psychological, behavioral, emotional, and communication problems are frequent in children with CP. It’s not compulsory to have highly rated parental stress in case of children having any disability and child’s effect agitated behaviors. Effective rehabilitation programs should provide not only sufficient opportunities for the children’s disabilities but also psychological support for the mothers. Key Words: Cerebral Palsy, Children, Stress, Behavior, Parental Distress, Functional Difficulties, Locomotor Abilities

Effectiveness of local cold application on pain and behavioral distress during invasive intravenous procedures - A pilot study

Pain induced by the medical procedures is one of the reasons for avoidance of health care services. During hospitalization intravenous cannulation is the most common procedure done. This preliminary study aimed to evaluate the effectiveness of local cold application in preventing or minimizing pain among children while undergoing invasive intravenous procedures and conducted this study. Objectives – To assess and evaluate the intensity of pain and behavioural distress among children during invasive intravenous procedures with and without local cold application and to determine the association between the intensity of pain, behavioural distress in children undergoing invasive intravenous procedures and selected variables. Methods- An experimental approach with post test only control group design was used for the study. The sample for the study comprised of 24 children with age group of 3 - 12 years; 12 children for each experimental group and control group selected by purposive sampling with random assignment. Pain and behavioural distress were assessed using Revised Faces Pain Assessment Scale and behavioural distress Scale respectively. Findings- Majority of children were between the age group of 3 to 5.9 years. Most (79.2%) had history of hospitalization and invasive procedures. The results of the pilot study show that cold application before the invasive intravenous procedures reduces pain and pain associated behavioural distress among children caused due to invasive intravenous procedures.

Caregivers’ perceived changes in engaged time with preschool-aged children during COVID-19: Familial correlates and relations to children's learning behavior and emotional distress

The COVID-19 pandemic and its resulting containment measures have forced many children and their caregivers around the world to spend unprecedented amounts of time at home. Based on a sample of 764 households with preschool-aged children in Wuhan, China, where the pandemic began, this study examined how primary caregivers perceived changes in the amount of time spent engaging with their children (i.e., engaged time) from the start of the pandemic and whether these changes were associated with children's learning behavior and emotional distress. The results showed that primary caregivers generally perceived increases in the amount of engaged time spent on indoor activities with their children but decreases in the amount of engaged time spent playing with their children outdoors. A bigger family size and greater loss of family income during the pandemic were associated with bigger perceived increases in caregivers’ engaged time spent on indoor activities, whilst a higher level of parental education was associated with bigger perceived decreases in engaged time spent playing with children outdoors. The family's poorer physical health and higher levels of chaos during the pandemic were related to smaller perceived increases in caregivers’ engaged time spent on educational activities. Finally, although bigger perceived increases in caregivers’ indoor engaged time (e.g., time spent on educational activities) were associated with higher levels of positive learning behavior and fewer symptoms of anxiety and withdrawal in the children, bigger perceived decreases in outdoor play time were associated with fewer symptoms of anxiety and withdrawal. These findings offer valuable insights into caregivers’ allocation of engaged time with their preschool-aged children during the COVID-19 pandemic.

Effect of Depression, Anxiety and Stress on Mental Health of Teachers

This study was conducted to examine the relationship between Depression, Stress and Anxiety with Mental Health among Teachers. Depression, Stress, Anxiety Scale (21 item) was used to collect the information from the participants developed by Lovibond and Lovibond (1995), Secondly, Mental Health Index Scale was used to study mental health of teacher developed by Veit and Ware (1983). Sample was comprised of 200 participants from different schools, colleges (government, private) and University of Haripur. Data was collected through convenience sampling technique with door to door survey and hypotheses were analyzed by using t test, descriptive statics, and Pearson correlation. Hypothesis of this study were supported. According to the current study, mental health and its sub-dimensions such as life satisfaction, psychological wellbeing was negatively correlated with depression, anxiety and stress. Likewise mental health and its sub dimensions such as loss of behavior and psychological distress were positively related with stress. Female instructors were more likely than male teachers to feel depression anxiety and stress which turnout to have negative impact on their mental health. The current study aimed to see if teachers' greater rates of depression, anxiety, and stress are linked to reports of mental health. The current study's findings may help psychologists and administrators better understand the requirements of the teacher population by identifying the levels and impacts of depression, anxiety, and stress on teachers. Possible interventions and policy changes may, in turn, reduce teacher burnout and increase teacher mental health status as well as improvements of students’ performance.

Infertility affects the quality of life of Southwestern Nigerian women and their partners

BackgroundInfertility has been described as one of the most important reproductive health concerns of Nigerian women. Based on the importance placed on offspring in Africa; infertile women experience high levels of psychological distress, relationship conflicts and hazardous sexual behaviors. The aim of this study was to explore the challenges those infertile women, and their partners experience in the cultural context of Southwestern Nigeria and how those experiences affect their access to health care services. MethodsThe study employed a qualitative research design. In-depth interviews were conducted with fifteen participants diagnosed with primary or secondary infertility, and who were receiving treatment at a tertiary health care center in Ekiti State, Southwestern Nigeria. Thematic categorization and content analysis were used to analyze the data. ResultsFifteen participants, 13 women and 2 men, were selected based on attendance to the infertility clinic and their willingness to participate in the study. The participants reported having experienced negative emotional and psychological effects of infertility, and stated that infertility has affected them socially, psychologically and in their relationships. Two of the participants stated that their partners had abandoned them because of their inability to conceive. Most of the participants stated that there was social stigma associated with infertility and almost all (14 of 15) said the society is not doing enough to support people facing fertility problems. All the participants utilized medical interventions and religious activities to treat infertility. ConclusionInfertility presented a psychological burden for Nigerian women and their partners, affecting them in many spheres of life. The Nigerian societal construct is not supportive of couples facing fertility problems. Support groups should be created for couples who have experience similar challenges. These groups would allow individuals to come together to freely discuss and share their experiences, thus helping to alleviate the psychological distress associated with infertility.

Optimal Deep Learning-based Cyberattack Detection and Classification Technique on Social Networks

Cyberbullying (CB) is a distressing online behavior that disturbs mental health significantly. Earlier studies have employed statistical and Machine Learning (ML) techniques for CB detection. With this motivation, the current paper presents an Optimal Deep Learning-based Cyberbullying Detection and Classification (ODL-CDC) technique for CB detection in social networks. The proposed ODL-CDC technique involves different processes such as pre-processing, prediction, and hyperparameter optimization. In addition, GloVe approach is employed in the generation of word embedding. Besides, the pre-processed data is fed into Bidirectional Gated Recurrent Neural Network (BiGRNN) model for prediction. Moreover, hyperparameter tuning of BiGRNN model is carried out with the help of Search and Rescue Optimization (SRO) algorithm. In order to validate the improved classification performance of ODL-CDC technique, a comprehensive experimental analysis was carried out upon benchmark dataset and the results were inspected under varying aspects. A detailed comparative study portrayed the superiority of the proposed ODL-CDC technique over recent techniques, in terms of performance, with the maximum accuracy of 92.45%.

Symposium

COVID-19 has disrupted everyday life worldwide and is the first disease event since the 1918 H1N1 Spanish influenza (flu) pandemic. The extensive damage wreaked by historical pandemics on health, economy, and society was a function of pathogen characteristics and lack of public health resources.In particular this pandemic has worsened neurodevelopmental disorders ADHD, ASD,IDD with an increase in MH, Psychosocial consequences in children and parents.Many of the NDDs are illnesses of life span and require multiple supportive, life enhancing interventions.COVID Pandemic increased phobias,anxiety,clinginess, distraction, irritability, depression, mood lability, impaired social interaction, sleep disturbances, low self-esteem, substance use disorder, and suicide.In India,USA and around the globe Parents and caregivers are experiencing much turmoil. They are increasingly burdened by the changing nature of caring for their children and other family members. May cause caregivers to experience intense distress, anxiety, loneliness, agitation,depression, social withdrawal and other challenging behaviors. There is evidence that there is a higher risk for those residing in residential group homes.Parents are finding themselves simultaneously expected to play the role of parent, special education teacher, and individual aide, all the while having to provide care for other children in the home and juggle work-from-home.children with NDD and families need evaluations, treatments and supports by professionals, as the ongoing pandemic can exacerbate the current challenges and provide ways of handling, coping.Also focus on identification of long-term control strategies that balance consideration of health in at risk populations, societal behavior, and economic impact.ANCIPS 2022

MDMA/ecstasy use and psilocybin use are associated with lowered odds of psychological distress and suicidal thoughts in a sample of US adults

Suicide is one of the leading causes of death worldwide and rates within the United States have risen over the past two decades. Hence, there is a critical need for novel tools to treat suicidal ideation and related mental health conditions. 3,4-Methylenedioxymethamphetamine (MDMA)/ecstasy and classic psychedelics may be two such tools. The aim of this study was to assess non-causal associations between MDMA/ecstasy and classic psychedelic use and psychological distress and suicide risk. In this study, we examined the aforementioned associations among 484,732 adult participants in the National Survey on Drug Use and Health (2008-2019). Lifetime MDMA/ecstasy use was associated with reduced odds of past year suicidal thinking (10% reduced odds; odds ratio (OR) = 0.90; 95% confidence interval, CI = (0.84-0.97); p < 0.01) and past year suicidal planning (OR = 0.88; 95% CI = (0.78-0.99); p < 0.05). Furthermore, lifetime psilocybin use was associated with reduced odds of past month psychological distress (OR = 0.78; 95% CI = (0.73-0.84); p < 0.001) and past year suicidal thinking (OR = 0.90; 95% CI = (0.83-0.96); p < 0.01). Finally, lysergic acid diethylamide (LSD) was associated with increased odds of past year suicidal thinking (OR = 1.07; 95% CI = (1.00-1.15); p < 0.05). MDMA/ecstasy and psilocybin use are associated with reduced odds of suicidal thinking and related outcomes-though experimental studies are needed to determine whether these associations are causal. These findings call for more research into the efficacy of MDMA/ecstasy and classic psychedelics for treating psychological distress and suicidal thoughts and behaviors, and for updated drug legislation that allows for further investigation into these substances.

Parental perceived immigration threat and children's mental health, self-regulation and executive functioning in pre-Kindergarten.

Many children in immigrant households endure unique stressors shaped by national, state, and local immigration policies and enforcement activity in the United States. Qualitative studies find that during times of heightened immigration enforcement, children as young as 3 years of age show signs of behavioral distress related to national anti-immigrant sentiment and the possibility of losing a parent. Using multiple sources of data from 168 racially and ethnically diverse families of children in pre-Kindergarten, the present study examined variability in perceived levels of immigration enforcement threat by parental immigrant status and ethnicity. This study examined associations between immigration enforcement threat and child mental health, self-regulation, and executive functioning and whether parent immigrant status or child gender moderates these associations. We found substantial variability in perceived immigration threat, with immigrant parents and Latinx parents reporting significantly greater levels of immigration threat compared to nonimmigrant parents and non-Latinx parents. Immigration enforcement threat was associated with greater child separation anxiety and overanxious behaviors, and lower self-regulation among boys and girls and among children of immigrant and U.S.-born parents. In contrast to our hypothesis, immigration enforcement threat was associated with higher self-regulation according to independent assessor ratings. Educators and healthcare providers working with young children from immigrant and Latinx households should be aware of the disproportionate stress experienced by immigrant and Latinx families due to a xenophobic sociopolitical climate marked by heightened immigration enforcement threat and racist, anti-immigrant rhetoric. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Distraction of Children Undergoing Vaccination

Abstract Vaccination is a procedure considered painful for children; therefore, the healthcare team should provide conditions for adequate pain assessment and control. This study sought to evaluate whether behavioral distraction procedures contribute to reduce pain perception and anxiety indicators in children during vaccination. One hundred and four children between three and 12 years attending a Health Center in the Federal District participated in the study. Children were divided into four groups: baseline, groups with balloons, cards and tablets. Data were obtained by means of sociodemographic questionnaires, the Monica and Friends Pain Scale and the Observational Scale of Distress Behavior. The collected data were measured using the SPSS Statistics program. Results show that the intervention groups had lower averages, concerning pain levels, incidence of competing behaviors and duration of vaccine procedures, compared to baseline.

Assessing the dimensionality and construct validity of the military stigma scale across current service members

ABSTRACT US service members are at elevated risk for distress and suicidal behavior, compared to the general US population. However, despite the availability of evidence-based treatments, only 40% of Service members in need of mental health care seek help. One potential reason for the lower use of services is that service members experience stigma or concerns that the act of seeking mental health care from a mental health provider carries a mark of disgrace. The Military Stigma Scale (MSS) was designed to assess two theoretical dimensions of help-seeking stigma (public and self), specifically among service members. The goal of the current study was to further examine the validity of the MSS among 347 active duty service members. Examination of unidimensional, two-factor, and bifactor models revealed that a bifactor model, with a general (overall stigma), two specific factors (public and self-stigma), and one method factor (accounting for negatively worded items) provided the best fit to the data. Ancillary reliability analyses also supported the MSS measuring a broad stigma factor associated with seeking mental health care in the military. Subsequent model analyses showed that the MSS was associated with other stigma-related constructs. Overall, findings suggest that the MSS is a reliable and validated scale that can be used to assess military help-seeking stigma and to evaluate results of programs designed to reduce stigma.

Distress Behavior Conversations: Supporting Whole Person Whole Team Responses in VA Community Living Centers

Heightened isolation during the pandemic has exacerbated the stress, anxiety, and adverse consequences through the loss of family connections older people experience in LTC. Heavy workload and staffing shortage limit staff’s capacity to assist residents in accessing regular virtual visits. Using a Collaborative Action Research (CAR) approach, this project aims to assess the implementation of a telepresence robot, Double 3 to help residents connect with their families. CAR allows careful planning of implementation with stakeholders (patient and family partners, staff, and decision-makers), tailoring adaption to the complex LTC environment. We will program path planning to allow efficient movement between target destinations (residents' rooms) and the charging dock. For example, the robot will go to a resident’s room every morning or evening to help the resident to make a virtual call with family. The project involves three phases (a) Observe and Reflect, (b) Act and Adapt, (c) Evaluate. We work with two Canadian LTC homes in British Columbia to investigate feasibility and acceptability. CAR emphasizes research with, rather than research on people. Meaningful engagement with patient and family partners, frontline staff, and decision-makers at each site throughout the whole project will ensure the project will meet the local needs. Anticipated resident outcomes include improved quality of life, mood, perceived loneliness, perceived social support, and acceptance. Anticipated staff outcomes include perceived ease of use, and acceptability.

Anti-inflammatory iron chelator, DIBI, reduces leukocyte-endothelial adhesion and clinical symptoms of LPS-induced interstitial cystitis in mice.

Interstitial cystitis (IC) is a prevalent and debilitating chronic inflammatory disease of the urinary bladder. Currently there are no fully effective therapeutic agents available, in part due to the still obscure pathogenesis of IC. Lipopolysaccharide (LPS) also known as endotoxin from Gram negative bacteria elicits IC in mice and has formed the basis of model systems for investigation. Excess free iron plays an important role in inflammation through generation of reactive oxygen species (ROS). The novel iron chelator DIBI has been shown to sequester excess free iron and dampen excess inflammatory responses to systemic LPS administration and also to Gram negative bacterial infections. The overall objective of this study was to evaluate the effects of DIBI on LPS induced IC in mice. Leukocyte activation, endothelial adhesion and functional capillary density were assessed by intravital microscopy of the bladder microcirculation following a single intravesical LPS administration with or without intravesical DIBI treatment. Clinical IC symptoms were also assessed through behavioral and pain threshold force measurements. Four groups of female BALB/c mice (n = 5-6/group) were randomized in this study: control group, IC group without therapy, IC group with DIBI therapy and control group with DIBI therapy. The groups were examined using intravital microscopy (IVM) of the bladder for leukocyte-endothelial interactions (adherent leukocytes, temporarily interacting leukocytes) and functional capillary density (FCD). A modified behavioral score by Boucher et al. and Von-Frey-Aesthesiometry were used to evaluate key behavioral indices related to pain and visceral pain perception. LPS introduced intravesically induced an early (≤2h) inflammation of the bladder evidenced by leukocyte activation and adhesion to bladder capillary walls. Intravesical DIBI therapy of mice 30min following LPS administration and assessed after 1.5h treatment showed a significant decrease in the number of adherent leukocytes compared to IC animals without DIBI treatment. DIBI treated mice showed a significantly lowered increase in behavioral distress scores compared to IC mice without therapy. Untreated IC mice exhibited a significantly decreased threshold force value for evoked pain response and DIBI treatment improved the threshold pain response. A significant inverse correlation was found for the two pain and suffering evaluation methods results. DIBI reduced inflammatory endothelial leukocyte adhesion and key indices related to pain and suffering over those observed in untreated IC mice. Our findings suggest a potential therapeutic role for DIBI for IC treatment.

Implementation Science Translation: Program Sustainment for Managing Distress Behavior in Dementia

Distress behaviors in dementia (DBD) are common in nursing home settings, are distressing, and result in poorer outcomes for residents and staff. We present on the implementation of STAR-VA, an interdisciplinary intervention for effective management of DBD in Veterans Health Administration (VA) nursing home settings, called Community Living Centers (CLCs). A primary focus of this symposium is the use of implementation science concepts to improve and sustain evidence-based programs through tailored implementation strategies and key partnerships. Key implementation science concepts from conceptual frameworks, including the Consolidated Framework for Implementation Research (CFIR) and the use of organizational Knowledge Reservoirs (KR) for sustaining new clinical practices, formed the basis of this work. Their application in health care practice will be discussed using STAR-VA as an exemplar. Interdisciplinary CLC staff feedback during STAR-VA implementation and sustainment is presented, including feedback regarding barriers to integrating new program interventions into usual care processes. Mapping key implementation strategies onto reported barriers informed development of implementation tools and strategies designed to guide adaptions tailored to the needs of the residents and frontline staff, increasing the chances of successful sustainment. Finally, we highlight the importance of key leadership partnerships in implementation of evidence-based programs to improve care of residents with DBD and present strategies for developing these partnerships. Discussion will include the importance of using implementation science to implement evidence-based interventions for effective management of DBD and strategies for sustainment of these effective practices into usual care.

Adolescents take more risks on days they have high diurnal cortisol or emotional distress

This study investigates how the interplay between adolescents’ daily levels of emotional distress and diurnal cortisol relates to their risk-taking behaviors. Specifically, we test competing hypotheses whether emotional distress exacerbates the link between cortisol and risk taking, or whether cortisol only predicts risk taking in the absence of emotional distress. Ethnically diverse adolescents (N = 370; ages 11–18) reported their daily levels of emotional distress and risk-taking behavior for 5 days, and provided 4 saliva samples/day for 4 days. Emotional distress was positively associated with risk taking the same day and on average across days. Moreover, emotional distress and total cortisol output interactively predicted risk taking, such that total cortisol output was positively associated with risk taking on days when adolescents felt low levels of emotional distress, but not on days when adolescents felt high levels of emotional distress. High levels of emotional distress were associated with high levels of risk taking regardless of total cortisol output. There were no direct associations between cortisol and risk taking on daily or average levels. Results suggest that cortisol is associated with risk-taking behavior on days when adolescents are not already feeling emotionally distressed enough to take risks.

COVID-19 lockdown in Spain: Psychological impact is greatest on younger and vulnerable children.

In 2020, quarantine home confinement measures were implemented in Spain to control a pandemic for the first time. The objective of this study is to assess both the psychological and social impact of that ‘lockdown’ on different age groups of children and adolescents and also the different strategies adopted by families in that situation. We collected data via an online questionnaire answered by 850 participants, parents of young people aged between 4 and 18, between 24th April and 8th May 2020. Our results show that living in a home smaller than 80 m2 is associated with an increased risk of presenting clinical symptoms of emotional or behavioural distress, with an odds ratio of 2.54 (95% CI: 1.07–6.02), p = 0.034; while increased age is a predictor of better psychological functioning during lockdown: coefficient of 0.25 (95% CI: 0.07–0.41), p = 0.004. Moreover, age is also a marker of higher scores on the scale of psychological symptoms, with a coefficient of 0.02 (95% CI: 0.01–0.04), p = .005. To conclude, younger children present poorer behavioural and emotional functioning and more symptoms of emotional distress than adolescents during lockdown. Living in a small home is a risk factor for presenting clinical symptoms. These findings should be taken into consideration when planning for future home confinement episodes and when considering preventative strategies in the realm of mental health care.