Elevated Symptoms Research Articles

Coding Interactive Behaviour Instrument: Mother-Infant Interaction Quality, Construct Validity, Measurement Invariance, and Postnatal Depression and Anxiety

The quality of parent-child interaction has consistently been associated with child psychosocial outcomes. Postnatal depression (PND) and anxiety (PNA) can have an adverse effect on the parent-child interaction. The Coding Interactive Behaviour (CIB) measure has frequently been used to assess parent-infant interaction quality; however, few have investigated the construct validity. The purpose of this study is to: (1) compare two theoretical models and one data-driven model for best fit and to test the best fitting one for measurement invariance among mothers with and without PND, and (2) compare effects of PND and PNA on the mother-infant interactions. The sample consisted of mothers with PND (n = 236) and a subclinical sample of mothers with elevated symptoms of PND but did not meet criteria for a diagnosis (n = 183) and their infants (aged ≤ 6 months). PND was assessed with a diagnostic interview and PNA using a self-report measure. Confirmatory factor analyses showed that the data-driven model, consisting of the composites ‘Maternal Sensitivity’, ‘Child Engagement’, ‘Maternal Social Withdrawal’, and ‘Maternal Controlling Behaviour’, reached the best fit and showed measurement invariance with regard to PND. Factorial ANOVAs showed no effects of PND and PNA on the composites. The study is the first to investigate and find measurement invariance in the CIB, providing evidence of construct validity. The importance of investigating the factor structure of an instrument liable to change due to contextual factors is discussed.

Effect of Brief Interpersonal Therapy on Depression During Pregnancy

Prenatal depression is prevalent with negative consequences for both the mother and developing fetus. Brief, effective, and safe interventions to reduce depression during pregnancy are needed. To evaluate depression improvement (symptoms and diagnosis) among pregnant individuals from diverse backgrounds randomized to brief interpersonal psychotherapy (IPT) vs enhanced usual care (EUC). A prospective, evaluator-blinded, randomized clinical trial, the Care Project, was conducted among adult pregnant individuals who reported elevated symptoms during routine obstetric care depression screening in general practice in obstetrics and gynecology (OB/GYN) clinics. Participants were recruited between July 2017 and August 2021. Repeated measures follow-up occurred across pregnancy from baseline (mean [SD], 16.7 [4.2] gestational weeks) through term. Pregnant participants were randomized to IPT or EUC and included in intent-to-treat analyses. Treatment comprised an engagement session and 8 active sessions of brief IPT (MOMCare) during pregnancy. EUC included engagement and maternity support services. Two depression symptom scales, the 20-item Symptom Checklist and the Edinburgh Postnatal Depression Scale, were assessed at baseline and repeatedly across pregnancy. Structured Clinical Interview for DSM-5 ascertained major depressive disorder (MDD) at baseline and the end of gestation. Of 234 participants, 115 were allocated to IPT (mean [SD] age, 29.7 [5.9] years; 57 [49.6%] enrolled in Medicaid; 42 [36.5%] had current MDD; 106 [92.2%] received intervention) and 119 to EUC (mean [SD] age, 30.1 [5.9] years; 62 [52.1%] enrolled in Medicaid; 44 [37%] had MDD). The 20-item Symptom Checklist scores improved from baseline over gestation for IPT but not EUC (d = 0.57; 95% CI, 0.22-0.91; mean [SD] change for IPT vs EUC: 26.7 [1.14] to 13.6 [1.40] vs 27.1 [1.12] to 23.5 [1.34]). IPT participants more rapidly improved on Edinburgh Postnatal Depression Scale compared with EUC (d = 0.40; 95% CI, 0.06-0.74; mean [SD] change for IPT vs EUC: 11.4 [0.38] to 5.4 [0.57] vs 11.5 [0.37] to 7.6 [0.55]). MDD rate by end of gestation had decreased significantly for IPT participants (7 [6.1%]) vs EUC (31 [26.1%]) (odds ratio, 4.99; 95% CI, 2.08-11.97). In this study, brief IPT significantly reduced prenatal depression symptoms and MDD compared with EUC among pregnant individuals from diverse racial, ethnic, and socioeconomic backgrounds recruited from primary OB/GYN clinics. As a safe, effective intervention to relieve depression during pregnancy, brief IPT may positively affect mothers' mental health and the developing fetus. ClinicalTrials.gov Identifier: NCT03011801.

Evaluation of cognitive disengagement syndrome in children with obsessive-compulsive disorder: Clinical implications.

Cognitive disengagement syndrome (CDS) has been found to be associated with internalizing symptoms. Yet, no study thus far has focused on whether there is an association between obsessive-compulsive disorder (OCD) and CDS. The purpose of this study is to examine the symptom frequency and clinical implications of CDS in children with OCD. The study included sixty-one children with OCD and sixty-six typically developing children. Children were evaluated by a semi-constructed diagnosis interview, Obsessive-Compulsive Inventory, Barkley Child Attention Scale, and Stroop test. The frequency of elevated symptoms of CDS, and total time, total error, and total correction scores of the Stroop test were significantly higher in the OCD group compared to the controls. Elevated CDS symptoms were significantly associated with higher OCD symptom prevalence and poorer performance on the Stroop Test. Moreover, poor insight, hoarding symptoms, mental compulsions, and ADHD comorbidity were significantly higher in those with elevated CDS symptoms than in those without CDS in the OCD group. The findings of this study provide clinical implications that CDS symptoms may contribute to deficits in attentional orientation, conceptual flexibility, and cognitive processing speed in OCD.

Impact of the COVID-19 pandemic on young people with and without pre-existing mental health problems

The objective was to examine pandemic-related changes in depression and anxiety symptoms in adolescents and young adults in Germany considering pre-existing depression and anxiety problems. In this cross-sectional study, 11,523 adolescents and young adults aged 14–21 years who perceived an impact of the Coronavirus disease (COVID-19) pandemic on their mental health reported the frequencies of depression and anxiety symptoms retrospectively for different pre-pandemic and pandemic phases. Data were collected using web-based questionnaires between January 5th and February 20th, 2022. Depression and anxiety were assessed with a modified version of the Patient Health Questionnaire (PHQ-4). Scale-fit cut-offs were used to identify pre-existing elevated depression and anxiety scores. Multilevel mixed linear models were conducted to assess changes in depression and anxiety symptoms from 2019 to 2021 and compare for age, gender and pre-pandemic mental health problems. Among young people who were experiencing mental health changes as a result of the pandemic, the frequency of depression and anxiety symptoms increased during the COVID-19 pandemic. This association was moderated by age, gender, and pre-existing elevated depression/anxiety scores. For young people without elevated pre-pandemic depression/anxiety, the scores increased strongly over time, with 61% reporting elevated depression symptoms and 44% reporting elevated anxiety symptoms in 2021. In contrast, self-perceived change was minimal for adolescents and young adults with elevated pre-pandemic depression and anxiety. Among young people whose mental health has been affected by the COVID-19 pandemic, the group without pre-pandemic mental health conditions reported greater deterioration than those with elevated pre-pandemic depression and anxiety scores. Thus, adolescents and young adults without pre-existing depression and anxiety problems who perceived a change in general mental health due to the pandemic reported an alarming increase in symptoms of depression and anxiety during the COVID-19 pandemic period.

The Relationship Between Family Cohesion and Depression Among School-Going Children With Elevated Symptoms of Behavioral Challenges in Southern Uganda

PurposeDepression is among the leading causes of disability and contributes significantly to the overall disease burden affecting children. Family cohesion has been identified as a protective factor against depression. Examining this relationship is necessary in sub-Saharan Africa, specifically in Uganda—a country characterized by a high prevalence of HIV/AIDS, and high rates of chronic poverty, all of which stress family functioning and elevate child behavioral challenges. This study examined the relationship between family cohesion and depression among school-going children with elevated symptoms of behavioral challenges in southern Uganda. MethodsAt baseline, 2089 children were enrolled in the National Institutes of Health-funded Strengthening Mental Health and Research Training Africa study in Southwestern Uganda. This article analyzed data from 626 children aged 8–13 years with elevated behavioral challenges. We conducted multilevel mixed-effects Poisson regression to determine the association between family cohesion and depression. We controlled for sociodemographic and household characteristics. ResultsThe mean age was 10.3 years. The overall mean depression score was 3.2 (standard deviation = 2.7, range = 0–15). Family cohesion (β = −0.03, 95% confidence interval [CI]: −0.04, −0.02, p < .001) and owning essential items by the child (β = −0.13, 95% CI: −0.23, −0.04, p = .005) were protective against depression among children. Additionally, we observed being a single orphan (β = −0.44, 95% CI: −0.03, −0.86, p = .036) and having both parents (β = −0.43, 95% CI: −0.06, −0.81, p = .023) were associated with depression among children. DiscussionFindings from this study reveal that family cohesion was protective against depression. Therefore, it is vital to strengthen family support systems by developing programs aimed at strengthening family relationships as a catalyst for addressing depression among children.

Lethal means safety counseling among firearm-owning U.S. National Guard personnel: Hyperarousal symptoms as a moderator of treatment outcomes.

The U.S. Department of Defense and other stakeholders recommend lethal means safety counseling (LMSC) to reduce suicide risk among military service members. Despite the promise of LMSC, few studies have examined moderators of LMSC treatment outcomes, such as posttraumatic stress disorder (PTSD) symptoms. Individuals with elevated PTSD symptoms are characteristically hypervigilant to threat and are more likely to store their firearms unsafely, which might impact their treatment response to LMSC. In this secondary analysis of the Project Safe Guard LMSC intervention, 209 firearm-owning members of the Mississippi National Guard completed self-report surveys (M [SD] age = 35.2 [10.1] years; 86.6% male, 79.4% White). We used logistic regression to examine the moderating effect of PTSD symptoms (PTSD Checklist for DSM-5; e.g., hyperarousal symptoms) on the association between treatment groups (LMSC vs. control; cable lock provision vs. no cable lock provision) and the use of new locking devices at 6-month follow-up. At 6-month follow-up, 24.9% (n = 52) of participants reported new firearm locking device use. The interaction between hyperarousal symptoms and LMSC (vs. control) was significant. Specifically, LMSC increased the use of new firearm locking devices relative to control at 6-month follow-up for individuals with low/medium, but not high, levels of baseline hyperarousal symptoms. Hyperarousal symptoms did not moderate the association between cable lock provision (vs. no cable lock provision) and use of new locking devices. Findings suggest that existing LMSC interventions need to be adapted for use with service members with elevated hyperarousal symptoms. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Addressing Child Mental Health Inequities Through Parental Mental Health and Preschool Attendance.

Prevention is key to reducing socioeconomic inequities in children's mental health problems, especially given limited availability and accessibility of services. We investigated the potential to reduce inequities for disadvantaged children by improving parental mental health and preschool attendance in early childhood. Data from the nationally representative birth cohort, Longitudinal Study of Australian Children (N = 5107, commenced in 2004), were used to examine the impact of socioeconomic disadvantage (0-1 year) on children's mental health problems (10-11 years). Using an interventional effects approach, we estimated the extent to which inequities could be reduced by improving disadvantaged children's parental mental health (4-5 years) and their preschool attendance (4-5 years). Disadvantaged children had a higher prevalence of elevated mental health symptoms (32.8%) compared with their nondisadvantaged peers (18.7%): confounder-adjusted difference in prevalence is 11.6% (95% confidence interval: 7.7% to 15.4%). Improving disadvantaged children's parental mental health and their preschool attendance to the level of their nondisadvantaged peers could reduce 6.5% and 0.3% of socioeconomic differences in children's mental health problems, respectively (equivalent to 0.8% and 0.04% absolute reductions). If these interventions were delivered in combination, a 10.8% (95% confidence interval: 6.9% to 14.7%) higher prevalence of elevated symptoms would remain for disadvantaged children. Targeted policy interventions that improve parental mental health and preschool attendance for disadvantaged children are potential opportunities to reduce socioeconomic inequities in children's mental health problems. Such interventions should be considered within a broader, sustained, and multipronged approach that includes addressing socioeconomic disadvantage itself.

Low standards yet disappointed: ADHD symptoms and experiential avoidance in college students

The literature suggests that ADHD symptoms are associated with experiential avoidance (EA), but little is known about factors that explain this relation. The present study examined indirect effects of ADHD symptoms on EA via perfectionism in a sample of 3720 undergraduates who completed an online survey. Results showed that perfectionism partially explained the relation between ADHD symptoms and EA, yet the direction of findings differed when examining different elements of perfectionism. Specifically, ADHD symptoms predicted higher Discrepancy scores, but lower Standards and Order scores. This suggests that undergraduates with elevated ADHD symptoms do not strive towards orderliness or hold themselves to overly high standards, yet judge themselves harshly for falling short of their expectations. Targeting this harsh judgment through the use of cognitive-behavioral, or acceptance and commitment therapy may be beneficial for undergraduates with elevated symptoms of ADHD.

PD41-06 POOLED ANALYSIS OF 330+ SUBJECTS TREATED WITH THE PROSTATIC URETHRAL LIFT (PUL) REVEALS UNDERTREATMENT IMPACTS DURABILITY

You have accessJournal of UrologyCME1 Apr 2023PD41-06 POOLED ANALYSIS OF 330+ SUBJECTS TREATED WITH THE PROSTATIC URETHRAL LIFT (PUL) REVEALS UNDERTREATMENT IMPACTS DURABILITY Claus Roehrborn, Steven Gange, Mark Rochester, Neil Barber, and Peter Chin Claus RoehrbornClaus Roehrborn More articles by this author , Steven GangeSteven Gange More articles by this author , Mark RochesterMark Rochester More articles by this author , Neil BarberNeil Barber More articles by this author , and Peter ChinPeter Chin More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003346.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Durability is increasingly the focus of discussions on BPH treatment outcomes. In the present analysis, we examine how baseline and procedural variables underlie treatment durability in over 330 PUL subjects treated in a controlled trial setting. METHODS: Logistic regression analysis was built aggregating patients from five PUL controlled studies. ‘Successful durability’ was defined as a subject that did not undergo surgical retreatment for BPH (± being BPH medication free) at 1- and 5-years post-PUL. Covariates used in the model included age, race, BMI, prostate volume, proxies of BPH disease severity (IPSS, QoL, Qmax, PVR, PSA), medical history (i.e., history of diabetes, retention, UTI), and procedural characteristics (number of implants, implants per prostate volume). RESULTS: In these controlled studies, PUL was durable in most subjects at 1 and 5 years. With increasing prostate volume, increasing numbers of implants were placed. Average number of implants placed was 4.8 (SD 1.6). No patient who received seven or more implants required BPH surgical retreatment during follow up. 1-year durability: Baseline IPSS total score did not impact durability, although increased hesitancy/straining at baseline (IPSS Q6) predicted surgical or medical failure. In addition, fewer overall implants placed (≤4 vs >4) as well as lower implant-to-prostate volume ratio (≤1 vs >1 implant/10cc volume) predisposed subjects to surgical retreatment or return to medication. 5-year durability: The symptom of incomplete emptying (high IPSS Q1) at baseline impacted surgical retreatment rate which was 13.7% at 5 years. At baseline, high quality of life score (high dissatisfaction), high IPSS total scores (elevated symptoms), and high IPSS obstructive domain scores (i.e., incomplete emptying Q1, intermittency Q3, weak stream Q5) predicted retreatment with either surgery or medication. CONCLUSIONS: Lack of PUL durability at 1 year is associated with undertreatment (≤4 implants placed). In those patients who successfully avoid surgical retreatment, implant density is higher (>1 implant/10 cc volume). Durability at 5 years is primarily affected by poor IPSS obstructive symptoms at baseline. Source of Funding: Teleflex, Inc © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e1060 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Claus Roehrborn More articles by this author Steven Gange More articles by this author Mark Rochester More articles by this author Neil Barber More articles by this author Peter Chin More articles by this author Expand All Advertisement PDF downloadLoading ...

PD19-10 PROGRESSION OF OVERACTIVE BLADDER SYMPTOMS IN PATIENTS WITH PRIOR SARS-CoV-2 INFECTION

You have accessJournal of UrologyCME1 Apr 2023PD19-10 PROGRESSION OF OVERACTIVE BLADDER SYMPTOMS IN PATIENTS WITH PRIOR SARS-CoV-2 INFECTION Priya Padmanabhan, Bernadette Zwaans, and Ly Hoang Roberts Priya PadmanabhanPriya Padmanabhan More articles by this author , Bernadette ZwaansBernadette Zwaans More articles by this author , and Ly Hoang RobertsLy Hoang Roberts More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003285.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Infection with SARS-CoV-2 can result in de novo or worsening genitourinary (GU) symptoms, such as frequency, urgency, nocturia, and pain/pressure, also referred to as COVID-19 associated cystitis (CAC). The aim of this study was to follow progression of OAB symptoms in patients that previously reported new or worsening OAB symptoms after COVID-19 diagnosis. METHODS: 19,128 individuals from a Beaumont COVID-19 serology study, were invited to participate in a follow-up study, with 2,137 subsequent respondents. Participants were divided into a COVID-, Ser+ (positive serology test only) or PCR+ (positive PCR test) groups. Initially, patients were asked to score their OAB symptoms retrospectively prior to the pandemic (baseline) and at present time (day 0). Participants were subsequently asked to score their symptoms at 2-, 4-, 8- and 12-months follow-up. Participants that obtained COVID-19 diagnosis during follow-up phase were excluded from the study. GU symptoms were assessed using the ICIQ-OAB. The minimal important difference (MID) of ICIQ-OAB of 1 is considered a significant change. Data was collected between May 2021 and July 2022. RESULTS: Of 2,137 participants, 564 (26.4%) previously tested positive for COVID, and 1,573 (73.6%) were COVID naïve (COVID-). Of these, 592 participants reported a ≥1 unit increase in OAB score at study onset (Day 0) compared to pre-pandemic; 243 (41%) were COVID-, 129 (21.8%) had positive serology test (Ser+), and 220 (37.2%) were COVID+ based on PCR test (PCR+). OAB score of these three cohorts were similar at pre-pandemic (2.71 vs 2.97 vs 2.53; p=0.193) but significantly higher at start of study (day 0) in PCR+ versus COVID- or Ser+ groups (5.83 vs 5.12 vs 5.33; p=0.019). In prospective follow-up, change in ICIQ-OAB scores from baseline were recorded at 2, 4, 8 and 12 months. At day 0, both Ser+ and PCR+ cohorts had significantly higher change in OAB score than COVID- group (2.8 and 3.11 vs 2.16; p=0.001). However, after 12 months follow-up, change in OAB score was similar between COVID- (1.86), Ser+ (2.15) and PCR+ (2.09). By 12 months, 74% of COVID-, 80.5% of Ser+ and 72.4% of PCR+ participants still reported significant increase in ICIQ-OAB scores from pre-pandemic levels. CONCLUSIONS: We previously demonstrated that COVID-19 infections increases the risk for developing CAC. COVID infected individuals with CAC take up to 12 months to reach levels of COVID- patients with baseline elevated OAB Symptoms. Elevated ICIQ-OAB scores in COVID- participants may be contributed to other consequences of the pandemic such as elevated stress and depression. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e581 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Priya Padmanabhan More articles by this author Bernadette Zwaans More articles by this author Ly Hoang Roberts More articles by this author Expand All Advertisement PDF downloadLoading ...

359 Utilization of machine learning approaches on multimodal and ambulatory data to predict individualized symptom course in adults with obsessive-compulsive disorder.

OBJECTIVES/GOALS: This study will collect multimodal and longitudinal data in adults with obsessive-compulsive disorder and healthy controls. A mixed effects random forest machine learning approach will be taken to develop a model that can predict individualized longitudinal OCD symptom burden. METHODS/STUDY POPULATION: Baseline resting state functional MRI (rsfMRI) and measures of symptom burden will be collected in adults with OCD and healthy controls. Longitudinal measures of behavior and physiology–such as heart rate, activity, and sleep metrics - will be collected using Fitbit Charge 5 tracker. Daily assessments of symptom burden and functional status will be collected through a smartphone app. Individuals with OCD will start pharmacotherapy during the study period and all participants will be followed for a total of 10 weeks. Repeat rsfMRI imaging will occur at study conclusion. Data will be analyzed using a mixed effects random forest machine learning algorithm with assessment of model performance. RESULTS/ANTICIPATED RESULTS: Prior studies of symptom severity in psychiatric illness and affect in non-clinical populations have found longitudinal features - such as lexical and acoustic measures, participant context, heart rate, and sleep metrics–that were predictive of these states over time. It is anticipated that the present study will extend these results to individuals with OCD and identify physiologic and behavioral features that track personalized symptom burden longitudinally in this patient population. A model able to predict when symptoms are elevated could allow for provision of additional treatment or interventions targeted to times of high symptom burden. DISCUSSION/SIGNIFICANCE: This study will be the first to collect and analyze longitudinal measures of behavior, symptoms, and physiology in patients with OCD with a goal of predicting symptom burden. Identification of elevated symptom burden would allow for implementation of just-in-time treatment, during these periods.

Human contact in internet-based interventions for depression: A pre-registered replication and meta-analysis of randomized trials

IntroductionInternet-based self-help interventions have shown to be effective in the treatment of depression. Several meta-analyses indicated that human contact has a crucial impact on adherence and outcome. While most research focused on the role of guidance during interventions, a review by Andersson and Johansson (2012) suggested that contact before the intervention too may play an important role. ObjectiveWe investigated the impact of the degree of contact in internet-based interventions (IBIs) for depression on outcome in adults suffering from elevated symptoms of depression. MethodsWe conducted a preregistered meta-analysis (www.osf.io/4mzyd) and included trials comparing IBIs for depression against control conditions (treatment as usual [TAU] or waiting list [WL]) in patients with symptoms of unipolar depression searching the databases PsycINFO and Cochrane's Central Register of Controlled Trials (CENTRAL) limited to entries from EMBASE and PubMed. Following Andersson and Johansson (2012), contact before an intervention was defined as having had a diagnostic interview before the IBI, and contact during intervention was defined as having received guidance during the IBI. IBIs were grouped as providing (0) no contact, (1) contact before the IBI, (2) contact during the IBI, or (3) contact both before and during the IBI. The primary outcome was standardized mean difference (SMD) of the IBI and control in depressive symptoms at treatment termination. Secondary outcomes were study dropout and adherence to the IBI. ResultsWe included 56 eligible trials that randomized 13,335 patients to 75 internet-based intervention conditions and control groups (TAU in 23 trials, WL in 33 trials). In total, 44 trials (78.57 %) were judged to show some concerns or a high risk of bias. Overall heterogeneity was high regarding the primary outcome (I2s < 66 %) and even higher for secondary outcomes (I2s < 91 %). Degree of contact was a robust predictor of outcome and adherence in all pre-registered and exploratory analyses. We found the effect of the IBI to increase with higher degree of contact. However, in pair-wise contrasts, only IBIs offering both contact before and during the intervention (SMD = 0.573, 95 % CI: 0.437, 0.709) significantly outperformed interventions offering no contact (SMD = 0.224, 95 % CI: 0.090, 0.340). ConclusionsThe results suggest that contact before and during an intervention increases the effects of IBIs. The combination of contact before and during the intervention seems to a pivotal role regarding adherence as well as treatment outcome for patients suffering from depression.

Online structured dance/movement therapy reduces bodily detachment in depersonalization-derealization disorder

BackgroundDepersonalization-derealization disorder (DDD) is a dissociative disorder encompassing pronounced disconnections from the self and from external reality. As DDD is inherently tied to a detachment from the body, dance/movement therapy could provide an innovative treatment approach. Materials and methodsWe developed two online dance tasks to reduce detachment either by training body awareness (BA task) or enhancing the salience of bodily signals through dance exercise (DE task). Individuals with DDD (n = 31) and healthy controls (n = 29) performed both tasks individually in a cross-over design. We assessed symptom severity (Cambridge Depersonalization Scale), interoceptive awareness (Multidimensional Assessment of Interoceptive Awareness – II), mindfulness (Five Facet Mindfulness Questionnaire), and body vigilance (Body Vigilance Scale) before, during and after the tasks. ResultsAt baseline, individuals with DDD exhibited elevated depersonalization-derealization symptoms alongside lower levels of interoceptive awareness and mindfulness compared to controls. Both tasks reduced symptoms in the DDD group, though dance exercise was perceived as easier. The DE task increased mindfulness in those with DDD more than the BA task, whereas controls showed the opposite pattern. In the DDD group, within-subject correlations showed that lower levels of symptoms were associated with task-specific elevations in interoceptive awareness and mindfulness. ConclusionIndividual and structured dance/movement practice, performed at home without an instructor present, offers an effective tool to reduce symptoms in DDD and can be tailored to address specific cognitive components of a mindful engagement with the body.

Pandemic grief in El Salvador: factors that predict dysfunctional grief due to a COVID-19 death among Salvadoran adults

Thousands of people have died of COVID-19 in El Salvador. However, little is known about the mental health of those who are mourning the loss of a loved one to COVID-19. Therefore, the objective of this study was to examine the dysfunctional grief associated with COVID-19 death among Salvadoran adults. A sample of 435 Salvadorans (M = 29 years; SD = 8.75) who lost a family member or loved one to COVID-19 completed a digital survey using the Google Forms platform, during April 2 and 28, 2022. The results revealed that 35.1% reported clinically elevated symptoms of dysfunctional grief and among those mourners, and 25.1% also exhibited clinical levels of coronavirus anxiety. A binary logistic regression revealed that predictor variables such as COVID-19 anxiety (p = .003), depression (p = .021), and COVID-19 obsession (p = .032) were significant (χ2 = 84.31; Nagelkerke R2 = .242) and predict a 24.2% chance of dysfunctional bereavement.

Emotion Regulation Is Associated with Anxiety, Depression and Stress in Adults with Cerebral Palsy

Emotion regulation difficulties are associated with many neurological conditions and negatively impact daily function. Yet little is known about emotion regulation in adults with cerebral palsy (CP). Our aim was to investigate emotion regulation in adults with CP and its relationship with condition-related and/or socio-demographic factors. In a cross-sectional study of adults with CP, participants completed a survey containing the Difficulties in Emotion Regulation Scale (DERS), Depression Anxiety and Stress Scale-21 (DASS-21), and socio-demographic and condition-related questions. Descriptive statistics, chi-squared and Mann-Whitney tests were performed. Of the 42 adults with CP (x31.5 years, SD13.5) that were tested, 38 had within normal limits DERS total scores; however, a significantly higher proportion of participants experienced elevated scores (i.e., more difficulties with emotion regulation) than would be expected in the general population across five of the six DERs subdomains. Moderate-extremely severe depression and anxiety symptoms were reported by 33% and 60% of participants, respectively. The DERS total scores for participants with elevated depression, anxiety, and stress scores were significantly higher than the DERS totals score for those without elevated depression, anxiety, and stress scores. DERS and DASS-21 scores did not differ significantly by condition-related nor socio-demographic characteristics. In conclusion, emotion regulation difficulties were associated with elevated symptoms of depression and anxiety, which were overrepresented in the adults with CP participating in this study.

Pain and insomnia as risk factors for first lifetime onsets of anxiety, depression, and suicidality in adolescence.

Chronic pain and mental health problems have both been identified as public health emergencies and co-occur at high rates. This prospective, longitudinal investigation examined whether chronic pain status, pain-related symptoms (intensity, interference), pain catastrophizing, and insomnia severity predicted first lifetime onset of depressive and/or anxiety disorders as well as suicidality in a cohort of youth with a parental history of mood and/or anxiety disorders. Participants included 145 youth ( Mage = 13.74 years; 64% female) who completed structured diagnostic interviews at baseline and at 9- and 18-month follow-up to assess depressive and anxiety disorders as well as suicidality. Participants completed baseline questionnaires assessing depressive and anxiety symptoms, pain symptoms and characteristics, pain interference, pain catastrophizing, and insomnia severity. Approximately 25% of youth reported having chronic pain at baseline. Nearly half (47.3%) developed a depressive disorder (21.3%), anxiety disorder (15.7%), or both (10.3%), and 34% endorsed experiencing suicidality at follow-up. Increased pain interference, intensity, catastrophizing, and insomnia severity predicted increased likelihood of first lifetime onset of a depressive disorder at follow-up, over and above sex and baseline symptoms. Chronic pain at baseline was associated with the increased likelihood of onset of suicidality at follow-up. Increased pain intensity and interference at baseline predicted increased severity of suicidality at follow-up. Insomnia severity predicted increased likelihood of anxiety disorder onset. The presence of chronic pain and elevated pain-related symptoms and insomnia are premorbid risk factors for the development of significant mental health disorders and issues in youth.

Interpersonal transmission of ROCD symptoms and susceptibility to infidelity in romantic relationships

Relationship obsessive–compulsive disorder (ROCD) is a disabling presentation of obsessive-compulsive disorder (OCD) centering on close interpersonal relationships. Previous studies focused on the personal consequences of ROCD symptoms. Yet, studies investigating the consequences of ROCD symptoms on one's partner are scarce. In this study, we assessed whether exposure to romantic partners' elevated ROCD symptoms would heighten participants' ROCD symptoms and would increase participants' evaluation of their own and their partners' susceptibility to infidelity. Heterosexual couples (Ncouples = 50; Mage = 25.8) completed self-report questionnaires. One randomly selected partner of each romantic dyad was then randomly allocated to being exposed to information suggesting their partner has low (low-exposure) or high (high-exposure) levels of ROCD symptoms. Results indicated that participants in the high-exposure group showed higher ROCD symptoms than participants in the low-exposure group. Exposure to allegedly elevated levels of partners' ROCD symptoms also led participants to evaluate their own and their partners' susceptibility to infidelity as higher than participants in the low-exposure group, particularly among participants with pre-existing ROCD symptoms. These results illustrate a ‘contagious’ effect of unmediated exposure to partners' ROCD symptoms and its potentially unfavorable consequences. Clinical implications regarding partner involvement in the treatment of ROCD are discussed.

Potency of Emotional Freedom Technique on Post partum blues and parenting stress among Post caesarean section mothers in selected hospitals at Erode – Partially randomized patient preference study

Context: The first months postpartum can be challenging for parents, leading to elevated symptoms of parenting stress, depression and anxiety. Methods: The aim of this study was to compare the potency of emotional freedom technique on post partum blues and parenting stress among post caesarean section mothers. The total sample size was 150 post partum caesarean section mothers. All study subjects were asked preferences about emotional freedom technique or standard methods of care. According to their strong preference the treatment conditions were allocated. 150 subjects were interviewed before intervention by assessing background variables. On the 2nd post caesarean section day, the subjects were assessed for postpartum blues by using Likert Am I Blue? Assessment scale and parental stress was measured by adopting parental stress scale. Experimental arm received emotional freedom technique for 30 minutes, twice a day (morning and evening) for 4 days. Control arm received standard methods of care. Posttest was conducted by using the same assessment techniques in experimental arm and control arm. Results: Paired‘t’ test and Unpaired‘t’ test showed statistical significance by scaling down the symptoms of post partum blues and parenting stress in experimental arm comparatively to the control arm among post caesarean section mothers. Conclusion: Emotional freedom technique was quite effective for curtailing the symptoms of post partum blues and parenting stress among post caesarean section mothers.

Longitudinal assessment of mental health after a flood: roles of social support, hope, recovery stressors, and prior lifetime trauma

Objectives Severe weather events have mental health consequences for survivors that may change over time. We assessed post-flood mental health longitudinally in three groups of mostly middle-aged and older adults who varied in current and prior severe weather experiences. Method Predictors of central interest were age, perceived social support, state hope (including agency and pathways), recovery stressors, and prior lifetime trauma. Criterion variables included symptoms of depression, post-traumatic stress disorder (PTSD), and worry. Results Analyses of variance yielded significant Disaster Exposure Group x Wave interactions for depression and PTSD symptoms. Those with flooded homes and properties had elevated symptoms at Wave 1 which were reduced at Wave 2. Older age was associated with fewer symptoms of depression, PTSD, and worry. Recovery stressors and lifetime trauma predicted more PTSD symptoms. Greater agency predicted less PTSD and depression symptoms, whereas pathways predicted less worry. Conclusion These data show that mental health symptoms may decrease over time for those directly impacted by severe flooding. State hope appears to contribute to better mental health after exposure to a devastating flood. Implications for understanding the dynamic relationships among risk variables and positive factors that promote post-disaster mental health in the years after a flood are considered.

Antecedents and Consequences of Child Externalizing Problems: Differences in Dynamic Parent–Child Processes

Given that noncompliance is the most common externalizing problem during middle childhood and reliably predicts significant conduct problems, innovations in elucidating its etiology are sorely needed. Evaluation of in-the-moment antecedents and consequences of child noncompliance improves traction on this goal, given that multiple theories contend that child noncompliance and parent behavior mutually influence each other through negative reciprocation as well as contingent praise processes. Among a sample of 140 families (child age: 6–10 years; 32.1% female), the present study capitalized on intensive repeated measures of observed child noncompliance and parent negative talk and praise objectively coded during three unique tasks. We employed dynamic structural equation modeling to evaluate within-dyad parent–child behavioral dynamics and between-dyad differences therein. Results provided mixed support for hypotheses and suggested that antecedents and consequences of child noncompliance differed according to task demands and child ADHD symptoms. Contrary to models of coercive cycles, during child-led play, parent negative talk was more likely following prior child noncompliance, but child noncompliance was less likely following prior parent negative talk. As expected, during parent-led play, parent praise was less likely following prior child noncompliance, which was also less likely following prior parent praise. Relative to youth with fewer symptoms, for children with elevated ADHD symptoms, during a challenging clean-up task, child noncompliance was less stable and less contingent on prior parent negative talk. Results are discussed in terms of their implications of real-time parent–child interactions for typical and atypical development of externalizing problems.