Global Distress Research Articles

Abstract CT147: The impact of a technology based program on symptom distress among Asian American breast cancer survivors

Abstract Purpose: Asian American breast cancer survivors are reported to experience physical and psychological symptoms that could be easily avoidable because of their cultural stigma and hesitance related to breast cancer. Also, they are more likely to have delays in getting help, information, and support. Studies have indicated a dire need to support Asian American breast cancer survivors in their symptom management while considering their cultural hesitance and stigma. Technology-based programs using computers and mobile devices are reported to help improve symptom experience of cancer survivors including Asian American breast cancer survivors. The purpose of this study was to decide the specific characteristics of Asian American breast cancer survivors whose symptom distress was effectively improved by a technology-based program. Methods: This study was a part of a randomized controlled trial among 115 Asian American breast cancer survivors. The instruments included: multiple questions on background factors and disease factors, the Cancer Behavior Inventory, the Questions on Attitudes, Subjective Norm, Perceived Behavioral Control, and Behavioral Intention, the Memorial Symptom Assessment Scale-Short Form, and the Supportive Care Needs Survey-Short Form 34. The data analysis was done through chi-square tests, t-tests, repeated measurement analyses, and decision tree analyses. Results: The interactions between time and group were significant in the changes of the global distress index (GDI) and physical symptom distress (PHYS) scores (p<.05). Those with high psychological support needs had the largest decrease in the GDI scores (1.253 points). Those with high physical and daily living support needs who had a short U.S. residence period and who were young had the largest decrease in the PHYS scores (1.133 points). Those with high psychological support needs had the largest decrease in the psychologic symptom distress scores (1.511 points). Conclusions: The findings of this study indicated several characteristics of Asian American breast cancer survivors whose symptom distress was highly decreased by a technology-based intervention (e.g., those who had a short U.S. residence period, those who were young, etc.). These characteristics need to be considered in the future design and implementation of a technology-based intervention among this specific population. Table 1.Changes in the Symptom Distress scores (n=115).PrePost 1 monthPost 3 monthspPost 3 months- PrepM±SDM±SDM±SDtime *groupM±SDCont. vs. Int.GDICont.1.410±0.6921.445±0.6631.438±0.628.0210.028±0.534.012Int.1.543±0.6961.326±0.6071.325±0.589-0.218±0.498Total1.475±0.6941.387±0.6361.383±0.609-0.092±0.529PHYSCont.1.170±0.5321.242±0.5601.260±0.567.0070.090±0.506.002Int.1.292±0.6131.155±0.5761.089±0.500-0.202±0.459Total1.229±0.5741.199±0.5671.177±0.540-0.052±0.503PSYCHCont.1.525±0.8411.502±0.7551.506±0.740.136-0.019±0.722.157Int.1.657±0.8491.389±0.6881.453±0.704-0.204±0.672Total1.589±0.8431.447±0.7221.480±0.720-0.109±0.702 Citation Format: Eun-Ok Im, Jee-Seon Yi, Wonshik Chee. The impact of a technology based program on symptom distress among Asian American breast cancer survivors [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr CT147.

Edmonton Symptom Assessment System: Psychometric validation of six-point Verbal Rating Scale in Polish hospice setting

Introduction: The Edmonton Symptom Assessment System (ESAS) quantifying the most common symptoms rated in the numerical rating scale (NRS) for some respondents are cumbersome or incomprehensible. The study aimed to introduce, implement and validate psychometric properties of the ESAS (revisited) six-point Verbal Rating Scale — Polish version (ESAS-r 6VRS-PL) into a Polish hospice setting. Methods: In a cross-sectional, observational prospective psychometric validation study the adult advanced cancer patients admitted to a hospice were evaluated twice for test-retest reliability. Each patient’s evaluation encompassed the ESAS-r 6VRS-PL, which was compared on the first day with the validated Polish version of the European Organisation for Research and Treatment of Cancer QLQ-C15-PAL, considered the gold standard, to accomplish its external construct validity. Results: Of the 57 patients enrolled 48 were evaluated twice and 9 (15.5%) dropped out. All respondents were able to describe their symptoms in < 15 minutes independently without any need to clarify the meaning of the questions and only occasionally with assistance in reading the questions or answers. The high intraclass correlation coefficient of the ESAS Global Distress Score was noted (0.825; 95%CI 0.723–0.888). Similar items of the ESAS-r 6VRS-PL and QLQ-C15-PAL showed moderate correlations (range 0.59–0.65; p < 0.001). The internal consistency of the ESAS-r 6VRS-PL measured using Cronbach’s alpha coefficient was fairly high, reaching 0.723 (item range 0.664–0.734). Conclusion: The ESAS-r 6VRS-PL is a simple, valid, reliable and feasible test that allows estimating the QoL in advanced cancer patients.

Factors associated with anxiety and depression among patients with Covid-19

BackgroundThe 2019 Coronavirus disease (COVID-19) has caused a global distress. However, its psychological impact on patients is unclear. We aim to determine the mental health status and explore related factors of anxiety and depression among patients with (COVID-19). Methods and main outcome measuresThis is a cross-sectional descriptive survey conducted among COVID-19 patients at the Mohammed VI University Hospital Centre in Marrakech over a period of four months. We assessed symptoms of depression and anxiety using the Arabic version of the Hospital Anxiety and Depression Scale (HADS) on admission. The significance threshold used for any data comparison test was the value of p < 0.05. ResultsA total of 103 participants were included. The average age was 44, 17 ± 17, 19 years. About 54,4% of the subjects were male. Of the 103 participants, 36.89% and 23.30% patients with COVID-19 had symptoms of anxiety or depression; respectively. The mean score of anxiety subscale and depression subscale for all patients was 6.45 ± 4.29 and 5.38 ± 4.47, respectively. The bivariate analysis showed that age (p=0, 0004; p=0, 0002), oxygen saturation level (p=0, 0003; p=0, 0059), hospital stay (p <0, 0001; p <0, 0001) and family infection with SARS-CoV-2 (p=0, 0094; p=0, 0023) were associated with anxiety and depression respectively for COVID-19 patients. Moreover, gender (p=0, 0119) was associated with depression. ConclusionThere is an increasing level of anxiety and depression in hospitalized patients with COVID-19. Mental concern and appropriate intervention remain an important part of clinical care for those who are at risk.

Caregiver‐reported outcomes of pediatric transplantation: Changes and predictors at 6 months post‐transplant

It is widely assumed that pediatric solid organ transplantation results in better caregiver-reported outcomes, including reduced caregiver psychological distress and increased child health-related quality of life (HRQOL), yet little empirical evidence of this expectation exists. The current investigation aims to fill this gap and identify key clinical course factors predictive of caregiver-reported outcomes. Forty-nine caregivers of children (Mage =10.30years, SD=5.43) presenting for kidney, liver, or heart transplant evaluation reported on their psychological distress levels (anxiety, depression, somatization, and global psychological stress) and their children's HRQOL at children's pretransplant evaluations and 6months post-transplant. Clinical course factors were abstracted via medical chart review. Caregivers did not report significant changes in their psychological distress from pre- to post-transplant but reported significantly improved child HRQOL across most domains (ds=-.45 to -.54). Higher post-transplant caregiver global psychological distress was predicted by older child age, shorter time since diagnosis, and lower pretransplant caregiver-reported child HRQOL even after controlling for pretransplant caregiver psychological distress. Lower post-transplant child total HRQOL was predicted by more post-transplant hospitalizations even after controlling for pretransplant child total HRQOL. These preliminary results indicate pediatric solid organ transplantation was associated with some improved caregiver-reported outcomes, specifically children's HRQOL, but not caregivers' psychological distress. Linear regression models identify several clinical course and pretransplant factors associated with transplantation outcomes. Characterizing how caregivers view their psychological distress levels and children's HRQOL across the transplantation process could inform family-centered holistic care and support caregiver adaptation to transplantation.

Symptom prevalence, burden and correlates among people living with HIV in Vietnam: a two-centre self-report study

ABSTRACT Physical and psychological symptoms among people living with HIV (PLWH) adversely affect quality of life and treatment adherence. Study objectives were: (i) to determine validity and reliability of a Vietnamese translation of the Memorial Symptom Assessment Scale–Short Form (MSAS-SF) among PLWH in Vietnam; (ii) to measure prevalence and burden of physical and psychological symptoms using the MSAS-SF including the Global Distress Index (GDI), Physical Distress subscale (PHYS), and Psychological Distress subscale (PSY); (iii) to identify symptom burden risk factors. We recruited 567 patients. Cronbach’s alpha scores were: total MSAS-SF 0.91, GDI 0.83, PHYS 0.85, PSYCH 0.81. The scale showed good discriminant validity (low vs high function) (p < 0.001). The mean number of symptoms was 7.66, and the most prevalent were “worrying” (41.6%), “lack of energy” (40.6%), “feeling irritable” (40.4%), and “feeling sad” (39.2%). Monthly income below the poverty line was independently associated with increased: GDI,, PHYS, and PSY and a greater number of symptoms. The Vietnamese version of the MSAS-SF is valid to measure symptom prevalence and burden in HIV-positive populations. Here is a high symptom prevalence and burden among PLWH in Vietnam, especially those living in poverty, and a great need for palliative care integrated with HIV treatment.

Effect of Matching Therapists to Patients vs Assignment as Usual on Adult Psychotherapy Outcomes

Psychotherapists possess strengths and weaknesses in treating different mental health problems, yet performance information is rarely harnessed in mental health care (MHC). To our knowledge, no prior studies have tested the causal efficacy of prospectively matching patients to therapists with empirically derived strengths in treating patients' specific concerns. To test the effect of measurement-based matching vs case assignment as usual (CAU) on psychotherapy outcomes. In this randomized clinical trial, adult outpatients were recruited between November 2017 and April 2019. Assessments occurred at baseline and repeatedly during treatment at 6 community MHC clinics in Cleveland, Ohio. To be eligible, patients had to make their own MHC decisions. Of 1329 individuals screened, 288 were randomized. Excluding those who withdrew or provided no assessments beyond baseline, 218 patients treated by 48 therapists were included in the primary modified intent-to-treat analyses. Therapist performance was assessed pretrial across 15 or more historical cases based on patients' pre-post reporting across 12 problem domains of the routinely administered Treatment Outcome Package (TOP). Therapists were classified in each domain as effective (on average, patients' symptoms reliably improved), neutral (on average, patients' symptoms neither reliably improved nor deteriorated), or ineffective (on average, patients' symptoms reliably deteriorated). Trial patients were randomly assigned to good-fitting therapists (matched group) or were assigned to therapists pragmatically (CAU group). There were multiple match levels, ranging from therapists being effective on the 3 most elevated domains reported by patients and not ineffective on any others (highest) to not effective on the most elevated domains reported by patients but also not ineffective on any domain (lowest). Therapists treated patients in the matched and CAU groups, and treatment was unmanipulated. General symptomatic and functional impairment across all TOP domains (average z scores relative to the general population mean; higher scores indicate greater impairment), global distress (Symptom Checklist-10; higher scores indicate greater distress), and domain-specific impairment on each individual's most elevated TOP-assessed problem. Of 218 patients, 147 (67.4%) were female, and 193 (88.5%) were White. The mean (SD) age was 33.9 (11.2) years. Multilevel modeling indicated a match effect on reductions in weekly general symptomatic and functional impairment (γ110 = -0.03; 95% CI, -0.05 to -0.01; d = 0.75), global distress (γ110 = -0.16; 95% CI, -0.30 to -0.02; d = 0.50), and domain-specific impairment (γ110 = -0.01; 95% CI -0.01 to -0.006; d = 0.60), with no adverse events. Matching patients with therapists based on therapists' performance strengths can improve MHC outcomes. ClinicalTrials.gov Identifier: NCT02990000.

PSY2 Impact of Mepolizumab on Health-Related Quality of Life in Patients With Hypereosinophilic Syndrome

Mepolizumab, an anti–interleukin-5 monoclonal antibody, reduces disease flares in patients with hypereosinophilic syndrome (HES). Here, we assessed the impact of mepolizumab on symptom burden, health-related quality of life (HRQoL), and work productivity and impairment (WPAI). This placebo-controlled, double-blind, parallel-group, Phase III trial enrolled patients ≥12 years old with HES for ≥6 months, ≥2 flares in the previous 12 months, and BEC ≥1000 cells/μL at screening. Patients maintained ≥4 weeks stable HES therapy before randomization (1:1) to 4-weekly subcutaneous mepolizumab (300 mg) or placebo, plus baseline HES therapy, for 32 weeks. Change from baseline at Week 32 in symptom burden was assessed using a modified version of the memorial symptom assessment scale (MSAS-SF) (scale:0–4). Descriptive analyses of HRQoL and WPAI were performed using the short form-36 (SF-36) questionnaire, including an overall derived score (health utility index) and mental/physical component summary scores (scale:0–100) and the WPAI index general health questionnaire (scale:0–100%). At Week 32, MSAS-SF total score improved in patients receiving mepolizumab (n=54) versus placebo (n=54) (median change: -0.19 vs 0.05, P=0.032). Global distress index score, physical symptom subscale score, and psychological symptom subscale score numerically improved with mepolizumab versus placebo but were not statistically significance (median changes: -0.23 vs 0.12, P=0.096; -0.13 vs 0.10, P=0.083; -0.22 vs -0.02, P=0.551, respectively). Likewise, a small numerical improvement in SF-36 score was observed with mepolizumab versus placebo (mean[SD] changes: utility index: 0.08[0.10] vs 0.04[0.08]; mental score: 3.55[9.03] vs 1.46[8.77]; physical score: 6.33[9.47] vs 3.81[5.75]). Mepolizumab treatment was also associated with numerically greater reductions in impairment while working, overall work impairment, and activity impairment versus placebo (mean[SD] % changes: -20.6[22.94] vs -2.4[21.66]; -17.0[39.63] vs -5.4[25.46]; -19.0[27.66] vs -3.7[24.98], respectively). With mepolizumab treatment, patients with HES had a trend for an improvement in disease symptoms, HRQoL, and WPAI versus placebo. FUNDING: GSK(200622/NCT02836496).

Text4Support Mobile-Based Programming for Individuals Accessing Addictions and Mental Health Services-Retroactive Program Analysis at Baseline, 12 Weeks, and 6 Months.

Objective: Where traditional approaches fall short, widely accessible and accepted, yet under leveraged, digital technologies such as text messaging present novel opportunities to solve a range of health care solutions. The following provides a preliminary analysis of the Text4Support program, a text-messaging intervention using the principles of cognitive behavioral therapy, which seeks to support the health and well-being of individuals seeking support for addiction or mental health concerns. The goal of this study was to assess whether the Text4Support program improved the perceived overall mental well-being of participants.Methods: The evaluation analyzes survey responses of individuals who were enrolled in the Text4Support program beginning in July 2019, who had completed the 6-months program by May 2020. Participants were asked to provide responses to three surveys during their time in the program—at baseline, 12-weeks and 6-months, which included questions documenting demographic information, general satisfaction with the program, and a participants' level of “global distress” through use of the Clinical Outcomes Routine Evaluation System (CORE-10)—a validated brief 10-item assessment and outcome measurement tool used to assess conditions including anxiety, depression, physical problems, and risk to self.Results and Conclusions: This data set did not include a large enough sample of participants to reach statistical significance. Nevertheless, the study provides some preliminary analysis, and identifies opportunities for the future analysis and research.

The Multidimensional Psychological Flexibility Inventory (MPFI): Discriminant validity of psychological flexibility with distress

The psychological flexibility model of behavior change underpins acceptance and commitment therapy (ACT). However, the measurement of psychological flexibility over the past 20 years has mostly hinged on the use of measures with poor discriminant validity and fuzzy boundaries with distress and negative emotionality. The current study analyzed the structure of psychological flexibility as assessed with the recently developed Multidimensional Psychological Flexibility Inventory (MPFI) and examined its link with distress. We used data from an online cross-sectional survey (N = 1542) which assessed psychological flexibility with the MPFI and the Acceptance and Action Questionnaire-II (AAQ-II), as well as anxiety, and depression. Exploratory and confirmatory factor analyses highlighted that the six psychological flexibility processes of the MPFI loaded on a psychological flexibility factor, while anxiety, depression and the AAQ-II loaded on a distress factor, supporting the discriminant validity of the MPFI in assessing psychological flexibility. Findings were consistent with those from prior studies which suggest that the AAQ-II is more of a measure of global distress than psychological inflexibility or by proxy, psychological flexibility. The 30-item MPFI psychological flexibility scale demonstrated good construct and discriminant validity. Overall, findings support psychological flexibility as a construct that is empirically distinct from distress.

Technology-enhanced palliative care for patients with cancer on phase 1 clinical trials.

TPS12136 Background: Patients w advanced cancer participating in Phase I trials carry a high symptom burden from cancer and prior therapies. Our prior work shows patients on phase I trials w multiple active symptoms impacting their immediate quality of life with implications on toxicities and clinical outcomes on subsequent therapy. To identify an effective scalable approach to comprehensive symptom management for patients w adv cancer on phase I trials, we leveraged the increased technology use to design a technology-enhanced symptom management and palliative care intervention (TEC). Methods: Patients w adv cancer seen in the phase I clinic will be given the Edmonton Symptom Assessment System (ESAS), a validated patient-reported outcomes (PRO) tool of common cancer symptoms to identify those with a high symptom burden defined as ≥4 out of 10 on &gt;1 ESAS symptom and a Global Distress Score (GDS) of ≥20. The GDS, a validated score of overall symptom intensity derived from the ESAS, is comprised of 6 physical (pain, fatigue, nausea, drowsiness, appetite, shortness of breath) &amp; 2 psychosocial symptoms (depression, anxiety), and overall wellbeing. TEC is an innovative patient-centered care program of strategic vigorous symptom management where standard-of-care clinic visits are complemented by proactive symptom monitoring between clinic visits remotely and through provider-initiated calls. In this pilot randomized study, we will determine the effect sizes of High-Intensity TEC (HI-TEC; q3day remote PRO assessments w preset provider-initiated call bw visits), Low-Intensity TEC (LO-TEC; q5day remote PRO assessments w preset provider-initiated call bw visits), and Standard Palliative Care (no preset provider contact bw visits). Our guiding hypothesis is that a comprehensive, proactive, technology-enhanced symptom management program led by a Palliative Care team can mitigate the high symptom burden of patients with advanced cancers enrolling in phase I trials. The primary objective assesses the effect size of each TEC intervention on the GDS measure of symptom burden prior to C1D1 on phase I trial. Our working hypothesis is that HI-TEC and LO-TEC will be associated with a lower overall symptom burden signifying symptom optimization prior to starting on a phase I trial. Secondary objectives aim to estimate the effect size of TEC on the following: Symptom burden over 12 weeks on a phase I trial using ESAS, quality of life using FACIT-Sp, PRO-CTCAE and patient satisfaction using FAMCARE-P13. clinical outcomes at 6 months including OS, treatment outcomes (interruptions, dose reductions, discontinuation, time on trial) and quality metrics for end-of-life (EOL) (chemotherapy in the last 14 days of life, ICU admit in last 30 days of life, death without hospice or &lt; 3d of hospice). Qualitatively assessment of patients’ + caregivers’ perceptions of receiving TEC-based cancer care. Clinical trial information: NCI-2020-07465.

Effects of the Brain Wave Modulation Technique Administered Online on Stress, Anxiety, Global Distress, and Affect During the First Wave of the COVID-19 Pandemic: A Randomized Clinical Trial.

This study aims to evaluate the effects of an innovative mind-body practice named the brain wave modulation technique (BWM-T) on stress, anxiety, global distress, and affect. The technique was administered online through a web-based video conferencing platform. The intervention started on week four of the first quarantine in Italy (week commencing 30th March 2020), for a duration of 4 weeks and ended before lockdown measures were loosened. 310 people participated in the study, mean age 28.73 years old (SD = 9.16), 77.8% women. Of these, about half were randomly assigned to the experimental group and the other half served as controls. Participants completed online psychological tests before and after the intervention. 266 people (144 experimental, 122 controls) completed the post-intervention tests. Consistent with our hypothesis, the study’s findings indicate a reduction in the levels of stress, anxiety, global distress, and negative affect in the experimental group, compared to the control group. Moreover, the experimental group also showed higher levels of positive affect, compared to controls after the intervention. The present findings add to the current literature in suggesting that the BWM-T reduced stress not only when administered face-to face but also when administered online during the COVID-19 pandemic. Moreover, we also noted that the BWM-T has an effect on anxiety, global distress, and affect, which we had not investigated in previous studies.

Involvement in litigation in children with PTSD following motor vehicle accident: Associations with emotional distress and treatment outcomes

ObjectivesLitigation is common in the context of Post-traumatic Stress Disorder (PTSD) and mild Traumatic Brain Injury (mTBI), adding contradicting motivations to individuals' engagement in psychotherapeutic interventions. This study's main goal was to explore the relationship between litigation status and emotional distress among children with PTSD following motor vehicle accidents (MVAs). We also present preliminary findings from a pilot study on treatment efficacy for children with PTSD, with and without litigation. MethodsParticipants included 76 children with PTSD following MVA and their main caregiving parent. The associations between litigation status (litigation involvement, litigation phase, and litigation's emotional impact) and children's global distress, PTSD, persistent post-concussion symptoms (PPCS), and sub-optimal effort, and parents' PTSD symptoms were assessed before and after intervention for PTSD. Comorbid mTBI was explored as a possible moderating factor. ResultsInvolvement in litigation was not related to children's and parents' pre-intervention distress, nor to the presence of mTBI or to children's effort. However, higher emotional impact of litigation on parents was associated with children's higher PPCS pre-intervention. A pilot study on intervention outcomes found an improvement both in children with and without litigation involvement. A greater decrease in PPCS following intervention was found in children of parents with higher emotional impact of litigation. ConclusionsThe emotional impact of litigation on parents should be considered while addressing children in litigation context. However, this study's preliminary findings suggest that children with litigation involvement may benefit from treatment, thus litigation should not serve solely as an exclusion criterion for psychological intervention. A larger study should further explore this issue.

GMDSS Equipment Usage: Seafarers’ Experience

Maritime non-commercial communications are performed using the equipment of Global Maritime Distress and Safety System (GMDSS), under the International Convention for the Safety of Life at Sea (SOLAS). This equipment includes numerous devices of different technologies, features and user interfaces, which every officer of the watch (OOW) must know how to use. Besides, the equipment, i.e., its technology has not changed significantly in the last 30 years. Therefore, the purpose of this research was to collect and analyze information on how often GMDSS devices are used and whether any modernization is needed. The main research method was a questionnaire survey intended for experienced officers. Each question, as well as the answers of the respondents, were analyzed in detail and presented graphically. The results of the survey analysis indicate that the VHF (Very High Frequency) radiotelephone, Navigational Telex (NAVTEX) receiver, and Enhanced Group Call (EGC) receiver are still very used, while Digital Selective Calling (DSC) devices and MF/HF (Medium Frequency/High Frequency) radios (telephone and telex) are almost unused onboard. Additionally, more than 80% of respondents believe that GMDSS needs modernization.

The association between perceived patient-centered care and symptoms experienced by patients undergoing anti-cancer treatment.

PurposeCancer patients undergoing active anti-cancer treatment experience multiple symptoms concurrently. Over the years, studies to improve patients’ physical and psychological discomfort by focusing on patients’ needs and preferences have reported promising outcomes. This study aims to explore perceived patient-centered care and its association to symptoms experienced by cancer patients undergoing active anti-cancer treatment.MethodsA cross-sectional study was conducted at an outpatient cancer center between August 2018 and July 2019 among adult cancer patients receiving chemotherapy and biological therapy. Participants were asked by their oncology nurse to complete a self-administered questionnaire which included the three subscales (physical, psychological, and global distress) of the Memorial Symptoms Assessment Scale as well as the perceived patient-centered care questionnaire. To examine the association between participants’ perceived patient-centered care and each of the symptoms scale scores, three hierarchical (block-wise) linear regression models were performed.ResultsOf the 125 participants, 57 (45.6%) were diagnosed with breast cancer and were treated with chemotherapy either alone (n = 62, 49.6%), with radiotherapy (n = 4, 3.2%), or with biological therapy (n = 45, 36.0%). Hierarchical regression models found that perceived patient-centered care contributed to 11.3%, β = − .351 (p < 0.001); 8.9%, β = − .311 (p < 0.001); and 10.3% β = −.336 (p < 0.001) of the variance of the global distress index, physical symptoms, and psychological symptoms, respectively.ConclusionsThis study shows the importance of perceived patient-centered care in alleviating physical and psychological symptoms and overall distress in cancer patients undergoing active anti-cancer therapy. Our findings call for oncology teams to adopt and implement patient-centered care as part of their routine work.

Effectiveness of stress control large group psychoeducation for anxiety and depression: Systematic review and meta-analysis.

This review sought to evaluate the effectiveness of the 'Stress Control' (SC) large psychoeducational 6-session group programme developed to increase access to treatment for patients with anxiety and depression. Systematic review and meta-analysis (Prospero registration: CRD42020173676). Pre-post and post-treatment follow-up effect sizes were extracted and synthesized in a random effects meta-analysis, and variations in effect sizes were investigated via moderator analyses. Secondary analyses synthesized between-group effect sizes from controlled studies containing comparator treatments and calculated the average dropout rate. The quality of the meta-analysis was assessed using the GRADE approach. Nineteen studies with pre-post treatment outcomes were included. The average group size was N=39, and the average dropout rate was 34%. Pooled effect sizes indicated moderate pre-post treatment reductions in anxiety (ES=0.58; CI 0.41 to 0.75; N=5597; Z=7.13; p<.001), moderate reductions in depression (ES=0.62; CI 0.44 to 0.80; N=5538, Z=7.30; p<.001), and large reductions in global distress (ES=0.86; CI 0.61 to 1.11; N=591; Z=7.41; p<.001). At follow-up, improvements in anxiety, depression, and global distress were maintained. When SC was compared to active and passive controls, outcomes were equivalent for anxiety (ES=0.12, 95% CI -0.25 to 0.49, Z=-0.70; p=.482) and depression (ES=0.15, 95% CI -0.24 to 0.54, Z=0.84; p=.401). SC appears to be a clinically effective and durable low-intensity group intervention that facilitates access to treatment for large patient numbers. However, conclusions are limited by the low methodological quality of the evidence. The stress control version of large group psychoeducation is appropriate and effective for mild-to-moderate anxiety and depression The evidence base for stress control is predominantly made up of practice-based studies Stress control needs to form one component of the overall offer made to patients presenting with mild-to-moderate anxiety and depression The competencies required to deliver such groups need better specification.

Relations between implicit attitudes towards eating disorder stimuli and disordered eating symptoms among at-risk college women

This study examined implicit attitudes towards different eating disorder (ED) relevant stimuli— emaciation, hard-exercise, the self, and eating related stimuli—and their relationship with explicit ED symptoms in two symptomatic samples of college-aged women. Study 1 found that positive implicit attitudes towards eating and self-relevant images were associated with greater state body image satisfaction and self-esteem and with less ED-related intentions. Study 2 found that positive implicit attitudes towards eating and self-relevant images were associated with less trait global ED psychopathology and distress and greater self-esteem. Overall, positive implicit evaluations of eating and self-related stimuli were negatively associated with ED symptoms and related psychopathology and positively related to self-esteem. However, implicit attitudes towards emaciation and hard exercise were not associated with explicit ED symptoms in either sample. These findings suggest that implicit attitudes towards eating and self-related stimuli, in particular, may be viable targets for reconditioning in novel treatment paradigms such as therapeutic evaluative conditioning interventions.

Psychopathogical status and personality correlates of problem gambling severity in sports bettors undergoing treatment for gambling disorder.

Background and aimsSports betting has been barely explored independently from other gambling behaviors. Little evidence is available regarding the factors affecting its severity in a clinical sample. The current study explores new determinants for sports betting severity in Spain by the inclusion of psychopathological distress and personality factors.MethodsA sample of 352 Spanish sports bettors undergoing treatment for gambling disorder was recruited. Multiple regression models were used to evaluate the effects of sociodemographic variables, the age of onset of gambling behavior, the global psychopathological distress (SCL-90R GSI) and the personality profile (TCI-R) on sports betting severity and their influence over frequency (bets per episode) and debts due to gambling.ResultsWe found that older age, higher psychopathological distress, lower self-directedness level, and higher novelty seeking level were predictors of gambling severity in Spanish sports bettors. The highest betting frequency was found in men, with the lowest education levels but the highest social status, the highest psychopathological distress, reward dependence score, and self-transcendence trait and the lowest persistence score. Debts were also associated to higher score in cooperativeness as well as older age.Discussion and conclusionsOur findings call for further exploration of factors affecting sports betting severity regarded as a separate gambling entity subtype, as some of the traditional factors typically found in gamblers do not apply to sports bettors or apply inversely in our country. Consequently, sports bettors might deserve specific clinical approaches to tackle the singularities of their gambling behavior.

Tardive Dyskinesia: Assessing and Treating a Debilitating Side Effect of Prolonged Antipsychotic Exposure

Tardive Dyskinesia: Assessing and Treating a Debilitating Side Effect of Prolonged Antipsychotic Exposure

The relationship between global distress, mentalizing and well-being in a German teacher sample

Many studies have linked global distress including higher psychological symptom severity and high levels of stress with low levels of well-being among teachers, indicating a need to identify and empirically evaluate protective factors. Mentalizing—the capacity to understand behavior in terms of intentional mental states—may be a candidate protective factor to mediate this association, enhancing well-being in the face of high levels of global distress. The present study examines whether the capacity to mentalize can buffer subjectively experienced stress and psychological symptom severity in a sample of teachers. 215 teachers completed questionnaires measuring self-rated experiences of stress, psychological symptoms, mentalizing capacities and well-being in a cross-sectional design. Structural equation modeling was used to test mediation effects. Our findings show that mentalizing was positively associated with well-being. In addition, mentalizing counteracted the negative influence of stress and psychological symptom severity. However, a structural equation model assessing the mediating effect of global distress on well-being via mentalizing was not significant. Therefore, the data indicate that teachers’ capacity to mentalize, regardless of psychological symptom load and subjective experience of stress, has a positive impact on their well-being. The study highlights the protective function of mentalizing and forms a framework for psychological interventions to increase teachers’ well-being.

Climate induced Coastline Changes: A case study in Togo (West Africa)

Changing climate is a global distress these days. Global warming is one of the men driven outcome of climate change which causes the glaciers to melt, shoreline regression and raises the level of sea. The regression of shoreline in Togo resulted in vandalization of human habitat and infrastructure. This research aims to monitor the coastal erosion utilizing the geospatial techniques in Togo from 1988 to 2020. The process of extraction and existence of change in shoreline is analyzed. Scientific problems regarding the precision of classification algorithms methods utilized for shoreline extraction using various satellite images are also considered. Thus, NDWI index derived from multisource satellite images were used in this research paper. The performance of Iso Cluster Unsupervised Classification, Otsu threshold segmentation and Sup- port Vector Machine (SVM) Supervised Classification techniques are monitored for the shoreline extraction. This study also takes into account the topographic morphology including non linear and linear coastal surfaces. The rate of change of shoreline was estimated through the statistical linear regression method (LRR). The results demonstrated that the SVM Supervised Classification method worked accurately for topographic morphology than other methods.