Improvements In Psychological Distress Research Articles

The mediation role of emotion regulation strategies on the relationship between mindfulness effects, psychological well-being and distress among youths: findings from a randomized controlled trial

AbstractThe Gaia program is a 12-week mindfulness intervention based on cultivating body, emotional, and ecological self-awareness, which has been shown to be effective in reducing children’s and adolescents’ internalizing problems, and improving psychological well-being, and psychological distress in early adolescents. To clarify the psychological processes underlying mindfulness effects on mental health among adolescents, the present study aimed to examine whether emotion regulation strategies (i.e., cognitive reappraisal and expressive suppression) may be considered as key processes linking the Gaia program effects to improvements in psychological distress and well-being. A total of 361 adolescents (mean age 14 years) were randomly assigned to one of two groups: the Gaia program (i.e., experimental group; N = 210) and waiting list (i.e., control group; N = 151). Measures were administered at three time points, approximately every three months: one week before treatment, one week after treatment, and three months after treatment. Using a structural equation model (SEM), we found that the Gaia Program had a positive and significant indirect effect on psychological well-being only via cognitive reappraisal as measured at follow-up [B = 0.181, 95% C.I. (0.012; 0.395)], whereas no significant indirect effects were found on psychological distress through cognitive reappraisal and expressive suppression. Findings from this study provide evidence of key emotional processes underlying the effects of a mindfulness intervention on positive but not negative psychological outcomes.

Acute and Long-Term Effects of App-Delivered Heartfulness Meditation on Psychological Outcomes and the Endocannabinoid Signaling System in Cyclic Vomiting Syndrome.

Cyclic vomiting syndrome (CVS) is a disorder of gut-brain interaction often triggered by stress. Interventions such as meditation may improve psychological outcomes and health-related quality of life (HRQoL), but their efficacy and the underlying mechanism are unknown. We conducted a 6-week single-arm pilot study to assess the effects of heartfulness meditation (HFM) in CVS using a custom-designed meditation app. Primary outcomes included state and trait anxiety and mood state changes pre vs post-meditation, and secondary outcomes were psychological distress, coping, sleep quality, and HRQoL at baseline and at weeks 3 and 6. Serum concentrations of endocannabinoids N -arachidonylethanolamine and 2-arachidonoylglycerol and related lipids were measured pre- and post-HFM at baseline and week 6. In 30 treatment completers, there was a significant improvement in state anxiety ( P < 0.001), total mood disturbance ( P < 0.001), and other mood states (all P values < 0.05) across the 3 time points. Trait anxiety was also improved at week 6. There was a significant improvement in psychological distress (Global Severity Index), sleep quality (daytime dysfunction), coping (using religion/spirituality), and HRQoL (mental and physical) across the 3 time points (all P < 0.05). Significant increases in N -arachidonylethanolamine and related lipids N -oleoylethanolamine and palmitoylethanolamide post vs pre-HFM were observed at week 6 ( P < 0.001, 0.002, 0.003, respectively). No adverse effects were noted. App-delivered HFM is feasible, safe, and effective and improves psychological outcomes and augments endocannabinoids. This provides insight into the mechanism underlying HFM and has potential for widespread use as a digital therapeutic in CVS and other disorder of gut-brain interaction.

Evaluating the Feasibility of a Guided Culturally Adapted Internet-Delivered Mindfulness Intervention for Indonesian University Students Experiencing Psychological Distress

ObjectivesPsychological distress is common among university students globally. A culturally relevant internet-based mindfulness intervention could be a potential solution for addressing students’ distress in low- and middle-income countries (LMICs), including Indonesia. However, internet-based mindfulness interventions are new in Indonesia. In this study, we evaluated the feasibility, acceptability, and mental health outcomes of a counsellor-guided, culturally adapted, internet-delivered mindfulness intervention for Indonesian university students experiencing psychological distress.MethodThis open pilot trial used a single-arm pre-post-test design. Indonesian university students with elevated distress (n = 40) enrolled in a 4-week counsellor-guided internet-delivered mindfulness intervention. Participants completed the Indonesian adaptation of the Depression Anxiety Stress Scales (DASS-21) at screening, baseline, and post-treatment. They also completed the Indonesian version of Kessler’s Psychological Distress Scale (K-10) prior to each lesson, Five Facet Mindfulness Questionnaire (FFMQ) and Indonesian Well-Being Scale (IWBS) at baseline and post-treatment, and questionnaires to evaluate the feasibility, acceptability, and treatment satisfaction.ResultsResults showed the feasibility and acceptability of our guided culturally adapted Indonesian internet-delivered mindfulness intervention, with good completion rates (70%). We also found large and significant improvements in distress, mindfulness, and well-being (Hedges’ g = 0.85–1.68) from pre- to post-treatment. Participants reported that the program was satisfactory.ConclusionsThis study suggested that a counsellor-guided culturally adapted internet-based mindfulness intervention was feasible, acceptable, and associated with improvements in psychological distress, well-being, and mindfulness among university students in Indonesia. A randomized controlled trial with follow-up is needed to evaluate the intervention’s effectiveness.PreregistrationThis trial was preregistered on the Australian New Zealand Clinical Trial Registry (ACTRN12620000135910).

SMART Family and Friends: Feasibility and outcomes of a video-conference delivered intervention for families impacted by another's methamphetamine use

IntroductionFamilies affected by another's substance use, including methamphetamine, experience harms to their mental and physical health. Yet, research has paid little attention to support and service needs of this population. This pilot study examines the feasibility and outcomes of SMART Family and Friends, a video-conference-delivered mutual-support group targeting families affected by another's methamphetamine use. MethodsRecruitment for this study occurred between March–October 2021 via the SMART Recovery Australia website. Participants were English-speaking Australian residents, ≥18 years, affected by another's methamphetamine use, interested in participating in a manualised eight-module group delivered via video-conferencing. Feasibility was evaluated by attendance rates, participant satisfaction, fidelity ratings, and semi-structured interviews. Measures of distress, quality of life, and family functioning assessed outcomes at baseline and one-month post-treatment conclusion. ResultsForty-three participants commenced SMART Family and Friends groups. 84 % (n = 36) completed ≥4 modules, 67 % (n = 29) completed ≥6, and 42 % (n = 18) completed all 8 modules. Participant satisfaction (M = 4.32, SD = 0.66, out of 5) and facilitator fidelity (>94 % for all modules) were high. A within-group analysis, without comparison condition demonstrated significant improvements in psychological distress (d = 0.38), family impact (d = 0.64), family strain symptoms (d = 0.48), and total family burden (d = 0.69) post-treatment. Qualitative findings illustrated the benefits and challenges of the video-conference-delivered group, as well as recommendations for improvement. ConclusionsResults provide initial support for the feasibility and positive outcomes of the SMART Family and Friends program. These findings demonstrate the successful provision of a mutual-support group for affected families delivered via video-conferencing, and merit further sufficiently powered randomised-control-trials to evaluate efficacy.

P1079 Mindfulness-based cognitive therapy to reduce psychological distress in patients with Inflammatory Bowel Disease: first results of a multicentre randomised controlled trial (MindIBD)

Abstract Background Many patients with Inflammatory Bowel Diseases (IBD) suffer from psychological distress and fatigue. Moreover they report a reduced quality of life. The availability of psychosocial treatment options is limited. As mindfulness-based cognitive therapy (MBCT) has been shown to reduce psychological distress and fatigue, and improve quality of life in other populations, MBCT might also be effective in patients with IBD. Methods The MindIBD study was a prospective, multicentre, randomised controlled trial, conducted in one academic and three general hospitals in the Netherlands. Patients of 16 years and older with a confirmed IBD diagnosis were eligible if the IBD was in remission (based on faecal calprotectin &amp;lt;250 mg/kg and no changes in IBD medication for at least three months) and they experienced at least mild psychological distress (based on Hospital Anxiety and Depression Scale (HADS) total score ≥ 11). Participants were allocated in the intervention group (MBCT plus treatment as usual) or control group (treatment as usual alone). Assessments were conducted at baseline, post-intervention (3 months) and at 6, 9 and 12 months after baseline. Primary outcome was the effect on psychological distress post-intervention. Secondary outcomes included fatigue, perceived disease control, disease activity, disease-specific quality of life and positive mental health. This trial was registered at ClinicalTrials.gov: NCT04646785. Results A total of 142 IBD patients were randomly assigned to the intervention group (n=70) or the control group (n=72). The study population had a median age of 50 years (IQR 39-59 years), consisted of 91 women (64%) and 68 participants (48%) were diagnosed with Crohn’s disease. Post-intervention, participants in the intervention group showed a mean decrease on the HADS total of 4.7 ± 6.3 points compared to a mean decrease of 1.2 ± 5.2 points in the control group. This difference in improvement of psychological distress was statistically significant (p&amp;lt;0.001), and this benefit was maintained during follow-up (p=0.005). MBCT did also result in a significant improvement on fatigue (p=0.022) and positive mental health (p=0.022) post-intervention. These improvements remained in favour of the intervention group during follow-up, although not significantly different. No differences were found on perceived disease control, disease activity and disease-specific quality of life. Conclusion MBCT reduces psychological distress and improves fatigue and positive mental health. Therefore MBCT can be considered as a valuable addition to the limited psychosocial interventions for patients with IBD to improve psychological distress, fatigue and positive mental health.

How do mindfulness and compassion programs improve mental health and well-being? The role of attentional processing of emotional information

Background and objectivesAlthough the benefits of Meditation-Based Programs are well documented, the mechanisms underlying these benefits have not been fully elucidated. Therefore, we examined whether: (1) formal training in mindfulness and compassion meditation modifies the distribution of attentional resources towards emotional information; and (2) whether changes in attentional processing of emotional information after the meditation programs mediate the improvements in psychological distress, emotion regulation, and well-being. MethodsA sample of 103 participants enrolled in the study: 36 in the mindfulness program (MBSR), 30 in the compassion program (CCT), and 37 in the no-intervention comparison group (CG). The assessment before and after the programs included the completion of an emotional Attentional Blink task (AB) together with self-report measures of psychological distress, emotion regulation, and well-being. ResultsMBSR and CCT reduced similarly the AB deficit, whereas no changes occurred in the CG. This AB reduction was found for the different emotional and non-emotional stimuli (i.e., negative, positive, and neutral), showing a significant disengagement from first-target emotions and significant accessibility of second-target emotions to consciousness. The effects of both meditation programs on the psychological measures were mediated by changes in the AB and emotion regulation skills. LimitationsDue to our naturalistic design in a real-world community setting, random assignment of participants was not feasible. ConclusionsMeditation may promote more flexible and balanced attention to emotional information, which may be a key transdiagnostic mechanism underlying its benefits on emotional distress and well-being.

Sixteen years of innovation in youth mental healthcare: Outcomes for young people attending Australia's headspace centre services.

Australia's headspace initiative is world-leading in nation-wide youth mental healthcare reform for young people aged 12 to 25 years, now with 16 years of implementation. This paper examines changes in the key outcomes of psychological distress, psychosocial functioning, and quality of life for young people accessing headspace centres across Australia for mental health problems. Routinely collected data from headspace clients commencing an episode of care within the data collection period, 1 April 2019 to 30 March 2020, and at 90-day follow-up were analysed. Participants came from the 108 fully-established headspace centres across Australia, and comprised 58,233 young people aged 12-25 years first accessing headspace centres for mental health problems during the data collection period. Main outcome measures were self-reported psychological distress and quality of life, and clinician-reported social and occupational functioning. Most headspace mental health clients presented with depression and anxiety issues (75.21%). There were 35.27% with a diagnosis: overall, 21.74% diagnosed with anxiety, 18.51% with depression, and 8.60% were sub-syndromal. Younger males were more likely to present for anger issues. Cognitive behavioural therapy was the most common treatment. There were significant improvements in all outcome scores over time (P<0.001). From presentation to last service rating, over one-third had significant improvements in psychological distress and a similar proportion in psychosocial functioning; just under half improved in self-reported quality of life. Significant improvement on any of the three outcomes was shown for 70.96% of headspace mental health clients. After 16 years of headspace implementation, positive outcomes are being achieved, particularly when multi-dimensional outcomes are considered. A suite of outcomes that capture meaningful change for young people's quality of life, distress and functioning, is critical for early intervention, primary care settings with diverse client presentations, such as the headspace youth mental healthcare initiative.

Feasibility of delivering a virtual 1-day acceptance and commitment therapy workshop to rural veterans through community partnerships

BackgroundThis single-arm, open pilot study examined the feasibility and initial efficacy of a 1-day virtual Acceptance and Commitment Therapy (ACT) group workshop for distressed veterans. MethodsWe collaborated with veteran-serving community-based organizations to enhance outreach to veterans, especially those in rural areas. Veterans completed a baseline assessment and two follow-up assessments (1 month, 3 months) after workshop participation. Feasibility outcomes included reach (workshop recruitment and completion rates; veteran characteristics) and acceptability (open-ended survey question about satisfaction). Clinical outcomes included psychological distress (Outcome Questionnaire-45), stressor-related distress (PTSD Checklist-5), community reintegration (Military to Civilian Questionnaire), and meaning and purpose (PROMIS Short Form). Psychological flexibility (Action and Acceptance Questionnaire-II) – the proposed change mechanism underlying ACT – was also measured. ResultsSixty-four veterans (50% rural, 39% self-identified as female) participated in a virtual workshop (97.1% completion rate). Overall, veterans liked the format and interactive nature of workshops. Convenience was noted as a benefit, while connectivity issues were highlighted as a drawback. Veterans showed improvements in psychological distress (F(2,109) = 3.30; p = 0.041), stressor-related distress (F(2,110) = 9.50; p = 0.0002), community reintegration (F(2,108) = 4.34; p = 0.015), and meaning and purpose (F(2,100) = 4.06; p = 0.020) over time. No between-group differences were detected, based on rurality or gender. ConclusionPilot findings were promising and warrant a larger randomized trial to assess the efficacy of the 1-day virtual ACT workshop. Integrating community-engaged and participatory-research designs can enhance the external validity of these future studies and promote greater health equity.

A Digital Lifestyle Program for Psychological Distress, Wellbeing and Return-to-Work: A Proof-of-Concept Study

ObjectiveTo demonstrate proof-of-concept for a chatbot-led digital lifestyle medicine program in aiding rehabilitation for return-to-work. DesignRetrospective cohort study with pre-post measures. SettingCommunity setting, Australia. Participants78 adult participants (mean age 46 years, 32% female) with an active workers’ compensation claim (N=78). InterventionsA 6-week digital lifestyle medicine program led by an artificially intelligent virtual health coach and weekly telehealth calls with a health coach. Main Outcome MeasuresAdherence (% program completions) and engagement (% of daily and weekly sessions completed), changes in depression, anxiety and distress (K10), psychological wellbeing (WHO-5), return-to-work confidence and anxiety and change in work status. ResultsSixty participants completed the program (72%), with improvements in psychological distress (P≤.001, r=.47), depression (P<.001, r=.55), anxiety (P<.001, r=.46) and wellbeing (P<.001, r=.62) were noted, as well as increased confidence about returning to work (P≤.001, r=.51) and improved work status (P≤.001). Anxiety about returning to work remained unchanged. Participants completed an average of 73% of daily virtual coach sessions and 95% of telehealth coaching sessions. ConclusionsArtificial intelligence technology may be able to provide a practical, supportive, and low-cost intervention to improve psychosocial outcomes among individuals on an active workers’ compensation claim. Further, controlled research is needed to confirm these findings.

Mentalizing and epistemic trust as critical success factors in psychosomatic rehabilitation: results of a single center longitudinal observational study.

Inpatient psychosomatic rehabilitation is a key treatment for patients with mental health issues. However, knowledge about critical success factors for beneficial treatment outcomes is scarce. The aim of this study was to evaluate the association of mentalizing and epistemic trust with the improvement of psychological distress during rehabilitation. In this naturalistic longitudinal observational study, patients completed routine assessments of psychological distress (BSI), health-related quality of life (HRQOL; WHODAS), mentalizing (MZQ), and epistemic trust (ETMCQ) before (T1) and after (T2) psychosomatic rehabilitation. Repeated measures ANOVA (rANOVAs) and structural equation models (SEMs) were calculated to investigate the association of mentalizing and epistemic trust with the improvement in psychological distress. A total sample of n = 249 patients were included in the study. Improvement in mentalizing was correlated with improvement in depression (r = 0.36), anxiety (r = 0.46), and somatization (r = 0.23), as well as improved cognition (r = 0.36), social functioning (r = 0.33), and social participation (r = 0.48; all p < 0.001). Mentalizing partially mediated changes in psychological distress between T1 and T2: the direct association decreased from β = 0.69 to β = 0.57 and the explained variance increased from 47 to 61%. Decreases in epistemic mistrust (β = 0.42, 0.18-0.28; p < 0.001) and epistemic credulity (β = 0.19, 0.29-0.38; p < 0.001) and increases in epistemic trust (β = 0.42, 0.18-0.28; p < 0.001) significantly predicted improved mentalizing. A good model fit was found (χ2 = 3.248, p = 0.66; CFI = 0.99; TLI = 0.99; RMSEA = 0.000). Mentalizing was identified as a critical success factor in psychosomatic inpatient rehabilitation. A key component to increase mentalizing in this treatment context is the improvement of epistemic mistrust.

Improvements in psychological distress in patients participating in a cooking programme following digestive cancer surgery: A retrospective, propensity score-matched pilot study

Introduction: This retrospective pilot study evaluated whether an Instrumental Activities of Daily Living intervention relieves psychological distress during hospital stays after digestive cancer surgery. Methods: In all, 24 patients were divided into two groups according to the experience of cooking programme during hospital stay (‘control group’, n = 11 and ‘cooking group’, n = 13) and both groups received usual postoperative care. The two groups were matched using propensity scores to reduce the potential for confounding factors. Outcome measures included psychological distress assessed by the Hospital Anxiety and Depression Scale and Basic Activities of Daily Living assessed by the Functional Independence Measure. Assessment time points were after surgical treatment and before discharge. Results: Propensity score matching generated nine pairs (‘control group’, n = 9 and ‘cooking group’, n = 9). The Functional Independence Measure improved in both groups ( p = 0.008, r = 0.89) and the improvements in the Hospital Anxiety and Depression Scale were only found in the cooking group ( p ⩽ 0.049, r ⩾ 0.66). Conclusion: We found significant improvement in Basic Activities of Daily Livings in both groups and additional improvements in psychological distress in the cooking group. These observations suggest that Instrumental Activities of Daily Living-based intervention could improve mental health in patients with cancer in their early postoperative period.

Adventure-Based Cognitive Behavioral Intervention for Hong Kong University Students: A Randomized Controlled Study

Purpose: This study developed and evaluated an adventure-based cognitive behavioral intervention (aCBI) program to respond to the higher education mental health crisis in Hong Kong. Methods: The aCBI program was delivered in the form of a 13-week general education (GE) course and was evaluated at pre-, post-, and 3-month follow-up. A total of 544 undergraduate students who experienced psychological distress were randomized to either the aCBI group (n = 197) or the wait-list control group (WLC) (n = 347). Results: Compared with their WLC counterparts, the aCBI participants showed significantly stronger improvements in psychological distress, perceived stress, positive and negative emotions, and resilience at the posttest and 3-month follow-up. Positive and negative thoughts and sense-making coping partially mediated the treatment effects of aCBI. Conclusions: The aCBI program shows promise for inclusion in higher education curriculums to bridge the mental health service gaps for Chinese university students.

Analysis of Patient Characteristics in the Inpatient Treatment of Behavioural Addictions: an Exploratory Study

Clinical research on the treatment of behavioral addictions is still scarce. The current study aims to analyze the therapy model for behavioral addictions implemented at the Privatklinik Meiringen, a psychiatric hospital in Switzerland. Patient characteristics over a period of two years were analyzed, documenting abnormalities and changes in their psychological state. A total of 49 individuals between the ages of 18 and 64 were included from the inpatient setting. The patient characteristics were presented with descriptive statistics. Using validated measuring instruments, the psychological state of the patients at the time of admission and discharge was recorded and analyzed. All study participants suffered from psychological comorbidities besides the diagnosis of behavioral addiction. Depression constituted the most common comorbidity, whereas the distribution and incidence of comorbidities varied depending on specific behavioral addiction present in the patient. A clear improvement in psychological distress between the first and the last surveys could be demonstrated. The study provides an exploratory insight into the peculiarities of characteristics of patients suffering from behavioral addiction in an inpatient setting and an overview of their comorbidity spectrum. The retrospective nature of the study prevents an assessment of the effectiveness of the therapy.

The insomnia, fatigue, and psychological well-being of hospital nurses 18 months after the COVID-19 pandemic began: Across-sectional study.

BackgroundResearch has shown sleep problems, elevated fatigue, and high cases of burnout, as well as signs of post‐traumatic stress and psychological distress among nurses during the COVID‐19 pandemic. Many US hospitals attempted to minimise its impact on staff by providing basic resources, mental health services, and wellness programs. Therefore, it is critical to re‐evaluate these well‐being indices and guide future administrative efforts.PurposeTo determine the long‐term impact of the COVID‐19 pandemic after 18 months on hospital nurses' insomnia, fatigue, burnout, post‐traumatic stress, and psychological distress.DesignCross‐sectional.MethodsData were collected online mainly through state board and nursing association listservs between July–September 2021 (N = 2488). The survey had psychometrically tested instruments (Insomnia Severity Index, Occupational Fatigue Exhaustion Recovery Scale, Maslach Burnout Inventory, Short Post‐Traumatic Stress Disorder, and Patient Health Questionnaire‐4) and sections on demographics, health, and work. The STrengthening the Reporting of Observational studies in Epidemiology checklist was followed for reporting.ResultsNurses had subthreshold insomnia, moderate‐to‐high chronic fatigue, high acute fatigue, and low‐to‐moderate intershift recovery. Regarding burnout, they experienced increased emotional exhaustion and personal accomplishment, and some depersonalisation. Nurses had mild psychological distress but scored high on post‐traumatic stress. Nurses who frequently cared for patients with COVID‐19 in the past months scored significantly worse in all measures than their co‐workers. Factors such as nursing experience, shift length, and frequency of rest breaks were significantly related to all well‐being indices.ConclusionNurses' experiences were similar to findings from the early pandemic but with minor improvements in psychological distress. Nurses who frequently provided COVID‐19 patient care, worked ≥12 h per shift, and skipped rest breaks scored worse on almost all well‐being indices.Relevance to clinical practiceAdministration can help nurses' recovery by providing psychological support, mental health services, and treatment options for insomnia, as well as re‐structure current work schedules and ensure that rest breaks are taken.

The safety and efficacy of psilocybin therapy in patients with cancer and major depressive disorder.

12097 Background: More than 17 million people in the U.S. live with cancer and up to 25% of them have major depression. Depression leads to lower treatment adherence, reduced quality of life, and higher rates of mortality in cancer. Yet, interventions used to treat depression in patients with cancer have limited success. Prior trials using psilocybin to treat anxiety and depression associated with cancer suggested improvements in psychological distress. However, treatment in a homogenous psychiatric sample has yet to be investigated. Further, psilocybin has not been given in groups, and in a setting conducive to the “whole person” approach to treatment. This trial built upon previous studies and tested the safety, feasibility, and efficacy of psilocybin therapy in cancer patients diagnosed with major depressive disorder (MDD), with the novel use of group treatment in a cancer center setting. Methods: Phase II, single-center, open label trial, where 30 patients received a dose of 25 mg of psilocybin. Inclusion criteria: 1) age ≥ 18 years, 2) met criteria for MDD, 3) a Hamilton Depression Rating Scale score ≥ 18 at baseline, 4) diagnosis of a malignant neoplasm. Patients who had curative treatment for cancer as well as those with advanced metastatic disease were included. Patients were divided into cohorts and they received 1 group preparation session, simultaneous administration of psilocybin, and 2 group integration sessions. Therapeutic care was also provided before, during, and after the session using the 1:1 model of psychological support. The primary outcome measures for safety were adverse events, vital signs, ECGs, blood tests, and suicidality scores (C-SSRS). The secondary and exploratory outcome measures consisted of 15 assessments conducted at baseline and post-treatment at day 1, week 1, week 3, and week 8 to determine the efficacy of treatment. Results: A total of 30 patients were enrolled over the course of only 8 months with an attrition rate of 0%. All completed the trial with no serious adverse events. Beyond high tolerability of the treatment, we also found a clinically meaningful change in depressive symptoms. After a single administration of psilocybin therapy, the average score on the Montgomery Asberg Depression Rating Scale (MADRS) dropped by 19.1 points (95% CI, 22.3 to 16.0, p &lt; 0.0001). A sustained response rate (a decrease of ≥ 50% in the MADRS score from baseline to week 8) was seen by 24 patients. 50% of patients showed complete remission of depression symptoms (a MADRS score &lt; 10) one week after treatment, which was sustained for up to 8 weeks. Conclusions: This study adds to the growing body of psilocybin research with promising results showing the safety, feasibility, and efficacy of simultaneous psilocybin treatment in patients with cancer with MDD. The value of group support for patients with cancer was also explored, with implications for increased scalability of psilocybin therapy in real-world settings. Clinical trial information: NCT04593563.

A workplace Acceptance and Commitment Therapy (ACT) intervention for improving healthcare staff psychological distress: A randomised controlled trial.

The levels of psychological distress and burnout among healthcare staff are high, with negative implications for patient care. A growing body of evidence indicates that workplace programmes based on Acceptance and Commitment Therapy (ACT) are effective for improving employees’ general psychological health. However, there is a paucity of research examining the specific psychological and/or behavioural processes through which workplace ACT programmes transmit their beneficial effects. The aim of this randomised controlled trial was to investigate the outcomes and putative processes of change in a 4-session ACT training programme designed to reduce psychological distress among healthcare staff (n = 98). Ninety-eight employees of a healthcare organisation were randomly allocated to the ACT intervention or to a waiting list control group. Study measures were administered on four occasions (baseline, mid-intervention, post-intervention, and follow-up) over a three-month evaluation period. Results showed that the ACT intervention led to a significant decrease in symptoms of psychological distress and a less pronounced reduction in burnout. These effects were mediated primarily via an improvement in mindfulness skills and values-based behaviour and moderated by participants’ initial levels of distress. At four-week post-intervention, 48% of participants who received the ACT intervention showed reliable improvements in psychological distress, with just under half of the aforementioned improvements (46.15%) meeting criteria for clinically significant change. The results advance ACT as an effective stress management intervention for healthcare staff. The findings should be confirmed in a large scale randomised controlled trial with longer follow-up and cost-effectiveness analyses.

A Novel Psychological Group Intervention Targeting Appearance-Related Distress Among People With a Visible Disfigurement (Inside Out): A Case Study

People with a medical condition that leads to visible disfigurement often face significant psychosocial challenges related to their disfigurement, such as psychological distress, negative self-esteem and feelings of shame. In addition, they often encounter social difficulties including stigmatization, dealing with reactions of others and limitations in personal relationships. The availability of evidence-based psychological support tailored to these specific patients’ needs is limited. The aim of this study is to describe the development and content of Inside Out, a 5-session, theory-based psychological group intervention for people with a visible disfigurement due to a medical condition. This group intervention is based on a combination of Cognitive Behavioral Therapy, Acceptance and Commitment Therapy, and Competitive Memory Training. One case, a woman with facial palsy and psychological distress due to appearance-related problems, is presented to illustrate the intervention. This detailed description provides an in-depth illustration of the course and content of this treatment. Qualitative results show that this treatment is feasible and highly valued by the patient. Scores on pre-, post- and 3-month follow-up assessments showed improvements in psychological distress and level of acceptance of the condition. This case study shows how a psychological group intervention might contribute to the improvement of psychological wellbeing in individuals with a visible disfigurement.

The contribution of skills to the effectiveness of dialectical behavioral therapy.

The present study investigated the effectiveness of dialectical behavioral therapy (DBT) and the effect of improvement in DBT skills on clinical outcomes. Participants included 57 adults who attended a community mental health service and underwent one of two modes of DBT. Twenty-six adults had been diagnosed with borderline personality disorder (BPD) and participated in comprehensive DBT (DBT-C; including group skills training, individual therapy, and phone coaching). Thirty-one adults had BPD traits and participated in DBT skills training (DBT-S; group skills training only). In the present study, the DBT skills examined were mindfulness, emotion regulation, and interpersonal effectiveness; the clinical outcomes examined were borderline symptoms, psychological distress, and quality of life. Six 2 × 2 analysis of covariances indicated significant improvements in psychological distress, quality of life, mindfulness, and interpersonal effectiveness (but not borderline symptoms and emotion regulation), over a 6-month period. Mode of delivery of DBT did not impact on the improvement in DBT skills and clinical outcomes over the 6-month period. Hierarchical multiple regression results indicated that improvement in DBT skills (mindfulness, emotion regulation, and interpersonal effectiveness) were associated with reductions in borderline symptoms and psychological distress, with emotion regulation the only skill uniquely associated with improvements in clinical outcomes. The results of the present study support the effectiveness of DBT and the specific role of emotion regulation for favorable clinical outcomes over a 6-month period, independent of the mode of delivery of DBT.

Psychological Interventions for Children with Autism during the COVID-19 Pandemic through a Remote Behavioral Skills Training Program.

COVID-19 has impacted negatively on the mental health of children with autism spectrum disorder (ASD), as well as on their parents. Remote health services are a sustainable approach to behavior management interventions and to giving caregivers emotional support in several clinical domains. During the COVID-19 pandemic, we investigated the feasibility of a web-based behavioral skills training (BST) program for 16 parents and their children with ASD at home. The BST parent training package was tailored to each different specific behavioral disorder that characterizes children with ASD. After training, we found a significant reduction in the frequency of all the targeted behavioral disorders, as well as an improvement in psychological distress and the perception of the severity of ASD-related symptoms in parents. Our data confirm the efficacy of remote health care systems in the management of behavioral disorders of children with ASD, as well as of their parents during the COVID-19 pandemic.

Satisfaction and Mental Health Outcomes Associated with a Large Regional Helpline.

We surveyed users of a behavioral health helpline serving New York City and surroundings, to assess their helpline experiences, changes in psychological distress after contacting the helpline, and factors associated with differences in these measures. We surveyed users twice: roughly 2 weeks following their helpline contact, from 4/2019 to 9/2019 (N = 1097 respondents) and again 6 months following contact, from 10/2019 to 3/2020 (N = 732 respondents). Eighty-nine percent of respondents reported that contacting the helpline helped them deal a little or a lot more effectively with their problems. Rates of psychological distress decreased from 41.3% 2 weeks following helpline contact to 29.0% 6 months after (P < 0.05). Improvements in psychological distress were found across a range of demographic characteristics and were greatest for repeat users. Users reported broadly positive experiences with the helpline and improved psychological distress 6 months later. Behavioral health helplines can offer beneficial services to diverse populations, complementing the formal behavioral healthcare system.Supplementary InformationThe online version contains supplementary material available at 10.1007/s10597-021-00931-5.