Measures Of Anxiety Research Articles

The psychosocial impact of alopecia in men: A mixed-methods survey study.

The most common forms of hair loss in men, alopecia areata (AA) (an autoimmune condition) and androgenetic alopecia (AGA) (pattern baldness), alter individuals' appearance in ways that may impact psychological and social wellbeing. We currently have a limited understanding about this impact of alopecia in men, their support needs, and preferences. We sought to investigate and explore the psychosocial impact of alopecia on men, alongside their experiences of treatment and support. The study used a mixed methods cross-sectional online survey with 177 men aged 17-79: 83 with AGA and 94 with AA. Quantitative questions included purpose-made rating scales of men's support experiences, and standardised measures of wellbeing and appearance-focused anxiety. Qualitative data comprised participants' answers to an open-ended question asking about their subjectively salient experiences related to their alopecia. The combined findings indicate that while participants in both subsamples had sought minimal support for psychosocial concerns, such concerns were in fact commonplace. Over half of participants (56%-57%) shared qualitative accounts of depleted confidence, while wellbeing scores were on average lower than matched norms. Participants identifying as sexual minority also reported greater appearance-focused anxiety compared to those identifying as straight. The apparent contrast between participants' minimal help-seeking and accounts of affected wellbeing suggests an unmet support need for men with alopecia. Masculine norms may impede men from accessing psychosocial support, both by discouraging help-seeking behaviours and by encouraging minimisation of appearance concerns. The findings also suggest sexual minority status may pose a greater risk of distress in affected men.

Feeling anxious and being engaged in a warming world: climate anxiety and adolescents' pro-environmental behavior.

Climate anxiety is increasingly prevalent among adolescents worldwide. Are climate-anxious adolescents prone to engage in pro-environmental behavior? Or might the association between climate anxiety and pro-environmental be curvilinear, such that high levels of climate anxiety become 'paralyzing'? And do these associations depend on whether adolescents believe that, with effort, the worst impacts of climate change can still be prevented? We addressed these questions in three studies (two preregistered; combined N = 2,211), conducted across two countries. We used cross-sectional and longitudinal methods, and various measures of climate anxiety and pro-environmental behavior. We performed Bayesian regression analyses comparing two models that tested competing hypotheses. The first model included a linear effect of climate anxiety on pro-environmental behavior, and the second model included both a linear and a curvilinear (i.e. inverted U-shaped) effect of climate anxiety on pro-environmental behavior. Next, we added environmental efficacy to the best fitting model and explored its moderating effects. Adolescents reported low-to-moderate levels of climate anxiety. Across the board, we found evidence for a small, positive, and mostly linear (rather than curvilinear) association between climate anxiety and pro-environmental behavior. While Study 1 supported a curvilinear association (Bayes Factor (BF) = 18.87), Studies 2 and 3 mostly supported a linear model (BFs range 6.86-12.71), except for weak support (BF = 1.62) for a curvilinear association between climate anxiety symptoms and public sphere pro-environmental behavior. Adolescents' environmental efficacy moderated this link for public sphere (e.g. activism), but not private sphere (e.g. recycling), pro-environmental behavior. Climate-anxious adolescents are prone to engage in pro-environmental behavior. We found limited evidence for 'eco-paralysis' (i.e. a passive state of pro-environmental behavioral stasis) at high levels of climate anxiety. Our results are consistent with the possibility that supporting adolescents' environmental efficacy will help climate-anxious adolescents engage in public sphere pro-environmental behavior.

Fecal microbiota transplantation of patients with anorexia nervosa did not alter flexible behavior in rats.

Patients with anorexia nervosa (AN) are often anxious, display inflexible behavior and disrupted reward processing. Emerging evidence suggests that gut dysbiosis in patients contributes to the disease phenotype and progression. In a preclinical study, we explored whether AN-derived microbiota impacts cognitive flexibility, anxiety, and dopamine signaling using fecal microbiota transplantation (FMT) in tyrosine hydroxylase-cre rats. We performed probabilistic reversal learning task (PRLT) at the baseline, after antibiotic treatment, and following FMT from patients with AN and controls. We assessed flexible behavior, task engagement, and ventral tegmental area (VTA) dopamine signaling during and in the absence of reward. Furthermore, anxiety-like behavior was evaluated with open field (OF) and elevated plus maze (EPM) tests. Neither antibiotic-induced dysbiosis nor AN FMT led to significant alterations in the number of reversals or lever press strategies after reinforced or nonreinforced lever presses (win and lose-stay) in the PRLT. However, the number of initiated trials decreased after antibiotic treatment while remaining unchanged after FMT. No significant differences were observed in VTA dopamine activity, anxiety measures in the OF and EPM tests. Microbiome analysis revealed limited overlap between the microbiota of the donors and recipients. No evidence was found that the microbiota of patients compared to controls, nor a depleted microbiome impacts cognitive flexibility. Nonetheless, antibiotic-induced dysbiosis resulted in reduced task engagement during the PRLT. The relatively low efficiency of the FMT is a limitation of our study and highlights the need for improved protocols to draw robust conclusions in future studies. While our study did not reveal direct impacts of AN-associated gut microbiota on cognitive flexibility or anxiety behaviors in our preclinical model, we observed a decrease in task engagement after antibiotic-induced dysbiosis, underscoring that the presence of a gut microbiome matters. Our findings underscore the need for further refinement in FMT protocols to better elucidate the complex interplay between gut microbiota and behaviors characteristic of anorexia nervosa.

Physicians’ Anxiety Post-COVID Pandemic: A Cross-Sectional Study

The psychological burden of physicians has been the focus of many researchers since the 1950s, and some papers have found a high prevalence of anxiety and depressive disorders among medical staff. Recent studies have shown that the coronavirus pandemic didn’t go easy on healthcare workers. The fact that it has been three years since the outbreak, has motivated our study. Which aims to evaluate the intensity of anxiety among medical personnel and the risk factors that could be incriminated post-COVID pandemic and if the level of anxiety is back to normal. This is a cross-sectional study, carried out with a survey split into 2 parts sociodemographic and work-related data, and the French version of the Hamilton anxiety scale, Statistical analysis was performed using Jamovi et Microsoft Excel. About half of the 116 physicians in our study had no anxiety (55.2%), while 21.6% had mild anxiety, 10.3% had moderate anxiety, and 12.9% had severe anxiety. The identified risk factors for anxiety were female gender, personal and family history of anxiety disorder, doing night shifts, and being a general practitioner. The anxiety rate of physicians is back to normal post-COVID pandemic. But we shouldn’t stop there. The mental health status of medical personnel depends on several of the factors listed above. Determining them would imply a call for the implementation of preventive measures for anxiety and depressive disorders among physicians. Because taking care of physicians is taking care of patients.

The roles of intolerance of uncertainty and mindfulness in psychological distress: a two-wave longitudinal study

Intolerance of uncertainty (IU) is a vulnerability factor that is believed to play a significant role in the development and maintenance of many affective disorders. Previous research indicated that the strength of the association between IU and psychological distress tend to change depending on certain trait characteristics. Therefore, the current study aimed to examine whether the interaction between IU and mindfulness will prospectively predict anxiety and depression measured five weeks later. The data were collected from 243 university students (129 female) between ages 18 and 29 at two different time points via questionnaires assessing intolerance of uncertainty, mindfulness, anxiety, and depression at time 1, followed by only measures of anxiety and depression at time 2. The results revealed that higher IU scores were associated with higher levels of depression for the participants who have low levels of mindfulness. A similar pattern was not observed for anxiety. The findings indicated that mindfulness prospectively predicts lower levels of depression only for the individuals who have lower levels of intolerance of uncertainty.

Handedness in schizophrenia and affective disorders: a large-scale cross-disorder study.

While most people are right-handed, a minority are left-handed or mixed-handed. It has been suggested that mental and developmental disorders are associated with increased prevalence of left-handedness and mixed-handedness. However, substantial heterogeneity exists across disorders, indicating that not all disorders are associated with a considerable shift away from right-handedness. Increased frequencies in left- and mixed-handedness have also been associated with more severe clinical symptoms, indicating that symptom severity rather than diagnosis explains the high prevalence of non-right-handedness in mental disorders. To address this issue, the present study investigated the association between handedness and measures of stress reactivity, depression, mania, anxiety, and positive and negative symptoms in a large sample of 994 healthy controls and 1213 patients with DSM IV affective disorders, schizoaffective disorders, or schizophrenia. A series of complementary analyses revealed lower lateralization and a higher percentage of mixed-handedness in patients with major depression (14.9%) and schizophrenia (24.0%) compared to healthy controls (12%). For patients with schizophrenia, higher symptom severity was associated with an increasing tendency towards left-handedness. No associations were found for patients diagnosed with major depression, bipolar disorder, or schizoaffective disorder. In healthy controls, no association between hand preference and symptoms was evident. Taken together, these findings suggest that both diagnosis and symptom severity are relevant for the shift away from right-handedness in mental disorders like schizophrenia and major depression.

The Path from Personality to Anxiety and Depression Is Mediated by Cognition in Multiple Sclerosis.

Multiple sclerosis (MS) is a neurodegenerative immunological disease causing significant impairment in all life areas. Therefore, personality changes are observed and associated with higher prevalence of depression and anxiety disorders. Considering this relationship, we hypothesized that clinical symptoms and personality disorders are more prevalent in MS and that dysfunctional psychological mechanisms mediate the path from personality disorders to clinical symptoms. The study sample consisted of 43 patients with MS (age M = 41.9, SD = 11.5) and 31 controls (age M = 39.8, SD = 10.3). Measures of personality, anxiety, depression, fatigue, health status, and dysfunctional psychological mechanisms were conducted. The prevalence of clinical symptoms was increased in MS patients as compared to controls. Also, dependent and schizoid personality traits (PTs) were observed in the patient sample. Negative automatic thoughts (NATs) were found to mediate the association between dependent PT and clinical symptoms. Along with schizoid PT, all dysfunctional psychological mechanisms impacted clinical symptoms. The results of our research are in line with previous studies showing that anxiety, depression, and dysfunctional personality traits are more prevalent in MS as compared to controls. PTs and dysfunctional psychological mechanisms predicted depression, anxiety, fatigue, and health status in MS patients. Cognition acts as a strong mediator between PTs and psychopathology in MS. Hence, integrative personalized psychological treatment is recommended to improve the quality of care in MS.

Death-is-life-enhancing: Adaptation and validation of the Norwegian Death Mindsets Measure (NDMM)

While existing psychological frameworks and their accompanying measures focus on death as anxiety-inducing and debilitating, we highlight an overlooked perspective of death—that death can be a basis for living with more meaning and presence. The present research adapts and validates the Death Mindsets Measure (DMM), which assesses the mindset that “death-is-life-enhancing,” for a Norwegian context. Firstly, we translated the DMM and consulted with Norwegian bereavement experts and bereaved Norwegians on items’ clarity and relevance to cultural perspectives of death. Secondly, we validated the Norwegian DMM (NDMM) on a predominantly bereaved community sample of Norwegians (N = 241). Using structural equation modeling, we confirmed the hierarchical two-factor structure of our measure. The NDMM also demonstrated high internal consistency and discriminant validity with existing death anxiety and death attitudinal measures. Finally, our measure explained additional variance in psychological well-being beyond existing death anxiety and attitudinal measures.

Library Anxiety Among Undergraduate Students with Visual Disabilities

Library anxiety, a phenomenon characterized by discomfort, fear, or other negative emotions associated with navigating libraries, is a significant issue for many undergraduate students. This study, which examined the library anxiety reported by 37 visually disabled undergraduate students across seven state universities in Indonesia, sheds light on this critical topic. The measurement of library anxiety was based on the Malay Version of Bostick's Library Anxiety Scale, as adapted by Karim and Rashid (2016), which includes three factors: barriers with service providers, affective boundaries, and comfort with library technology. The research also explores library anxiety as a variable itself. The findings, derived from a descriptive quantitative research method using purposive sampling, reveal that visually disabled students experienced low levels of library anxiety. However, the anxieties experienced involved navigating the library facility and engaging with library technology. Notably, library anxiety, as its culminating variable, showed that male students experienced a higher level of library anxiety than female students. This study underscores the importance of applying the Bostick scale to explore more disabled students’ experiences with library anxiety, providing valuable insights for educators, policymakers, and researchers.

Measurement of anxiety after childbirth. Polish version of Postpartum Specific Anxiety Scale – Research Short Form

Measurement of anxiety after childbirth. Polish version of Postpartum Specific Anxiety Scale – Research Short Form

Longitudinal associations of depression, anxiety, and stress among healthcare workers assisting patients with end-stage cancer during the COVID-19 pandemic: the moderator role of emotional exhaustion

BackgroundThis study aimed to analyze the moderating role of emotional exhaustion in the relationships between longitudinal associations of depression, anxiety, and stress among healthcare workers assisting end-of-life cancer patients during the COVID-19 pandemic.MethodsA longitudinal study involving a final sample of 122 healthcare workers (61.5% females, mean age = 39.09 ± 11.04 years) was conducted. These participants completed the Maslach Burnout Inventory (MBI) and the Depression Anxiety Stress Scales-21 (DASS-21). Results: Results of correlation analysis showed that emotional exhaustion was correlated with both T1 and T2 measures of depression, anxiety, and stress. Results of the moderation analysis indicated that emotional exhaustion moderated the relationships between consecutive measures of depression and anxiety. Each of the moderation models explained about half of the variance for depression and anxiety. When considering stress, results did not show a moderating role for emotional exhaustion.ConclusionsOverall, the results of this study highlight that emotional exhaustion moderated depression and anxiety over time. Psychological interventions to promote psychological mental health among healthcare workers assisting patients with end-stage cancer should carefully consider these findings.

Influence of Nurses' Perceptions of Government Policies and COVID-19 Risks on Their Mental Health Status: A Web-Based Cross-Sectional Study.

This study aimed to understand nurses' perceptions of COVID-19-related policies and risks during the outbreak of COVID-19 in Hong Kong and to determine how their perceptions influenced their mental health status. A web-based online survey among Hong Kong nurses was conducted. The questionnaire included a self-designed 5-point Likert scale with 17 items to assess the nurses' perceptions of COVID-19-related policies and risks, as well as the Davidson Trauma Scale (DTS), the Perceived Stress Scale (PSS), the Patient Health Questionnaire-2 (PHQ-2) and the Generalised Anxiety Disorder scale (GAD) for measurement of posttraumatic stress disorder (PTSD), stress, depression and anxiety, respectively. Of 592 nurses enrolled, 30.6% had PTSD (DTS total score ≥40), and 80.4%, 19.9% and 16.4% had moderate-to-high levels of stress (PSS-10 score ≥14), depression (PHQ-2 score ≥3) and anxiety (GAD score ≥3), respectively. The top three concerned aspects were 'worried about themselves and friends to suffer this disease' (84.5%), 'insufficient number of isolation wards' (81.8%) and 'insufficient number of personal protective equipment' (74.3%). Logistic regression analyses showed that more negative perception on 'personal protective equipment in the healthcare institutions', 'the confidence in HK's control of COVID-19', 'worried about themselves and friends to suffer this disease' and 'self-perceived risk of infection' indicated higher severity of the four mental health problems (all p < 0.01). The perception on 'public gathering ban', 'the number of isolation wards' and 'expected time to control COVID-19' were significantly associated with PTSD and stress (all p < 0.05). Nurses' perception on government policies and COVID-19 risks played an important role in predicting their mental health status. Policy makers should be aware of nurses' psychological responses and provide timely and targeted emotional support to nurses amid and after the COVID-19 pandemic.

Dealing with couple infidelity in romantic relationships: A group intervention feasibility study.

The extent to which group therapy benefits individuals who have experienced couple infidelity remains unexamined. In this study, a brief group intervention for individuals who experienced couple infidelity was designed, and the feasibility of the intervention was evaluated (i.e., acceptability; implementation; measurements' performance and, limited-efficacy testing). The final sample was composed of 20 women and 4 men (M = 29.95 years, SD = 12.3). Twenty-four completed pre and post assessments and 20 of these completed the follow-up assessment. At pre, post, and follow-up, participants responded to a questionnaire packet that included measures of depression, anxiety and PTSD symptoms, relationship self-efficacy, centrality of event, cognitive fusion, and decision to forgive. Also, follow-up interviews were conducted. The closed group intervention consisted of eight 90-min weekly sessions. The group therapy process component was based on solution-focused therapy. Psychoeducation component included mindfulness, reflection on personal values, factors that contribute to infidelity, and forgiveness. Session rating scores indicated an overall high acceptance of the intervention, its contents, and goals. Interview reports showed that dealing with thoughts and emotions, understanding infidelity, and forgiveness were the most helpful contents. Group support and processes were also positively valued. Repeated-measures MANOVA results indicated statistically significant decrease in symptoms, cognitive fusion, and importance of the event, as well as an increase in self-efficacy. Measurement instruments showed adequate reliability. These results indicate that a group treatment may be an alternative format to help individuals deal with psychological consequences of couple infidelity, when couple therapy is not possible.

Effect of virtual reality-based biofeedback for depressive and anxiety symptoms: Randomized controlled study

BackgroundThe use of virtual reality (VR)-based biofeedback (BF), a relatively new intervention, is a non-pharmacological treatment of depressive and anxiety symptoms. However, studies on VR-based BF are lacking and inconclusive. MethodsA total of 131 adults were recruited from the community. Participants who scored ≥10 on the Patient Health Questionnaire-9 (PHQ-9) or ≥9 on the Panic Disorder Severity Scale (PDSS) were included in the group with depressive or anxiety symptoms (DAS group), and others as the healthy control group (HC group). Participants from the DAS group were randomly assigned to VR-based or conventional BF intervention. All individuals visited at three times (weeks 0, 2, and 4), and completed the Montgomery-Asberg Depression Rating Scale (MADRS), the State-Trait Anxiety Inventory (STAI), and a visual analog scale (VAS) before and after the intervention, and PHQ-9 at the beginning and final visit. ResultsThe analysis included a total of 118 participants (DAS/VR: 40, DAS/BF: 38, HC/VR: 40). There was no significant difference in demographic variables among the three groups. After the intervention, the DAS/VR group exhibited significant decreases in MADRS (70.0 %), PHQ-9 (64.1 %), STAI (29.5 %), and VAS (61.7 %) scores compared to the baseline (p <0.001). There were no significant differences between the effects of VR-based BF and conventional BF with a therapist. The HC group also showed significant decreases in the measures of depression and anxiety after receiving VR-based BF. ConclusionVR-based BF was effective in reducing depressive and anxiety symptoms, even for subthreshold depression and anxiety symptoms in the HC group.

A comparison of patients with epileptic seizures (ES) versus those with psychogenic non-epileptic seizures (PNES) on measures of alexithymia, mood, and anxiety

ObjectiveTo compare persons with epilepsy (PWE) to those with psychogenic non-epileptic seizures (PNES) on measures of depression, anxiety, and alexithymia subscales (i.e., difficulty identifying emotions, difficulty describing emotions, and external-oriented thinking). Material and methodsIn this retrospective study, 235 epilepsy patients and 90 patients with PNES were evaluated between 2012 and 2020 at the Northeast Regional Epilepsy Group. These patients had completed the Toronto Alexithymia Scale (TAS-20), The Center for Epidemiologic Studies - Depression Scale (CES-D) and The State-Trait Anxiety Inventory (STAI). Background information was collected regarding work/student/disability status at the time of the evaluation history of psychiatric diagnosis; psychological trauma; and involvement in psychotherapy either at the time of the evaluation or prior. ResultsSignificant differences between PWEs and those with PNES were found not only in historical data (e.g., Psychiatric History, History of Trauma, and History of Therapy) (p < .001) but also on measures of Depression (p = .002) and Anxiety (p < .001). ANOVA analysis also revealed significant differences in the distribution of the TAS-Total score, TAS-Describing emotions, and TAS-Identifying emotions. Using logistic regression (stepwise model) the optimal set of predictors for a differential diagnosis of epilepsy and PNES was combination of TAS-Identifying emotions score, history of psychological trauma, and history of therapy. The accuracy of the prediction was determined to be 80.2 %. ConclusionsAlthough higher alexithymia rates are present in PNES and PWEs, clinicians may find a combination of TAS-Identifying Emotion score, history of trauma, and history of psychotherapy useful in supporting a differential diagnosis. Also, a subgroup may exist among those with PNES with high levels of alexithymia, depression, and anxiety that may require a different treatment approach focused on addressing difficulties in identifying and describing their emotions and their other symptomatology.

Web-Based Therapist-Guided Mindfulness-Based Cognitive Behavioral Therapy for Body Dysmorphic Disorder: Pilot Randomized Controlled Trial.

Internet-based cognitive behavioral therapy (CBT) and stand-alone mindfulness meditation interventions are gaining empirical support for a wide variety of mental health conditions. In this study, we test the efficacy of web-based therapist-guided mindfulness-based cognitive behavioral therapy (CBT-M) for body dysmorphic disorder (BDD), a psychiatric disorder characterized by preoccupations with perceived defects in appearance. This study aims to determine whether CBT-M for BDD delivered on the web is feasible and acceptable and whether mindfulness meditation adds to CBT treatment effects for BDD. In this 8-week, 2-arm, parallel pilot randomized controlled trial, n=28 adults (aged between 18 and 55 years) were randomly allocated to an experimental group (web-based therapist-guided CBT-M) or a control group (web-based therapist-guided CBT). Study retention, accrual, and intervention adherence were assessed, along with self-report measures for BDD, depression, anxiety, and pain intensity taken at baseline and postintervention. This study was feasible to implement and deemed acceptable by participants. After 8 weeks, significant improvements were found on all outcome measures for both treatment groups, and large between-group effect sizes favoring CBT-M were found for BDD symptom severity (d=-0.96), depression (d=-1.06), pain severity (d=-1.12), and pain interference (d=-1.28). However, linear mixed models demonstrated no significant differences between the groups over 8 weeks. The results suggest that mindfulness meditation may add to beneficial web-based CBT treatment effects for BDD. An adequately powered randomized control trial of web-based CBT-M is warranted. ClinicalTrials.gov NCT05402475, http://clinicaltrials.gov/ct2/show/NCT05402475.

The Prevalence of Maternal Depression and Anxiety Beyond 1 Year Postpartum: A Systematic Review.

Maternal depression and anxiety occurring beyond the 1-year postpartum period can lead to significant suffering for both mother and child. This study aimed to systematically review and synthesize studies reporting the prevalence and incidence of maternal depression and anxiety beyond 1 year post-childbirth. A systematic literature review of the PsycINFO, Medline, and Embase databases identified studies reporting on the prevalence and/or incidence of depression and/or anxiety among mothers between 1 and 12years post-childbirth. The quality of the included studies was assessed. Findings were synthesized qualitatively. Twenty-one studies were identified that met the inclusion and exclusion criteria. All studies reported the prevalence of depression, with 31 estimates ranging from 6.6% at 3 to 11years post-childbirth to 41.4% at 3 to 4 years post-childbirth. Five of these studies also reported the prevalence of depression in subgroups (e.g., ethnic origin, income, marital status). Four studies reported the prevalence of anxiety, with nine estimates ranging from 3.7% at 5 years post-childbirth to 37.0% at 3 to 4 years post-childbirth. Only one study reported incidence. The quality of the included studies was variable, with most studies scoring above 7/9. Maternal anxiety and depression remain prevalent beyond the first year postpartum, particularly in marginalized subgroups. Current observational studies lack consistency and produce highly variable prevalence rates, calling for more standardized measures of depression and anxiety. Clinical practice and research should consider the prevalence of maternal anxiety and depression beyond this period.

On the Measurement of Aging Anxiety: Comparative Validity of Two Popular Measures Among Older Adults

Aging anxiety is a distinct form of fear characterized by negative feelings associated with growing older. This study directly compared two common measures of aging anxiety within an older adult sample. Participants completed the Anxiety about Aging Scale, the Personal Anxiety Toward Aging Scale and several related constructs including ageism, expectations regarding aging, dementia worry, and death anxiety. The two measures significantly and strongly associated with one another. The Anxiety about Aging Scale (AAS) showed evidence of convergent validity through significant and strong correlations with ageism, expectations regarding aging, and death anxiety, and a moderate correlation with dementia worry. The Personal Anxiety Toward Aging Scale (PAAS) also showed evidence of convergent validity through strong correlations with expectations regarding aging and death anxiety, and moderate correlations with ageism and dementia worry. Factor analysis showed a better model fit for the AAS. Key findings lend support for the AAS as a psychometrically stronger measure than the PAAS for older adult assessment.

Neuropsychology intervention for managing invisible symptoms of MS (NIMIS-MS) group: A pilot effectiveness and acceptability study

BackgroundPeople with MS (pwMS) commonly experience a range of hidden symptoms, including cognitive impairment, anxiety and depression, fatigue, pain, and sensory difficulties. These “invisible” symptoms can significantly impact wellbeing, relationships, employment and life goals. We developed a novel bespoke online group neuropsychological intervention combining psychoeducation and cognitive rehabilitation with an Acceptance and Commitment Therapy (ACT)-informed approach for pwMS in an acute tertiary hospital. This ‘Neuropsychological Intervention for Managing Invisible Symptoms’ in MS (NIMIS-MS) consisted of 6 sessions, each with a psychoeducation and ACT component. The content included psychoeducation around managing cognitive difficulties, fatigue, pain, sleep and other unpleasant sensations in MS with the general approach of understanding, monitoring, and recognising patterns and potential triggers. Specific cognitive rehabilitation and fatigue management strategies were introduced. The ACT-informed component focussed on three core ACT areas of the ‘Triflex’ of psychological flexibility (Harris, 2019): Being Present, Opening Up, and Doing What Matters. Methods118 pwMS attended the NIMIS-MS group intervention which was delivered 14 times in six-week blocks over an 18-month period. To evaluate the effectiveness and acceptability, participants completed measures of depression and anxiety (HADS), functional impairment (WSAS), Values- Progress (VQ) and Values- Obstruction (VQ), and Acceptance of MS (MSAS) pre and post NIMIs-MS group intervention. Qualitative feedback was obtained during focus groups after the final session and via online feedback questionnaires ResultsPre-post analysis showed that symptoms of depression and anxiety were significantly lower and acceptance of MS was significantly higher following completion of the NIMIS-MS group. Qualitative feedback showed that participants reported that they felt more equipped to manage the “invisible” symptoms of MS following completion of the group, and benefited from using ACT-based strategies and techniques. Participants highly valued the peer support that evolved during the NIMIS-MS groups. The online format was considered more accessible than in-person groups, due to less concerns of travel time, cost, fatigue, and comfort and infection. ConclusionEvaluation suggests that our novel NIMIS-MS groups is an acceptable, beneficial and feasible approach for providing neuropsychological interventions to individuals with MS.

The factor structure of the Hopkins Symptom Checklist 25 among persons seeking HIV testing

ABSTRACT Rates of anxiety and depression are high among individuals living with HIV. The Hopkins Symptom Checklist (HSCL) is a screening tool to identify symptoms of depression and anxiety. The objective of this study was to determine the factor structure of the 25-item HSCL in a population-based sample of individuals seeking HIV testing in the Western Cape in South Africa. Participants volunteered for HIV testing at two non-medical HIV testing sites in the Western Cape. We used convenience sampling to administer the scale prior to their undergoing HIV testing. Data were analysed using exploratory factor analysis, using an extraction method of principal components with Promax (oblique) rotation. The Cronbach's alpha reliability indices were calculated for each of the independent factors to determine internal consistency. Factor analysis revealed a three-factor structure that explained 56.86% of the total variance. These factors included depression (14 items), anxiety (7 items) and somatic symptoms (4 items). Alpha levels ranged from 0.67 to 0.94. We found that the HSCL is a reliable measure for depression and anxiety, and consists of 3 distinguishable factors depression, anxiety, and somatic symptoms.