Measures Of Symptoms Research Articles

Patient Perception and Experience of Laparoscopic Excision vs. Ablation of endometriosis: a crowd-sourced comparative evaluation of symptom and Quality of Life outcomes

Study Objective: To compare laparoscopic Ablation and Excision in terms of symptom and Quality of Life outcomes as perceived by endometriosis patients. DesignA Cohort, Method comparison Questionnaire-based study SettingEndometriosis-focused Social Media site PatientsEndometriosis patients with history of Laparoscopic Ablation and Excision. InterventionsOn-line questionnaire focused on pre and post procedure (ablation and excision) outcomes across 63 measures in 5 realms: Physical Symptoms, Functional Impact, Psycho-emotional Impact, Social/Sexual Impact, Economic/Educational Impact. Measurements and Main Results232 respondents with surgical history that included laparoscopic ablation and excision (without concomitant or interposed hysterectomy) identified for ablation only physical symptom improvement of 11.3% and 8.5% for dysmenorrhea and menorrhagia respectively. Ablation provided no significant improvement in any other physical symptom measure. Excision was identified as providing improvements across all symptoms ranging from 28% to 46%.In terms of Functional Impact, ablation provided non-significant improvements or worsening of status. Excision demonstrated significant improvement for patients across most measures of Functional Impact.In terms of Psycho-emotional Impact, a worsening of QoL status is identified in 23 of 24 measures following ablation. Excision demonstrated improvement in 22 of 24 measures.For Social-Sexual Impact, ablation resulted in worsened status across all measures with excision demonstrating improvements in all measures, significantly so in most.For Economic/Educational Impact, significant worsening of measures or insignificant improvements were demonstrated following ablation. Excision demonstrated significant improvement in most measures.In all realms, pre-Excision status was worse than pre-Ablation.Allowing for a more focused comparison of ablation and excision, 113 respondents with a surgical history of ablation sequentially followed by excision demonstrated outcomes similar to the larger group: overall worsening of status resulting from ablation and overall improvement in status following excision with pre-Excision morbidity higher than pre-Ablation. ConclusionIn this cohort of patients undergoing laparoscopic endometriosis excision after having undergone endometriosis ablation, the former demonstrated greater beneficial effect over a broad spectrum of symptom and QoL measures.

Exploring correlations between Conners' Continuous Performance Test and subjective measures of attention deficit hyperactivity disorder symptoms in a paediatric clinical sample.

Attention deficit hyperactivity disorder (ADHD) is a childhood-onset neurodevelopmental condition characterised by inattention and/or hyperactivity-impulsivity. The ADHD symptoms are often evaluated and quantified using various assessment tools, such as the Conners' Continuous Performance Test II (CCPT-II), ADHD Rating Scale (ADHD-RS), Child Behaviour Checklist (CBCL), Clinical Global Assessment Scale (CGAS) and Clinical Global Impression Scale (CGIS). This study sought to compare CCPT-II with parent- and clinician-rated rating scales (ADHD-RS, CBCL, CGAS and CGIS) in measuring the core ADHD symptoms within the paediatric ADHD population. The data, gathered from a large-scale randomised controlled trial involving 172 children aged 6-12 years with ADHD, was pooled, and a Pearson correlation analysis was conducted. No significant correlations were observed between CCPT-II and ADHD-RS, as well as the various subscales of CBCL, CGAS and CGIS. While CCPT-II may offer insights into ADHD symptomatology, its relationship with parent- and clinician-rated rating scales such as ADHD-RS, CBCL, CGAS and CGIS appears limited. Further research is warranted to elucidate the nuances of these assessment tools and their roles in evaluating ADHD.

Understanding Intensive Care Unit Family Caregivers' Vulnerability to Post-Traumatic Stress Disorder: The Impact of Neurotic Personality Traits, Emotional Suppression, and Perceptions of Unexpected Death.

Rationale: Family members of patients who die in an intensive care unit (ICU) are at heightened risk of post-traumatic stress disorder (PTSD) symptoms. Not all surrogates develop these symptoms and heterogeneity exists in PTSD symptom clusters. Objectives: The study tested a personality model of PTSD symptoms in bereaved family caregivers of ICU patients. It was hypothesized that family members endorsing higher levels of neurotic personality traits would report higher levels of PTSD symptom clusters and that these associations would be explained by tendencies to view the patient's death as unexpected and to cope by suppressing their emotions. Methods: Participants were family members of ICU patients at an urban, academic medical center who either died or were discharged to an inpatient hospice unit. Participants were contacted for participation at least six months after the patient's death. Participants completed measures of personality, emotion regulation, and PTSD symptoms. Data were analyzed using path analysis. Results: Approximately one-third (35%) of the sample of 162 caregivers endorsed at-risk levels of PTSD. Individuals reporting higher levels of neurotic personality traits reported more PTSD symptoms (r = 0.53, p < 0.001). Perceptions that the patient death was unexpected partially explained the association of neuroticism with the intrusive re-experiencing PTSD symptoms (B = 0.45, p = 0.031). In contrast, emotional suppression partially explained the association of neuroticism with avoidance (B = 0.70, p = 0.010) and hyperarousal symptom clusters (B = 0.37, p = 0.041). Conclusions: Family vulnerability to PTSD after an ICU death can be conceptualized based on neurotic personality traits. Tendencies to view the patient's death as unexpected may contribute to intrusive thoughts and memories of the ICU experience. Individuals may avoid reminders and remain at heightened levels of arousal when they suppress their emotional experiences. Key Message: Family members who experience the death of a loved one following ICU treatment are vulnerable to PTSD symptoms. These reactions to ICU-related losses may be shaped by family members' personalities, expectations, and emotion regulation styles. Understanding these characteristics could inform family screening and intervention efforts in the ICU.

462P Evaluating EEG as an outcome measure for CNS Symptoms in myotonic dystrophy type 1: a clinical trial analysis

462P Evaluating EEG as an outcome measure for CNS Symptoms in myotonic dystrophy type 1: a clinical trial analysis

Childhood trauma and dissociative symptoms among young adults: A longitudinal study of the role of self-stigma

Dissociative symptoms, which are psychiatric phenomena recognized in both ICD-11 and DSM-5-TR, refer to failures in the process of integrating one's biopsychosocial experiences. While research shows that childhood trauma is associated with dissociative symptoms, little is known about whether childhood trauma could predict increases in dissociative symptoms even within a short period of time. Additionally, it remains unclear what moderators may influence this relationship. This study examined the effects of childhood trauma on subsequent dissociative symptoms and explored the potential moderating effects of mental health-related self-stigma. We analyzed longitudinal survey data from an international sample of young adults (N = 146). Participants completed validated standardized measures of childhood trauma, self-stigma, and dissociative symptoms at baseline, and they reported their dissociative symptoms again after approximately three months. Over 75 % of participants with pathological dissociation at baseline continued to exhibit pathological dissociation at follow-up. Baseline childhood trauma was associated with increases in dissociative symptoms even within a short period of time. Self-stigma significantly moderated the relationship between baseline childhood trauma and subsequent dissociative symptoms, after controlling for baseline dissociative symptoms. This study confirmed that childhood trauma is associated with increases in dissociative symptoms even within three months. We also found that self-stigma may exacerbate the effects of childhood trauma on subsequent dissociative symptoms. The results provide insights into the prevention and management of dissociative symptoms in childhood trauma survivors and inform the modification of the trauma model of dissociation.

The moderating role of sleep hours in the relationship between childhood trauma and depressive symptoms: A longitudinal investigation

Although childhood trauma has been identified as one of the major risk factors for depression, the potential mechanisms behind this relationship remain less clear. As sleep disturbances are associated with both childhood trauma and depression, this study examined the moderating effects of sleep hours on this relationship. The sample consisted of young adults from an international longitudinal survey project (N = 146). Participants completed validated screening measures of childhood trauma and depressive symptoms and reported their sleep hours at baseline (T1), and then reported their depressive symptoms again at follow-up (T2) after 3 months. Multiple regression and moderation analyses were used to analyze the data. T1 childhood trauma was positively correlated to depressive symptoms at both T1 (r = .26, p < .01) and T2 (r = .21, p < .05). After controlling for demographic variables and T1 depressive symptoms, T1 sleep hours significantly predicted T2 depressive symptoms (β = .136, p = .038). Furthermore, the number of sleep hours moderated the effects of T1 childhood trauma on T2 depressive symptoms. T1 childhood trauma predicted T2 depressive symptoms only when sleep hours were low (B = .2056, p = .0075). This study provided evidence that childhood trauma was significantly associated with aggravated depressive symptoms under sleep deprivation. Proactive management of sleep problems might be beneficial to people with childhood trauma. Future studies are needed to evaluate sleep-focused interventions for childhood trauma survivors.

The impact on obesity-related quality of life and eating satisfaction in the early period after laparoscopic sleeve gastrectomy.

Obesity impairs patients' quality of life (QoL). Laparoscopic sleeve gastrectomy (LSG) is a common procedure for patients with severe obesity; however, studies reporting changes in obesity-related QoL are limited. The aim of this study was to assess changes in obesity-related QoL and food tolerance in the early postoperative period. We included 20 consecutive patients who underwent LSG between May 2021 and July 2023. We evaluated changes in obesity-related QoL 6 months after surgery using an obesity and weight loss QoL questionnaire (OWLQOL) and a weight related symptom measure (WRSM). Additionally, we assessed eating satisfaction and food tolerance after surgery. The percentages of total weight loss and excess weight loss were 28.5% and 79.1%, respectively. OWLQOL scores and WRSM changed from 36.5 to 73.0 points and from 44.0 to 15.0 points (p = .007, .007), respectively. The food tolerance score decreased from 25 to 21.2 points (p < .001), while eating satisfaction showed no significant change (p = .25). Obesity-related QoL is enhanced even in the early postoperative period, without sacrificing eating satisfaction. The findings of this study may provide valuable insights for patients when considering LSG.

Low-dose titrated amitriptyline as second-line treatment for adults with irritable bowel syndrome in primary care: the ATLANTIS RCT.

Irritable bowel syndrome, characterised by abdominal pain and a change in stool form or frequency, is most often managed in primary care. When first-line therapies are ineffective, National Institute for Health and Care Excellence guidelines suggest considering low-dose tricyclic antidepressants as second-line treatment, but their effectiveness in primary care is unknown and they are infrequently prescribed by general practitioners. To evaluate the clinical and cost-effectiveness of low-dose titrated amitriptyline as a second-line treatment for irritable bowel syndrome in primary care. A pragmatic, randomised, multicentre, two-arm, double-blind, placebo-controlled trial. A nested, qualitative study explored participant and general practitioner experiences of treatments and trial participation, and implications for wider use of amitriptyline for irritable bowel syndrome in primary care. Participants, clinicians, investigators and analysts were masked to allocation. Fifty-five general practices in three regions in England (Wessex, West of England, West Yorkshire). Patients aged ≥ 18 years meeting Rome IV criteria for irritable bowel syndrome with ongoing symptoms after trying first-line treatments and no contraindications to TCAs. Amitriptyline 10 mg once-daily, self-titrated by participants to a maximum of 30 mg once-daily or matched placebo for 6 months. Participants randomised 1 : 1 with most having the option to continue blinded treatment for a further 6 months. The primary participant-reported outcome was the effect of amitriptyline on global irritable bowel syndrome symptoms at 6 months, measured using the irritable bowel syndrome Severity Scoring System, with a 35-point between-group difference defined as the minimum clinically important difference. The key secondary outcome was the proportion of participants reporting subjective global assessment of relief at 6 months, defined as somewhat, considerable, or complete relief of symptoms. Other secondary outcomes included: effect on global symptoms, via the irritable bowel syndrome Severity Scoring System, and subjective global assessment of relief of irritable bowel syndrome symptoms at 3 and 12 months; effect on somatic symptom-reporting at 6 months; anxiety an-d depression scores; ability to work and participate in other activities at 3, 6 and 12 months; acceptability, tolerability and adherence to trial medication. Four hundred and sixty-three participants were randomised to amitriptyline (232) or placebo (231). An intention-to-treat analysis of the primary outcome showed a significant difference in favour of amitriptyline for irritable bowel syndrome Severity Scoring System score between arms at 6 months [-27.0, 95% confidence interval (CI) -46.9 to -7.10; p = 0.008]. For the key secondary outcome of subjective global assessment of relief of irritable bowel syndrome symptoms, amitriptyline was superior to placebo at 6 months (odds ratio 1.78, 95% CI 1.19 to 2.66; p = 0.005). Amitriptyline was superior to placebo across a range of other irritable bowel syndrome symptom measures but had no impact on somatoform symptom-reporting, anxiety, depression, or work and social adjustment scores. Adverse event trial withdrawals were more common with amitriptyline (12.9% vs. 8.7% for placebo) but most adverse events were mild. The qualitative study thematically analysed 77 semistructured interviews with 42 participants and 16 GPs. Most participants found the self-titration process acceptable and empowering. General practitioners should offer low-dose amitriptyline to patients with irritable bowel syndrome whose symptoms do not improve with first-line therapies. Guidance and resources should support GP-patient communication to distinguish amitriptyline for irritable bowel syndrome from use as an antidepressant and to support patients managing their own dose titration. This trial is registered as ISRCTN48075063. This award was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme (NIHR award ref: 16/162/01) and is published in full in Health Technology Assessment Vol. 28, No. 66. See the NIHR Funding and Awards website for further award information.

Intrapersonal, Cultural, and Community Assets among Puerto Rican Hurricane Maria Survivors: A Latent Profile Analysis

In September 2017, Hurricane Maria decimated Puerto Rico and resulted in the deaths of thousands of people, the destruction of thousands of homes, and the mass migration of hundreds of thousands of Puerto Ricans to the U.S. mainland. Because of these events, Puerto Rican Hurricane Maria survivors on the U.S. mainland are at risk for depressive symptomatology. The purpose of this study was to examine sources of protection against depressive symptoms in this population, with a focus on identifying protective assets and how such assets are differentially distributed across subsets of survivors. A sample of 319 Puerto Rican Hurricane Maria survivors ( Mage = 38.5 years, 77% women) completed surveys of intrapersonal, cultural, and community assets, as well as a measure of depressive symptoms. Results showed that optimism and religiosity at the intrapersonal level, and collective efficacy and community safety at the community level, emerged as significant protective assets against depression. Results from a latent profile analysis revealed four classes of survivors based on their degree and type of protection: High Protection, Safe Community, Moderate Protection, and Low Protection. The High Protection class reported fewer depressive symptoms compared with the Moderate and Low Protection classes but reported similar levels of depressive symptoms as the Safe Community class. Findings suggest that intrapersonal cognitive factors, and community efficacy and safety factors may represent salient assets among hurricane survivors on the U.S. mainland. Findings also illustrate that subsets of Puerto Rican Hurricane Maria survivors vary in their degree and type of protective assets.

The Associations between Depression and Sugar Consumption Are Mediated by Emotional Eating and Craving Control in Multi-Ethnic Young Adults.

Individuals with mental health conditions such as depression are vulnerable to poor dietary habits, potentially due to the maladaptive eating behaviors often used to regulate negative emotion. However, the specific dietary components most associated with depression, as well as the mediating roles of emotion regulation and other eating behaviors, remains ambiguous in young adults. For this cross-sectional evaluation, a total of 151 (86 F, 65 M; BMI: 22.0 ± 5.1 kg/m2; age: 21.4 ± 2.5 y) multi-ethnic participants (50 White, 36 Black, 60 Asian, and 5 White Hispanic) completed a digital 24-h dietary recall and self-reported measures of depressive symptoms, emotional regulation, and eating behaviors. LASSO regression was used to identify the dietary variables most associated with each subscale and to remove extraneous dietary variables, and multiple regression and mediation analyses were conducted for the remaining variables. Out of >100 dietary factors included, only added sugar in the combined sample (p = 0.043), and relative sugar in females (p = 0.045), were retained and positively associated with depressive symptoms. However, the relationships between depression and added and relative sugar intake were mediated by craving control and emotional eating, respectively. Individuals with higher added sugar intake (p = 0.012-0.037), and females with higher relative sugar intake (p = 0.029-0.033), had significantly higher odds of risk for major depression disorder and the use of mental health medications. Added and relative sugar intake are significantly associated with depressive symptoms in young adults, but these relationships may be mediated by facets of emotional dysregulation, such as emotional eating and craving control.

Criterion validity of a single-item measure of fear avoidance behavior following mild traumatic brain injury

Maladaptive coping such as fear avoidance behavior can prolong recovery from mild traumatic brain injury (mTBI). Routine assessment of fear avoidance may improve management of mTBI. This study aimed to validate a single-item measure of fear avoidance to make its assessment more pragmatic. The present study is a secondary analysis of a clinical trial that involved adults with persistent post-concussion symptoms (N = 90, 63% female). Participants completed the single-item fear avoidance rating, a validated legacy measure of fear avoidance (Fear Avoidance Behavior after Traumatic Brain Injury; FAB-TBI), and measures of anxiety (General Anxiety Disorder-7), depression (Patient Health Questionnaire-9), post-concussion symptoms (Rivermead Postconcussion Symptoms Questionnaire), and disability (World Health Organization Disability Assessment Schedule 12.0). Questionnaires were completed twice, at baseline (mean 18.1 weeks post injury) and again 12–16 weeks later following study-delivered rehabilitation in addition to usual care. We analyzed the associations (Spearman’s correlations) and agreement (weighted Kappa) between the single-item and FAB-TBI at baseline, posttreatment, individual FAB-TBI item scores, and the change in scores between baseline and posttreatment. In addition, we examined correlations between the single-item fear avoidance measure and related constructs, including anxiety, depression, post-concussion symptoms, and disability. The single-item fear avoidance measure correlated strongly with the FAB-TBI both at baseline and following treatment (ρ = 0.63 − 0.67, p < .001), and moderately with FAB-TBI item scores (ρ = 0.4 − 0.6). The correlation between the change in these scores from baseline to posttreatment was moderate (ρ = 0.45, p < .001). Agreement between the single-item fear avoidance measure and discretized FAB-TBI scores was moderate (κ = 0.45 − 0.51). Before and after treatment, the single-item fear avoidance measure correlated moderately with anxiety (ρ = 0.34), depression (ρ = 0.43), post-concussion symptoms (ρ = 0.50), and disability (ρ = 0.43). The FAB-TBI was more strongly correlated with these measures (ρ = 0.53 − 0.73). In summary, the present study supports the criterion validity of the single-item fear avoidance measure. This measure may be a useful screening and monitoring tool for patients with mTBI but is not a substitute for the FAB-TBI questionnaire.

Longitudinal interactions between maternal depression symptoms and familial stressful life events on child anxiety symptoms at 5years of age.

In the current study we identified salient parental factors for child anxiety symptoms by considering the role of stressful life events, maternal anxiety symptoms, maternal depressive symptoms, and maternal neuroticism. Families (N=399) in an urban area in the United States were participants in a longitudinal study beginning in infancy. Mothers completed measures of stressful life events (Revised Life Events Questionnaire at all visits), maternal anxiety and depressive symptoms (State-Trait Anxiety Inventory and Beck Depression Inventory, respectively, at infancy between 5 and 12months, at 2years, and at 3years), maternal neuroticism (NEO Five-Factor Inventory at infancy), and child anxiety symptoms (Child Behavior Checklist 1.5-5 at 5years). Linear mixed models (LMMs) were used in analyses. Maternal depressive symptoms from infancy through 3years were associated with child anxiety symptoms; other main effects modeled (stressful life events, maternal anxiety symptoms, maternal neuroticism) were not associated with child anxiety symptoms. There was a significant interaction effect between stressful life events and maternal depression. Stressful events from infancy through 5years of age increased risk for child anxiety symptoms at 5years if the child's mother had a mild mood disturbance or depression, but not for children with non-depressed mothers.

A role for event centrality in prolonged grief disorder.

Having a traumatic or negative event at the centre of one's identity is associated with adverse psychological outcomes including post-traumatic stress, depression, and prolonged grief disorder (PGD). However, direct investigation of the role of centrality of a bereavement-event in the maintenance of PGD symptoms is scarce and has not compared immediate and long-term changes in event centrality nor examined the nature of the loss. Data from bereaved partners and adult children in The Aarhus Bereavement Study at four time points over 26months post-loss were included in this study. Participants completed a PGD symptom measure and the Centrality of Events Scale (CES) on each occasion. Results suggest that bereaved partners had higher PGD and CES scores than bereaved adult children at all four post-bereavement time points. Regardless of relationship type, maintaining higher CES scores over time predicted PGD symptoms, over and above initial symptoms. Our findings suggest a risk factor for maintaining PGD symptoms is the continued centrality of the bereavement to ones' life story and autobiographical memory. This finding links the mechanisms for maintaining PGD symptoms to those involved in other disorders such as post-traumatic stress, with implications for theoretical models of prolonged grief as well as treatment.

Consensus-based recommendations for the diagnosis and treatment of anxiety and depression in children and adolescents with epilepsy: A report from the Psychiatric Pediatric Issues Task Force of the International League Against Epilepsy.

The Psychiatric Pediatric Issues Task Force of the International League Against Epilepsy (ILAE) aimed to develop recommendations for the diagnosis and treatment of anxiety and depression in children and adolescents with epilepsy. The Task Force conducted a systematic review and identified two studies that assessed the accuracy of four screening measures for depression and anxiety symptoms compared with a psychiatric interview. Nine studies met the eligibility criteria for treatment of anxiety and depressive disorders or symptoms. The risk of bias and certainty of evidence were assessed. The evidence generated by this review followed by consensus where evidence was missing generated 47 recommendations. Those with a high level of agreement (≥80%) are summarized. Diagnosis: (1) Universal screening for anxiety and depression is recommended. Closer surveillance is recommended for children after 12 years, at higher risk (e.g., suicide-related behavior), with subthreshold symptoms, and experiencing seizure worsening or therapeutic modifications. (2) Multiple sources of ascertainment and a formal screening are recommended. Clinical interviews are recommended whenever possible. The healthcare provider must always explain that symptom recognition is essential to optimize treatment outcomes and reduce morbidity. (3) Questioning about the relationship between symptoms of anxiety or depression with seizure worsening/control and behavioral adverse effects of antiseizure medications is recommended. Treatment: (1) An individualized treatment plan is recommended. (2) For mild depression, active monitoring must be considered. (3) Referral to a mental health care provider must be considered for moderate to severe depression and anxiety. (4) Clinical care pathways must be developed. (5) Psychosocial interventions must be tailored and age-appropriate. (6) Healthcare providers must monitor children with epilepsy who are prescribed antidepressants, considering symptoms and functioning that may not improve simultaneously. (7) Caregiver education is essential to ensure treatment adherence. (8) A shared-care model involving all healthcare providers is recommended for children and adolescents with epilepsy and mental health disorders. We identified clinical decisions in the management of depression and anxiety that lack solid evidence and provide consensus-based guidance to address the care of children and adolescents with epilepsy.

Social Anxiety, Perceptions of Social Support, and Behavior in Anticipation of Online Peer Interaction

Abstract: Most Americans aged 18–49 use social media ( Atske, 2021 ). The social compensation ( McKenna &amp; Bargh, 2000 ) and social enhancement ( Kraut et al., 2002 ) hypotheses offer two frameworks for understanding online social behavior, yet the evidence for these hypotheses is mixed. Two factors that may be important to consider in the context of online social behavior are social anxiety symptoms ( Weidman et al., 2012 ) and perceived social support ( O’Day &amp; Heimberg, 2021 ). This study aimed to understand how online social behavior may be associated with social anxiety and perceived social support. Participants ( N = 303) completed self-report measures of social anxiety symptoms and perceived social support, as well as a task designed to simulate online social interactions. Participants who mentioned social activities in a mock social media profile had significantly lower social anxiety and significantly higher perceived social support than those who did not. There were no significant associations between social anxiety or perceived social support and the number of people with whom participants expressed interest in interacting. Participants with higher perceived social support indicated that they wanted to maximize their chances of interacting with another person. Overall, these findings provide some support for the social enhancement hypotheses. Further research is needed to disentangle how social anxiety and perceived social support may be relevant to online social behavior.

Occurrence of potentially traumatic events, type, and severity in undergraduate students

ABSTRACT Background Trauma exposure can have significant mental health impacts on students that impair academic performance and engagement. It is therefore important to describe the occurrence of trauma experiences and associated symptoms among undergraduate students. Objective This study aimed to 1) assess the rates of potentially traumatic experiences, 2) examine the frequency of different trauma experience types, and 3) compare post-traumatic stress (PTS) symptom severity across experience subtypes in a large sample of undergraduate students. Methods Participants were 806 undergraduate students from three Australian universities who completed online self-report measures of trauma exposure, psychological distress, and PTS symptoms. Results Approximately two-thirds of students (64%) reported having experienced at least one potentially traumatic event. The most common experience types were the unexpected death of a loved one and accidents. Students reporting exposure to potential trauma had significantly higher general distress than non-exposed students. Events involving interpersonal violence were associated with greater PTS symptom severity. Conclusions This study provides evidence that the occurrence of potentially traumatic events is high among university students and may carry negative effects for mental health and functioning. Results highlight the need for trauma-informed educational approaches and robust counselling services to support students managing trauma histories.

Clinical characteristics associated with problematic pornography use among individuals seeking treatment for opioid use disorder

AbstractBackground and AimsMany jurisdictions are experiencing opioid epidemics. Opioid use disorder (OUD) often co-occurs with other psychiatric disorders including behavioral addictions like gambling disorder. However, little is known regarding the frequency and correlates of problematic pornography use (PPU) among people seeking treatment for OUD. Here we aimed to investigate PPU and its correlates in people seeking OUD treatment.MethodFrom October 2018 to March 2020, 1,272 individuals seeking OUD treatment were screened for PPU by completing the Brief Pornography Screen (BPS), a 5-item instrument validated for assessing PPU. Self-reported data were used.ResultsAmong the sample there were 707 (60%) males and 565 (40%) females. The mean age of participants was 37.9 ± 10.5 years (range 18–73), there were 707 (60%) males and 565 (40%) females, 14.4% (n = 183) exhibited low positive BPS scores (1 ≤ score ≤4), and 4.5% of the sample (n = 57) screened positive for PPU (BPS score ≥4). Individuals screening positive for PPU versus negative were mostly male (77%), scored higher on measures of impulsivity in the domains of positive urgency, negative urgency, and sensation-seeking and demonstrated more psychopathology on measures of substance use, psychotic symptoms, emotional lability, depression/functioning and self-harm.Discussion and ConclusionA minority of individuals seeking treatment for OUD screened positive for PPU. Among individuals with OUD, those screening positive (versus negative) for PPU were more impulsive and experienced more psychiatric symptoms, suggesting the need for additional investigation and screening for and addressing PPU in people with OUD.

Measurement of Patients' Acceptable Symptom Levels and Priorities for Symptom Improvement in Advanced Prostate Cancer.

Limited research has evaluated the success criteria and priorities for symptom improvement of patients with cancer to inform patient-centered care. In this study, we adapted and tested a measure of these constructs, the Patient-Centered Outcomes Questionnaire (PCOQ), for patients with advanced prostate cancer. We compared acceptable symptom severity levels following symptom treatment across 10 symptoms and identified patient subgroups based on symptom importance. Patients with advanced prostate cancer (N = 99) participated in a one-time survey, which included a modified version of the PCOQ, standard symptom measures, and additional clinical characteristics. The modified PCOQ demonstrated construct validity through its correlations with related theoretical constructs. There was a moderate correlation between symptom severity and importance. Acceptable symptom severity levels were generally low, with sexual dysfunction having a higher acceptable severity than most other symptoms. Three patient subgroups were identified: (1) those who rated all symptoms as low in importance (n = 43); (2) those who rated all symptoms as moderately important (n = 33); and (3) those who rated all symptoms as highly important (n= 18). Subgroups were associated with functional status, fatigue, sleep problems, pain, and emotional distress. The modified PCOQ demonstrated preliminary evidence of construct validity. Patients generally considered low symptom severity to be acceptable, with variations across symptoms. Results suggest that symptom severity and importance are related but distinct aspects of the symptom experience in advanced prostate cancer. Patients' diverse priorities for symptom improvement point to the need for individualized treatment plans.

Depressive symptoms, cognitive functions and daily activities: An extended network analysis in monozygotic and dizygotic twins

BackgroundThe network theory posits that depression emerges as the result of individual symptoms triggering each other. Risk factors for depression can impact these between-symptoms interactions through extended networks. The study aimed to model the extended network of depressive symptoms and known depression risk factors – objective cognitive function, intellectual, physical, and social daily activities, and then, compare the observed networks between monozygotic (MZ) and dizygotic (DZ) co-twins. MethodsTwin pairs, 722 MZ and 2200 DZ, aged 40–79, were selected from the Dansh Twin Registry for having complete measures of depressive symptoms (e.g., sadness), cognitive functions (e.g., verbal memory), physical (e.g., brisk walk), intellectual (e.g., reading newspapers) and social activities (e.g., phone calls). Gaussian graphical models were used to estimate and compare the networks first between co-twins and then, between MZ to DZ twin pairs separately. ResultsSpecific intellectual, physical and social activities were central in the extended networks of depressive symptoms and, with the exception of processing speed, more central than cognition. The extended networks' structure was more homogeneous between MZ co-twins relative to DZ co-twins. Cognitive nodes were more central in MZ than DZ co-twins. LimitationsCross-sectional design, participants were middle-aged or older, mostly affective (non-somatic) depressive symptoms. ConclusionsIn depression networks, core connecting elements were intellectual, physical and social activities. The interaction between cognition and daily activities seems critical for triggering depressive symptoms. Thus, clinical interventions aimed at preventing depression and associated cognitive deficits should focus on maintenance and/or engagement in stimulating daily activities.

Comparison of the GAD-7 and ImPACT symptom cluster scores in measuring anxiety among college athletes

Assessing mental health needs among college athletes is important given the frequency of symptoms of depression and anxiety and associated complications that may arise after a sports-related concussion. The purpose of this study was to explore the utility of the General Anxiety Disorder-7 (GAD-7) as an independent measure of anxiety symptoms among Division II collegiate athletes (n = 568) during baseline concussion assessments, which also included the post-concussion symptom scale (PCSS) and a measure of depression, the Patient Health Questionnaire-9 (PHQ-9). While only 31 athletes (5.5%) fell above the established GAD-7 cutoff score of 5 or more, a sizable proportion of them (13 or 41.9%) endorsed 0 items on the PCSS affective symptom cluster. Additionally, ∼2% of athletes reported elevated symptoms of anxiety but not depression. These findings support the incorporation of a brief stand-alone anxiety screening tool during concussion baseline evaluations to ensure better detection of student athletes with elevated anxiety symptoms who might otherwise be overlooked, so they may be referred for further diagnostic assessment.