Psychological Services Research Articles

Progress of systematic psychological interventions in elderly patients with femoral fractures: A comprehensive review

This review aims to gain a deeper understanding of the psychological state of elderly patients with femoral fractures and provide more theoretical and practical support for clinical treatment and care. Through a literature analysis, we found that elderly patients with femoral fractures face various psychological issues such as anxiety, depression, sleep disorders, and social isolation. The application of systematic nursing interventions in clinical practice, including cognitive-behavioral therapy, mindfulness therapy, family therapy, art therapy, interpersonal therapy, emotion-focused therapy, and relaxation training, has yielded significant results. Systematic psychological interventions can improve the psychological state and quality of life of elderly patients with femoral fractures. Therefore, promoting the application and practice of systematic psychological interventions in the clinical care of elderly patients with fractures will provide more effective psychological services to a wider group of patients with fractures in the future.

Psychological assessment and the role of the psychologist in early palliative care

BackgroundEarly palliative care (EPC) is a recommended model for improving the quality of life for patients with advanced cancer and their caregivers. However, limited research has focused on the role of psychological evaluation within EPC. The Veneto Institute of Oncology (IOV), a Comprehensive Cancer Centre, employs an interdisciplinary team to assess patients with advanced-stage disease. This study aims to assess the psychological needs of these patients, investigate any correlations between psychological symptoms (PSs) and factors such as awareness of diagnosis and prognosis, symptoms detected using the Edmonton Symptom Assessment System (ESAS), as well as the patient’s gender, age, social issues, and survival and to clarify the psychologist’s role within the interdisciplinary team.MethodsData were retrieved from a prospectively maintained database. From 1st January 2018 to 31st December 2021, 819 consecutive patients were evaluated during EPC consultations, with 753 participants enrolled in the study. The ESAS was administered to each patient before the consultation.ResultsMore than half of the patients (385, 57.1%) reported at least one PS, with an ESAS score of ≥4. Specifically, 34.9% reported depression, 28.7% reported anxiety, and 43.2% indicated feeling “not well.” Referring oncologists tended to overestimate the presence of PSs compared to patient self-reports (51.8% versus 41.3%). According to the psychologists’ assessment, 29.2% of participants were found to have depression, and 10.8% of participants had anxiety. Additionally, 31 patients (10.8%) with psychological disorders were diagnosed with an adaptation disorder related to a physical condition. The psychology service engaged 47% of patients, while 18.5% declined psychological support. Patients exhibiting other ESAS symptoms with scores of ≥4 had an increased odds ratio for reporting PSs of ≥4. However, multivariable analysis revealed no significant relationship between PSs and awareness of diagnosis and prognosis.ConclusionThe systematic use of self-assessment in EPC is essential for understanding patient’s experience, determining whether PSs stem from physical disorders, and prioritizing interventions. Awareness of prognosis does not correlate with increased anxiety and depression in patients. Therefore, EPC is an ideal opportunity to discuss prognosis and facilitate patients’ end-of-life choices early in their care journey.

Does psychology fail in the face of genocide? Insights about Gaza before and after October 7, 2023

Purpose The purpose of this paper is to explore the role of psychologists working with a community mental health center in the Gaza Strip, using Freirean pedagogical and Fanonian post-colonial theories as a framework. The study aims to highlight how political injustice contributes significantly to psychological distress in the region. It emphasizes the importance of collective well-being, liberatory practices and agency in therapeutic work. This research seeks to demonstrate that psychology and science cannot remain politically neutral, as they are inherently imbued with values that can either uphold oppressive systems or promote resistance and advocacy for change. Design/methodology/approach This study uses a theoretical and qualitative approach, drawing from Freirean pedagogical and Fanonian post-colonial frameworks. It involves reflective analysis of the authors’ experiences as psychologists from Italy and South Africa working with a community mental health center in Gaza. The research includes a critical examination of political and social contexts that affect mental health in the region. Through the roles of trainers, clinical supervisors and researchers, the authors integrate liberatory psychological practices and emphasize solidarity with the people of Gaza, providing insights into the interplay between political contexts and psychological well-being. Findings The findings indicate that political injustice is a primary cause of psychological distress in Gaza. The research underscores the dual role of mental health professionals: while they might inadvertently promote adjustment to oppressive systems, they also have the potential to enhance resistance, advocacy and activism. The study reveals that liberatory psychological practices can empower individuals and communities, fostering agency and collective well-being. Furthermore, the mental health needs of the population, alongside humanitarian aid and physical safety, are critical for the current crisis and future rebuilding efforts in Gaza. Research limitations/implications This paper is limited by its qualitative nature and the specific context of the Gaza Strip, which may not be generalizable to other settings. However, it provides valuable insights into the role of psychology in politically charged environments. The implications for further research include the need to explore liberatory practices in other conflict-affected areas and to examine the impact of psychologists’ roles as advocates for change. The study highlights the importance of integrating political awareness into psychological practice and research, encouraging professionals to engage actively in addressing systemic injustices. Practical implications The practical implications of this work emphasize the need for mental health professionals to incorporate political awareness and advocacy into their practice. By doing so, they can support communities in resisting oppressive systems and promote collective well-being. The research suggests training programs for psychologists that focus on liberatory practices and agency, equipping them to work effectively in conflict zones. Additionally, the study advocates for strengthening psychological services in Gaza, both during and after crises, to address the population’s mental health needs and support rebuilding efforts. Social implications The social implications of this paper highlight the critical role of psychology in addressing the political and social determinants of mental health. By aligning psychological practice with liberatory principles, mental health professionals can contribute to social justice and empower communities to resist oppression. The study advocates for a shift in the perception of psychology as a politically neutral discipline, urging professionals to engage actively in social change. It underscores the importance of solidarity with marginalized populations and the need for mental health support that is responsive to the broader socio-political context. Originality/value This essay offers original insights into the application of Freirean and Fanonian theories in the context of mental health work in Gaza. It provides a unique perspective on the role of psychologists as agents of change and solidarity in politically oppressive environments. The research contributes to the growing body of literature on the intersection of psychology and social justice, highlighting the potential of liberatory practices to empower communities. By challenging the notion of political neutrality in psychology, this study adds value to the discourse on the ethical responsibilities of mental health professionals.

Online interaction of teachers in the system of formation of research skills of students with special educational needs

The article describes the features of creating and using an electronic educational environment for online interaction of teachers. The well-founded importance of online experience exchange between teaching staff for the organization of research activities of students involved in inclusive education. The content of electronic educational modules for teacher collaboration in Google Class is described. The stages of the "World Cafe" as a modern form of interaction between teachers and a practical psychologist in an educational institution, which involves taking into account the educational opportunities of students with different nosologies, are revealed. Based on the results of diagnosing the professional competencies of the teachers of the control and experimental groups, the effectiveness of the proposed online interaction of pedagogical workers with the psychological service of the educational institution was determined.

Effects of COVID-19 pandemic on psychiatric and psychological consultation-liaison contacts in a general hospital in North-East of Italy: a retrospective study

BackgroundThe COVID-19 pandemic has prompted significant changes in healthcare, particularly affecting psychiatric and psychological Consultation-Liaison (CL) services in general hospital settings.AimTo assess the effects of COVID-19-related restrictions on utilization of psychiatric and psychological CL services in Northeast Italy during 2020, and to compare it to the use of services in the previous year (2019).MethodsThe study collected data on psychiatric and psychological consultations in 2019 and 2020 from a hospital database. It categorizes consultations by type of patient (inpatient or outpatient) and referral source (hospital wards, general practitioners, other specialists). Pandemic-related restrictions were classified as “lockdown,” “intermediate restrictions,” and “no or reduced restrictions” based on the Covid Stringency Index (CSI). Poisson regression models were employed to analyze the data.ResultsThe findings reveal a significant 28% increase in the number of psychiatric and psychological consultations in 2020. Consultations for outpatients increased by 51%, while those for inpatients decreased by 11%. However, the lockdown and intermediate restriction phases were deemed responsible of a decrease of 42.9% and 19.5% in consultations respectively.DiscussionThis study highlights the persistent psychological burden during the COVID-19 pandemic, alongside reduced CL services due to lockdown measures. Integrating telemedicine into these types of services becomes imperative for meeting patient needs during restrictions. These findings can inform policies and practices to improve effective mental health care delivery during and beyond pandemics. Future research should explore the impact of pandemic-related restrictions on mental healthcare across settings and clinical factors affecting service accessibility.

Psychological experience of patients with postpartum depression: A qualitative meta-synthesis.

To determine the psychological experiences of patients with postpartum depression by systematically reviewing, retrieving, and synthesizing data from qualitative studies. Nine databases were systematically searched for relevant publications, from database establishment to September 20, 2024. All qualitative studies in English and Chinese that explored the real-life experiences, feelings, etc., of individuals affected by postpartum depression after childbirth were included. The qualitative meta-synthesis was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. Two independent reviewers selected these studies and evaluated the quality of each study, conducting a meta-analysis to integrate the results. A total of 28 studies revealed 12 sub-themes and 3 descriptive themes: negative physical and psychological experiences and coping strategies, role transition discomfort and impact, lack of relevant support. The prominence of negative physical and psychological experiences, the discomfort of role transformation, and the lack of relevant support in patients with postpartum depression. In future studies, more attention should be paid to maternal mental health, and full mental health screening during pregnancy and childbirth should be implemented. Psychological counseling services should also be provided to pregnant women. [REGISTRATION: PROSPERO ID: CRD42024504506].

Access to psychological therapies amongst patients with a mental health diagnosis in primary care: a data linkage study.

Significant numbers of people in England have fallen into a gap between primary care psychological therapies and specialist mental health services. We aim to examine pathways to care by looking at demographic variation in detection and referral to primary and secondary psychological services in south London. Longitudinal descriptive study using a record linkage between a primary care database (Lambeth DataNet) and a secondary care mental health database (CRIS). We extracted data on mental health diagnosis, prescriptions and episodes of care in mental health services for all patients of working age registered from 1 January 2008 to 1 March 2018 (pre-covid era). Of those with a mental disorder detected in primary care (n = 110,419; 26.8%); 33.7% (n = 37,253) received no treatment; 21.3% (n = 23,548) exclusively accessed psychological treatment within NHS Talking Therapies and 7.6% accessed secondary care psychological therapies. People from minoritised groups were more likely to be prescribed psychotropic medication as the only treatment offered compared to the White British group. Men, Black African and Asian groups were less likely to access NHS Talking Therapies. People with a personality disorder diagnosis had the highest prevalence and number of NHS Talking Therapies treatment episodes (48.0%, n = 960), a similar percentage (44.1%, n = 881) received secondary care psychology treatment. Our study highlights marked inequalities in access to psychological therapies for men and people from some minoritised ethnic groups across primary and secondary care and how individuals with personality disorders are offered multiple short-term courses in NHS Talking Therapies even where this is not recommended treatment.

School-based eating disorder prevention programmes and their impact on adolescent mental health: systematic review.

Growing evidence indicates an association between disordered eating and a range of mental health problems, including anxiety, depression and emotional dysregulation. This study aimed to explore whether reducing risk factors for eating disorders, such as body dissatisfaction and low self-esteem, through school-based programmes can enhance adolescent mental health. We searched PubMed, PsycINFO, EMBASE and Web of Science from the date of inception to 15 October 2023. Data were synthesised by using a systematic narrative synthesis framework, and formal assessments were conducted to assess the quality of the included studies. After title/abstract screening and full-text assessment, 13 articles met the pre-specified inclusion criteria, comprising a total of 14 studies (n = 5853). Notably, three studies encompassed multiple programmes, leading to the identification of 17 eating disorder prevention programmes. Among these programmes, seven (41%) employed dissonance-based approaches. Topics covered in the programmes included psychoeducation, body acceptance, sociocultural issues, nutrition and physical activities, self-esteem and stress coping. Ten (59%) of the programmes were effective in improving adolescent mental health. Six of the 14 studies (43%) did not specify follow-up time, and quality assessments found the majority to be of either high (five studies, 36%) or fair (eight studies, 57%) quality. The findings from the ten effective programmes consistently support the use of body acceptance strategies in improving the mental health of adolescent students. Brief interventions delivered by trained, non-licensed facilitators appear good for the sustainable implementation of in-school psychological services to support well-being among adolescents.

Teacher perspectives and barriers in implementing inclusive education for Indian children with special needs: A pilot study

AbstractInclusive education is crucial for integrating children with special needs into mainstream educational settings. This pilot study explores the attitudes of teachers in India toward providing inclusive education to children with disabilities, and the challenges they face. As the Indian education system continues to evolve, there are significant gaps in teacher preparedness and the availability of resources, especially given the socio‐cultural and economic diversity of the country. The study aims to assess the perspectives of 30 primary and secondary school teachers regarding their experiences with inclusive education, focusing on their attitudes, challenges, and the resources available for supporting students with special needs. A mixed‐methods approach was employed, utilising surveys and interviews to gather both quantitative and qualitative data. The results indicate that while many teachers hold a positive attitude toward inclusive education, they face numerous challenges in its implementation, including a lack of specialised training, insufficient support services and inadequate teaching materials. Teachers expressed particular difficulty in supporting students with severe disabilities due to the lack of behavioural and psychological services in schools. This study emphasises the importance of continued teacher training and infrastructure improvements to foster effective inclusive education. It also highlights the need for policy changes, such as the integration of the Samagra Shiksha scheme and recognition of the 2016 Rights of Persons with Disabilities Act, to support teachers in overcoming the barriers they face. The findings from this pilot study will inform a larger, more comprehensive study, and provide the foundation for future reforms of inclusive education in India.

Psychological difficulties and the needs for psychological services for high school students

Adolescents experience numerous changes, both psychologically and physically, and they are also the age group with a high prevalence of mental problems that need counseling help. The study aims to assess the difficulties and the needs for psychological support, factors affecting the need to use psychological services among adolescents. A cross-sectional study was conducted on 672 high school students in Thu Duc City, Vietnam. The results showed that there was a statistically significant difference between grades 10–12 in student’s difficulties (DS) and a statistically significant difference in needs for psychological services (NPS, RPS). Additionally, there was a statistically significant difference in academic performance for DS. The findings also implied that RPS was predicted by a DS, NPS, and factors affecting the need to use psychological services (FA), in which NPS and DS were mediators in the relationship between FA and RPS. The study significantly contributes to research practices and the theoretical framework that the parliament and the government use to make counselors mandatory in schools. Meanwhile, the study suggested that school counselors, educators, and teachers must appropriately evaluate students' counseling needs and psychological difficulties; this is essential to providing support and interventions when students deal with challenges promptly.

Service Providers' Perceptions of Psychological, Emotional, and Behavioral Issues Among Children and Adolescents During COVID‐19 in South Korea

ABSTRACTVarious emotional and psychological support services for children and adolescents were implemented in South Korea during the COVID‐19 era. However, little is known about the limitations and future directions of current support services from the perspective of service providers. The purpose of this study was to explore service providers' perspectives on emotional and psychological support services for children and adolescents. The present study purposively recruited 11 clinical practitioners providing support services for children and adolescents to conduct semistructured focus group interviews. Thematic analysis identified four major themes: (a) a noticeable increase in problematic behaviors among children and adolescents (e.g., intrinsic and extrinsic problem behaviors); (b) changes in service use patterns (e.g., increased non‐face‐to‐face services); (c) frustrations with inadequate support systems (e.g., the absence of qualified professionals); and (d) identifying future directions (e.g., improving awareness of support services). The findings highlight the necessity of enhancing awareness of how to access services by reducing stigma. The findings also emphasize the need for improved cooperation between public and private facilities, as well as a greater number of skilled professionals to provide high‐quality programs. The practical and political implications are discussed based on the findings.

Implementation of Digital-Based Counseling Media to Prevent and Handle Cases of Sexual Harassment Among Students in Higher Education

Theoretically, this study is the application of the counseling media model in higher education. The model needs to be developed in higher education, particularly digital-based ones, so that it can directly benefit students and the targeted higher education. Seiring perkembangan era digital, counseling services must adhere to the needs of the counselee with various increasingly complicated life issues. Untuk menjawab pertanyaan yang diajukan oleh peneliti, metode penelitian diperlukan. Analysis of Mixed Method Sequential Explanatory Designs is the research method used for this. The goal of this approach is to gather quantitative data about the use of the digital-based counseling media model, followed by descriptive interviews to validate the quantitative data findings. Purposive sampling or the researcher's considerations were used to take the sample. There are several ways to address and prevent sexual harassment in higher education, including creating a specific task force that works in institutional units under university supervision. These include the Counseling Service Unit (ULK) of UIN Kyai Abdurrahman Wahid (Gusdur), the Psychology Service Unit (ULP) of UIN Bandung, the Counseling Center of LPM UIN Surabaya, and several campuses that continue to handle sexual harassment cases using social media platforms like WhatsApp, Google Meet, and Zoom, such as Cirebon Islamic Institute, UIN Ar-Raniry Banda Aceh, UIN Bangka Belitung, and UIN Kyai Ahmad Siddiq Jember. UIN Gusdur (https://cdc.uingusdur.ac.id/), UIN Surabaya @konseling_uinsa and UIN Bandung (https://ulp.uinsgd.ac.id) are examples of universities that use digital-based counseling medium. The Cirebon Islamic Institute, UIN Ar-Raniry Banda Aceh, UIN Bangka Belitung, and UIN Kyai are further universities that offer online counseling. Counseling begins with registration and is conducted over social media platforms such as Zoom and Google Meet. The findings indicate that the latent element of digital-based counseling in addressing and avoiding sexual harassment in higher education has a t-value of 0.870 (> 0.05). The effectiveness of digital-based counseling is then at 0.608 (> 0.05), with these results having a substantial value, indicating that it has an impact on handling and preventing sexual harassment situations in universities.

Psychosocial Needs of People Living With Pleural Mesothelioma and Family Carers: A Mixed Methods Study.

Mesothelioma is a cancer of growing global incidence, especially in developing countries, with unique complex psychosocial impacts on patients and their carers. To provide a comprehensive understanding of the psychosocial needs of people living with pleural mesothelioma and family carers. A mixed methods design with 61 semi-structured interviews and psychometrically validated questionnaires to assess pleural mesothelioma patients' (n=36) quality of life and frailty and carers' (n=25) caregiving experiences, quality of life, and pre-loss prolonged grief symptoms. People with mesothelioma (29 men, 7 women, aged 46-89years) indicated moderate quality of life; 18 (50%) met criteria for frailty. Current carers (21 women, 4 men; aged 41-79years) generally reported positive caregiving experiences and high quality of life; 5 (20%) scored in the range indicative of risk for prolonged grief disorder. Four themes were generated: a desire for tailored information with bespoke detail, assistance to coordinate tasks of treatment, improved social and peer support, and effective psychological services. Needs varied, with main concerns being about breaking the news to spouses/children, the impact of the disease and death on family, loss of personal future, managing psychological symptoms, and avoiding burden. These specific and unmet psychosocial needs provide a strong basis for individualised care pathways to address these needs via the integration of psychology into the multidisciplinary care team and the development and evaluation of mental health and wellbeing interventions for mesothelioma patients and carers. Doing so will reduce psychosocial distress and improve residual vitality.

A Metaanalysis of the relationship between growth mindset and mental health in Chinese samples

Innovations in mental health are desperately needed in Healthy China with increasing benefits of a growth mindset on mental health among Chinese. Currently, empirical research in China reveals significant discrepancies in the correlation between growth mindset and mental health. To elucidate this discrepancy, we conducted a meta-analysis on 59 studies utilizing a random-effects model, with 68 effect sizes and 54,302 participants included. The main effects revealed a significantly positive correlation between growth mindset and positive indicators of mental health (r = 0.36, [0.27, 0.45]), as well as a significantly negative correlation between growth mindset and negative indicators of mental health (r = −0.25, [−0.31, −0.20]). Subgroup test and meta-regression results indicated that age, economic region, and measurement instruments moderated the growth mindset and positive indicators of mental health. In contrast, negative indicators were moderated by gender and measurement instruments. The above findings suggest that a growth mindset significantly correlates with mental health. Consequently, it can be developed into an effective psychological service strategy in Healthy China. Future empirical studies should continue to examine this relationship and explore additional potential moderating variables. Furthermore, the clinical effects of growth mindset interventions in mental health should be tested.

Socio-demographic and clinical predictors of post-acute, mid-and long-term psychological sequelae of COVID-19: a two-year cross-sectional investigation on 1317 patients at the University Hospital of Verona

BackgroundThe present paper focuses on socio-demographics, clinical variables, and the distance from the infection in predicting the long-term psycho-social consequences of COVID-19.MethodsPatients were screened with a cross-sectional design at the Psychological Service of the University Hospital of Verona (Italy) at 3, 6, 12, and 18 months after their SARS-CoV-2 infection. The assessment was part of the Horizon 2020-funded ORCHESTRA Project and included the Hospital Anxiety and Depression Scale (HADS), the Short Form Health Survey 36 (SF-36), the Impact of Event Scale-Revised (IES-R), and ad-hoc questions measuring pre-post COVID-19 changes on psycho-social dimensions (sleep quality, nutrition, level of autonomy, work, social relationships, emotional wellbeing).ResultsBetween June 2021 and June 2023, we evaluated 1317 patients (mean age 56.6 ± 14.8 years; 48% male): 35% at three months, 40% at 6, 20% at 12, and 5% at 18 months after the infection. Thirty-five percent were hospitalized due to COVID-19. Overall, 16% reported some form of clinically significant mental distress following the infection (HADS-TOT), with 13% and 6%, respectively, experiencing anxiety (HADS-Anxiety) and depressive symptoms (HADS-Depression). Four percent testified post-traumatic symptoms. The SF-36 scale revealed that 16% and 17% of subjects had physical or psychological deterioration in quality of life, respectively. The regression analyses showed that females experienced higher levels of anxiety and depression compared to males, along with worse mental and physical quality of life and pre-post infection changes in nearly all the investigated psycho-social dimensions. Younger people felt more anxiety and had a reduced mental quality of life than their older counterparts, who, in turn, had poorer scores in terms of autonomy and physical functioning. Hospitalized patients had lower levels of self-sufficiency, social relationships, and work than non-hospitalized people. The latter were more anxious and reported a lower physical quality of life. Finally, patients evaluated for the first time at 12- and 18 months showed a more significant impairment in mental and physical quality of life than those assessed at three months.ConclusionsOur data show that COVID-19 psychological sequelae tend to persist over time, still needing clinical attention and intervention planning, especially for females.

Earthquake Anxiety & Self-Compassion Skill: A Study on Their Demographic Differences & Relationships

This study aims at analyzing the relationship between earthquake anxiety and self-compassion skill, while evaluating gender differences. Data from a total of 273 participants were used to assess the earthquake anxiety and self-compassion skill levels of the participants. The findings indicate that the earthquake anxiety is higher among women but the self-compassion skill is more apparent among men. In the reliability analysis performed for the earthquake anxiety and self-compassion skill measurements; Crohnbach’s alpha coefficients were used. Accordingly, the coefficients were calculated as (0.98) for earthquake anxiety scale and (0.84) for self-compassion scale. It was revealed that both scales had high reliability coefficients. Correlation analysis results indicate that the individuals with high earthquake anxiety have lower self-compassion skill. In addition, it was observed that the earthquake anxiety increased according to the risk magnitude, that is to say, it was found that the earthquake anxiety were more apparent in the individuals residing in the areas at high earthquake risk. The regression model established between self-compassion scale and earthquake anxiety scale were also found significant. These findings shed a light to the further studies to be performed to better understand the complex relationship between earthquake anxiety and self-compassion skill. This study makes an important contribution to the fact that psychological support services and crisis intervention programs can reach to the individuals more efficiently, taking the relationship between earthquake anxiety and self-compassion skill.

Study tours as strategy in building multi-level public health system transformation in Ukraine (UA)

Abstract With 14 million Ukrainians in need of psychological aid (UNDP) and a strained health system, UA urgently requires mental health and psychological support services (MHPSS). As a TA partner on the USAID funded Public Health System Recovery and Resilience project in UA, the Philadelphia (PHL) team supports capacity building for population-based MHPSS at the community level with a study tour strategy. Such approaches apply to other countries interested in remodeling public health systems. The strategy aims to advance community based MHPSS through in person tours in PHL with remote follow up to stimulate vision, exchange ideas and accelerate action among governmental, community, and academic partners. The study tours presented overviews on health policy, system development, program services delivered to children and adults, community interventions, and workforce development of professionals and paraprofessionals. All included the foundational principles of trauma-informed practice. The June 2023 tour hosted 11 decision makers and regional officials who embraced the vision for system development and endorsed further engagement. The December 2023 tour hosted 13 practitioners and coordinators of health and social services to observe community programs. Results include development of PHL NGOs and UA social service hub partnerships to implement train the trainer programs for peers/people with lived experience and for mural arts programs to promote community engagement and empowerment. The September 2024 tour involves university partners from nursing, social work and psychology and PHL counterparts to strengthen curricula to include mental health competencies, support faculty development with potential for collaborative research and student exchange, and design post-graduate continuing education courses for upskilling the incumbent workforce. Study tours and direct exchange are an effective strategy for capacity building for MHPSS in Ukraine to address population health needs. Key messages • The sequenced study tour strategy affects distinct levels of change makers in UA. The results are governmental buy-in, partnerships for programmatic development, and academic advancement. • The study tour model promotes systematic change and offers solutions to MHPSS workforce shortages through information exchange, relationship building, and capacity development.

Adverse childhood experiences and dissociation among Italian public psychology service users

Different studies have provided evidence that adverse childhood experiences (ACEs) are associated with mental health problems as a function of racial and ethnic diversity. The aim of the present study was thus to study the association between ACEs and dissociation in a sample of Southern Italian public psychology service (PPS) users. A sample of 183 adults who requested psychotherapeutic treatment within an Italian PPS was recruited. ACEs were assessed via the Adverse Childhood Experiences Questionnaire (ACE-Q). Dissociative symptoms were assessed via the Dissociative Experiences Scale (DES-II) and the Somatoform Dissociation Questionnaire (SDQ-20). Dissociative syndromes were assessed via two scales of the Millon Clinical Multiaxial Inventory (MCMI-III): the Somatoform Syndrome (H) and the Post-Traumatic Stress Disorder Syndrome (R) scales. The most common types of ACEs in our sample were emotional neglect and emotional abuse. The number of ACEs showed a significant association with all the different measures of dissociation administered. Logistic regression analysis for the DES-II resulted in a solution made up of sexual abuse and parental separation or divorce. The regression analysis for the SDQ-20 resulted in a solution made up of emotional abuse, physical neglect, and parental separation or divorce. Sexual abuse positively predicted PTSD scale scores, while no solution was found for somatoform disorder. ACEs and dissociation were strongly associated in this study, but the nature of this association depended on the aspect of dissociation under investigation, particularly when we considered the distinction between dissociative symptoms versus syndromes. Cultural characteristics and clinical implications for public services are discussed.

Fear of recurrence and its association with mental health outcomes after spontaneous coronary artery dissection (SCAD)

Abstract Background Spontaneous coronary artery dissection (SCAD) is a rare cause of acute myocardial infarction, predominantly affecting younger women with few traditional cardiac risk factors. The condition is characterised by relatively high rates of recurrence. Recent qualitative studies demonstrate that SCAD survivors often experience fears about the future, particularly relating to SCAD recurrence and death. Research in psycho-oncology demonstrates that experiencing fear of cancer recurrence predicts worse outcomes for mental health and quality of life, an association that is also likely in cardiac patients. To date, no quantitative research has investigated fear of recurrence and its association with mental health in SCAD survivors. Purpose The aim of this study was to investigate the prevalence of fears relating to SCAD recurrence and the association of fear of recurrence with mental health outcomes. Methods 293 SCAD survivors completed an online questionnaire assessing the psychosocial impacts of SCAD. Participants rated whether they experienced these impacts ‘not at all’, ‘a small amount, ‘a moderate amount’ or ‘a large amount’ within the first six months of their SCAD. Items related to fears about the future, recurrence, and death were extracted for analysis. Participants also completed measures of anxiety (Generalised Anxiety Disorder-7), depression (Patient Health Questionnaire-9), distress (Cardiac Distress Inventory - Short Form), and mental health related quality of life (Short Form 12, mental health component). Results In the six months following their SCAD, 97.6% of survivors experienced some level of worry about having another SCAD, 95.6% were concerned about triggering another SCAD, 95.6% experienced fear of the future, and 82.6% experienced fear of dying. Reports of experiencing ‘a large amount’ of fear in these areas were 54.6%, 45.1%, 42.7%, and 30.4% respectively. The amount of worry reported about having another SCAD was significantly associated with increased levels of anxiety, depression, and cardiac distress, and reduced mental health quality of life. Conclusions Almost all SCAD survivors reported fears, worries, and concerns related to recurrence. Worry about SCAD recurrence was significantly associated with important mental health outcomes. Cardiac health professionals should monitor fears of recurrence in their patients, as a large amount of worry may be indicative of poor mental health, and referral to psychology services may be appropriate.Rates of fears of SCAD recurrence

Should face-to-face in-person therapy be preserved for some clients with anxiety? Evaluation of Anxiety UK's psychological therapy services before and during the COVID-19 pandemic.

The COVID-19 pandemic initiated a mass switch to psychological therapy being delivered remotely, including at Anxiety UK, a national mental health charity. Understanding the impact of this forced switch could raise implications for the provision of psychological therapies going forwards. To understand whether the forced switch to remote therapy had any impact on outcomes, and if certain groups should continue to be routinely offered certain delivery modalities in future. Data were available for 2323 individuals who accessed Anxiety UK services between January 2019 and October 2021. Demographic data, baseline and discharge anxiety and depression symptoms, and mode of therapy delivery were available.Regression models were built to model (a) the mode of therapy delivery received pre-pandemic using logistic regression, and (b) outcomes pre- and post-pandemic onset within demographic groups. No statistically significant changes in baseline anxiety symptoms, demographics or outcomes were observed before and after the onset of the COVID-19 pandemic.Pre-pandemic, males were more likely to receive online video therapy than telephone therapy (Relative Risk Ratio (RRR) 1.42, [1.01, 1.99]), while older clients were less likely to receive online video therapy (RRR 0.98, [0.97, 0.99]). However, no differences in outcomes were observed post-pandemic onset within these groups, with only the number of sessions of therapy being a significant predictor of outcomes. Anxiety UK services remained effective throughout the pandemic. We observed no evidence that any demographic group had worse outcomes following the forced switch to remote therapy.