Psychosocial Interview Research Articles

A Mixed-Methods study of the impact of sex and situational pain catastrophizing on pain sensitivity.

It is well established that catastrophic thinking about pain modulates clinical pain severity, but it may also relate to interindividual differences in the pain experience during procedures. This mixed-methods study investigated the relationship between ratings of situational pain catastrophizing and reported pain sensitivity in the context of receiving a nerve block without sedation, and explored participants' experiences. Healthy volunteers (n = 42) completed baseline psychosocial questionnaires, underwent quantitative sensory testing, and received a lower extremity nerve block, followed by further psychosocial assessment and interviews. Associations of catastrophizing scores with pain sensitivity and procedural site pain were assessed using Spearman's correlations. Interviews were reviewed using an immersion/crystallization approach to identify emergent themes. Greater situational catastrophizing scores were associated with higher pain sensitivity, measured as lower pain threshold and tolerance. Although females exhibited greater pain sensitivity generally, moderation analysis revealed a significant association between situational catastrophizing scores and pain sensitivity only among male participants. Qualitative interviews revealed the importance of participants' emotional responses to pain, and a mismatch of expectation and experience with procedural pain. Males also reported more negative comments about procedural pain. Examination of the variable subjective experience while receiving a nerve block in this experimental lab-based study revealed an important relationship between situational pain catastrophizing scores and pain sensitivity, which was more prominent among male participants. These findings reinforce how insight into individual expectations, emotions, and thought processes may impact pain sensitivity during procedures, and may inform strategies to personalize care, improving patient satisfaction and procedural acceptance.

Improving Adolescent Psychosocial Assessment through Standardized Patient Simulation: An Interdisciplinary Quality Improvement Initiative.

Adolescent suicide and mental illness have increased at alarming rates. Healthcare professionals report a lack of skill and confidence in obtaining adolescent histories and managing confidential care due to limited training in residency. Nursing professional development practitioners face challenges of adequately preparing interdisciplinary healthcare providers to assess, identify, and intervene at all points of contact with adolescents. To increase the confidence in clinical communication skills and clinical competency, and to increase the number of social work referrals related to modifiable risk factors for adolescent patients, a Texas pediatric tertiary care center utilized standardized patient (SP) methodology to supplement traditional clinical experiences with communication-focused education based on the Home, Education, Eating, Activities, Drugs, Sexuality, Suicidality, and Safety (HEEADSSS) interviewing. This quality improvement (QI) pilot demonstrated the benefits of utilizing standardized patient methodology in communication-focused education based on the HEEADSSS interviewing. Following the SP simulations, confidence in clinical communication skills increased by 13%, clinical competency in performing comprehensive psychosocial interviews increased by 11%, use of HEEADSSS increased by 64%, and social work referrals increased by 89%. This interdisciplinary SP interviewing simulation pilot was beneficial in improving the 36 physician and nursing residents' ability to conduct psychosocial assessments for risk factors of suicidality among adolescents.

Sociodemographic and psychosocial risk factors of railway suicide a mixed-methods study combining data of all suicide decedents in the Netherlands with data from a psychosocial autopsy study

BackgroundRailway suicide has profound implications for the victims and their family, and affects train drivers, railway personnel, emergency services and witnesses. To inform a multilevel prevention strategy, more knowledge is required about psychosocial and precipitating risk factors of railway suicide.MethodsData from Statistics Netherlands of all suicides between 2017 and 2021 (n = 9.241) of whom 986 died by railway suicide and interview data from a psychosocial autopsy of railway suicide decedents (n = 39) were integrated. We performed logistic regression analyses to identify sociodemographic predictors of railway suicide compared to other methods of suicide. The Constant Comparative Method was subsequently employed on interview data from the psychosocial autopsy to identify patterns in psychosocial risk factors for railway suicide.ResultsThe strongest predictors of railway suicide compared to other suicide methods were young age (< 30 years old), native Dutch, a high educational level, living in a multi-person household (especially living with parents or in an institution), living in a rural area and a high annual household income of > 150.000 euros. Several subgroups emerged in the psychosocial autopsy interviews, which specifically reflect populations at risk of railway suicide. These subgroups were [1] young adult males with autism spectrum disorder who strived for more autonomy and an independent life, [2] young adult females with persistent suicidal thoughts and behaviours, [3] middle-aged males with a persistent mood disorder who lived with family and who faced stressors proximal to the suicide in personal and professional settings, [4] male out-of-the-blue suicides and [5] persons with psychotic symptoms and a rapid deterioration.Conclusionsbased on our findings we propose and discuss several recommendations to prevent railway suicide. We must continue to invest in a safe railway environment by training personnel and installing barriers. Additionally, we should adopt prevention strategies that align the needs of subgroups at increased risk, including young females who have attempted other methods of suicide and young males with autism spectrum disorder. Future research should determine the cost-effectiveness and feasibility of low-maintenance, automated interventions near crossings and psychiatric facilities.

ANXIETY IN PATIENTS UNDERGOING OPEN-HEART SURGERY: THE ROLE OF CHARACTER, STRENGTH, AND HOPE IN A STRUCTURE EQUATION MODEL

Abstract In an era of patient-centered care, more research is needed to examine the protective function of patients’ internal strengths against the damage of poor mental health. Mental health plays a significant role in cardiac health. Anxiety is a mortality risk for cardiac patients, the evidence has indicated high prevalence (13-59.5%) post cardiac events. However, anxiety hasn’t been extensively investigated as depression in cardiac patients, especially after open-heart surgery (OHS). Even less is known about protective function of Character Strength Hope in cardiac anxiety during stressful OHS, also a life-altering intervention for advanced heart conditions. This interdisciplinary study evaluated a structural equation model (SEM) on the relationship of Hope with pre- and post-OHS anxiety. Two weeks prior to the scheduled operation, research assistants conducted a face-to-face psychosocial interview with 481 patients (male, 58%; mean age=62 years, range=35-89) at the hospital, followed by a second telephone interview to assess an indicator of Hope two-days prior to surgery. Postoperative measures were assessed 36 days after OHS. Female and older patients reported higher levels of anxiety preoperatively. The SEM demonstrated adequate fit of the final solution in which pre- and post-OHS anxiety levels were related. Higher levels of pre-OHS anxiety were related to lower levels of optimism and hope right before OHS. Higher levels of optimism, indicating Hope predicted lower levels of post-OHS anxiety. Because patients with high anxiety would be disadvantaged in postoperative recovery, our finding suggests enhancing preoperative strength, Hope, might have some psychological benefits for optimal outcomes in patients undergoing OHS.

The VUCA World of Arab and Moldovan Migrants in Romania

Abstract This paper sets out to investigate the impact of the VUCA world (Volatility, Uncertainty, Complexity, Ambiguity) on the vulnerability and resilience of incoming migrants in Romania, as well as on their integration patterns. Vulnerability and resilience are conceptualized through the four elements of the VUCA world. Data was collected through 35 semi-structured, psycho-social interviews, and 4 focus groups carried out between January 2020 and November 2021 with young migrants (aged 18 to 29). Participants came from two ethnic backgrounds: young migrants of Arab and Moldovan origins. Results show that much of VUCA is generated by the lack of employment opportunities and by the bureaucratic public administration. At the same time, the challenges raised by the VUCA world for migrants can be reduced through the improvement of destination language skills and through the development of social networks.

Nonopioid Substance Use among Patients Who Recently Initiated Office-based Buprenorphine Treatment.

Medications for opioid use disorder (MOUDs) like buprenorphine are a first-line treatment for individuals who have opioid use disorder (OUD); however, these medications are not designed to impact the use of other classes of drugs. This descriptive study provides up-to-date information about nonopioid substance use among patients who recently initiated office-based buprenorphine treatment for OUD using data from 2 ongoing clinical trials. The study sample was composed of 257 patients from 6 federally qualified health centers in the mid-Atlantic region who recently (i.e., within the past 28 days) initiated office-based buprenorphine treatment between July 2020 and May 2022. After the screening and informed consent processes, participants completed a urine drug screen and psychosocial interview as a part of the study baseline assessment. Descriptive analyses were performed on urine drug screen results to identify the prevalence and types of substances detected. More than half of participants provided urine specimens that were positive for nonopioid substances, with marijuana (37%, n = 95), cocaine (22%, n = 56), and benzodiazepines (11%, n = 28) detected with the highest frequencies. A significant number of participants used nonopioid substances after initiating buprenorphine treatment, suggesting that some patients receiving MOUDs could potentially benefit from adjunctive psychosocial treatment and supports to address their nonopioid substance use.

Two-Speed Integration? A Comparative Analysis of Barriers and Resilience Strategies of Young Migrants in Vulnerable Conditions in Romania

This comparative study focuses on the barriers to social and economic inclusion, as well as the integration and coping strategies of Arab and Moldovan migrants in Romania. We explored the integration barriers they face, the main individual and societal aspects that lead to their resilience, and their self-perception of vulnerability, by carrying out 35 psychosocial interviews and four focus groups with young migrants (aged 18 to 29), belonging to the two different subgroups (of Arab and Moldovan origins, respectively). The comparative analysis revealed that migrants from Arab countries face harsher integration barriers compared to Moldovan migrants, they have a more severe self-perceived vulnerability, and their integration may be a longer and more complex process. Results showed that mastery of the language and the network of acquaintances play an indispensable role in inclusion. Moldovans integrate more easily than Arabs, thanks to their fluency in Romanian, the native language shared with the majority local population, the geographical and cultural proximity to the country of destination, and the larger personal network. We highlight the need for improving integration policies for young migrants, tailoring them to the specific problems and barriers that migrants are facing.

Substance Use Disorders and Psychiatric Illness Among Transitional Age Youth Experiencing Homelessness

Transitional age youth experiencing homelessness (TAY-EH) bear a high burden of substance use disorders (SUDs) and psychopathology. However, limited data exist on the co-occurrence and interactions between these diagnoses in this marginalized group. This study sought to identify rates of single and co-occurring SUDs and psychiatric diagnoses among a sample of TAY-EH and to investigate associations between psychopathology and prevalence and severity of SUDs in this group. TAY-EH accessing a low-threshold social service agency in a large metropolitan area completed psychosocial and diagnostic interviews to assess for SUDs and psychopathology. Analyses examined rates of single and co-occurring disorders and associations between burden of psychopathology and presence and severity of SUDs. The assessment was completed by 140 TAY-EH; the majority were youth of color (54% Black/African American, 16% Latinx), and 57% identified as male. Rates of single and co-occurring psychiatric disorders and specific SUDs (cannabis use disorder [CUD] and alcohol use disorder [AUD]) were notably high. An increasing number of psychiatric diagnoses was significantly associated with elevated CUD/AUD prevalence and severity. Mood, anxiety, attention-deficit/hyperactivity, and antisocial personality disorders were significantly associated with elevated CUD/AUD prevalence and severity, as was suicidality (all p < .05). This study reveals a complex overlay of SUDs and psychopathology facing TAY-EH, with a significant association between co-occurring psychopathology and severity of CUD/AUD. To the authors' knowledge, this is the first study to examine associations between specific psychopathology and severity of SUDs among TAY-EH. Further research into the mechanistic and temporal links between these conditions is needed to inform tailored treatment interventions.

Psychosocial Characteristics and Experiences in Patients with Multiple Endocrine Neoplasia Type 2 (MEN2) and Medullary Thyroid Carcinoma (MTC).

Multiple Endocrine Neoplasia type 2 (MEN2) is a genetic cancer syndrome for which there are limited data pertaining to the quality of life and psychosocial experiences of persons affected. Medullary thyroid carcinoma (MTC) is a rare disease of the thyroid gland often associated with MEN2. MTC often progresses slowly and may present with a myriad of physical symptoms including hair loss, sleep disturbance, fatigue, weight changes, heart palpitations, and constipation or diarrhea. Like other cancers or rare, inheritable illnesses, patients with MEN2 and MTC may be at risk for psychosocial stressors. The current, cross-sectional study administered a structured psychosocial interview and The Distress Thermometer/Problem Checklist to 63 patients with MEN2 and MTC and their caregivers. Despite reports of overall good health, 46% of adults and 44% of youth reported that pain interferes with their daily life; 53% of adults and 59% of youth reported that pain interferes with their mood. Pediatric patients frequently reported experiencing attention challenges (50%) and difficulty concentrating (65%). Parents reported that mood shifts and becoming upset easily were the most prevalent concerns for their children. The most frequent need for services included education about MTC, treatment and research participation, and the opportunity to meet others with MTC.

Blood lead levels mediate the relationship between social adversity and child externalizing behavior

Background/aimsThe association between social adversity and externalizing behavioral problems in children is well-documented. What is much less researched are biological mechanisms that may mediate such relationships. This study examines the hypothesis that low blood lead mediates the relationship between social adversity and child externalizing behavior problems. MethodsIn this cross-sectional study, participants were 131 children aged 11–12 years (mean = 11.90) from Philadelphia, US. A venous fasting blood sample was taken and analyzed for blood lead levels. A social adversity index was calculated based on 10 total indicators derived from a psychosocial interview of the parent and official neighborhood data, while child behavior outcomes (internalizing and externalizing behavior) were assessed using both parent-report and child self-report. ResultsThe mean blood lead level was 2.20 μg/dL. Both relatively higher blood lead levels and higher social adversity scores were associated with higher levels of parent-reported and child self-reported externalizing behaviors. Additionally, blood lead mediated the relationship between social adversity and child-reported externalizing behavior (Indirect effect: B = 0.03, 95% CI: 0.004, 0.09) and partially mediated the relationship between social adversity and parent-reported externalizing behavior (Indirect Effect: B = 0.03, 95% CI: 0.01, 0.07). ConclusionTo our knowledge, this study is the first to suggest that blood lead levels play a mediating role in the relationship between externalizing behavior problems and social adversity. Findings have potentially important implications for public health and environmental regulation as well as understanding biological mechanisms that link social inequality with health outcomes, especially in youth from low-income, urban areas.

Maternal Psychological Risk Moderates the Impacts of Attachment-Based Intervention on Mother-Toddler Mutuality and Toddler Behavior Problems: A Randomized Controlled Trial.

Although there is robust evidence of the benefits of attachment-based parenting interventions, limited research has examined their impact on dyadic mutuality and toddler behavior problems. Given the central question in prevention research of what works for whom, and the documented relation of maternal psychological risk to parenting and intervention response, it is important to consider the moderating role of maternal psychological risk in the efficacy of attachment-based interventions. The current study extends prior research on a randomized controlled trial of Attachment and Biobehavioral Catch-up (ABC) by examining its impact on dyadic mutuality and the moderating role of maternal psychological risk in ABC's impact on dyadic mutuality and toddler behavior problems. ABC (10 sessions) was provided as a supplement to Early Head Start (EHS) for a sample of predominantly low-income Latinx families. Control families received home-based EHS plus 1 book per week for 10weeks. We administered a psychosocial interview and video-recorded parent-toddler interaction pre- and post-intervention. Using intent-to-treat analyses, we found main effects of ABC on dyadic mutuality. We conducted latent class analysis to identify patterns of interrelationships among indicators of baseline maternal risk exposure to characterize a latent risk factor and used this factor to examine the moderating role of maternal psychological risk in ABC's impact on dyadic mutuality and toddler behavior problems. ABC seemed to be particularly beneficial for the development of positive, synchronous dyadic interactions and for reduction of toddler behavior problems in higher-risk EHS families. Findings are discussed in the context of designing and evaluating preventive interventions, with a specific focus on families at psychological risk.

Longitudinal predictors of suicidal ideation: Emerging to early adulthood

Few studies have examined the longitudinal trajectory of suicidal ideation (SI) in community samples, particularly during emerging adulthood. Additionally, there is scant data on predictors of longer-term course of SI across this period. We examined multiple domains of adolescent psychosocial and clinical functioning as predictors of SI trajectory and explored whether biological sex moderates those associations. The data came from the Oregon Adolescent Depression Project. Participants completed self-reports of psychosocial and clinical functioning and interviews assessing psychopathology in mid-late adolescence. SI was assessed using up to seven annual mailer assessments spanning ages 19–31. Multilevel growth models found that SI declined across emerging adulthood. Multiple indices of adolescent functioning were associated with higher levels of SI three years later. Few adolescent functioning constructs predicted faster reductions in SI, and no constructs predicted slower longitudinal reductions (or increases) in SI. Similar associations were found when controlling for adolescent SI. Lastly, we found little evidence for sex differences in these associations. This work shows that adolescent functioning is largely associated with initial and enduring levels of SI. Moreover, associations were similar between sexes. Given the modest associations found across long periods of time, future research should focus on proximal risk factors for SI.

Vital exhaustion and risk of myocardial infarction in male population aged 25- 64 years in Russia/Siberia. Epidemiological program WHO Monica-psychosocial

Abstract Funding Acknowledgements Type of funding sources: None. Purpose To determine the effect of vital exhaustions (VE) on risk of myocardial infarction (MI) in male population aged 25-64 years in Russia/Siberia. Methods Within the framework of WHO program MONICA-psychosocial a representative sample of men 25-64 years was examined in 1994 year in Novosibirsk. Total sample of 657 males were measured for VE symptoms at baseline with the use of the MONICA - psychosocial Interview - Vital Exhaustion scale. The incidence of new-onset MI cases was revealed over 14-years of follow-up in frame budgetary issue # AAAA-A17-117112850280-2. Cox - proportional regression model was used for an estimation of hazard ratio (HR). Results Prevalence of VE in cohort of men with AH was 73.7%. 58% men had high level of VE and 15.7% - an average level of VE. The risk MI incidence over the first 5 years of follow-up in a group with VE was 2.7-fold higher compare o those without VE. Within 10 years HR = 2.25, within 14 years HR = 2,1 for males with VE (p for all &amp;lt;0.05). In the multivariate Cox regression model after controlling for social factors (education, occupation, marital status) and age, the influence of vital exhaustion on MI risk decreased but remained statistically significant HR = 1.16 (p &amp;lt;0.05). Marital status as divorced and primary degree (elementary school) increased risk of MI more significantly in men with VE. Conclusions Vital exhaustion is a predictor of higher risk of MI in middle-age men. Level of MI risk influenced by social gradient.

Perceived Fatigue Impact and Cognitive Variability in Multiple Sclerosis.

People with Multiple Sclerosis (PwMS) and healthy controls (HCs) were evaluated on cognitive variability indices and we examined the relationship between fatigue and cognitive variability between these groups. Intraindividual variability (IIV) on a neuropsychological test battery was hypothesized to mediate the group differences expected in fatigue. Fifty-nine PwMS and 51 HCs completed a psychosocial interview and battery of neuropsychological tests and questionnaires during a 1-day visit. Fatigue in this study was measured with the Fatigue Impact Scale (FIS), a self-report multidimensional measure of fatigue. IIV was operationalized using two different measures, a maximum discrepancy score (MDS) and intraindividual standard deviation (ISD), in two cognitive domains, memory and attention/processing speed. Two mediation analyses with group (PwMS or HCs) as the independent variable, variability composite (memory or attention/processing speed) measures as the mediators, total residual fatigue (after accounting for age) as the outcome, and depression as a covariate were conducted. The Baron and Kenny approach to testing mediation and the PROCESS macro for testing the strength of the indirect effect were used. Results of a mediation analysis using 5000 bootstrap samples indicated that IIV in domains of both attention/processing speed and memory significantly mediated the effect of patient status on total residual fatigue. IIV is an objective performance measure that is related to differences in fatigue impact between PwMS and HCs. PwMS experience more variability across tests of attention/processing speed and memory and this experience of variable performance may increase the impact of fatigue.

Adult men suicide: a developmental approach

Background and objective: This study aims to verify the role of humiliating events and their context in provoking suicide and the contribution of childhood parental maltreatment. Materials and methods: A family member of consecutive adult male suicides, aged between 18 and 53, was recruited at the Montreal coroner’s mortuary for a psychosocial autopsy interview (N = 63) and 7 others through the coroner-in-chief’s office. Live events were assessed with the Life Events and Difficulties Schedule (LEDS) and parental maltreatment with the Child Experience of Care and Abuse (CECA) Interview. Results: Two thirds of the suicides presented most of the following factors: a separation from a partner, half of them involving the man’s intractable behavior, financial and marital difficulties, a diagnosis of substance use and/or personality disorder, a history of parental maltreatment and impulsivity. However, other subgroups of men suicide differed significantly from this portrait. Conclusions: Humiliation events and parental maltreatment are key factors of men’s suicide.

Neurocognitive and quality of life study in perinatally HIV-infected young people and their peers. NeuroCoRISpeS study

BackgroundAssessing the role of HIV and non-HIV related factors is essential for a better understanding of the neurocognitive outcomes in perinatally HIV-infected (PHIV+) young people. The aim of our study was to assess cognition and quality of life (QoL) of a PHIV+ cohort of young people and to compare it with a control group. MethodsThirty PHIV+ and 30 HIV(−) healthy young adults matched by age, sex and socioeconomic status completed a protocol that included neurocognitive tests, a psychosocial semi-structured interview and a QoL questionnaire (PedsQL). Neurocognitive domain-specific and domain-general (NPZ-5) Z-scores were calculated. CDC AIDS-defining category C or not C (PHIV+/C, PHIV+/noC) was considered to evaluate differences within the PHIV+ group. Univariate and multivariate analysis were performed. ResultsSixty patients were included; 67% were female; median age (IQR) 19 years (18–21). Regarding PHIV+ young people, 27% showed CDC C category (none encephalopathy), 93% were on ART and 77% had undetectable viral load. No differences regarding occupation were found, although the HIV(−) group repeated less grades (p=0.028) and had a higher education level (p=0.021).No differences were found between PHIV+/noC and HIV(−) participants. However, the PHIV+/C group showed poorer performance than PHIV+/noC (NPZ-5, p=0.037) and HIV(−) subjects (crystallised intelligence, p=0.025; intelligence quotient, p=0.016). Higher nadir CD4+ T-cell count was related to better Z-score in memory (p=0.007) and NPZ-5 (p=0.025). Earlier and longer exposure to ART resulted in better performance in memory (p=0.004) and executive functions (p=0.015), respectively. ConclusionsNo significant differences were found in the neurocognitive profile nor QoL between PHIV+/noC and HIV(−) adolescents; however, PHIV+/C participants obtained lower scores. The use of longer and earlier ART seems to have a beneficial effect.

Adverse Childhood Experiences in Trainees and Physicians With Professionalism Lapses: Implications for Medical Education and Remediation.

Unprofessional behavior, which can include failure to engage, dishonest and/or disrespectful behavior, and poor self-awareness, can be demonstrated by medical trainees and practicing physicians. In the authors' experience, these types of behaviors are associated with exposure to adverse childhood experiences (ACEs). Given this overlap, the authors studied the percentage of ACEs among trainees and physicians referred for fitness-for-duty evaluations and patterns between the types of ACEs experienced and the reason for referral. A final sample of 123 cases of U.S. trainees and physicians who had been referred to a Midwestern center for assessment and/or remediation of professionalism issues from 2013 to 2018 was created. Included professionalism lapses fell within 3 categories: boundary violation, disruptive behavior, or potential substance use disorder concerns. All participants completed a psychosocial developmental interview, which includes questions about ACE exposure. Overall rate of reported ACEs and types of ACEs reported were explored. Eighty-six (70%) participants reported at least 1 ACE, while 27 (22%) reported 4 or more. Compared with national data, these results show significantly higher occurrence rates of 1 or more ACEs and a lower occurrence rate of 0 ACEs. ACEs that predicted reasons for referral were physical or sexual abuse, feeling unwanted or unloved, witnessing abuse of their mother or stepmother, or caretaker substance use. In this sample, ACE exposure was associated with professionalism issues. Remediating individuals with professionalism issues and exposure to ACEs can be complicated by heightened responses to stressful stimuli, difficulties with collaboration and trust, and decreased self-efficacy. Adoption of a trauma-informed medical education approach may help those that have been impacted by trauma rebuild a sense of control and empowerment. The findings of this study may be useful predictors in identifying those at risk of problematic behavior and recidivism before a sentinel event.

Abnormal heart rate variability at school age in survivors of neonatal hypoxic-ischemic encephalopathy managed with therapeutic hypothermia.

Major deficits in the autonomic nervous system function, detected by measuring heart rate variability (HRV), are reported in neonatal hypoxic-ischemic encephalopathy (HIE)). However, it is unknown if they will recover in the long-term. Because of the possible implications for the neurological outcome, this study aimed to evaluate the HRV at school age, in a cohort of children who survived HIE managed with therapeutic hypothermia. A cross-sectional study of HRV in 40 children: 20 HIE survivors and 20 healthy peers. All underwent 5-min plethysmography using the PPG Stress Flow device (BioTekna Italy). Absolute and normalized HRV spectral power in the very low frequency (VLF), low frequency (LF), and high frequency (HF) bands and total power were compared between patients and healthy children. The outcome evaluation included neurological, cognitive (WISC-IV), and psychosocial (Parent Stress Index-Short Form-PSI-SF and psychosocial interview) measures. All mean HRV values were significantly higher in survivors of HIE, compared to healthy peers, with the larger effect size for the HF band (Total Power 8.57±0.59 vs 7.82±0.77ms2, p .003 ES 0.21; HF 7.82+0.77 vs 8.57+0.59ms2, p .001EF 0.24). None of the children had major health, neurological and psychosocial (PSI-SF/interview) problems. The IQ (WISC-IV) was normal in 17/20 patients, borderline in 2, and <70 in 1. HRV measures highlight autonomic dysfunction at school age in survivors of neonatal HIE, in the absence of major neurodevelopmental and psychosocial problems. The significance of this finding for children's future life needs further neuropsychiatric investigations and longer follow-up.

Neurocognitive and quality of life study in perinatally HIV-infected young people and their peers. NeuroCoRISpeS study

BackgroundAssessing the role of HIV and non-HIV related factors is essential for a better understanding of the neurocognitive outcomes in perinatally HIV-infected (PHIV+) young people. The aim of our study was to assess cognition and quality of life (QoL) of a PHIV+ cohort of young people and to compare it with a control group. MethodsThirty PHIV+ and 30 HIV(−) healthy young adults matched by age, sex and socioeconomic status completed a protocol that included neurocognitive tests, a psychosocial semi-structured interview and a QoL questionnaire (PedsQL). Neurocognitive domain-specific and domain-general (NPZ-5) Z-scores were calculated. CDC AIDS-defining category C or not C (PHIV+/C, PHIV+/noC) was considered to evaluate differences within the PHIV+ group. Univariate and multivariate analysis were performed. ResultsSixty patients were included; 67% were female; median age (IQR) 19 years (18–21). Regarding PHIV+ young people, 27% showed CDC C category (none encephalopathy), 93% were on ART and 77% had undetectable viral load. No differences regarding occupation were found, although the HIV(−) group repeated less grades (p=0.028) and had a higher education level (p=0.021).No differences were found between PHIV+/noC and HIV(−) participants. However, the PHIV+/C group showed poorer performance than PHIV+/noC (NPZ-5, p=0.037) and HIV(−) subjects (crystallised intelligence, p=0.025; intelligence quotient, p=0.016). Higher nadir CD4+ T-cell count was related to better Z-score in memory (p=0.007) and NPZ-5 (p=0.025). Earlier and longer exposure to ART resulted in better performance in memory (p=0.004) and executive functions (p=0.015), respectively. ConclusionsNo significant differences were found in the neurocognitive profile nor QoL between PHIV+/noC and HIV(−) adolescents; however, PHIV+/C participants obtained lower scores. The use of longer and earlier ART seems to have a beneficial effect.

Association between fatigue, motivational measures (BIS/BAS) and semi-structured psychosocial interview in hemodialytic treatment

BackgroundNowadays there is a growing interest in exploring causes of fatigue symptoms and the possible linked aspects in patients with Chronic Kidney Disease (CKD) receiving hemodialysis (HD) treatment. Inflammatory processes were demonstrated to influence motivational systems functioning in chronic conditions. However, there is a lack of connection between quantitative motivational systems measure and patients self-report motivational and fatigue issue. Thus, the aim of this study was to identify an association between HD patients reward mechanisms, fatigue severity and psychosocial variables emerging from semi-structured interviews.MethodsInterviews were held for a sample of ninety-four patients (54 males, 40 females; Mage = 62.98 ± 17.94; dialytic mean age in months = 76.55 ± 84.89) receiving chronic HD treatment and consequently analyzed by means of quantitative and qualitative analysis. Behavioral motivation systems reflecting inhibition/approach tendency to rewards were measured by Behavioral Inhibition/Activation System (BIS/BAS) scale and the fatigue severity experienced by HD patients was measured with the Fatigue Severity Scale. Scale results were correlated to psychosocial variables and topics derived from the semi-structured interviews.ResultsFindings highlight the presence of two effects: one related to the Behavioral Activation System (BAS) as a protective factor against the HD treatment pervasive consequences; the other one deals with the self-reported levels of fatigue that seemed to significantly interfere with patients’ daily life, as a function of gender.ConclusionsSuch results encourage the use of a mixed method approach to understand the complexity of the subjective experience of patients’ facing chronic disease and treatments.