Self-help Strategies Research Articles

Help-seeking intentions and depression treatment beliefs amongst Sri Lankan Australians: A survey following a mental health literacy framework.

There is evidence that Asian migrants in Australia may be relatively reluctant to seek professional help for depression. Reluctance may be related to poor mental health literacy, including limited knowledge of help-seeking options and treatments, and a preference to seek help from informal networks. This study investigated Sri Lankan Australians' knowledge about managing depression by examining their hypothetical help-seeking intentions and perceptions about interventions and help-providers' helpfulness. Following Jorm's mental health literacy framework, participants (N = 374) were presented with a vignette of a Sri Lankan Australian exhibiting symptomatology consistent with Major Depressive Disorder, and asked to indicate their intentions to seek help by responding to the question: "If you had Mr Silva's problem, what would you do?". Participants also rated the likely helpfulness of various professional and informal helpers and interventions in addressing a problem akin to Mr Silva's. Participants reported being likely to seek help from GPs (35.8%), psychologists (25.7%) and friends (24.3%). Additionally, those who intended to seek informal help were significantly less likely to seek professional help, and vice versa. Furthermore, psychologists (94.1%), counsellors (93.3%), close friends (92.5%) and compatriots (91.4%) were most frequently categorised as helpful. Given participants' high endorsement of psychiatric treatment, psychological treatment, and self-help strategies such as engaging in enjoyable activities, it would be helpful for clinicians to emphasise the benefits of these interventions for managing depression. Additionally, recognising some participants' inclination towards religious practices and helpers, clinicians can consider integrating these help-seeking behaviours into therapeutic approaches. Future research is warranted to examine the predictors of help-seeking intentions.

Remote monitoring of patients with chronic heart failure class II-III (NYHA) using the mobile application 'M-cardio' in residents of Kyrgyzstan

Abstract Background This study aimed to assess the impact of remote monitoring through the "M-cardio" mobile application on patients with chronic heart failure (CHF) of NYHA class II-III, particularly those of ischemic etiology, residing in Kyrgyzstan. Methods A total of 244 patients with NYHA class II-III heart failure due to ischemic etiology were included in the study. During the inpatient phase, patients underwent training on self-monitoring and self-help strategies for heart failure. The intervention group received additional training on using the "M-cardio" mobile application. Patients were randomized into two groups: 1) intervention group with remote monitoring using the mobile application (n=127), and 2) control group under standard outpatient observation at their residence (n=117). The intervention group used the mobile application with a developed algorithm for clinical indicators, allowing real-time assessment of the patient's condition. The observation period extended for 12 months. Results The study evaluated changes in quality of life (MLHFQ), self-care ability (EHFSBS), and physical activity tolerance (6MWT). Initially, there were no significant differences between the groups. However, improvements in quality of life and self-care ability in the intervention group were evident at 6 months and persisted up to 12 months (44.8 ± 6.7 points and 56.5 ± 7.9 points, p < 0.01, in the intervention and control groups, respectively). Significant differences were also observed in physical activity tolerance after 12 months (6MWT) - 319 ± 79 meters in the intervention group and 233 ± 64 meters in the control group (p < 0.001). Moreover, there was a notable decrease in the proportion of patients discontinuing essential medications in the intervention group compared to the control group, particularly in ACE inhibitors/ARBs and beta-blockers. Conclusions The preliminary results indicate that the "M-cardio" mobile application for remote monitoring significantly improved the quality of life, self-care capabilities, and functional status of heart failure patients. The application demonstrated effectiveness in reducing recurrent hospitalizations and enhancing medication adherence, suggesting its potential for improving long-term outcomes and survival.

A functional intervention within a cognitive approach to chronic cervical radiculopathy

BackgroundMost patients with cervical radiculopathy improve within the first months without treatment or with non-surgical treatment. A systematic review concluded that these patients improve, regardless of their intervention. Still, many patients are offered surgery, despite limited evidence regarding the indications for surgical treatments. The aim of this article is to describe the intervention that is going to be followed in the non-surgical treatment arm of a randomised controlled trial (RCT) comparing the effectiveness of surgical and non-surgical treatment for patients with cervical radiculopathy.MethodsThe non-surgical intervention is a functional intervention within a cognitive approach founded on previous experiences, and current recommendations for best practice care of musculoskeletal pain and cervical radiculopathy. It is based on the biopsychosocial rather than a biomedical perspective, comprises an interdisciplinary approach (physicians, physiotherapy specialists), and includes brief intervention and graded activities. The intervention consists of 6 sessions over 12 weeks. The primary goals are first, to validate the patients´ symptoms and build a therapeutic alliance, second, to explore the understanding and promote alternatives, and third, to explore problems and opportunities based on patients´ symptoms and function. Motivational factors toward self-management are challenging. We will attempt shared decision-making in planning progress for the individual patient and emphasise learning of practical self-help strategies and encouragement to stay active (reinforcing the positive natural course). General physical activities such as walking will be promoted along with simple functional exercises for the neck- and shoulder region. We will also explore social activity, comorbidities, pain location, sleep, and work-related factors. The health providers will set individualised goals together with each patient.DiscussionThe aim of the intervention is to describe a functional intervention within a cognitive approach for patients with chronic cervical radiculopathy. The effectiveness of the present program will be compared to surgery in a randomised controlled trial.

‘It's just one step too far’: Negotiating physical activity for perinatal mental health

BackgroundPhysical activity is recommended as a self-help strategy for some mild to moderate perinatal mental illnesses. Despite this, we know very little about how women remain active, or take up physical activity, in the context of changing family life and perinatal mental illness. We seek to explore: a) how women negotiate physical activity for their mental health during transitions into parenthood and the early years; and b) the experiences of women with perinatal mental illness in relation to physical activity. MethodsAn anonymous UK-wide qualitative online survey was used to better understand how physical activity may be used for perinatal mental health, barriers to activity and changes over time. 186 women with babies and children up to four years completed the survey. Reflexive thematic analysis was used to analyse the qualitative data and generate themes. ResultsThemes generated from this data were: 1) negotiating being active for perinatal mental health (the benefits and how these women remained active); 2) barriers to PA associated with mental illness (some women were active but still experienced general barriers to further PA, and there were several emotional barriers from mental illness); and 3) PA, guilt and the importance of valuing walking (guilt about not being active enough, guilt and feelings of failure exacerbated by questions about PA levels without support offered; regular walking not valued as PA exacerbating feelings of guilt). Conclusions and ImplicationsThis study provides new empirical data on the experiences of new mothers’, physical activity and mental health with important implications for physical activity messaging and support for women during this time through maternity care. Individualised conversations are important and the value of walking and incidental activity from activities that mothers and families find enjoyable should be promoted.

Development and Pilot-Testing of an Optimized Conversational Agent or "Chatbot" for Peruvian Adolescents Living With HIV to Facilitate Mental Health Screening, Education, Self-Help, and Linkage to Care: Protocol for a Mixed Methods, Community-Engaged Study.

Adolescents living with HIV are disproportionally affected by depression, which worsens antiretroviral therapy adherence, increases viral load, and doubles the risk of mortality. Because most adolescents living with HIV live in low- and middle-income countries, few receive depression treatment due to a lack of mental health services and specialists in low-resource settings. Chatbot technology, used increasingly in health service delivery, is a promising approach for delivering low-intensity depression care to adolescents living with HIV in resource-constrained settings. The goal of this study is to develop and pilot-test for the feasibility and acceptability of a prototype, optimized conversational agent (chatbot) to provide mental health education, self-help skills, and care linkage for adolescents living with HIV. Chatbot development comprises 3 phases conducted over 2 years. In the first phase (year 1), formative research will be conducted to understand the views, opinions, and preferences of up to 48 youths aged 10-19 years (6 focus groups of up to 8 adolescents living with HIV per group), their caregivers (5 in-depth interviews), and HIV program personnel (5 in-depth interviews) regarding depression among adolescents living with HIV. We will also investigate the perceived acceptability of a mental health chatbot, including barriers and facilitators to accessing and using a chatbot for depression care by adolescents living with HIV. In the second phase (year 1), we will iteratively program a chatbot using the SmartBot360 software with successive versions (0.1, 0.2, and 0.3), meeting regularly with a Youth Advisory Board comprised of adolescents living with HIV who will guide and inform the chatbot development and content to arrive at a prototype version (version 1.0) for pilot-testing. In the third phase (year 2), we will pilot-test the prototype chatbot among 50 adolescents living with HIV naïve to its development. Participants will interact with the chatbot for up to 2 weeks, and data will be collected on the acceptability of the chatbot-delivered depression education and self-help strategies, depression knowledge changes, and intention to seek care linkage. The study was awarded in April 2022, received institutional review board approval in November 2022, received funding in December 2022, and commenced recruitment in March 2023. By the completion of study phases 1 and 2, we expect our chatbot to incorporate key needs and preferences gathered from focus groups and interviews to develop the chatbot. By the completion of study phase 3, we will have assessed the feasibility and acceptability of the prototype chatbot. Study phase 3 began in April 2024. Final results are expected by January 2025 and published thereafter. The study will produce a prototype mental health chatbot developed with and for adolescents living with HIV that will be ready for efficacy testing in a subsequent, larger study. DERR1-10.2196/55559.

0852 Self-help Strategies for Sleep in Children and Adolescents with Epilepsy

0852 Self-help Strategies for Sleep in Children and Adolescents with Epilepsy

The Connection Between the High Frequency Data and Schizophrenia

Schizophrenia is a mental disorder that affects millions of people around the world. While the exact causes of schizophrenia are still not fully understood, recent research has suggested that the brain's frequency filter may play a role in its development. The brain's frequency filter helps us process and interpret the sensory information we receive. It allows us to focus on what is important while filtering out unnecessary or irrelevant information. The exact cause of schizophernia is not known but believed to involve a combination of genetic, environmental, and brain chemical/neurotransmitter factors. Risk factors include family history, certain gene variants, pregnancy/birth complications, drug use, and stress. For individuals with schizophrenia, this filtering process may not function properly, leading to cognitive impairments and the manifestation of symptoms. In summary, schizophrenia is a serious but treatable mental health condition with both biological and socio-environmental contributors. A combination of medication, therapy, social support, and self-help strategies are important for management. Diagnosis is based on the pattern and severity of symptoms. No single test can diagnose it. Doctors also check to rule out other possible causes. Without treatment, schizophrenia can severely disrupt daily functioning and carry increased risks like heavy smoking, suicide, homelessness, poverty, and self-neglect. Support via therapy and rehabilitation can help manage these issues.

The connection between professional burnout of medical workers and the self-help methods during the COVID-19 pandemic

IntroductionMany medical workers suffered from severe professional burnout while working in the conditions of the COVID-19 pandemic, but few of them had the opportunity to find psychological help.ObjectivesThe aim of the research was to study the relationship between emotional burnout and self-help strategies in medical professionals during the pandemic.MethodsThe Maslach Burnout Inventory (MBI) was used to measure the level of professional burnout. It was filled out by medical workers from January 2021 to November 2022.The sample consisted of 314 medical workers (57 men and 255 women), whose average age was 36.97±11.93. According to the level of education, the sample included specialists with secondary general education (4.14%), with secondary special education (19.4%), with incomplete higher education (11.46%), with higher education (59.87%) and PhD (5.1%). 35 people (11%) of the surveyed medical workers worked in the red zone.ResultsWhen medical workers experience severe Emotional Exhaustion and Depersonalization, they often try to help themselves by drinking alcohol (r=0.156; p=0.005; r=0.184; p=0.001), eating (r=0.227; p=0.000; r=0.151; p=0.007), taking medications (r=0.204; p=0.000; r=0.212; p=0.005), solitude (r=0.204; p=0.000; r=0.133; p=0.019), watching TV series (r=0.173; p=0.002; r=0.146; p=0.01). With an increase in the Reduction of professional skills, medical workers also eat more (r=-0.148; p=0.009) and try to learn something new, engage in self-development (r=-0.137; p=0.015). It is important to note that the desire to seek psychological help is associated only with Emotional Exhaustion (r=0.121, p=0.032), that is, he/she may be aware at an early stage of professional burnout, when the symptoms of depersonalization and reduction of professional skills have not yet occurred.ConclusionsThus, all the considered self-help methods are already used with pronounced symptoms of professional burnout, but do not lead to its pronounced decrease. It is important to note that seeking psychological help is possible with awareness of emotional exhaustion, but not with depersonalization and reduction of professional skills.Disclosure: Research is supported by the Russian Science Foundation, project No. 21-18-00624.Disclosure of InterestNone Declared

Development of a Multiplatform Tool for the Prevention of Prevalent Mental Health Pathologies in Adults: Protocol for a Randomized Control Trial.

The prevalence of depression and anxiety has increased in recent years, with many individuals having trouble accessing mental health support. Smartphones have become an integral part of modern life, with apps offering new ways to deliver evidence-based self-help strategies to cope with common mental health symptoms. However, most of them do not have empirical evidence of their overall effectiveness or the effectiveness of their components, which could pose a risk for users. The aim of this study is to evaluate the effectiveness of the modules of evaluation, psychoeducation, and emotional regulation strategies in a multiplatform self-help mental health mobile app in the Maule region of Chile. A sample of 196 adults will be selected, who will be randomly assigned to different components of the app for a fixed period to assess its ability to reduce symptomatology. The trial is not yet recruiting and is expected to end in October 2024. The first results are expected in April 2024. This is the first study in Chile to develop and test the effectiveness of a mobile app to manage anxiety and depression symptoms in adults. The intervention proposed is based on evidence suggesting that the internet or remote intervention tools and self-management of prevalent symptomatology could be the future of mental health care systems in the digital era. If the effects of the intervention are positive, wide implementation in Chile and other Spanish-speaking countries could be possible in the future. PRR1-10.2196/52324.

Commentary] When ‘Ignorance is Bliss’ in Medicine

Treatment of diseases can be simple as well as effective with only limited medical knowledge, provided the physician is connected with the ‘pure consciousness’ within oneself, which is also the basis of everything in the universe. The ‘inner self’ or ‘pure consciousness’ has refreshing and healing qualities. This healing ‘inner self’ is within the conscious reach of every individual in the waking state, through the practice of meditation. The physician connected to his ‘inner self’ can help the patient to reach a more blissful state of consciousness, thus facilitating healing of all types of diseases. While mind-body therapies are patient-dependent self-help strategies, the physician who is connected with the ‘inner self’, can directly help to initiate the healing process. Positivity is manifested by the physician regardless of whether the medical knowledge he utilizes is ‘simple’ or the more complex ‘scientific’. There may be ‘ignorance’ of complex ‘scientific knowledge’, but there is ‘wisdom’ of being connected with the source of all healing.

Commentary] When ‘Ignorance is Bliss’ in Medicine

Treatment of diseases can be simple as well as effective with only limited medical knowledge, provided the physician is connected with the ‘pure consciousness’ within oneself, which is also the basis of everything in the universe. The ‘inner self’ or ‘pure consciousness’ has refreshing and healing qualities. This healing ‘inner self’ is within the conscious reach of every individual in the waking state, through the practice of meditation. The physician connected to his ‘inner self’ can help the patient to reach a more blissful state of consciousness, thus facilitating healing of all types of diseases. While mind-body therapies are patient-dependent self-help strategies, the physician who is connected with the ‘inner self’, can directly help to initiate the healing process. Positivity is manifested by the physician regardless of whether the medical knowledge he utilizes is ‘simple’ or the more complex ‘scientific’. There may be ‘ignorance’ of complex ‘scientific knowledge’, but there is ‘wisdom’ of being connected with the source of all healing.

Interdisciplinary pain therapy in the elderly

Chronic pain in the elderly is becoming increasingly important and is associated with serious health impacts. Therefore, international guidelines demand that pain therapy for the elderly preferably be amultimodal therapy based on abio-psycho-social pain model. Specific psychometric tests and interview guidelines are available for the interdisciplinary pain assessment. Evidence for the effectiveness of multimodal pain therapy in the elderly remains limited. However, controlled clinical trials have shown that these patients benefit-especially if the intervention is adapted to their specific needs. The focus of movement therapy is not only muscle strengthening but also coordination exercises. In individual physical therapy and occupational therapy, everyday solutions can be developed for individual physical limitations that are more frequent in old age. In psychological training, pain acceptance, balancing rest and activity, social integration and dealing with aging are particularly important topics. Relaxation and mindfulness techniques can also favorably affect pain and function. Thus, these are popular with patients and are often adopted in everyday pain management. Pain education is considered useful as an adjunctive measure and can also be increasingly supported by digital media in the elderly. Complementary therapy components include confrontational treatment of fear-avoidance beliefs (the German AMIKA scale, Ältere Menschen in körperlicher Aktion, "older people in physical action") and naturopathic applications as an active self-help strategy. Since it is unclear how long the achieved therapeutic effects last, follow-up care is of particular importance in therapy for older patients.

Development of mental health first-aid guidelines for psychosis: a Delphi expert consensus study in Argentina and Chile

BackgroundPsychotic symptoms may be less common than anxiety or affective symptoms, but they are still frequent and typically highly debilitating. Community members can have a role in helping to identify, offer initial help and facilitate access to mental health services of individuals experiencing psychosis. Mental health first aid guidelines for helping a person experiencing psychosis have been developed for the global north. This study aimed to adapt the English- language guidelines for Chile and Argentina.MethodsA Delphi expert consensus study was conducted with two panels of experts, one of people with lived experience of psychosis (either their own or as a carer; n = 29) and another one of health professionals (n = 29). Overall, 249 survey items from the original English guidelines and 26 items suggested by the local team formed a total of 275 that were evaluated in the first round. Participants were invited to rate how essential or important those statements were for Chile and Argentina, and encouraged to suggest new statements if necessary. These were presented in a second round. Items with 80% of endorsement by both panels were included in the guidelines for Chile and Argentina.ResultsData were obtained over two survey rounds. Consensus was achieved on 244 statements, including 26 statements locally generated for the second round. Almost 20% of the English statements were not endorsed (n = 50), showing the applicability of the original guidelines but also the importance of culturally adapting them. Attributions and tasks expected to be delivered by first aiders were shrunk in favour of a greater involvement of mental health professionals. Self-help strategies were mostly not endorsed and as were items relating to respecting the person’s autonomy.ConclusionsWhile panellists agreed that first aiders should be aware of human rights principles, items based on recovery principles were only partially endorsed. Further research on the dissemination of these guidelines and development of a Mental Health First Aid training course for Chile and Argentina is still required.

Short Form of Mental Health Literacy Questionnaire for Adults: Psychometric Properties of Serbian Version.

Mental health literacy (MHL) has been widely explored by researchers who focus on youth mental health. However, there is little data related to the validity and reliability of the tools for the assessment of MHL constructs. The present study aimed to adapt the short version of Mental Health Literacy Questionnaire for young adults in Serbian sample and examine its psychometric properties. Translation and adaptation of items were performed using the following procedures: item are translated from English or Serbian by a bilingual translator and using a think-aloud procedure, back-translation, semantic comparison of the translation, and analysis of the translated version by the original version of the manuscript. The sample consisted of 344 participants aged 17 to 25 years, which is in accordance with the recommended number of participants needed for quantitative instrument validation studies. Confirmatory factor, internal consistency, and external validity analyses were performed. The results supported the validity of a shorter version of the questionnaire (MHLq-SVa), composed of 16 items that fit with four previously defined MHL dimensions (knowledge, beliefs, help-seeking intentions, and self-help strategies). Internal consistency, between-factor correlations, and correlations with other relevant mental health constructs further supported the adequacy of the instrument's psychometric properties. We recommend the MHLq-SVa as valid and reliable measure for assessing MHL in young adults and encourage further exploration at more diverse and representative samples.

“A bit lost”—Living with attention deficit hyperactivity disorder in the transition between adolescence and adulthood: an exploratory qualitative study

BackgroundAttention deficit hyperactivity disorder (ADHD) begins in childhood and in many cases persists into adulthood. The transition from adolescence to adulthood for young people with ADHD is a vulnerable time and can be associated with comorbid conditions and unfavorable outcomes. Thus, further studies are needed to explore the characteristics of the transition period in emerging adulthood. The overall aim of this study was to gain increased knowledge of emerging adults’ experience of living with ADHD in the transition from adolescence to adulthood. This is a follow-up from a previous qualitative study that examined how young people experience receiving and living with a diagnosis of ADHD.MethodThe study has a qualitative retrospective design. Seven participants were included in this study using a purposive sampling method. We re-invited the same participants who were interviewed in 2015–2016 and conducted in-depth interviews. The data were subjected to Malterud’s systematic text condensation (STC).ResultsFour crosscutting themes were identified from our analysis: (1) low level of knowledge about ADHD and treatment options; (2) barriers to seeking and accessing help; (3) developing self-help strategies; and (4) a preference to discontinued medication use.ConclusionThe participants emphasized a need for more information about ADHD in transition phases and support, both from professionals and peers, about finding ways to live meaningful lives. The treatment they had been offered was particularly linked to symptom reduction and medication use. A more appropriate focus would have been linked to how they, as citizens, could gain knowledge and skills to live meaningful lives with ADHD.

Analysing the influence of screening ceremony strategy for the major streaming media companies: A case study of Tencent Video

The “screening ceremony” was established since Tencent Video embraced the “pay-on-demand-in-advance service” value-added service on top of the subscription model during the outbreak. This service’s value-added component is fairly straightforward, which causes users’ dissatisfaction and results in the termination of the value-added service. Therefore, the launch of the screening ceremony is a value-added service that better fits consumer preferences. The paper examined the current marketing strategy of Tencent Video and the illumination of the screening ceremony on the future promotion and application of major streaming video platforms to address this research gap. This investigation explored whether the “screening ceremony” could be a self-help strategy for major streaming media providers. This paper further responded to the marketing mix theory of the 4Cs and explored the four aspects of the theory and customers’ purchasing intents through the current marketing strategy of Tencent Video. Employed SWOT and qualitative analysis as strategic planning approaches. The findings of the analysis were that to increase customers’ desire to purchase, major streaming media platforms must provide customer value and connect with consumers. Meanwhile, major streaming media platforms need to provide value-added services that match the perceived value of the cost consumers pay.

The self-perceived needs of adolescents with suicidal behaviour: a scoping review.

Suicidal behaviour in adolescents is a major public health problem. Much research on this issue has focused on epidemiology and risk factors for suicidal behaviour, paying less attention to the self-perceived needs of adolescents. However, to increase engagement in suicide prevention, it is important to include the views of adolescents. A scoping review was performed to identify the available empirical study findings, of any study design, related to the self-perceived needs of adolescents with suicidal behaviour. The literature databases Medline, Embase, Psycinfo, CINAHL, ERIC, Scopus, and Web of Science were searched.Twenty-nine studies from 14 predominantly Anglo countries were included in the scoping review. The review showed that girls were overrepresented and that studies predominantly used qualitative approaches. The identified needs of adolescents with suicidal behaviour can broadly be grouped into needs related to the following areas: the importance of connecting with other people; adolescents' self-help strategies and personal growth after self-harm; mental healthcare; school or study programs; and needs related to society in relation to taboo on suicidal behaviour. Prevention of suicidal behaviour in adolescents will need to focus on development and strengthening of interventions fitting the needs of adolescents in these areas.

Validation and psychometric testing of the Arabic version of the mental health literacy scale among the Saudi Arabian general population

ObjectiveThis study aimed to validate the Arabic Version of the Mental Health Literacy Scale (Arabic-MHLS) among the Saudi Arabian general population, assessing its internal consistency, test-retest reliability, and structural validity.MethodsA total of 700 Arabic-speaking Saudi adults were randomly selected to complete the electronic questionnaire in May 2023, which generated 544 participants. Data were coded and stored in the ZdataCloud research data collection system database. Test-retest reliability was assessed using a subsample of 48 participants who completed the questionnaire twice, with a one-week interval. Structural validity was examined using confirmatory factor analysis (CFA) and Exploratory Factor Analysis (EFA).ResultsThe Arabic-MHLS demonstrated good internal consistency (Cronbach’s alpha = 0.87) and test-retest reliability (intraclass correlation coefficient = 0.89). EFA revealed a four-factor model closely resembling the model identified in the Slovenian validation of MHLS, with factor loadings ranging from 0.40 to 0.85. The four factors included knowledge of mental health disorders, knowledge of help-seeking, knowledge of self-help strategies, and knowledge of professional help also showed good internal consistency.ConclusionThe Arabic-MHLS is a valid and reliable tool for assessing mental health literacy in the Saudi Arabian general population. However, further research is needed to refine the measurement tool and understand the complex relationships between mental health literacy and other mental health-related concepts. This will contribute to the development of targeted interventions and policies aimed at improving mental health literacy and promoting mental well-being in the Saudi Arabian population and beyond.

Management of Premenstrual Disorders: ACOG Clinical Practice Guideline No. 7.

To provide recommendations for the management of premenstrual syndrome and premenstrual dysphoric disorder, collectively referred to as premenstrual disorders, based on assessment of the evidence regarding the safety and efficacy of available treatment options. An overview of the epidemiology, pathophysiology, and diagnosis of premenstrual disorders also is included to provide readers with relevant background information and context for the clinical recommendations. Reproductive-aged adults and adolescents with premenstrual symptoms. This guideline was developed using an a priori protocol in conjunction with a writing team consisting of two specialists in obstetrics and gynecology appointed by the ACOG Committee on Clinical Practice Guidelines-Gynecology and one external subject matter expert. ACOG medical librarians completed a comprehensive literature search for primary literature within Cochrane Library, Cochrane Collaboration Registry of Controlled Trials, EMBASE, PubMed, and MEDLINE. Studies that moved forward to the full-text screening stage were assessed by two authors from the writing team based on standardized inclusion and exclusion criteria. Included studies underwent quality assessment, and a modified GRADE (Grading of Recommendations Assessment, Development and Evaluations) evidence-to-decision framework was applied to interpret and translate the evidence into recommendation statements. This Clinical Practice Guideline includes recommendations on the following evidence-based treatment options for premenstrual disorders, with an acknowledgement that many patients may benefit from a multimodal approach that combines several interventions: pharmacologic agents (hormonal and nonhormonal), psychological counseling, complementary and alternative treatments, exercise and nutritional therapies, patient education and self-help strategies, and surgical management. Recommendations are classified by strength and evidence quality. Ungraded Good Practice Points are included to provide guidance when a formal recommendation could not be made because of inadequate or nonexistent evidence. Based on review of extrapolated data from adult populations and expert consensus, it was determined that the recommendations also apply to adolescents, with a few exceptions that are noted in the Clinical Practice Guideline.

The Relationship Between the Length of Recovery from Cyberbullying and the Number of Assistive Strategies Employed by Victims and the Quality of Self-perceived Assistive Strategies

Along with a series of derivative issues it brings about, cyberbullying is increasingly garnering the attention of the academic community. In the present study, the relationship between the recovery duration from cyberbullying and the auxiliary strategies selected by the victims was primarily focused on. This study examined the impact of exposure duration to cyberbullying on recovery time, the role of therapeutic dependency, and the effectiveness of perceived self-help strategies in a sample population from China, mainly comprising university students. Research indicates not only a correlation between longer exposure to cyberbullying and extended recovery time but also a negative correlation between the perceived effectiveness of self-help strategies and recovery time. However, there was no support for the hypothesis that predicts a decrease in recovery time with the application of various therapeutic strategies. The study suggests the possibility of therapeutic dependency and repeated revisiting of traumatic experiences prolonging recovery.