Self-report Screening Research Articles

W57. MENTAL HEALTH DATA COLLECTION IN THE ESTONIAN BIOBANK: INSTRUMENTS, METHODOLOGY AND PRELIMINARY RESULTS

Background: Background: Common psychiatric disorders are clinically heterogeneous and often display many overlapping symptoms as well as comorbidity across psychiatric disorders, hence complicating the genetic investigation of these disorders. To facilitate new discoveries and gain better understanding of the genetics of psychiatric problems, large well-phenotyped biobank samples are greatly needed. The Estonian Biobank (EstBB;N=200,000) is a data-rich national biobank that joins genomic, biomarker, electronic health record (EHR), national registry and questionnaire data to significantly advance the current knowledge of the genetic underpinnings of complex and rare diseases. We aimed to expand the EstBB database with rich phenotypic questionnaire-based information on a broad set of symptoms of common psychiatric disorders and related phenotypes. Methods: Methods: We compiled an online questionnaire “Wellbeing and mental health” which included self-report brief screening instruments to capture a broad range of symptoms on current and/or lifetime depression, anxiety disorders, mania, post-traumatic stress disorder, eating disorders, attention deficit/hyperactivity disorder, psychotic experiences, suicidal thoughts and behavior, cognition, substance (ab)use, problematic gambling and related risk- and protective factors, such as childhood adversity, stressful life events, social support, lifestyle, sociodemographic factors and life satisfaction. In addition, the participants were asked about the side effects, discontinuation and switching of medications prescribed for a mental health problem in their lifetime. Since the start of the data collection coincided with the peak of the second COVID-19 wave in Estonia, we included items related to current perceived stress, burnout and change in mental health during the pandemic. When selecting instruments, preference was given based on 1) reliability and validity of the instruments;2) whether an Estonian adaptation and/or validation has been conducted;3) application in other large biobanks (e.g. the UK Biobank) for future harmonization or replication;4) short length. Results: Results: The invitations to participate in the online mental health study were e-mailed out to all living EstBB participants with available e-mail addresses (N=184,622), followed by two e-mail reminders. The active data collection phase spanned over three months from March to May 2021. The preliminary response rate was 46.7% (N = 86,222) out of all who were contacted. We will present preliminary results on the comparison of respondents and non-respondents based on demographic data, psychiatric diagnoses in EHR and psychiatric polygenic risk scores. Discussion: Discussion: We have significantly expanded the EstBB resource with phenotypic information on a broad range of psychiatric symptoms and related phenotypes to facilitate future research in psychiatric genetics. Disclosure: Nothing to disclose.

Validation of health literacy questionnaires in Hungarian adult sample

Accessing health information adapted to one's health literacy level is a prerequisite for effective healing, rehabilitation, health education, and health promotion. This research aimed to validate the Hungarian version of two instruments measuring health literacy: the performance-based Newest Vital Sign and the self-reported Brief Health Literacy Screening Tool. These short instruments, which are frequently used in international surveys, can be applied to measure health literacy among the general population. The two instruments were tested in a nationwide cross-sectional study in the general population. The questionnaires' reliability and validity were evaluated using Cronbach-α, Spearman-Brown, corrected item-total correlation coefficients, and exploratory factor analysis (principal components analysis, varimax rotation). The internal consistency measured by the Cronbach-α was 0.72 for the Newest Vital Sign and 0.87 for the Brief Health Literacy Screening Tool, and the split-half reliabilities calculated with the Spearman-Brown correlation were 0.76 and 0.88, respectively. The correlation coefficients obtained during the item-total correlation analysis proved to be higher than the expected 0.3 value in all cases. Exploring the factor structure revealed that the two tests measure different dimensions of health literacy. Both tests proved to be reliable; the internal validity of the Brief Health Literacy Screening Tool is higher than that of the original questionnaire. Based on the factor analysis, their application is possible together if the goal is to examine subjective and objective health literacy together. Using the validated Hungarian version of these questionnaires is recommended as part of health literacy surveys conducted by interviewers. Orv Hetil. 2021; 162(39): 1579-1588.

Finalising the administration of co-SSPedi, a dyad approach to symptom screening for paediatric patients receiving cancer treatments

ObjectivesSymptom Screening in Pediatrics Tool (SSPedi) is a validated self-report symptom screening tool for patients with cancer 8–18 years of age. Co-SSPedi is a novel dyad approach in which both...

A novel sparse model-based algorithm to cluster categorical data for improved health screening and public health promotion

Screening for interpersonal violence is critical to mitigate the consequences of violence and improve women’s health. Current guidelines recommend that health care providers screen all women for experiences of violence. Despite these recommendations, studies have noted a large variation in provider-reported interpersonal violence screening rates ranging from 10% to 90%. Given the disparity in screening rates, identifying variables correlated with providers’ screening practices is an important contribution. A survey of healthcare providers previously collected was utilized for this analysis and consisted of the providers’ socio-demographics, attitudes and beliefs, practice environment characteristics as well as self-reported screening practices. The objective of the study was to stratify healthcare providers into relatively homogeneous clusters based on mixed types of categorical nominal and ordinal variables and correlate the identified clusters with the violence screening rates. This paper proposes a sparse categorical Factor Mixture Model (sc-FMM) to cluster a large number of categorical variables, in which an norm was used for variable selection. An Expectation Maximization framework integrated with Gauss-Hermite approximation was developed for model estimation. Simulation studies show significantly better performance of sc-FMM than competing methods. sc-FMM was applied to identify clusters/subgroups of healthcare providers. The identified clusters were further correlated with interpersonal violence screening rates. The findings reveal how the providers’ screening rate for interpersonal violence are associated with multi-source impacting factors which inform the formation of policy and intervention development to promote the uptake of routine screening for interpersonal violence in women.

Is adherence to 24-Hour Movement Guidelines associated with a higher academic achievement among adolescent males and females?

ObjectivesThis study aims to examine the independent and combined associations of 24-Hour Movement Guidelines for physical activity, screen time, and sleep duration with academic achievement in adolescent males and females. DesignCross-sectional study. Methods1290 Spanish adolescents (565 females), aged 11 to 16 years (13.06 ± 0.84), participated in this study. Self-reported physical activity, screen time, and sleep duration questionnaires were assessed. Academic achievement was calculated as an average score of the adolescents’' grades in first language (Spanish), first foreign language (English), and mathematics subjects. A multiple linear regression model was used to examine the association between meeting 24-Hour Movement Guidelines and academic achievement. Covariates included age, sex, socioeconomic status, body mass index, and cardiorespiratory fitness. ResultsNot meeting any of the three 24-Hour Movement Guidelines was associated with lower academic achievement in the whole sample (p < 0.001). Meeting physical activity and sleep duration guidelines, both independently and together, was associated with higher academic achievement in the whole sample (p < 0.001). Meeting at least two recommendations was associated with higher academic achievement in males (p < 0.01). However, trend analysis revealed that participants who met two or three recommendations had higher academic achievement compared to those who met one or none of these recommendations (p < 0.05). All these results were similar for males and females. ConclusionsOur findings suggest the importance of promoting more than one 24-Hour Movement Guidelines, mainly physical activity and sleep duration, which seems to contribute positively to increased academic performance in adolescents.

Behavioral Health Risk Factors for Nonmedical Prescription Opioid Use in Adolescence.

Adolescent nonmedical prescription opioid use is associated with overdose and other adverse outcomes, but its risk factors are poorly understood. Data were drawn from a prospective cohort study of Los Angeles, California, high school students. At baseline (mean age = 14.6 years), students completed self-report screening measures of problem alcohol, cannabis, and drug use and 6 mental health problems (major depression, generalized anxiety, panic disorder, social phobia, obsessive-compulsive disorder, and hypomania or mania). Past 6-month nonmedical prescription opioid use (yes or no) was assessed across 7 semiannual follow-ups. Among baseline never users of nonmedical prescription opioids (N = 3204), average past 6-month prevalence of new nonmedical prescription opioid use across the 42-month follow-up was 4.4% (range 3.5%-6.1%). In a multivariable model co-adjusting for 9 baseline behavioral problems and other factors, major depression, hypomania or mania, cannabis, alcohol, and other drug use problems were associated with increased odds of nonmedical prescription opioid use over follow-ups. Cumulative indices of behavioral health comorbidity showed successively greater odds of subsequent nonmedical prescription opioid use for students with 1 (odds ratio [OR]: 3.74; 95% confidence interval [CI]: 2.79-5.01), 2 (OR: 8.79; 95% CI: 5.95-12.99), or 3 (OR: 9.69; 95% CI: 5.63-16.68) vs 0 baseline substance use problems, and similar increases were associated with increasing number of mental health problems (1 [OR: 1.60; 95% CI: 1.03-2.88] to all 6 [OR: 3.98; 95% CI: 1.09-14.82] vs 0). Behavioral health problems may be associated with increased risk of subsequent nonmedical prescription opioid use during mid to late adolescence, with successively greater risk for those with greater behavioral health comorbidity. In pediatric clinical practice or school-based prevention, behavioral health screeners may be useful for identifying youth at high risk for nonmedical prescription opioid use.

Using objective clinical metrics to understand the relationship between the electronic health record and physician well-being: observational pilot study.

Electronic health records (EHRs) are a significant contributor to physicians' low satisfaction, reduced engagement and increased burnout. Yet the majority of evidence around EHR and physician harms is based on self-reported screen time, which may both over- and underreport actual exposure. The purpose of this study was to examine how objective EHR use correlates with physician well-being and to develop preliminary recommendations for well-being-based EHR interventions. Prior to the onset of COVID-19, psychiatry residents and attending physicians working in an out-patient clinic at an academic medical centre provided consent for access to EHR-usage logs and completed a well-being assessment made up of three scales: the Maslach Burnout Inventory, the Urecht Work Engagement Scale and the Professional Quality of Life Measure. Survey responses and objective EHR data were analysed with descriptive statistics. Responses were obtained from 20 psychiatry residents (total eligible residents n = 27; 74% participation) and 16 clinical faculty members (total eligible faculty n = 24; 67% participation) with an overall response rate of 71% (total eligible residents and faculty n = 51 and total residents and faculty who completed survey n = 36). Moderate correlations for multiple well-being domains emerged in analysis for all participants, especially around the time spent per note and patient visits closed the same day. EHR-usage logs represent an objective tool in the evaluation and enhancement of physician well-being. Results from our pilot study suggest that metrics for note writing efficiency and closing patient visits the same day are associated with physician well-being. These metrics will be important to study in ongoing efforts involving well-being-based EHR interventions.

Prevalence and Initial Diagnosis of Cerebral Palsy in Preterm and Term-Born Children in Taiwan: A Nationwide, Population-Based Cohort Study.

The aim of this long-term longitudinal study in Taiwan was to estimate and compare the prevalence of cerebral palsy (CP) and to identify the age of CP diagnosis of term-born and preterm children with different birthweights. Records of 1494 extremely low birth weight (ELBW, <1000 g), 3961 very low birth weight (VLBW, 1000–1499 g), 19,612 low birth weight (LBW, 1500–2499 g) preterm, and 100,268 matched term-born children were retrieved from Taiwan′s National Health Insurance Research Database. According to a 12-year retrospective data review, the results showed the highest prevalence of CP in preterm ELBW children (147.3 cases per 1000 neonatal survivors), followed by preterm VLBW (97.2 cases), preterm LBW (27.7 cases), with the lowest prevalence in term-born children (2.5 cases). Regardless of the birthweight group, 90% of preterm children with CP were diagnosed by 4 years of age, but it was 7 years before 90% of term-born children with CP were diagnosed. After removing the children whose CP was caused by brain infections, injuries, or cerebrovascular accidents after 4 months of age, there were similar mean ages at the initial CP diagnosis (1.58–1.64 years of age) across birthweight groups born prematurely, but initial diagnosis occurred at an older age (2.41 years of age) in term-born children. The results indicate that birthweight is reversely correlated with the prevalence of CP in preterm children. Although the three preterm birthweight groups received different types of developmental follow-up programs after birth, it did not influence their age at the initial diagnosis of CP. Furthermore, we suggest that follow-up for at least 4 years after birth for preterm children, and 7 years for term-born children, is optimal for estimating CP prevalence. In order to identify and provide early intervention for term-born children with CP earlier, it is suggested that parents routinely fill out a self-reported motor developmental screening questionnaire and pediatricians conduct a motor developmental examination on term-born children at each time of scheduled vaccination injections.

Compulsive Internet Use Scale: Psychometric Properties and Associations With Sleeping Patterns, Mental Health, and Well-Being in Lithuanian Medical Students During the Coronavirus Disease 2019 Pandemic.

Background: The increase in problematic Internet use (PIU) among medical students and resident doctors during the coronavirus disease 2019 (COVID-19) pandemic may be leading to significant impairments in everyday functioning, including sleeping patterns, anxiety, depressive symptoms, and overall well-being. The Compulsive Internet Use Scale (CIUS) has been developed to assess the severity of PIU, however, it has not been elucidated whether this scale is also applicable to medical students and resident doctors. The first aim of this study was to explore the psychometric properties of the Lithuanian version of the CIUS. The second aim was to examine associations between subjectively reported mental health symptoms and PIU during the COVID-19 pandemic.Methods: A total of 524 medical students and resident doctors (78.60% women, mean age 24 [SD 3] years old) participated in an online survey between December 2020 and February 2021. Participants completed the CIUS, the Pittsburgh Sleep Quality Index (PSQI) questionnaire, the Patient Health Questionnaire-9 (PHQ-9), the Generalized Anxiety Disorder Assessment-7 (GAD-7), and the WHO—Five Well-Being Index questionnaire (WHO-5).Results: The confirmatory factor analysis (CFA) suggested brief versions (CIUS-5, CIUS-7, and CIUS-9) rather than the original (CIUS-14) version of the CIUS questionnaire as reliable and structurally stable instruments that can be used to measure compulsive Internet use severity in the sample of medical students and resident doctors. The most prevalent online behaviors were social media use (90.1%), online shopping (15.6%), and online gaming/gambling (11.3%). Students with higher CIUS scores reported significantly lower academic achievements during the 6 months (r = 0.12–0.13; p < 0.006), as well as more severe depressive and anxiety symptoms, worsened sleep quality, and lower sense of well-being (r = 0.21–0.41; p's < 0.001). Both, during workdays (d = 0.87) and weekend (d = 0.33), students spent more time online than resident doctors (p's < 0.001).Conclusion: The brief, 5-, 7-, and 9-item versions of the Lithuanian CIUS are reliable and valid self-report screening instruments for evaluating the severity of PIU symptoms among the medical student population. Symptoms of PIU during the COVID-19 period were associated with worsened self-reported mental health and everyday functioning.

Structural Relationship among Children’s Academic Stress, Grit, Executive Function Difficulty, and Media Device Addiction

This study examined the structural relationship between children’s academic stress, grit, executive function difficulty, and media device addiction. Data on 1,132 children and their mothers from the 11&lt;sup&gt;th&lt;/sup&gt; (2018)Panel Study on Korean Children were used for the study. Data were collected by Academic Stress Scale, Grit Scale-Children, Child-Adolescent Self-reported Executive Function Difficulty Screening Questionnaire, and K-Internet Addiction Scale. Data were analyzed using SPSS 25.0 and AMOS 23.0 program with Pearson correlation, structural equation model and bootstrapping. The main results were as follows. 1) Children’s academic stress had a negative influence on their grit. 2) Children’s grit had a negative influence on their executive function difficulty and media device addiction. 3) Children’s executive function difficulty had a positive influence on their media device addiction. 4) The relationship between children’s academic stress and media device addiction was mediated by their grit and executive function difficulty. This study is significant in the sense that it found protective factors and risk factors for children’s addiction to media devices. We suggest that children’s grit be improved, and their academic stress and executive function difficulty be reduced to prevent and mediate children’s media device addiction.

Exploratory Factor Analysis of Unusual Sexual Interests

BackgroundUnusual sexual interests are largely intercorrelated, yet not much is known about underlying patterns of clusters between various sexual interests. AimTo identify underlying clusters of unusual sexual interests using exploratory factor analysis. MethodsWe conducted exploratory factor analysis with self-reported interest in a wide variety of unusual sexual acts for an online, international sample (N = 669; 61% female), and for women and men separately. Factor regression weights were correlated to self-reported sex life satisfaction, sexual outlet, and psychiatric symptoms. OutcomesParticipants rated the attractiveness of 50 unusual sexual activities, and reported on their sex life satisfaction (Arizona Sexual Experiences Scale), sexual outlet, and symptoms regarding ADHD (Adult ADHD Self-Report Screening Scale for DSM-5), depression, anxiety, and stress (Depression, Anxiety, and Stress Scale). ResultsWe identified 5 factors of unusual sexual interests that were largely comparable for women and men: submission/masochism, forbidden sexual activities, dominance/sadism, mysophilia (attraction to dirtiness or soiled things), and fetishism. For women, unusual sexual interests related to more psychiatric symptoms and higher sexual outlet, whereas this relation was less explicit for men. Clinical ImplicationsDifferent factors of unusual sexual interests may serve different underlying functions or motivations, for instance related to sexual, and emotional regulation. A better understanding of the nature of unusual sexual interests is important to be able to influence sexual interests that are unwanted or cause damage to others. Strengths & LimitationsStrength of this study include its anonymity, the avoidance of sexual orientation effects, and the possibility to indicate only a slight endorsement toward sexual items. Limitations include the sample's generalizability and the truthfulness of online responding. ConclusionUnusual sexual interests could be clustered into 5 factors that were largely comparable for women and men: submission/masochism, forbidden sexual activities, dominance/sadism, mysophilia, and fetishism. Schippers EE, Smid WJ, Huckelba AL, et al. Exploratory Factor Analysis of Unusual Sexual Interests. J Sex Med 2021;18:1615–1631.

Prevalence of and Factors Associated with Disordered Gambling Disorder, and Use of DSM-5 Based Sports Betting Questionnaire, in a Southwest Nigerian Community.

Background:Gambling disorder is rarely diagnosed in Nigeria. The prevalence and factors associated with gambling disorder in many parts of Nigeria are not known. Our study aimed to evaluate psychometric properties of the Diagnostic and Statistical Manual (DSM)-5 for use as a self-report screening instrument for large-scale studies in Nigeria.Methods:Cross-sectional surveys were done involving two independent sampled populations from a hospital setting and the surrounding community. Instruments administered included a semistructured sociodemographic questionnaire, South Oaks Gambling Screen (SOGS), International Classification of Diseases (ICD) 11 criteria, and a screening questionnaire based on Diagnostic Statistical Manual (DSM-5), which was designed as a self-report measure (Sports betting).Results:The prevalence rate for gambling disorder was 30.5%. The diagnostic accuracy of DSM-5 and ICD-11, and SOGS were comparably similar. Factors associated with gambling disorder (sports betting) were low educational level and poor employment status.Conclusion:The DSM-5-based screening questionnaire showed good psychometric properties, with sensitivity and specificity comparable to that of ICD-11 criteria and SOGS. The study also found a high prevalence of gambling disorder. There is a need to address educational and employment opportunities.

Implementing screening for social determinants of health using the Core 5 screening tool

Social determinants of health (SDOH) have been documented to underpin 80% of overall health and are being increasingly recognised as key factors in addressing tertiary health outcomes. Yet, despite the...

Psychometric assessment of two suicide screeners when used under routine conditions in military outpatient treatment programs.

Suicide remains a pressing problem among active-duty military personnel. Recent Department of Veterans Affairs and Department of Defense suicide prevention practice guidelines highlight the need for further screening research. The present study assessed the psychometric properties of 2 common self-report suicide screening tools: the Suicidal Behaviors Questionnaire-Revised (SBQ-R) and the Columbia Suicide Severity Rating Scale (C-SSRS) ideation subscale. Data (n = 200 active-duty personnel) were drawn from medical records and self-report questionnaires from 2 outpatient treatment settings in a military hospital. Primary findings include: (a) confirmatory factor analytic support for the SBQ-R but not the self-report version of the C-SSRS ideation severity subscale; and (b) acceptable reliability for both the SBQ-R and C-SSRS ideation severity subscale. Recommendations are offered for military suicide screening practice and research. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

#3113 Evaluating the PCL-C as a measure of trauma and PTSD symptoms in patients with functional neurological symptom disorder

AimsFunctional Neurological Symptom Disorder (FNSD) is common and disabling. Historically trauma was considered an essential aetiological factor, but the precise contribution of trauma to the disorder, and resulting disability, remains controversial. The PCL-C is a self-reported screening tool for PTSD symptoms based on DSM-IV criteria. A previous study in patients with FNSD demonstrated high scores on the PCL-C, with a reduction in scores following psychotherapy. However strong correlations with other psychological co-morbidities raised the possibility that the PCL-C may be capturing non-specific distress rather than indicators of previous traumatisation. The present study aimed to investigate (i) whether underlying factors measured by the PCL-C can distinguish specific trauma-memory-related symptoms from less specific emotion-regulation-related symptoms, (ii) the extent to which individual factors correlate with other psychopathology and health-related quality of life (HRQoL) measures and (iii) whether different factors change with psychotherapy, all in patients with FNSD.MethodsAn exploratory factor analysis of PCL-C responses from 473 FNSD patients pre-and post-psychotherapy was performed to generate1-4 factor models. The final factor model was determined through confirmatory factor analysis. Relationships between PCL-C factors, measures of comorbidities (depression, somatisation and anxiety) and HRQoL were assessed using regression analysis. Pre- and post-psychotherapy scores were compared.ResultsThe best model for the PCL-C comprised of two-factors: factor 1 (intrusive symptoms) explained 55.2% of the variance, whilst factor 2 (emotional dysregulation) explained 7.8% of the variance. Both factors reduced in severity after psychotherapy, but factor 2 reduced by more and correlated more strongly with a decrease in depression and anxiety than factor 1. Changes in depression, anxiety, somatic symptoms and mental HRQoL predicted 61.9% of the change in factor 2, but only 49.2% in factor 1. Improvements in mental HRQoL were strongly associated with a decrease in factor 2, but less so in factor 1.DiscussionThe factor analysis revealed the PCL-C represents two correlated but distinguishable symptom clusters in patients with FNSD: intrusive symptoms and emotional dysregulation. Both were elevated in our patient sample. The high level of intrusive symptoms suggests many patients with FNSD experience classical post-traumatic symptoms, which may indicate that subjective traumatic experiences contribute to pathogenesis and resulting disability. These symptoms showed some reduction with psychotherapy, but the greater reduction in emotional dysregulation symptoms and associated improvements in mental HRQoL suggest that psychotherapy may be more effective in reducing the burden of comorbidities and providing better coping strategies than in addressing core symptoms of the underlying disorder.

Lower Utilization of Colorectal Cancer Screening Among Vegetarians, Adventist Health Study-2.

This study aims to examine lifestyle predictors of the utilization of colorectal cancer screening. Using modified Poisson regression, we studied self-reported colorectal cancer screening utilization (colonoscopy or fecal occult blood test) with various dietary and lifestyle characteristics among 33,922 subjects aged 51 + years in the Adventist Health Study-2, a large population-based prospective cohort study. According to the multivariable-adjusted models, vegetarians were less likely to report screening: vegans, prevalence ratio (PR) = 0.80 (95% confidence interval 0.77-0.83); lacto-ovo-vegetarians (0.95 [0.93-0.97]); and semi-vegetarians (0.97 [0.94-0.99]) compared to non-vegetarians. Blacks were more likely than non-Blacks to be screened (1.04 [1.02-1.06]) and males were less likely (0.93 [0.92-0.95]) to utilize the screening tests. Older subjects were more likely to be screened, and unmarried and divorced/widowed subjects were less likely to screen. Education, personal income, and BMI were positively associated with screening, with p-value for trend < 0.001 for all three variables. A family history of colorectal cancer was associated with higher screening prevalence (1.15 [1.12-1.17]). Our stratified analyses on race and gender with dietary patterns showed non-Hispanic White vegans (PR = 0.77 [0.74-0.81]) and male vegans (PR = 0.76 [0.72-0.81]) were least likely compliant with colorectal cancer screening (p = 0.009 and p = 0.04, respectively). Vegans may believe that their personal risk for colorectal cancer is low due to their healthy lifestyle, resulting in lack of compliance to colorectal cancer screening. It remains to be seen whether vegans in AHS-2 also experience higher incidence of colorectal cancer or are diagnosed at a later stage.

Identifying mindfulness and acceptance as mediators between negative affect, functional disability and emotional distress in patients with fibromyalgia.

Fibromyalgia (FM) is a prevalent disabling condition characterised by chronic widespread pain. It is considered a complex illness in which the prognosis is conditioned by affective and cognitive mediators still largely unknown in FM. To investigate the correlation between psychological variables (acceptance, negative affect, and mindfulness) and functional disability or physical impact, anxiety/depression symptoms and emotional distress, and also to evaluate the mediating role of acceptance and mindfulness between negative affect, physical impact, anxiety/depression and emotional distress in individuals with FM. Two hundred and fifty-one patients with FM who met the 2010 ACR criteria were included and filled out validated self-reported screening measures. The study explored Pearson's correlation coefficients and multiple mediation using a Preacher and Hayes's computational software tool, including the indirect effect associated with the two mediators (mindfulness and acceptance). Functional disability or physical impact, anxiety/depression symptoms and emotional distress correlated positively with negative affect (r= 0.580) and negatively with acceptance and mindfulness (r= -0.579 and r= -0.471; all p-values <0.001), respectively. The mediation analyses showed that acceptance and mindfulness mediated the relationship between negative affect and dependent variables such as physical impact, anxiety/depression symptoms and distress. The findings highlight that mindfulness and acceptance have a significant indirect effect on physical impact, anxiety/depression and emotional distress when controlling for negative affect as an independent variable in the FM patients. Future investigation should replicate and extend these outcomes in other study populations to determine the mediating role of mindfulness and acceptance in FM.

Screen time and physical activity in children and adolescents aged 10-15 years.

BackgroundPrevious research studies have demonstrated a relationship between low levels of physical activity and high amounts of screen time in children and adolescents. However, this is usually based on self-reported data. Therefore, the aim of this cross-sectional study was to investigate the association between objectively measured smartphone screen time and physical activity among children and adolescents aged 10–15 years.MethodsDuring seven consecutive days, we objectively assessed smartphone screen time, using the SCRIIN smartphone application, and physical activity, using the SCRIIN activity tracker, in children and adolescents recruited from two schools in Stockholm County, Sweden. Moreover, the children/adolescents and their parents responded to a questionnaire, obtaining among other things: self-reported screen time, physical activity, sleep and health-related quality of life.ResultsA total of 121 children and adolescents (mean age: 12.1 ± 1.5) were included in the study. Objectively measured smartphone screen time was 161.2 ± 81.1 min/day. Mean physical activity, measured with the SCRIIN activity tracker, was 32.6 ± 16.5 active min/day. Minutes of screen time and physical activity did not differ between the children and adolescents from the two schools, despite located in different socioeconomic areas. Further, we found no association between smartphone screen time and physical activity. However, girls aged 14–15 years, had more smartphone screen time (p<0.01) and were significantly more physically active (p<0.01) than girls aged 10–12 years. In addition, boys reported more than five times more time spent on computer and video games than girls did.ConclusionSmartphone screen time was not associated with physical activity level among children and adolescents aged 10–15 years.

Australia-wide cross-sectional survey of general practitioners' knowledge and practice of lung cancer screening.

Low-dose computed tomography (LDCT) screening can reduce lung cancer deaths in high-risk individuals, yet current Australian guidelines do not recommend screening. Little is known about current screening practices in Australia. To evaluate the proportion of general practitioners who report ordering lung cancer screening for their patients, identify factors associated with ordering lung cancer screening and assess general practitioners (GP) rationale for recommending screening and preference of composition of any future national targeted screening programme. A survey was distributed to a nationally representative sample of 4000 Australian GP. The questionnaire included respondent demographics, self-reported screening practices, knowledge of screening recommendations, recent screening education, preference for recruitment methodologies for potential screening programmes and potential factors influencing the screening practices of GP. Two logistic regression models identified factors associated with self-reported chest X-ray (CXR) and LDCT screening within the past 12 months. A total of 323 GP completed the survey (participation rate 8.1%). Participants were mostly females (50.6%), from collective/group (79.1%) and metropolitan-based practices (73.5%). Despite the majority of responders understanding that screening is not recommended by Australian professional societies (71.2%), a substantial proportion of participants requested a CXR or LDCT screening (46.4% and 20.8% respectively). A variety of shared (GP reassurance, affordability of screening, believing screening is funded) and unique practice, educational and cognitive factors were associated with self-reported LDCT and CXR screening, with the strongest association being recent education about screening from radiology practices (odds ratio (aOR) for LDCT screening 10.4, P < 0.001). In Australia, lung cancer screening occurs outside a coordinated programme, and there is discordance between practice and national recommendations. This highlights an urgent need for clearer guidance from national and professional bodies.

The Validity of the World Health Organization Adult Attention-Deficit/Hyperactivity Disorder Self-Report Screening Scale for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition in Adolescence.

Objectives: Short, self-report screening measures for adolescent and adult attention-deficit/hyperactivity disorder (ADHD) would greatly enhance the likelihood of ADHD subjects to be correctly diagnosed and treated. This study aimed at testing the reliability, factor structure, convergent validity, external validity, and diagnostic accuracy of the official Italian translation of the ADHD Self-Report Screening Scale for DSM-5 (ASRS-5) in a sample of community-dwelling adolescents, extending previous data on adult participants to adolescent participants. Methods: Five hundred sixty-four community-dwelling male adolescents (mean age ≅15) were administered the ASRS-5, the Adult ADHD Self-Report Scale 18-item and 6-item versions (ASRS-18 and ASRS-6), the Wender Utah Rating Scale (WURS), and the Structured Clinician Interview for DSM-5-Clinician Version ADHD Module (SCID-5-CV-ADHD). School performance variables were also collected. Results: The item response theory (IRT) reliability of ASRS-5 was adequate. Dimensionality analyses strongly supported the unidimensional structure of ASRS-5 items; confirmatory factor analysis fit indices supported the adequacy of the one-factor model of ASRS-5. In terms of convergent validity, the ASRS-5 total score was significantly and positively associated with self-report and interview-based ADHD dimensional scores, as well as with school performance variables. Roughly 8.0% of our male adolescents met SCID-5-CV-ADHD criteria for categorical ADHD diagnosis. Ten-fold cross-validated receiver operating curve value was 0.843; precision-recall curve analysis suggests that an ASRS-5 total score >12 may be preferred for screening purposes in adolescence. Conclusions: Our data showed that the ASRS-5 may represent a psychometrically sound self-report instrument to reliably screen for DSM-5 ADHD, extending the range of application of ASRS-5 from adulthood to adolescence, suggesting that the ASRS-5 could be safely used for screening purposes also in community-dwelling adolescents, at least in its official Italian translation.