Symptomatology Scale Research Articles

Acceptability of a brief psychotherapeutic intervention protocol aimed at individuals who have experienced a highly stressful event

Introduction: we speak of highly stressful events when a situation or event has the potential to generate negative consequences in the affected individuals, such as the presence of post-traumatic and depressive symptoms. The construction of programs that prevent the occurrence of this type of response and that are accepted by users is one of the current challenges, since it can influence the expected results.Objective: to evaluate the acceptability of a brief systemic intervention protocol aimed at providing psychological support to people exposed to highly stressful events.Methods: an exploratory sequential comparative mixed design was used. A six-session program was applied, evaluating by means of scales of depressive symptomatology, post-traumatic growth and satisfaction with life in two moments pre and post, subsequently eight users and two therapists were interviewed.Results: the participants expressed a positive evaluation of the organized structure of the sessions, highlighting the empathy of the therapists as an important element. In addition, the use of relaxation techniques and narrative techniques were indicated as indicators of emotional well-being. In addition, a decrease in depressive symptoms and an increase in post-traumatic growth and life satisfaction were observed.Conclusions: the results demonstrate acceptability of the users and therapists, resulting useful for the proposed objectives.

Insight into Illness Among Inpatients in a National Forensic Mental Health Service: A Dundrum Forensic Redevelopment Evaluation Study (D-FOREST)

IntroductionForensic psychiatric services serve a dual purpose: treatment of mental disorders and prevention of associated violent reoffending. Progression along the secure care pathway is often impeded by impaired insight, mainly as a result of treatment-resistant psychoses.ObjectivesWe assessed levels of insight among patients in Ireland’s National Forensic Mental Health Service before and after its relocation from the historic 1850 campus in Dundrum to a modern facility in Portrane, Dublin.MethodsThe VAGUS insight scale was used in this repeated measures study before and after the relocation at two time points 42 months apart. All inpatients were invited to participate in completing the self-report (VAGUS-SR) and clinician-rated (VAGUS-CR) versions on both occasions. Total scores of both versions were averaged to obtain a combined VAGUS insight score. Corresponding Positive and Negative Syndrome Scale (PANSS) scores were used to ascertain correlations between the insight and symptomatology scales. This study is part of the Dundrum Forensic Redevelopment Evaluation Study (D-FOREST)Results40 pairs of observations were available for legal capacity to consent to medication, combined VAGUS-CR and VAGUS-SR assessments of insight (Cronbach’s alpha=0.927), and PANSS. VAGUS-CR insight and PANSS scores were progressively better from admission and high dependency wards through medium-term medium secure wards to rehabilitation and pre-discharge wards. Mean scores did not change significantly over this time interval. Those legally certified fit to give or withhold consent by their treating consultant psychiatrists scored significantly better on the VAGUS combined insight scale: 8.3 (SD 1.7) v 5.3 (2.2) at baseline, paired t=25.9, p<0.001; and also 42 months later: 8.2 (1.4) v 5.7 (3.9), paired t=5.2, p=0.022. PANSS subscales were all significantly better for those assessed as being capacitous. Change in combined VAGUS score correlated with change in all PANSS subscales. Binary logistic regression with legal capacity as the dependent variable yielded a model in which combined VAGUS score and PANSS positive symptom score were independent determinants of assessed capacity status. Receiver operating characteristic area under the curve was 0.873, 95% CI 0.760-0.986, at baseline and 0.856, 95% CI 0.720-0.991, at 42 months. A score of 7.3 yielded a sensitivity of 0.8 and a specificity of 0.8.ConclusionsThe combined VAGUS score is a reliable and valid measure of insight relevant to functional mental capacity to consent to treatment with sensitivity and specificity sufficient to guide but not bind clinical decision-making. It measures a quality that varies with symptom severity but is also partly independent of symptom severity; the constructive inclusion of self-reported insight is notable.Disclosure of InterestNone Declared

Evaluation of differences in quality of life in patients with chronic graft-versus-host disease

Objective: To evaluate the status of, differences in, and factors influencing quality of life (QoL) in patients with chronic graft-versus-host disease (GVHD). Methods: From September 2021 to February 2023, a cross-sectional study of 140 patients with chronic GVHD was conducted at our center. Symptom burden was assessed by the Lee Symptomatology Scale (LSS), and QoL was assessed by the Medical Outcome Study 36-Item Short-Form Health Survey (SF-36) (version 1) and five-level EuroQoL five-dimensional questionnaire (EQ-5D-5L). Results: Data from 140 respondents, including 32 (22.9%) with mild chronic GVHD, 87 (62.1%) with moderate chronic GVHD, and 21 (15.0%) with severe chronic GVHD, were analyzed. Of the respondents, 61.4% were male, and the median transplantation age was 34 (15-68) years. The primary diagnoses were acute myeloid leukemia (50.0%), acute lymphoblastic leukemia (20.0%), and myelodysplastic syndrome (15.0%). The common chronic GVHD-affected organs included the skin in 74 patients (52.9%), the eyes in 57 patients (40.7%), and the liver in 50 patients (35.7%). Among the whole cohort, the eye (20.48±23.75), psychological (16.13±17.00), and oral (13.66±20.55) scores were highest in the LSS group. The physiological function (36.07±11.13), social function (36.10±10.68), and role-emotional functioning (38.36±11.88) scores were lowest in the SF-36 group. The EQ-5D index was 0.764. The total LSS scores for mild, moderate, and severe chronic GVHD were 6.51±6.15, 10.07±5.61, and 20.90±10.09, respectively. The SF-36 physical component scores (PCSs) were 43.12±6.38, 40.73±7.14, and 36.97±6.97, respectively, and the mental component scores (MCSs) were 43.00±8.47, 38.90±9.52, and 28.96±9.63, respectively. The EQ-5D values were 0.810±0.124, 0.762±0.179, and 0.702±0.198, respectively. The multivariate analysis showed that the overall symptom burden (β=-0.517), oral symptom burden (β=-0.456), National Institute of Health (NIH) criteria for the eyes (β=-0.376), and nutrition-related symptom burden (β=-0.211) were significantly negatively correlated with the PCS. The NIH score (β=-0.260) was negatively correlated with the MCS score. Oral symptom burden (β=-0.400), joint/fascia NIH criteria (β=-0.332), number of involved systems (β=-0.253), overall NIH criteria (β=-0.205), and number of immunosuppressants taken (β=-0.171) were significantly negatively correlated with the EQ-5D score (all P<0.05). Medium to strong correlations were found between the EQ-5D score and the SF-36 score (|r|=0.384-0.571, P<0.001). Conclusions: The QoL of patients with chronic GVHD is impaired, and the more severe the disease, the poorer the QoL. Overall symptom burden, severity of eyes, and oral symptom burden were the most important factors affecting QoL.

The NETFIT trial: Smart wearable medical devices to assess the quality of life of patients with metastatic gastroenteropancreatic neuroendocrine tumors (GEP-NET).

e13627 Background: Patients diagnosed with an advanced NET are frequently deteriorating their quality of life due to tumor volume, hormone-release related symptoms and treatment toxicity. Changes on lifestyle of patients with solid tumors have shown an improvement in quality of life. However, NET patients are missed in those studies. Methods: We conducted a prospective, multicenter, observational study that included 40 patients with advanced NETs from 10 Spanish hospitals belonging to the Spanish Taskforce Group of Neuroendocrine and Endocrine Tumors (GETNE). The aim of the trial was to assess and monitor changes on different aspects in quality of life by a customized smartphone app linked to an activity wearable tracker. Data were analyzed at baseline and monthly for 16 weeks after physical activity, sleep and nutritional intervention. The primary objective was to evaluate improvement in the quality of life of patients with metastatic G1 and G2 GEP-NETs based on changes registered on the EORTC QOL-C30-GI.NET21 questionnaire during the first 16 weeks since the onset of an active systemic treatment with somatostatin analogs. Secondary endpoints included description of changes in physical exercise and sleep variables from baseline, as well as the evaluation of functional scales in patients with or without carcinoid syndrome. Results: A total of 40 patients were included in the study and all quality of life questionnaires were collected from week 0 to week 16 from 25 patients. In 15 patients there was a lack of compliance filling the questionnaires. All of the 25 patients analyzed experienced an improvement in at least one of the items of the QOL-C30 questionnaires of the primary endpoint after the first 16 weeks. As secondary outcomes it was shown a trend towards an improvement in vital signs, such as decrease in systolic blood pressure (median W0:130.7mmHg to W16:124.3mmHg p=0.3), diastolic (W0:88.7mmHg vs W16:83.3mmHg p=0.4) and heart rate (W0:93.3bpm vs W16:86bpm p=0.25). In addition, an improvement in sleep quality was observed, measured by the amount of deep REM sleep (W0:102.59 vs W16:115.3 median min/day p=0.31) or periods of light non-REM sleep (W0:301,43 vs W16:341,1 median min/day p=0.21). In the EORTC QLQ-C30 questionnaire, an improvement was observed in all functional scales (emotional function mean functional improvement (MFI) 5.3 (p=0.2), cognitive function MFI 4.0 (p=0.27), social function MFI 6.0 (p=0.3)), being deeply significant in role function (MFI 13.3 points; p=0.0156). There was an improvement in the symptomatology scales between W0 and W16, fatigue -3.7 p=0.3, nausea -1.3 p=0.5, pain -2.5 p=0.3, insomnia -9.7 p=0.05, anorexia -2.7 p= 0.3, diarrea -17.3 p=0.01. Conclusions: NETFIT trial showed that lifestyle intervention has a significant impact on the quality of life and symptomatic control of patients with metastatic G1/2 GEP-NETs.

A new approach to reduce toxicity and improve quality of life in colon cancer patients receiving adjuvant chemotherapy.

e15649 Background: We investigated the possibility of using accompanying therapy with enterosorbent in CRC patients receiving adjuvant chemotherapy. Methods: 40 pts (62 years [54.0-68.5]) with CRC (II-III) after radical surgery were randomized in 2 groups (1:1). Patients in the group 1 received ACT (XELOX), patients in group 2 received XELOX and enterosorbent "Polysorb" 30 mg orally, daily from 16 to 20 days of the ACT cycle. Results: The use of an enterosorbent can significantly reduce the manifestations of gastrointestinal toxicity: vomiting (5.0% vs 35.0%; p = 0.018), diarrhoea (5.0% vs. 40.0%; p = 0.008), flatulence ( 25.0% vs 70.0%; p = 0.004), constipation (0 vs 20.0%; p = 0.035) and abdominal pain (15.0% vs 50.0%; p = 0.018). In group 2, already by the 2nd cycle, the median scores on the QLQ-C30 symptomatology scale amounted to 22.0 points [14.0-28.5] vs 29.9 points [23.0-33.0] in the control group (p = 0.0441). By the 3 cycle in group 2, the average score on the QLQ-C29 symptomatic scale was 13.0±5.2 points (95% CI 10.5-15.4) and was significantly lower than in the control group (18.0±7.8 points (95% CI 14.3-21.6); p = 0.0224). When assessing the general condition according to the results of the analysis of the QLQ-C30 questionnaire, in the control group of patients there was a significant decrease in the number of points already by the beginning of the 2nd cycle of ACT - before the start of cycle 2 of ACT(p = 0.0369) and cycle 4 of ACT (p = 0.0447). Score of EQ-5D in the control group, significant decreases before 2 (from 84.9±6.4 points (95% CI 81.9-87.9) to 80.5 [77.55-86, 5]) (p = 0.0477) and 3 cycle ACT (from 80.5 [77.55-86.5] to 77.0±4.7 (95% CI 74.7-79.2)) (p = 0.0170), as well as a decrease in patient satisfaction with their condition at the time of the start of the 4th cycle of ACT compared with the baseline visit from 84.9±6.4 points (95% CI 81.9-87.9) to 75.7 ±6.7 points (95% CI 72.3-79.0) (p = 0.0001). Conclusions: The use of an enterosorbent as an accompanying therapy in CRC patients receiving ACT can significantly reduce the manifestation of chemotherapy toxicity and improve the quality of life of patients.

Analysis of the Mental and Physical Health Symptomatology Scale in a Sample of Emerging and Migrant Adults in Chile.

Health inequities exist in groups of greater psychosocial vulnerability such as emerging adults and migrants. The study aimed to generate evidence of the validity of the mental and physical health symptomatology scale in two samples of vulnerable groups: emerging university adults, who report high levels of mental health problems, and migrants, who report high levels of physical and mental health problems. Using non-probability sampling, in the first study, evidence of construct validity of the scale was reported in 652 emerging adults and, in the second, evidence of validity was provided from associations with the depression, stress and anxiety scale (DASS-21) among 283 migrants. The results indicate that in Study 1 the two-factor model had adequate indicators of fit and adequate reliability; only the mental health factor presented evidence of convergent validity. In Study 2, the mental health factor showed positive and large associations with the DASS-21, which decreased when the physical health symptoms factor was considered. These analyses provide evidence of validity for the scale, which is an easy-to-use instrument that allows for the assessment of health from an integral perspective.

Revisión sistemática y metaanálisis de intervenciones transdiagnósticas en línea de tercera generación

Existing meta-analyses on the effect of online psychological interventions (OPIs) have found small to medium effect sizes for the treatment of anxiety and depression. On the other hand, third-generation trans-diagnostic OPIs are very rare and, due to the large variability among disorders, symptoms or target populations, it is difficult to assess their overall effect. Other systematic reviews and meta-analyses have overly broad inclusion criteria that make the understanding of the findings more difficult. The current study aims to analyze the empirical evidence for third-wave trans-diagnostic OPIs designed to decrease symptoms and promote psychological flexibility, including studies that compare a OPI to some control condition ( e. g. , waiting list, treatment as usual or other that should not have any effect) and include a general symptomatology scale as dependent variable. A search without filters or timeframe was performed on Scopus and 1 408 articles were found, among which 21 were reviewed in depth and 6 were included for meta-analysis. Risk of bias was assessed by a quality and heterogeneity assessment. Separate meta-analyses were performed for general distress and psychological flexibility at post-treatment and last follow-up. Risk of bias analysis suggest low risk of threats to validity and attribute heterogeneity to between-study attrition rates. Additionally, meta-regression models for duration, attrition rate, and mean age are proposed for each time point. The results show significantly large effect sizes for both variables at both time points. According to the meta-regression models attrition rates are a mediating variable for the effect on general distress both at completion and at the last follow-up. On the other hand, duration, age and attrition rate are all mediating variables for the effect on psychological flexibility at the end of treatment. The findings suggest that the high attrition rates observed on tele-psychology need to be mitigated; if this is not possible, intention-to-treat approaches should be adopted for data analysis. https://doi.org/10.16888/interd.2023.40.2.5

Comparative Effectiveness of Intravenous Ketamine and Intranasal Esketamine in Real-World Setting Among Patients with Treatment Refractory Depression

Ketamine, an N-methyl-d-aspartate receptor antagonist, has been "repurposed" as a rapid-acting antidepressant for treatment-resistant depression (TRD). The s-enantiomer of ketamine, "esketamine," was FDA approved for TRD and depressive symptoms in adults with major depressive disorder with suicidal ideations/behaviors. Intravenous (IV) ketamine, although financially less expensive, is often not covered by insurance and intranasal (IN) esketamine, although covered by insurance can be expensive. There is a paucity of literature on efficacy data comparing subanesthetic IV ketamine and IN esketamine for TRD in a real-world scenario. Thus, we conducted this study comparing the efficacy and the number of treatments required to achieve remission/response with repeated use of subanesthetic IV ketamine/IN esketamine among TRD patients. This was an observational study where we included adults (≥18years) with TRD who provided consent and had received up to 6 IV ketamine infusions (0.5mg/kg, infused over 40minutes) or up to 8 intranasal (IN) esketamine (56/84mg) treatments for TRD at the Mayo Clinic Depression Center. Depression symptoms were measured utilizing the self-report 16-Item Quick Inventory of Depressive Symptomatology (QIDS-SR) scale before and 24hours after ketamine/esketamine treatment. Remission and response were defined as QIDS-SR 16 score ≤5 and ≥50% change in QIDS-SR 16, respectively. Continuous variables are reported as means±SD and categorical variables as counts and percentages. The Wilcoxon rank-sum test was used to compare continuous variables. Chi-square and Fisher's exact tests were used to compare categorical variables. The number of treatments to remission/response was calculated. Sixty-three adults with TRD, middle-aged (47.0±12.1 years), predominantly female (65%), of which 76% (n=48) and 24% (n=15) received IV ketamine and IN esketamine, respectively. Mean (SE) change in QIDS-SR 16 score was -8.7±0.7 (P<.001), a significant reduction (improvement) from baseline (mean±SD=17.6±3.7). Overall remission and response rates were 36.5% and 55.6%, respectively in the acute phase. Response (56.3% vs 53.3%) and remission rates (39.6% vs 26.7%) were similar among patients who received IV ketamine or IN esketamine, respectively (P>.05). The mean number of treatments received to achieve response (2.5±1.6 vs 4.6±2.1) and remission (2.4±1.3 vs 6.3±2.4) were significantly lower among patients who received IV ketamine compared to IN esketamine (P<.005). Most patients tolerated both treatments well. Intravenous ketamine and intranasal esketamine showed similar response/remission in TRD patients but the number of treatments required to achieve response/remission was significantly lower with IV ketamine compared to IN esketamine. These findings need to be investigated in a randomized control trial comparing these two treatment interventions. No funding.

Cognitive consequences of COVID-19: results of a cohort study from South America.

Neurological and psychiatric manifestations associated with SARS-CoV-2 infection have been reported throughout the scientific literature. However, studies on post-COVID cognitive impairment in people with no previous cognitive complaint are scarce. We aim to investigate the impact of COVID-19 on cognitive functions in adults without cognitive complaints before infection and to study cognitive dysfunction according to disease severity and cognitive risk factors. Forty-five post-COVID-19 patients and forty-five controls underwent extensive neuropsychological evaluation, which assessed cognitive domains such as memory, language, attention, executive functions, and visuospatial skills, including psychiatric symptomatology scales. Data were collected on the severity of infection, premorbid medical conditions, and functionality for activities of daily living before and after COVID-19. Significant differences between groups were found in cognitive composites of memory (p=0.016, Cohen's d= 0.73), attention (p<0.001, Cohen's d=1.2), executive functions (p<0.001, Cohen's d=1.4), and language (p=0.002, Cohen's d=0.87). The change from premorbid to post-infection functioning was significantly different between severity groups (WHODAS, p=0.037). Self-reported anxiety was associated with the presence of cognitive dysfunction in COVID-19 subjects (p=0.043). Our results suggest that the presence of cognitive symptoms in post-COVID-19 patients may persist for months after disease remission and argue for the inclusion of cognitive assessment as a protocolized stage of the post-COVID examination. Screening measures may not be sufficient to detect cognitive dysfunction in post-COVID-19 patients.

Identification Performance During Quarantine by COVID-19 Pandemic: Influence of Emotional Variables and Sleep Quality.

The COVID-19 pandemic has caused major disruptions in people’s lives around the globe. Sleep habits and emotional balance have been disturbed in a way that could be comparable to the havoc caused by a deep personal crisis or a traumatic experience. This unfortunate situation provides a unique context in which to study the impact of these imbalances on cognitive processes. In particular, the field of eyewitness science could benefit from these conditions, since they are also often present in crime victims, but can only be generated in the laboratory up to a certain ethical and practical limit. For several decades, eyewitness studies have tried to discover what variables affect people’s ability to properly recognize faces. However, the disparity of experimental designs and the limitations of laboratory work could be contributing to the lack of consensus around several factors, such as sleep, anxiety, and depression. Therefore, the possibility of observing the influence of these agents in natural contexts could shed light on this discussion. Here, we perform simple and repeated lineups with witnesses of mock-crime, considering the conditions related to the COVID-19 pandemic, which to some extent allow emulating the deterioration in general well-being that often afflicts crime victims. For this, 72 participants completed symptomatology scales, and watched a video portraying a staged violent episode. Subsequently, they gave testimony and participated in two lineups, in which we manipulated the presence/absence of the perpetrator, to recreate critical scenarios for the appearance of false recognitions. We found an increase in recognition errors in those individuals who did not have access to the perpetrator during the Initial lineup. Additionally, the conditions of the pandemic appear to have adversely affected the ability to witness and accurately perform lineups. These results reaffirm the need to move toward the standardization of research practices and methods for assessing testimonial evidence, especially in relation to the results of the lineups. Considering the degree of fallibility of these processes can lead to a reduction of wrongful convictions.

Abstract 901: Quality of life among oropharyngeal cancer survivors

Abstract Purpose: Oropharyngeal cancer incidence continues to increase in the United States. Studies on the quality of life (QOL) experienced by oropharyngeal cancer patients usually assessed QOL one year after diagnosis instead of in the long term, and most were hospital-based. The aim of this study is to assess oral health and QOL in oropharyngeal cancer survivors in a population-based cohort over a long term follow-up. Methods: First primary oropharyngeal cancer patients, with confirmed cancer diagnosis from 1996 to 2016 were identified in the Utah Cancer Registry. Between January and May of 2019, the patients completed the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core-30 (EORTC QLQ-C30), Quality of Life Questionnaire Head and Neck Cancer Module (EORTC QLQ-H&amp;N35) and Oral Health Impact Profile-14 (OHIP-14) questionnaire. Adjusted linear regression was used to assess associations between each dependent variables and QoL scores. The global health mean score ranges from 0 to 100; &amp;gt;70 is considered a high level of functioning and &amp;lt;70 is associated with lower level of symptomology based on previous studies. The OHIP-14 score ranges from 0 to 56; &amp;lt;9 is considered better functioning for oral health. Results: Among 262 oropharyngeal cancer survivors, 84.0% were male, 74.7% were sixty and older at cancer diagnosis, 21.8% were overweight (µ=26.5 (sd=4.9) kg/m2). More than half of participants had seen a dentist within the last 6 months (65.8%) and were former smokers (51.1%). The global QoL means scores for 1996-2000, 2001-2005, 2006-2010, and 2011-2016 were 77.5 (sd=16.3), 73.4 (sd=17.6), 67.3 (sd=24.1), and 73.4 (sd=20.4). Both the global QoL mean score (72.0 (sd=20.8)) and the OHIP-14 mean score (13.2 (sd=13.9)) were fairly high. Similarly, individual QoL physical, role, emotional, cognitive, and social mean scores from the QLQ-30 were also fairly high, ranging from 77.8 to 85.9. From the EORTC H&amp;N35 symptomatology scale, the highest symptom related mean scores were observed for weight gain (85.8 (sd=35.0)), pain-killers use (64.4 (sd=48.0)), and dry mouth (61.7 (sd=35.6)). Higher global QoL mean scores were seen with higher education (postgraduate vs technical school, 81.9 (sd=19.3) vs 67.9 (sd=22.4)), higher income ($100,000+ vs less than $25,00, 76.4 (sd=17.3) vs 60.2 (sd=24.6)), younger age (&amp;lt;40 vs &amp;gt;70, 87.5 (sd=17.7) vs 71.9 (sd=2.6)), and BMI (&amp;lt;18.5 vs 18.5-24.9, 45.8 (sd=26.7) vs 74.8 (sd=20.2)). Conclusion: Global QoL improvement suggests adaptability to a new normal among this group of U.S. oropharyngeal cancer survivors when compared to previous studies which were largely based on a shorter follow-up time. Oral health-related quality of life was marginally poor in our study, suggesting needed improvement in patient management overtime, with worse improvement in physical discomfort and physical disability scores across all demographic patient characteristics except with distant stage and recurrence. Citation Format: Alzina Koric, Marcus Monroe, Seungmin Kim, Esther Chang, Qingqing Hu, Siqi Hu, Mia Hashibe. Quality of life among oropharyngeal cancer survivors [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 901.

The Impact of Interparental Conflicts on Online Game Addiction Symptomatology: The Mediating Roles of the Parent-Adolescent Relationship and Loneliness in Adolescents.

Many studies have documented the close association that exists between interparental conflicts and the symptomatology of online game addiction. However, the underlying mechanism that drives this association has not been fully investigated. This cross-sectional study explores the effect of interparental conflicts on online game addiction symptomatology in adolescents, focusing on the mediating effects of the parent-adolescent relationship and of adolescent loneliness. A total of 553 middle school students completed a questionnaire that included: a perception of interparental conflict scale, a level of closeness to parents scale, a short UCLA Loneliness scale, and an online game addiction symptomatology scale. Results showed that interparental conflicts, parent-adolescent relations, and adolescent loneliness are all significantly related to online game addiction symptomatology in adolescents. Structural equation modeling results indicate that the effects of interparental conflicts on adolescent online game addiction symptomatology are partially mediated by the parent-adolescent relationship and by adolescent loneliness.

Mediating Role of Emotional Neglect and Self-Injurious Behaviors in the Relationship Between Family Satisfaction and Depression

The current research is aimed at investigating the mediating role of emotional neglect and self-injurious behaviors in the association between family satisfaction and depressive symptoms in 312 undergraduates (45% boys and 55% girls) in the age range of 14–19 years ( M = 17.23, SD = 1.02). The measures include the Emotional Neglect Scale, Self-Injurious Behaviors Scale, Family Satisfaction Scale, and Depressive Symptomatology Scale for Adolescents and a Demographic Performa. Results indicated that emotional neglect and self-injurious behaviors fully mediated the relationship between family satisfaction and depressive symptoms in college students. These findings have very important implications for counselors to provide tailor-made intervention plans and provide preventative measures to avoid serious consequences of depression.

The Neurostimulation of the Brain in Depression Trial: Protocol for a Randomized Controlled Trial of Transcranial Direct Current Stimulation in Treatment-Resistant Depression.

BackgroundMajor depressive disorder (MDD) is the second highest cause of disability worldwide. Standard treatments for MDD include medicine and talk therapy; however, approximately 1 in 5 Canadians fail to respond to these approaches and must consider alternatives. Transcranial direct current stimulation (tDCS) is a safe, noninvasive method that uses electrical stimulation to change the activation pattern of different brain regions. By targeting those regions known to be affected in MDD, tDCS may be useful in ameliorating treatment-resistant depression.ObjectiveThe objective of the Neurostimulation of the Brain in Depression trial is to compare the effectiveness of active versus sham tDCS in treating patients with ultraresistant MDD. The primary outcome will be the improvement in depressive symptoms, as measured by the change on the Mongtomery-Asberg Depression Rating Scale. Secondary outcomes will include changes in the Quick Inventory of Depressive Symptomatology Scale (subjective assessment), the World Health Organization Disability Assessment Schedule 2.0 (functional assessment), and the Screen for Cognitive Impairment in Psychiatry (cognitive assessment). Adverse events will be captured using the Young Mania Rating Scale; tDCS Adverse Events Questionnaire; Frequency, Intensity, and Burden of Side Effects Rating Scale; and Patient-Rated Inventory of Side Effects Scale. A parallel component of the study will involve assaying for baseline language function and the effect of treatment on language using an exploratory acoustic and semantic corpus analysis on recorded interviews. Participant accuracy and response latency on an auditory lexical decision task will also be evaluated.MethodsWe will recruit inpatients and outpatients in the city of Edmonton, Alberta, and will deliver the study interventions at the Grey Nuns and University of Alberta Hospitals. Written informed consent will be obtained from all participants before enrollment. Eligible participants will be randomly assigned, in a double-blinded fashion, to receive active or sham tDCS, and they will continue receiving their usual pharmacotherapy and psychotherapy throughout the trial. In both groups, participants will receive 30 weekday stimulation sessions, each session being 30 minutes in length, with the anode over the left dorsolateral prefrontal cortex and the cathode over the right. Participants in the active group will be stimulated at 2 mA throughout, whereas the sham group will receive only a brief period of stimulation to mimic skin sensations felt in the active group. Measurements will be conducted at regular points throughout the trial and 30 days after trial completion.ResultsThe trial has been approved by the University of Alberta Research Ethics Board and is scheduled to commence in June 2021. The target sample size is 60 participants.ConclusionsThis is a protocol for a multicenter, double-blinded, randomized controlled superiority trial comparing active versus sham tDCS in patients with treatment-resistant MDD.Trial RegistrationClinicalTrials.gov NCT04159012; http://clinicaltrials.gov/ct2/show/NCT04159012.International Registered Report Identifier (IRRID)PRR1-10.2196/22805

Social impairments in alternating hemiplegia of childhood.

To evaluate presence and severity of social impairments in alternating hemiplegia of childhood (AHC) and determine factors that are associated with social impairments. This was a retrospective analysis of 34 consecutive patients with AHC (19 females, 15 males; mean age: 9y 7mo, SD 8y 2mo, range 2y 7mo-40y), evaluated with the Social Responsiveness Scale, Second Edition (SRS-2). SRS-2 scores, indicating level of social impairment, were higher than population means (75, SD 14 vs 50, SD 10, p<0.001). Of these, 27 out of 34 had high scores: 23 severe (>76), four moderate (66-76). All subscale domains, including social cognition, social communication, social awareness, social motivation, restricted interests, and repetitive behavior, had abnormal scores compared to population means (p<0.001). High SRS-2 scores were associated with the presence of autism spectrum disorder (ASD) and epilepsy (p=0.01, p=0.04), but not with other scales of AHC disease symptomatology. All nine patients who received formal evaluations for ASD, because they had high SRS-2 scores, were diagnosed with ASD. Most patients with AHC have impaired social skills involving multiple domains. ASD is not uncommon. High SRS-2 scores in patients with AHC support referral to ASD evaluation. Our findings are consistent with current understandings of the pathophysiology of AHC and ASD, both thought to involve GABAergic dysfunction. Most patients with alternating hemiplegia of childhood (AHC) have impaired social skills involving multiple domains. These impairments are significant compared to population means. Most patients with AHC have high Social Responsiveness Scale, Second Edition (SRS-2) scores. Patients with AHC with high SRS-2 scores are likely to have autism spectrum disorder.

Indicators to distinguish symptom accentuators from symptom producers in individuals with a diagnosed adjustment disorder: A pilot study on inconsistency subtypes using SIMS and MMPI-2-RF.

In the context of legal damage evaluations, evaluees may exaggerate or simulate symptoms in an attempt to obtain greater economic compensation. To date, practitioners and researchers have focused on detecting malingering behavior as an exclusively unitary construct. However, we argue that there are two types of inconsistent behavior that speak to possible malingering-accentuating (i.e., exaggerating symptoms that are actually experienced) and simulating (i.e., fabricating symptoms entirely)-each with its own unique attributes; thus, it is necessary to distinguish between them. The aim of the present study was to identify objective indicators to differentiate symptom accentuators from symptom producers and consistent participants. We analyzed the Structured Inventory of Malingered Symptomatology scales and the Minnesota Multiphasic Personality Inventory-2 Restructured Form validity scales of 132 individuals with a diagnosed adjustment disorder with mixed anxiety and depressed mood who had undergone assessment for psychiatric/psychological damage. The results indicated that the SIMS Total Score, Neurologic Impairment and Low Intelligence scales and the MMPI-2-RF Infrequent Responses (F-r) and Response Bias (RBS) scales successfully discriminated among symptom accentuators, symptom producers, and consistent participants. Machine learning analysis was used to identify the most efficient parameter for classifying these three groups, recognizing the SIMS Total Score as the best indicator.

The effectiveness and impact of an intervention program on migration and health with Mexican undergraduate students

Abstract Migration has psychological impact on those that migrate, and on their families left behind. We evaluate an intervention program to strengthen individual, social, and family resources in 120 Mexican undergraduate students with migration in their families. The study was a quasi-experimental design. Data was gathered before, during, at the end, of the intervention and a year after. Depressive symptomatology, individual, social and family resources scales were evaluated. Participants increased their individual, social, and family resources, and decreased their depressive symptomatology more than the control group. We concluded that interventions within an educational and reflective open discussion space will help to address psychosocial problems in immigrant families member left behind.

Risk tolerance measured by probability discounting among individuals with primary mood and psychotic disorders.

Change in risk tolerance is a feature of multiple psychiatric disorders and may contribute to adverse outcomes. We used a probability discounting (PD) task to measure risk-taking behavior among individuals with bipolar disorder (BPAD), major depressive disorder (MDD), schizoaffective disorder (SCAD), and schizophrenia (SCZ). A PD task was administered to 117 patients and 88 healthy controls (HCs), along with a cognitive battery using the Cambridge Neuropsychological Test Automated Battery, and relevant symptomatology scales. We examined differences in PD rates between diagnostic groups, and compared with HCs, while controlling for potential confounding factors including measures of cognitive functioning. Individuals with a diagnosis of BPAD or SCAD/SCZ prefer smaller, more guaranteed rewards rather than larger, less likely rewards as compared with healthy controls (p = .002 and p = .034, respectively). There was no effect of performance on cognitive tasks, antipsychotic treatment, or symptomatology on the rate of probability discounting. This study supports the transdiagnostic measurement of risk-taking behaviors, even when such behaviors are not the primary area of psychopathology. Quantifying risk-taking may enable targeted therapeutic strategies across disorders. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

A phase 2, double-blind, placebo-controlled study of NSI-189 phosphate, a neurogenic compound, among outpatients with major depressive disorder

NSI-189 is a novel neurogenic compound independent of monoamine reuptake pathways. This trial evaluated oral NSI-189 as monotherapy in major depressive disorder. To improve signal detection, the sequential-parallel comparison design (SPCD) was chosen. Two hundred and twenty subjects were randomized to NSI-189 40 mg daily, 80 mg daily, or placebo for 12 weeks. The primary outcome measure was the Montogmery Asberg Depression Rating Scale (MADRS). Secondary subject-rated measures included the Symptoms of Depression Questionnaire (SDQ), the Cognitive and Physical Functioning Scale (CPFQ), the patient-rated version of the Quick Inventory of Depressive Symptomatology Scale (QIDS-SR), and subtests from the CogScreen and Cogstate cognitive tests. MADRS score reduction versus placebo did not reach significance for either dose (40 mg pooled mean difference −1.8, p = 0.22, 80 mg pooled mean difference −1.4, p = 0.34, respectively). However, the 40 mg dose showed greater overall reduction in SDQ (pooled mean difference −8.2; Cohen’s d for Stages 1 and 2 = −0.11 and −0.64, p = 0.04), and CPFQ scores (pooled mean difference −1.9; Cohen’s d for Stages 1 and 2 = −0.28 and −0.47, p = 0.03) versus placebo, as well as QIDS-SR scores in Stage 2 of SPCD (−2.5; Cohen’s d Stages 1 and 2 = −0.03 and −0.68, p = 0.04). The 40 mg dose also showed advantages on some objective cognitive measures of the CogScreen (absolute Cohen’s d ranged between 0.12 and 1.12 in favor of NSI-189, p values between 0.002 and 0.048 for those with overall significance), but not the Cogstate test. Both doses were well tolerated. These findings replicate those of phase 1b study, and warrant further exploration of the antidepressant and pro-cognitive effects of NSI-189.

Executive functions and clinical symptoms in children exposed to maltreatment

There is evidence of an association between childhood maltreatment and lifelong cognitive impairment. Few studies investigate cognitive functioning in maltreated children. The objective of this study was to investigate whether there are differences in executive processing between maltreated and nonmaltreated children. Additionally, clinical symptoms were compared between groups and possible associations between clinical symptoms, and deficits in executive functions were investigated. The sample consisted of 55 children (8–12 years), 30 with a history of maltreatment and 25 with no history of maltreatment. An interview was conducted with the child’s legal guardian and instruments were administered: Juvenile Victimization Questionnaire (JVQ), Child Behavior Checklist (CBCL), and Spence Children’s Anxiety Scale (SCAS). The following clinical instruments were administered to the children: JVQ, Trauma Symptom Checklist for Children (TSCC), and Children’s Depression Inventory (CDI). Children underwent neuropsychological assessment. Data were analyzed by comparing the groups for clinical and cognitive variables. Differences were found between the groups in all executive functions. Most clinical symptomatology scales showed differences between the groups. Few associations were found between clinical and executive impairment profiles. Cognitive stimulation interventions, focused on inhibitory control, should be proposed in combination with psychotherapy.