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Cureus Nov 2021Chronic pain is defined as pain that persists following tissue injury or disease processes and is believed to have taken place after healing. It is a functional...
Chronic pain is defined as pain that persists following tissue injury or disease processes and is believed to have taken place after healing. It is a functional impairment that causes discomfort and leads to the inability to perform various essential daily activities. Chronic pain in pediatrics can be of various types, the most commonly prevalent types being headaches, abdominal pain, and limb pain. Adolescents with chronic pain have been found to have generalized anxiety scores twice that of the average population, along with significant impairment of family dynamics. Some forms of chronic pain respond effectively to medication and psychotherapy, and recurrence is common when stress is triggered by external or environmental factors, most recently in the form of COVID-19. In this case series, we discuss three cases of worsening mental health presentations and chronic pain exacerbation in the context of the COVID-19 pandemic. We talk about the unique perspective of chronic pain in the pediatric population and comorbid mental illnesses and their management from a psychiatric standpoint.
PubMed: 34987917
DOI: 10.7759/cureus.20032 -
Frontiers in Psychiatry 2021Almost a century after Jacob Levy Moreno pioneered the group practice of psychodrama, research in this area has flourished to include different sub-fields of study and...
Almost a century after Jacob Levy Moreno pioneered the group practice of psychodrama, research in this area has flourished to include different sub-fields of study and psychodramatic intervention for various psychological conditions. By making use of scientometric analysis, particularly document citation analysis and keyword analysis, this study maps out dominant research domains in psychodrama since its inception. From these findings, projections of future research trends and an evaluation of psychodrama research are discussed. Generally, there has been an increased adoption of technology to facilitate psychodrama practice, along with an increasing integration of psychodramatic principles with other psychotherapies. To improve research in this area, this paper recommends greater transparency in the reporting of materials, processes and data used in publications. Finally, we encourage embracing new technological methods such as neuroimaging to provide greater insight into mechanisms of change in psychodrama. The field of psychodrama remains full of potential and innovations to be developed.
PubMed: 34867562
DOI: 10.3389/fpsyt.2021.780542 -
Social Work With Groups 2021Blacks/African Americans have the most severe and disproportionate burden of HIV of all racial/ethnic groups in the United States. Oppression (i.e., socio-structural...
Blacks/African Americans have the most severe and disproportionate burden of HIV of all racial/ethnic groups in the United States. Oppression (i.e., socio-structural (macro), institutional (exo), community (meso), and interpersonal (micro)), operates as four interrelated prongs that perpetuate the HIV epidemic in Black/ African American communities. Oppressive (i.e., racist and sexist) cultural scripts transferred to individuals through community, family and interpersonal relationships may play a role in HIV/STI risk. However, socio-behavioral health interventions or behavioral risk reduction interventions have traditionally focused solely on individual-level health risk behaviors allowing invisible, inequitable socio-structural factors to continue unchallenged. A new intervention, was sculpted from two existing interventions and (MAALES) to develop awareness of oppressive cultural scripts operating on interpersonal and intrapersonal levels and to take action against these oppressive messages to reclaim identity, restore relationships, and build community. This paper summarizes the theory and selected sociodramatic components of the intervention that promote healing in action to reduce HIV/STI risk among heterosexually identified, low-income African American men and women with multiple sex partners. Lessons learned in theory, research and practice are also discussed.
PubMed: 34483402
DOI: 10.1080/01609513.2020.1757923 -
Frontiers in Psychology 2021Empirical studies in the creative arts therapies (CATs; i.e., art therapy, dance/movement therapy, drama therapy, music therapy, psychodrama, and poetry/bibliotherapy)...
Empirical studies in the creative arts therapies (CATs; i.e., art therapy, dance/movement therapy, drama therapy, music therapy, psychodrama, and poetry/bibliotherapy) have grown rapidly in the last 10 years, documenting their positive impact on a wide range of psychological and physiological outcomes (e.g., stress, trauma, depression, anxiety, and pain). However, it remains unclear and the CATs have positive effects, and which therapeutic factors account for these changes. Research that specifically focuses on the therapeutic factors and/or mechanisms of change in CATs is only beginning to emerge. To gain more insight into how and why the CATs influence outcomes, we conducted a scoping review ( = 67) to pinpoint therapeutic factors specific to each CATs discipline, joint factors of CATs, and more generic common factors across all psychotherapy approaches. This review therefore provides an overview of empirical CATs studies dealing with therapeutic factors and/or mechanisms of change, and a detailed analysis of these therapeutic factors which are grouped into domains. A framework of 19 domains of CATs therapeutic factors is proposed, of which the three domains are composed solely of factors unique to the CATs: "embodiment," "concretization," and "symbolism and metaphors." The terminology used in change process research is clarified, and the implications for future research, clinical practice, and CATs education are discussed.
PubMed: 34366998
DOI: 10.3389/fpsyg.2021.678397 -
Frontiers in Psychology 2021In the midst of a global pandemic, psychology has a duty to identify dispositional or character traits that can be cultivated in citizens in order to create resiliency...
In the midst of a global pandemic, psychology has a duty to identify dispositional or character traits that can be cultivated in citizens in order to create resiliency in the face of profound losses, suffering and distress. Dispositional joy holds some promise as such a trait that could be especially important for well-being during the current pandemic and its consequences. The concept of the Joyful Life may operate as bridge between positive psychology and humanistic, existential, and spiritual views of the good life, by integrating hedonic, prudential, eudaimonic and chaironic visions of the good life. Previous phenomenological research on state joy suggests that momentary states of joy may have features that overlap with happiness but go beyond mere hedonic interests, and point to the experience of a life oriented toward virtue and a sense of the transcendent or the sacred. However, qualitative research on the Joyful Life, or dispositional joy, is sorely lacking. This study utilized a dialogical phenomenological analysis to conduct a group-based analysis of 17 volunteer students, who produced 51 autobiographical narrative descriptions of the joyful life. The dialogical analyses were assisted by integration of the Imagery in Movement Method, which incorporated expressive drawing and psychodrama as an aid to explicate implicit themes in the experiences of the participants. The analyses yielded ten invariant themes found across the autobiographical narrative descriptions: Being broken, being grounded, being centered, breaking open, being uplifted, being supertemporal, being open to the mystery, being grateful, opening up and out, and being together. The descriptions of a Joyful Life were consistent with a meaning orientation to happiness, due to their emphasis on the cultivation of virtue in the service of a higher calling, the realization of which was felt to be a gift or blessing. The discussion examines implications for future research, including the current relevance of a joyful disposition during a global pandemic. Due to the joyful disposition's tendency to transform suffering and tragedy into meaning, and its theme of an orientation to prosocial motivations, the Joyful Life may occupy a central place in the study of resiliency and personal growth in response to personal and collective trauma such as COVID-19.
PubMed: 34366969
DOI: 10.3389/fpsyg.2021.648600 -
Addictive Behaviors Dec 2021Esports has become one of the major online entertainment activities around the globe. Different from the previously dominant massively multiplayer online role-playing...
Esports has become one of the major online entertainment activities around the globe. Different from the previously dominant massively multiplayer online role-playing games, esports gaming has its unique structural characteristics, which substantially reshape the motivations, experiences, and behaviors of game users while raising new questions for research on Internet gaming disorder. In addition to identifying four structural characteristics of esports, the present study analyzed their implications from both theoretical and practical perspectives and conducted a cross-cultural examination by utilizing accurate and objective match history data of esports gamers in five different geographic regions (countries). Several findings of interest were obtained in this study. First, having in-game friend(s) in a premade team significantly increased gamers' propensity to play consecutive matches. Second, whereas Nordic and Eastern European gamers tended to play additional matches following wins, Japanese gamers were inclined to do so after experiencing losses. Third, low and high-skilled gamers were more likely to engage in consecutive play than their middle-skilled counterparts. With a focus on the competitive nature of esports, this study demonstrated that the presence of friend(s), the outcome of the previous match, and the level of gaming skill can significantly influence esports gamers' involvement.
Topics: Behavior, Addictive; Cross-Cultural Comparison; Humans; Internet; Motivation; Role Playing; Video Games
PubMed: 34332273
DOI: 10.1016/j.addbeh.2021.107056 -
The Arts in Psychotherapy Sep 2021Italy was severely hit by the COVID-19 pandemic. In early March 2020, a series of legislative decrees have been issued, establishing the restrictions that all Italian...
Italy was severely hit by the COVID-19 pandemic. In early March 2020, a series of legislative decrees have been issued, establishing the restrictions that all Italian citizens are required to respect, according to which it is strictly forbidden to leave the house if not for reasons of necessity, health, or work. This qualitative study investigated which aspects clients find helpful or hindering in shifting to group tele-psychodrama due to the COVID-19 pandemic, after participation in an in-person psychodrama group. Participants were 15 adults who were members of a pre-existing in-person psychodrama group that shifted to a tele-psychodrama group format facilitated by two psychodrama therapists. The Client Change Interview was used at the end of the tele-psychodrama as a post-treatment assessment. All the interviews were transcribed and then underwent a thematic analysis. The analysis yielded six shared themes: the role of tele-psychodrama sessions during COVID-19 pandemic; perceived effectiveness of tele-psychodrama; main advantages of tele-psychodrama; limitations encountered during the online intervention; the termination of tele-psychodrama; and the relationship with the therapist. The findings provide preliminary evidence for the clinical practice of tele-psychodrama and lays the groundwork for further studies that can contribute to the use of electronic platforms in psychodrama interventions.
PubMed: 34305221
DOI: 10.1016/j.aip.2021.101836 -
Journal of Behavioral Addictions Jul 2021Previous studies have reported that stronger avatar identification and negative self-concept are associated with gaming disorder (GD). This study aimed to examine the...
BACKGROUND AND AIMS
Previous studies have reported that stronger avatar identification and negative self-concept are associated with gaming disorder (GD). This study aimed to examine the value and significance of avatars based on firsthand accounts from regular and problematic gamers, and to identify any potential links between avatar-related experiences and excessive gaming.
METHODS
An online survey of 993 adult gamers yielded 3,972 text responses. Qualitative analysis of 59,059 words extracted 10 categories of avatar-related perspectives.
RESULTS
Some problem and non-problem gamers employed sentimental language (e.g., 'dear friend', 'like a child', 'part of my soul') to refer to their avatar. However, most participants perceived avatars as a means of achieving in-game goals and enabling greater interactivity (e.g., socializing). When asked to reflect on hypothetically losing their avatar, participants generally anticipated feeling temporary frustration or annoyance due to lost time and effort invested into the avatar. Although some participants reported that their avatar 'mattered', avatars were often considered as superficial ('just pixels') and peripheral to the primary reinforcement of achieving in-game rewards and objectives. Some broader psychological and identity issues such as gender dysphoria, rather than 'addiction', were cited as motivating persistent avatar-related interactions and attachment.
DISCUSSION AND CONCLUSIONS
Participants reported diverse views on the psychological value and function of avatars, but the relationship between avatars and problematic gaming or GD was largely unclear or inconsistent, and refuted by some participants. Future research with clinical samples may lead to a better understanding of player-avatar processes, including whether avatar-stimuli facilitate the development of maladaptive gaming habits, particularly among psychologically vulnerable players. Future investigations should be mindful of 'overpathologizing' avatar-related phenomena and recognize their important role in socializing, storytelling, and creative expression among gamers.
Topics: Adult; Female; Goals; Humans; Internet Addiction Disorder; Male; Motivation; Qualitative Research; Role Playing; Self Concept; Social Identification; Video Games
PubMed: 34280128
DOI: 10.1556/2006.2021.00038 -
BMC Medical Education Jul 2021Low back pain (LBP) is a condition with a high global prevalence, which is getting health professionals' attention, including physiotherapists as they must have the... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Low back pain (LBP) is a condition with a high global prevalence, which is getting health professionals' attention, including physiotherapists as they must have the skills to provide treatment that increases the patient's quality of life. Clinical simulations could be a pedagogic strategy that facilitates adequate training for students to acquire skills to improve their professional reasoning in this clinical situation.
OBJECTIVE
This study sought to determine the effects of clinical simulations with simulated patients (SP) on the physiotherapy students' clinical decision-making within a role-playing (RP) scenario while caring of LBP patients.
METHODS
This experimental study included 42 participants from two Colombian universities, randomized into two groups (SP, n = 21; RP, n = 21). The clinical skill of performing the Objective Structured Clinical Examination (OSCE-LBP) was evaluated while students cared for patients with LBP; after that, a pedagogical method was conducted that included clinical simulation and, finally, the OSCE-LBP was applied again to compare both groups.
RESULTS
Changes occurred in the OSCE-LBP among both groups of students: the scores increased (0.66 and 0.59 in RP and SP, respectively), and neither of the two was superior (p value 0.01; 95%CI - 0.21 to 0.23).
CONCLUSION
Both types of simulation favor decision-making in professional reasoning in physiotherapy students during interactions with individuals with LBP. Trial registration https://clinicaltrials.gov/ct2/show/NCT04428892 Identifying number: NCT04428892. It was retrospectively registered.
Topics: Humans; Low Back Pain; Physical Therapy Modalities; Quality of Life; Role Playing; Students
PubMed: 34243767
DOI: 10.1186/s12909-021-02812-7 -
BMC Medical Education Jun 2021The traditional curriculum for medical students in Japan does not include sufficient opportunities for students to develop their skills for musculoskeletal (MSK)...
BACKGROUND
The traditional curriculum for medical students in Japan does not include sufficient opportunities for students to develop their skills for musculoskeletal (MSK) examination and clinical reasoning and diagnosis. Therefore, an effective programme is required to help medical students and residents improve their clinical skills in MSK. This paper aims to assess the clinical skills of medical students who have participated in a peer role-playing simulation programme using a mini clinical evaluation exercise (mini-CEX).
METHODS
Participants were 90 female medical students who were completing their first orthopaedic clinical clerkship. They were divided into two groups. The simulation group participated in a role-play focussed on MSK cases as low-fidelity simulation, a structured debriefing with the course supervisor, and a self-reflection on Day 1 (n = 64). The control group did not participate in the role-play due to randomised clerkship schedules (n = 26). On Day 2 of the intervention, we observed and assessed all participants' performances during MSK outpatient encounters using the mini-CEX. We compared the mini-CEX score between the simulation group and the control group; the Wilcoxon rank-sum test was used for statistical analysis.
RESULTS
The mini-CEX scores for physical examination, clinical reasoning and diagnosis, and overall clinical competency were significantly higher in the simulation group than in the control group (p < .05, physical examination: p = .014, clinical reasoning: p = .042, overall: p = .016). These findings suggest that medical students who partake in a peer role-playing simulation programme could experience improved clinical skills for physical examination, clinical reasoning and diagnosis, and overall clinical competency in real-life MSK outpatient encounters.
CONCLUSIONS
Through a mini-CEX assessment, our findings indicate that medical students who participated in our peer role-playing simulation programme have improved clinical skills. Peer role-playing as a low-fidelity simulation and practical educational opportunity will enable educators to polish the competency of medical students in musculoskeletal physical examinations and clinical reasoning and diagnosis in a clinical setting.
Topics: Clinical Clerkship; Clinical Competence; Female; Humans; Japan; Physical Examination; Role Playing
PubMed: 34090441
DOI: 10.1186/s12909-021-02742-4