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JMIR Mental Health Jun 2024Internet-based cognitive behavioral interventions (iCBTs) are efficacious treatments for depression and anxiety. However, it is unknown whether adding human guidance is... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Internet-based cognitive behavioral interventions (iCBTs) are efficacious treatments for depression and anxiety. However, it is unknown whether adding human guidance is feasible and beneficial within a large educational setting.
OBJECTIVE
This study aims to potentially demonstrate the superiority of 2 variants of a transdiagnostic iCBT program (human-guided and computer-guided iCBT) over care as usual (CAU) in a large sample of university students and the superiority of human-guided iCBT over computer-guided iCBT.
METHODS
A total of 801 students with elevated levels of anxiety, depression, or both from a large university in the Netherlands were recruited as participants and randomized to 1 of 3 conditions: human-guided iCBT, computer-guided iCBT, and CAU. The primary outcome measures were depression (Patient Health Questionnaire) and anxiety (Generalized Anxiety Disorder scale). Secondary outcomes included substance use-related problems (Alcohol Use Disorder Identification Test and Drug Abuse Screening Test-10 items). Linear mixed models were used to estimate the effects of time, treatment group, and their interactions (slopes). The primary research question was whether the 3 conditions differed in improvement over 3 time points (baseline, midtreatment, and after treatment) in terms of depression and anxiety symptoms. Results were analyzed according to the intention-to-treat principle using multiple imputation. Patients were followed exploratively from baseline to 6 and 12 months.
RESULTS
In both short-term and long-term analyses, the slopes for the 3 conditions did not differ significantly in terms of depression and anxiety, although both web-based interventions were marginally more efficacious than CAU over 6 months (P values between .02 and .03). All groups showed significant improvement over time (P<.001). For the secondary outcomes, only significant improvements over time (across and not between groups) were found for drug use (P<.001). Significant differences were found in terms of adherence, indicating that participants in the human-guided condition did more sessions than those in the computer-guided condition (P=.002).
CONCLUSIONS
The transdiagnostic iCBT program offers a practical, feasible, and efficacious alternative to usual care to tackle mental health problems in a large university setting. There is no indication that human guidance should be preferred over technological guidance. The potential preference of human support also depends on the scale of implementation and cost-effectiveness, which need to be addressed in future trials.
TRIAL REGISTRATION
International Clinical Trials Registry Platform NL7328/NTR7544; https://trialsearch.who.int/Trial2.aspx?TrialID=NL-OMON26795.
Topics: Humans; Cognitive Behavioral Therapy; Male; Female; Students; Universities; Young Adult; Adult; Therapy, Computer-Assisted; Internet-Based Intervention; Depression; Anxiety; Netherlands; Internet; Adolescent; Treatment Outcome
PubMed: 38896474
DOI: 10.2196/50503 -
Frontiers in Psychology 2024Combat soldiers are exposed to various potentially traumatic events and face high risk of developing military-related psychopathology, such as depression, posttraumatic...
Combat soldiers are exposed to various potentially traumatic events and face high risk of developing military-related psychopathology, such as depression, posttraumatic stress and grief (PTSS). However, a strong body of research shows that resilience is the default in the aftermath of trauma and indeed, many veterans do not develop high symptomatic levels. To explicate this inconsistency, the current study examined the associations among PTSS, resilience, and patterns of emotional-approach coping. A sample of 595 male combat veterans filled out questionnaires on trauma exposure, PTSS, depressive symptoms, resilience, and emotional-approach coping. Their data were analyzed using structural equation modeling path analysis. Participants reported high exposure to potentially traumatic events during service. Mean scores were high for resilience and relatively low for PTSS and depressive symptoms; 13% had a clinical level of posttraumatic stress disorder. Structural equation modeling revealed that emotional-approach coping strategies mediated the relationship between resilience and PTSS. However, emotional expression was associated with lower PTSS levels, whereas emotional processing was associated with higher PTSS levels. These results suggest that although emotional-approach coping was related to higher resilience, emotional expression (an intrapersonal coping strategy) might have a more positive effect than self-oriented emotional coping strategies. Providing veterans with supportive opportunities and a wider repertoire of emotional coping skills might enhance their well-being, reduce postservice emotional distress while not harming veterans' resilience levels.
PubMed: 38895502
DOI: 10.3389/fpsyg.2024.1354669 -
Frontiers in Psychology 2024
PubMed: 38895498
DOI: 10.3389/fpsyg.2024.1424088 -
Frontiers in Psychiatry 2024Psychotic symptoms are among the most debilitating and challenging presentations of severe psychiatric diseases, such as schizophrenia, schizoaffective, and bipolar...
UNLABELLED
Psychotic symptoms are among the most debilitating and challenging presentations of severe psychiatric diseases, such as schizophrenia, schizoaffective, and bipolar disorder. A pathophysiological understanding of intrinsic brain activity underlying psychosis is crucial to improve diagnosis and treatment. While a potential continuum along the psychotic spectrum has been recently described in neuroimaging studies, especially for what concerns absolute and relative amplitude of low-frequency fluctuations (ALFF and fALFF), these efforts have given heterogeneous results. A transdiagnostic meta-analysis of ALFF/fALFF in patients with psychosis compared to healthy controls is currently lacking. Therefore, in this pre-registered systematic review and meta-analysis PubMed, Scopus, and Embase were searched for articles comparing ALFF/fALFF between psychotic patients and healthy controls. A quantitative synthesis of differences in (f)ALFF between patients along the psychotic spectrum and healthy controls was performed with Seed-based d Mapping, adjusting for age, sex, duration of illness, clinical severity. All results were corrected for multiple comparisons by Family-Wise Error rates. While lower ALFF and fALFF were detected in patients with psychosis in comparison to controls, no specific finding survived correction for multiple comparisons. Lack of this correction might explain the discordant findings highlighted in previous literature. Other potential explanations include methodological issues, such as the lack of standardization in pre-processing or analytical procedures among studies. Future research on ALFF/fALFF differences for patients with psychosis should prioritize the replicability of individual studies.
SYSTEMATIC REVIEW REGISTRATION
https://osf.io/, identifier (ycqpz).
PubMed: 38895037
DOI: 10.3389/fpsyt.2024.1378439 -
Frontiers in Psychiatry 2024The developmental age, comprising childhood and adolescence, constitutes an extremely important phase of neurodevelopment during which various psychiatric disorders can...
BACKGROUND
The developmental age, comprising childhood and adolescence, constitutes an extremely important phase of neurodevelopment during which various psychiatric disorders can emerge. Obsessive-Compulsive Disorder (OCD) and Eating Disorders (ED) often manifest during this critical developmental period sharing similarities but also differences in psychopathology, neurobiology, and etiopathogenesis. The aim of this study is to focus on clinical, genetic and neurobiological similarities and differences in OCD and ED.
METHODS
This study is based on a PubMed/MEDLINE and Cochrane Central Register for Controlled Trial (CENTRAL). The research adhered to the guidelines outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).
RESULTS
The aforementioned search yielded an initial collection of 335 articles, published from 1968 to September 2023. Through the application of inclusion and exclusion criteria, a total of 324 articles were excluded, culminating in a final selection of 10 articles.
CONCLUSIONS
Our findings showed both differences and similarities between OCD and ED. Obsessive-compulsive (OC) symptoms are more prevalent in ED characterized by a binge/purge profile than in those with a restrictive profile during developmental age. OC symptomatology appears to be a common dimension in both OCD and ED. When presents, OC symptomatology, exhibits transversal characteristic alterations in the anterior cingulate cortex and poorer cognitive flexibility. These correlations could be highlighted by genetic overlaps between disorders. A comprehensive definition, integrating psychopathological and neurobiological aspects could significantly aid treatment selection and thereby influence the prognosis of these patients.
PubMed: 38895032
DOI: 10.3389/fpsyt.2024.1407872 -
Cancers Jun 2024Understanding the impact of cancer on the experience of time is crucial in the context of hope and recovery. This study, a follow-up to a previous qualitative study of...
Understanding the impact of cancer on the experience of time is crucial in the context of hope and recovery. This study, a follow-up to a previous qualitative study of ovarian cancer patients - explored two types of such experiences-the memory of past happiness and the limited future planning. A sociodemographic questionnaire with nine questions about the experience of time was used on a convenience sample of 202 patients with various cancers, predominantly women with breast, ovarian, and cervical cancer. It was found that the respondents experienced increased focus on the present, decreased focus on the future, and a sense of unpredictability, with a relatively short temporal horizon measured in weeks and months, not years. Almost half of the respondents (46%) measured time during treatment by the rhythm of chemotherapy and check-ups, which thus appeared as the most meaningful events. The increase in the frequency with which patients underwent chemotherapy mildly affected their focus on the present (R = 0.25, < 0.05), likely because of the discomfort of the side effects. The correlations between age and time in treatment, on the one hand, and the experience of time, on the other, were negligible. Changed temporal experience during chemotherapy is a factor that can have an impact on patients' well-being and ability to cope with the disease. It thus should be taken into account when planning oncology care.
PubMed: 38893243
DOI: 10.3390/cancers16112124 -
Journal of Clinical Medicine May 2024Adolescents' early responses and overall outcomes during anorexia nervosa (AN) treatment may differ by patient gender, raising the question of whether evaluating...
Adolescents' early responses and overall outcomes during anorexia nervosa (AN) treatment may differ by patient gender, raising the question of whether evaluating clinical data during AN treatment may require different criteria. We investigated, using patient records, whether young men and young women with AN differed in terms of early treatment response (defined as weight change and variability within the first 14 days) and whether early treatment responses predicted treatment outcomes similarly across genders. : Weight changes predicted patient discharge weight across all gender groups. Weight variability predicted higher disordered eating psychopathology and higher body image insecurities at discharge. Gender differences emerged only for weight gain, which was more pronounced for young men, and gender modulated the effects of weight gain and variability on general psychopathology outcomes. The present findings suggest that early weight changes and weight variability are similarly important predictors of AN treatment outcomes in adolescents but also hint at possible gender differences in terms of the link between weight change and, respectively, variability on general psychopathology.
PubMed: 38892966
DOI: 10.3390/jcm13113255 -
Healthcare (Basel, Switzerland) May 2024Developing valid and reliable measures of psychological responses to climate change is of high importance, as this facilitates our understanding of people's...
Developing valid and reliable measures of psychological responses to climate change is of high importance, as this facilitates our understanding of people's psychological responses, including their pro-environmental behavior. Recently, the Climate Change Worry Scale (CCWS) was introduced. This study aimed to develop the first Polish version of the CCWS and explore its psychometric properties. Our sample comprised 420 Polish adults aged 18-70, with a mean age of 26.20 (standard deviation = 10.61) years. The CCWS's factor structure was assessed with confirmatory factor analysis. McDonald's omega and Cronbach's alpha coefficients were computed to assess internal consistency reliability. Pearson correlations between climate change worry (CCW) and experience of climate change (i.e., an individual's level of perception of being affected by climate change), pro-environmental behavior, ill-being (i.e., anxiety and depression symptoms), and well-being were calculated. Our results support the strong factorial validity of the CCWS, conforming to its intended one-factor solution, with excellent internal consistency reliability for the total scale score (i.e., McDonald's omega and Cronbach's alpha values of 0.93). We noted large positive correlations between CCW and experiences of climate change, as well as pro-environmental behavior, and medium positive correlations with psychopathology symptoms. CCW scores were not associated with well-being. As the CCWS represents a measure of a specific manifestation of worry, we also examined its discriminant validity against more general psychological distress markers, and it evidenced strong validity in this regard. Overall, the Polish version of the CCWS appears to have strong psychometric properties, and will therefore be a useful tool to use in research on psychological responses to climate change.
PubMed: 38891203
DOI: 10.3390/healthcare12111128 -
Translational Psychiatry Jun 2024A range of rare mutations involving micro-deletion or -duplication of genetic material (copy number variants (CNVs)) have been associated with high neurodevelopmental...
A range of rare mutations involving micro-deletion or -duplication of genetic material (copy number variants (CNVs)) have been associated with high neurodevelopmental and psychiatric risk (ND-CNVs). Irritability is frequently observed in childhood neurodevelopmental conditions, yet its aetiology is largely unknown. Genetic variation may play a role, but there is a sparsity of studies investigating the presentation of irritability in young people with ND-CNVs. This study aimed to investigate whether there is a difference in irritability in young people with rare ND-CNVs compared to those without ND-CNVs, and to what extent irritability is associated with psychiatric diagnoses and cognitive ability (IQ). Irritability and broader psychopathology were assessed in 485 young people with ND-CNVs and 164 sibling controls, using the child and adolescent psychiatric assessment. Autism was assessed using the social communication questionnaire, and intelligence quotient (IQ) by the Wechsler abbreviated scale of intelligence. Fifty four percent of young people with ND-CNVs met the threshold for irritability; significantly more than controls (OR = 3.77, CI = 3.07-7.90, p = 5.31 × 10). When controlling for the presence of other psychiatric comorbidities, ND-CNV status was still associated with irritability. There was no evidence for a relationship between irritability and IQ. Irritability is an important aspect of the clinical picture in young people with ND-CNVs. This work shows that genetic variation is associated with irritability in young people with ND-CNVs, independent of psychiatric comorbidities or IQ impairment. Clinicians should be aware of this increased risk to inform management and interventions.
Topics: Humans; Male; Female; Irritable Mood; DNA Copy Number Variations; Adolescent; Neurodevelopmental Disorders; Child; Intelligence; Case-Control Studies; Siblings
PubMed: 38890284
DOI: 10.1038/s41398-024-02975-z -
Schizophrenia Research Jun 2024The present study examined three empirically-derived childhood adversity dimensions as predictors of social, psychological, and symptom outcomes across three prospective...
The present study examined three empirically-derived childhood adversity dimensions as predictors of social, psychological, and symptom outcomes across three prospective assessments of a young adult sample. Participants were assessed five times over eight years with semi-structured interviews and questionnaires. The analyses used the dimensions underlying multiple subscales from well-established childhood adversity measures administered at the first two assessment waves (described in a previous report). Outcome data pertain to the last three assessment waves, with sample sizes ranging from 89 to 169. As hypothesized, the childhood adversity dimensions demonstrated overlapping and differential longitudinal associations with the outcomes. Deprivation predicted the negative (deficit-like) dimension of psychosis, while Threat and Intrafamilial Adversity predicted the positive (psychotic-like) dimension. Depression and anxiety symptoms were predicted by different childhood adversity dimensions over time. Furthermore, Threat predicted a smaller and less diverse social network, Intrafamilial Adversity predicted anxious attachment, and Deprivation predicted a smaller social network, anxious and avoidant attachment, perceived social support, and loneliness. The three adversity dimensions combined accounted for moderate to large proportions of variance in several outcomes. These results extend prior work by identifying associations of three meaningful dimensions of childhood adversity with different risk profiles across psychological, social, and psychopathological domains. The findings enhance our understanding of the impact of childhood adversity across young adulthood.
PubMed: 38889654
DOI: 10.1016/j.schres.2024.05.016