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Behavior Therapy Jul 2024Mindfulness is a promising health promotion strategy for African Americans, and it is imperative that culturally responsive mindfulness approaches be accessible to this... (Randomized Controlled Trial)
Randomized Controlled Trial
Mindfulness is a promising health promotion strategy for African Americans, and it is imperative that culturally responsive mindfulness approaches be accessible to this population. One way to address this need is to develop and test if culturally responsive mobile health (mhealth) applications are efficacious in reducing stress-related outcomes in this population. With this goal in mind, we employed a repeated-measures randomized control trial (RCT) across a 12-week intervention period to evaluate if participants in the intervention group outperformed a wait-list control group in reductions in stress, depressive symptoms, anxiety, emotional regulation difficulties as well as in increases in self-compassion, resilience, and mindfulness attitudes and behaviors. Our sample included 170 Black/African American participants who were randomly assigned to either the intervention condition (n = 84) or the wait-list control group (n = 86). Participants in the intervention condition reported more self-compassion, used more mindfulness, and had greater self-efficacy using mindfulness; yet, no other differences were evident. Participants expressed high levels of satisfaction with the app and gave it a positive rating for its relevance to their lives. These findings support the efficacy of a culturally responsive mindfulness mHealth app to enhance self-compassion and increase the use of health-promoting behaviors, like mindfulness, among African Americans. Implications for future research are discussed.
Topics: Humans; Black or African American; Female; Male; Mindfulness; Adult; Middle Aged; Telemedicine; Stress, Psychological; Mobile Applications; Depression; Anxiety; Self Efficacy; Empathy; Emotional Regulation
PubMed: 38937052
DOI: 10.1016/j.beth.2023.12.002 -
Neural Networks : the Official Journal... Jun 2024Our minds represent miscellaneous objects in the physical world metaphorically in an abstract and complex high-dimensional object space, which is implemented in a...
Our minds represent miscellaneous objects in the physical world metaphorically in an abstract and complex high-dimensional object space, which is implemented in a two-dimensional surface of the ventral temporal cortex (VTC) with topologically organized object selectivity. Here we investigated principles guiding the topographical organization of object selectivities in the VTC by constructing a hybrid Self-Organizing Map (SOM) model that harnesses a biologically inspired algorithm of wiring cost minimization and adheres to the constraints of the lateral wiring span of human VTC neurons. In a series of in silico experiments with functional brain neuroimaging and neurophysiological single-unit data from humans and non-human primates, the VTC-SOM predicted the topographical structure of fine-scale category-selective regions (face-, tool-, body-, and place-selective regions) and the boundary in large-scale abstract functional maps (animate vs. inanimate, real-word small-size vs. big-size, central vs. peripheral), with no significant loss in functionality (e.g., categorical selectivity and view-invariant representations). In addition, when the same principle was applied to V1 orientation preferences, a pinwheel-like topology emerged, suggesting the model's broad applicability. In summary, our study illustrates that the simple principle of wiring cost minimization, coupled with the appropriate biological constraint of lateral wiring span, is able to implement the high-dimensional object space in a two-dimensional cortical surface.
PubMed: 38936111
DOI: 10.1016/j.neunet.2024.106437 -
Journal of Psychosomatic Research Jun 2024Symptoms of anxiety increased early in the COVID-19 pandemic among people with systemic sclerosis (SSc) then returned to pre-pandemic levels, but this was an aggregate...
OBJECTIVE
Symptoms of anxiety increased early in the COVID-19 pandemic among people with systemic sclerosis (SSc) then returned to pre-pandemic levels, but this was an aggregate finding and did not evaluate whether vaccination may have contributed to reduced anxiety symptom levels. We investigated whether being vaccinated for COVID-19 was associated with reduced anxiety symptoms among people with SSc.
METHODS
The longitudinal Scleroderma Patient-centered Intervention Network (SPIN) COVID-19 Cohort was launched in April 2020 and included participants from the ongoing SPIN Cohort and external enrollees. Participants completed measures bi-weekly through July 2020, then every 4 weeks afterwards through August 2022 (32 assessments). We used linear mixed models to evaluate longitudinal trends of PROMIS Anxiety 4a v1.0 anxiety domain scores and their association with vaccination.
RESULTS
Among 517 participants included in analyses, 489 (95%) were vaccinated by September 2021, and no participants were vaccinated subsequently. Except for briefly at the beginning, when few had received a vaccine, and end, when only 28 participants remained unvaccinated, anxiety symptom trajectories were largely overlapping. Participants who were never vaccinated had higher anxiety symptoms by August 2022, but there were no other differences, and receiving a vaccination did not appear to change anxiety symptom trajectories meaningfully.
CONCLUSION
Vaccination did not appear to influence changes in anxiety symptoms among vulnerable people with SSc during the COVID-19 pandemic. This may be due to people restricting their behavior when they were unvaccinated and returning to more normal social engagement once vaccinated to maintain a steady level of anxiety symptoms.
PubMed: 38936011
DOI: 10.1016/j.jpsychores.2024.111852 -
JMIR MHealth and UHealth Jun 2024Rising rates of psychological distress (symptoms of depression, anxiety, and stress) among adults in the United States necessitate effective mental wellness...
BACKGROUND
Rising rates of psychological distress (symptoms of depression, anxiety, and stress) among adults in the United States necessitate effective mental wellness interventions. Despite the prevalence of smartphone app-based programs, research on their efficacy is limited, with only 14% showing clinically validated evidence. Our study evaluates Noom Mood, a commercially available smartphone-based app that uses cognitive behavioral therapy and mindfulness-based programming. In this study, we address gaps in the existing literature by examining postintervention outcomes and the broader impact on mental wellness.
OBJECTIVE
Noom Mood is a smartphone-based mental wellness program designed to be used by the general population. This prospective study evaluates the efficacy and postintervention outcomes of Noom Mood. We aim to address the rising psychological distress among adults in the United States.
METHODS
A 1-arm study design was used, with participants having access to the Noom Mood program for 16 weeks (N=273). Surveys were conducted at baseline, week 4, week 8, week 12, week 16, and week 32 (16 weeks' postprogram follow-up). This study assessed a range of mental health outcomes, including anxiety symptoms, depressive symptoms, perceived stress, well-being, quality of life, coping, emotion regulation, sleep, and workplace productivity (absenteeism or presenteeism).
RESULTS
The mean age of participants was 40.5 (SD 11.7) years. Statistically significant improvements in anxiety symptoms, depressive symptoms, and perceived stress were observed by week 4 and maintained through the 16-week intervention and the 32-week follow-up. The largest changes were observed in the first 4 weeks (29% lower, 25% lower, and 15% lower for anxiety symptoms, depressive symptoms, and perceived stress, respectively), and only small improvements were observed afterward. Reductions in clinically relevant anxiety (7-item generalized anxiety disorder scale) and depression (8-item Patient Health Questionnaire depression scale) criteria were also maintained from program initiation through the 16-week intervention and the 32-week follow-up. Work productivity also showed statistically significant results, with participants gaining 2.57 productive work days from baseline at 16 weeks, and remaining relatively stable (2.23 productive work days gained) at follow-up (32 weeks). Additionally, effects across all coping, sleep disturbance (23% lower at 32 weeks), and emotion dysregulation variables exhibited positive and significant trends at all time points (15% higher, 23% lower, and 25% higher respectively at 32 weeks).
CONCLUSIONS
This study contributes insights into the promising positive impact of Noom Mood on mental health and well-being outcomes, extending beyond the intervention phase. Though more rigorous studies are necessary to understand the mechanism of action at play, this exploratory study addresses critical gaps in the literature, highlighting the potential of smartphone-based mental wellness programs to lessen barriers to mental health support and improve diverse dimensions of well-being. Future research should explore the scalability, feasibility, and long-term adherence of such interventions across diverse populations.
Topics: Humans; Prospective Studies; Male; Female; Adult; Middle Aged; Surveys and Questionnaires; Mobile Applications; Health Promotion; Cognitive Behavioral Therapy; Program Evaluation; United States; Mindfulness; Quality of Life
PubMed: 38935946
DOI: 10.2196/54634 -
PloS One 2024At some point in their career, many healthcare workers will experience psychological distress associated with being unable to take morally or ethically correct action,...
OBJECTIVE
At some point in their career, many healthcare workers will experience psychological distress associated with being unable to take morally or ethically correct action, as it aligns with their own values; a phenomenon known as moral distress. Similarly, there are increasing reports of healthcare workers experiencing long-term mental and psychological pain, alongside internal dissonance, known as moral injury. This review examined the triggers and factors associated with moral distress and injury in Health and Social Care Workers (HSCW) employed across a range of clinical settings with the aim of understanding how to mitigate the effects of moral distress and identify potential preventative interventions.
METHODS
A systematic review was conducted and reported according to recommendations from Cochrane and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Searches were conducted and updated regularly until January 2024 on 2 main databases (CENTRAL, PubMed) and three specialist databases (Scopus, CINAHL, PsycArticles), alongside hand searches of study registration databases and other systematic reviews reference lists. Eligible studies included a HSCW sample, explored moral distress/injury as a main aim, and were written in English or Italian. Verbatim quotes were extracted, and article quality was assessed via the CASP toolkit. Thematic analysis was conducted to identify patterns and arrange codes into themes. Specific factors like culture and diversity were explored, and the effects of exceptional circumstances like the pandemic.
RESULTS
Fifty-one reports of 49 studies were included in the review. Causes and triggers were categorised under three domains: individual, social, and organisational. At the individual level, patients' care options, professionals' beliefs, locus of control, task planning, and the ability to make decisions based on experience, were indicated as elements that can cause or trigger moral distress. In addition, and relevant to the CoVID-19 pandemic, was use/access to personal protection resources. The social or relational factors were linked to the responsibility for advocating for and communication with patients and families, and professionals own support network. At organisational levels, hierarchy, regulations, support, workload, culture, and resources (staff and equipment) were identified as elements that can affect professionals' moral comfort. Patients' care, morals/beliefs/standards, advocacy role and culture of context were the most referenced elements. Data on cultural differences and diversity were not sufficient to make assumptions. Lack of resources and rapid policy changes have emerged as key triggers related to the pandemic. This suggests that those responsible for policy decisions should be mindful of the potential impact on staff of sudden and top-down change.
CONCLUSION
This review indicates that causes and triggers of moral injury are multifactorial and largely influenced by the context and constraints within which professionals work. Moral distress is linked to the duty and responsibility of care, and professionals' disposition to prioritise the wellbeing of patients. If the organisational values and regulations are in contrast with individuals' beliefs, repercussions on professionals' wellbeing and retention are to be expected. Organisational strategies to mitigate against moral distress, or the longer-term sequalae of moral injury, should address the individual, social, and organisational elements identified in this review.
Topics: Humans; Health Personnel; Morals; Social Workers; Qualitative Research; COVID-19; Psychological Distress; Stress, Psychological
PubMed: 38935754
DOI: 10.1371/journal.pone.0303013 -
PloS One 2024The successful unfolding of many social interactions relies on our capacity to predict other people's action goals, whether these are proximal (i.e., immediate) or...
The successful unfolding of many social interactions relies on our capacity to predict other people's action goals, whether these are proximal (i.e., immediate) or distal (i.e., upcoming). The present set of studies asks whether observers can predict the distal goal of two-step action sequences when presented with communicative modulations of the first movement component of the sequence. We conducted three online experiments in which we presented participants with animations of a box moving to a first target location before moving onwards to a final, either near or far, target location. The second movement component and the target locations were occluded. After observing the first movement, participants were asked to select the most likely final target location, i.e., the distal goal of the sequence. Experiment 1 showed that participants relied on the velocity modulations of the first movement to infer the distal goal. The results of Experiment 2 indicated that such predictions of distal goals are possible even when the second movement in the sequence does not contain any velocity information, thus suggesting that the information present in the first movement plays the major role in the process of linking movements to their distal goals. However, Experiment 3 showed that under some circumstances the second movement can also contribute to how observers predict a distal goal. We discuss these results in terms of the underlying simulation processes that enable observers to predict a distal goal from the observation of proximal communicative modulations.
Topics: Humans; Goals; Male; Female; Adult; Communication; Young Adult; Movement
PubMed: 38935629
DOI: 10.1371/journal.pone.0306072 -
European Child & Adolescent Psychiatry Jun 2024This systematic review examined the evidence on effectiveness and acceptability of cognitive behavioral therapy (CBT) interventions in improving quality of life (QoL)... (Review)
Review
BACKGROUND
This systematic review examined the evidence on effectiveness and acceptability of cognitive behavioral therapy (CBT) interventions in improving quality of life (QoL) and psychological well-being of unaccompanied minors (UM).
METHODS
PubMed, Scopus, Embase, ProQuest, PsycInfo, PsycArticles, and Open Dissertations databases were used to identify quantitative and qualitative studies. The Effective Public Health Practice Project (EPHPP) and Critical Appraisal Skills Programme (CASP) tools were used for quality assessment. Narrative synthesis and qualitative research synthesis were carried out to collate the findings.
RESULTS
18 studies were included. Two studies examined QoL, and five studies examined acceptability of interventions. Most quantitative studies (n = 10) were appraised as methodologically weak. Trauma-Focused CBT appears to have the most evidence demonstrating effectiveness in ameliorating symptoms of post-traumatic stress disorder, depression, and anxiety. Promising findings (i.e., increased mindfulness and psychological flexibility) were observed for third wave interventions but further replication is required.
CONCLUSIONS
The literature is tainted by under-powered studies, lacking blinding, and follow-up assessments. Female UM remain largely underrepresented. This review calls for a drastic augmentation of high quality quantitative and qualitative research focusing on augmenting QoL and examining acceptability rather than merely aiming for psychological symptom reduction in UM to enhance overall well-being and functionality. The research protocol was registered in PROSPERO (registration number: CRD42021293881).
PubMed: 38935131
DOI: 10.1007/s00787-024-02500-z -
Psychological Trauma : Theory,... Jun 2024Demand for trauma-focused therapy continues to increase, especially in community mental health care settings where group treatment models can be cost-effective and...
Online group-based internal family systems treatment for posttraumatic stress disorder: Feasibility and acceptability of the program for alleviating and resolving trauma and stress.
OBJECTIVE
Demand for trauma-focused therapy continues to increase, especially in community mental health care settings where group treatment models can be cost-effective and increase access to care. The Internal Family Systems (IFS) model for posttraumatic stress disorder (PTSD) may offer an effective therapeutic approach. The purpose of this proof-of-concept study was to evaluate the feasibility and acceptability of a novel, trauma-focused, group-based treatment approach and investigate potential mechanisms of action.
METHOD
Study participants completed the Program for Alleviating and Resolving Trauma and Stress (PARTS), an online-delivered program including 16 weeks of 90-min IFS-based groups with eight 50-min individual IFS counseling sessions. Participants completed assessments including clinician-administered and self-report measures of PTSD, common comorbid conditions (e.g., complex PTSD [disturbances in self-organization], depression, anxiety, and suicidality), and potential mechanisms (e.g., decentering, self-compassion, and emotion regulation).
RESULTS
Most participants ( = 11/15; 73%) attended 12+ group sessions, with 92% (12/13 responders) reporting they would recommend PARTS to a friend. All respondents reported the program was helpful (13/13; 100%). PTSD symptom severity was reduced from baseline to Weeks 16 ( = -0.7, = .005) and 24 ( = -0.9, < .001). A clinically meaningful response (i.e., 10+ point reduction on the Clinician-Administered PTSD Scale for [5th ed.]) was demonstrated in 53% of participants (8/15) by Week 24. Decentering, self-compassion, and emotion regulation all improved ( < .05).
CONCLUSIONS
PARTS was feasible and acceptable as a group-based, online intervention in an urban, public community health care system. While PARTS showed promise in reducing overall PTSD symptom severity, well-controlled efficacy research is needed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
PubMed: 38934934
DOI: 10.1037/tra0001688 -
The Behavioral and Brain Sciences Jun 2024Twenty-five commentaries raise questions concerning the origins of knowledge, the interplay of iconic and propositional representations in mental life, the architecture...
Twenty-five commentaries raise questions concerning the origins of knowledge, the interplay of iconic and propositional representations in mental life, the architecture of numerical and social cognition, the sources of uniquely human cognitive capacities, and the borders among core knowledge, perception, and thought. They also propose new methods, drawn from the vibrant, interdisciplinary cognitive sciences, for addressing these questions and deepening understanding of infant minds.
Topics: Humans; Infant; Cognition; Child Development; Knowledge; Social Cognition; Thinking
PubMed: 38934438
DOI: 10.1017/S0140525X24000049 -
Indian Journal of Community Medicine :... 2024The sample size is just about the most common question in the minds of many medical researchers. This size determines the reliability of the results and helps to detect... (Review)
Review
The sample size is just about the most common question in the minds of many medical researchers. This size determines the reliability of the results and helps to detect a medically important effect when present. Some studies miss an important effect due to inappropriate sample size. Many postgraduate students and established researchers often contact a statistician to help them determine an appropriate sample size for their study. More than 80 formulas are available to calculate sample size for different settings and the choice requires some expertise. Their use is even more difficult because most exact formulas are quite complex. An added difficulty is that different books, software, and websites use different formulas for the same problem. Such discrepancy in the published formulas confounds a biostatistician also. The objective of this communication is to present uniformly looking formulas for many situations together at one place in their simple but correct form, along with the setting where they are applicable. This will help in choosing an appropriate formula for the kind of research one is proposing to do and use it with confidence. This communication is restricted to the sample size required to detect a medically important effect when present - known to the statisticians as the test of hypothesis situation. Such a collection is not available anywhere, not even in any book. The sample size formulas for estimation are different and not discussed here.
PubMed: 38933799
DOI: 10.4103/ijcm.ijcm_787_23